About 15,000 nurses walked off the job Monday at three major New York City hospital systems — NewYork-Presbyterian, Mount Sinai, and Montefiore — after weekend negotiations failed to produce a breakthrough on disputes over staffing levels, benefits, and limits on the use of artificial intelligence, according to their union, the New York State Nurses Association. The hospitals remained open, hiring temporary nurses to fill the gap, amid a severe flu season.
The walkout falls in the early days of Mayor Zohran Mamdani’s new administration. The democratic socialist visited a NewYork-Presbyterian picket line Monday and expressed support for the nurses, while Gov. Kathy Hochul dispatched state health officials to the affected hospitals to monitor patient care.
Picket lines
“Nurses on strike! … Fair contract now!” nurses shouted outside NewYork-Presbyterian Hospital’s Upper Manhattan campus. Others picketed at Mount Sinai and Montefiore facilities, where a 2023 strike fed off pandemic-era frustrations and produced a deal that boosted staffing and pay.
Tristan Castillo, an emergency department nurse at Mount Sinai West, described an unfinished reckoning with hospital management. “They don’t want to give us a fair contract, and they don’t want to give us safe staffing, and now they’re trying to roll back on our benefits,” Castillo said.
Mamdani, whose mayoral campaign ran on a pro-worker platform, directed pointed language at hospital leadership from the picket line. “These executives are not having difficulty making ends meet,” the mayor said, adding that nurses were seeking “dignity, respect and the fair pay and treatment that they deserve. They should settle for nothing less.”
Other Democratic city and state politicians also visited striking nurses. Hochul called in a statement for a negotiated settlement that “recognizes the essential work nurses do.”
What nurses are demanding
Staffing levels are the central issue. The union says hospitals have given nurses unmanageable workloads, and disputes whether the systems have honored commitments made in 2023. Nurses also want improved workplace security, citing a recent incident in which a man with a sharp object barricaded himself in a Brooklyn hospital room and was killed by police.
The union additionally wants contractual limits on hospitals’ use of artificial intelligence — an unusual demand that reflects growing concern among healthcare workers about algorithmic tools in clinical settings.
The strike covers private, nonprofit hospitals only. Several other private hospitals in and near New York City reached deals in recent days to avert a possible walkout.
The hospitals’ position
Mount Sinai characterized the union as making “extreme economic demands.” Montefiore spokesperson Joe Solmonese said the union was pressing “$3.6 billion in reckless demands,” including what he described as exorbitant raises.
According to the hospitals — figures that do not include benefits — unionized registered nurses currently average $165,000 a year at Montefiore, $162,000 at Mount Sinai, and $163,000 at NewYork-Presbyterian’s Columbia University Irving Medical Center. Montefiore said the union’s proposals would raise the average to $220,000 in three years; Mount Sinai said the figure at its facilities would reach $275,000.
The union did not immediately respond to questions about its salary proposal or current wage levels.
NewYork-Presbyterian accused the union of staging the walkout “to create disruption” but said it was “ready to keep negotiating a fair and reasonable contract that reflects our respect for our nurses and the critical role they play, and also recognizes the challenging realities of today’s healthcare environment.”
The hospitals say they have improved staffing in recent years. The union and the hospitals dispute both how much progress has been made and whether hospitals have since retreated from staffing guarantees made in 2023.
Patient care and preparations
Nurses gave formal strike notice on Jan. 2. The hospitals vowed to “do whatever is necessary to minimize disruptions.” Mount Sinai said it had lined up 1,400 temporary nurses.
The strike could potentially force patient transfers, procedure cancellations, or ambulance diversions, though each medical center said it was prepared to meet patients’ needs. The walkout could also strain other city hospitals if patients avoid the facilities hit by the strike. Each hospital system is negotiating with the union independently.
The 2023 precedent
The current dispute echoes a three-day strike in 2023 at Mount Sinai and Montefiore that resulted in a deal raising pay 19% over three years and including staffing improvements. The union and the hospitals now disagree about how much of that staffing progress has materialized — and whether any of those commitments are being rolled back.