When thousands of New York City nurses walked off the job last month in what officials described as the city’s largest strike of its kind in decades, one child’s treatment became entwined with the walkout. Logan Coyle, 9, was a patient in the cancer unit at NewYork-Presbyterian’s children’s hospital in Manhattan, dealing with advanced liver cancer and a complex medical history that included chemotherapy and a triple transplant involving a liver, pancreas and small intestine.

Morgan Bieler, one of Logan’s longtime “primary nurses,” described the early days of the strike as uncertain, when she saw Logan holding up a handmade sign through his window: “Proud of My Primaries.” Bieler said the moment reinforced the union’s conviction that the work mattered, adding that Logan’s willingness to fight for as long as he has helped sustain the nurses through the early hours of the walkout.

Nearly a month later, Bieler said the situation remained acute for the NewYork-Presbyterian system, where more than 4,000 nurses were still on the picket line. Bieler said bone marrow transplants and chemotherapy treatments had been delayed or canceled entirely for some patients because of staffing challenges, and she said she worried about the long-term patients who remained in the hospital during the dispute.

Logan’s father, Jeff Coyle, said the continuing strike left vulnerable patients “caught in the middle” of disagreements over salaries, staffing levels, workplace safety, and other contractual issues. He said the impact of each additional day was severe for their family, calling the situation “collateral damage of this strike.”

As the negotiations elsewhere in the city moved toward resolution, NewYork-Presbyterian remained the sticking point. On Monday, the nurses union reached tentative deals with Mount Sinai and Montefiore, and the proposals—if approved by union members—would send unionized nurses back to work by Saturday, according to the union’s outreach on the negotiations.

Within NewYork-Presbyterian, the union said late Tuesday it was asking members to vote on a proposal hospital administrators had accepted but which the union’s bargaining committee rejected. In a video message provided to The Associated Press, Pat Kane, the union’s executive director, told nurses that they had reached the end of negotiations, saying: “You deserve to vote on it. You have fought so hard to get to this point.” Nancy Hagans, the union’s president, also urged members to vote in the same video, saying, “You deserve to vote on it. You have fought so hard to get to this point,” while noting the union members’ effort to reach that point.

Logan returned home Saturday after a tumor was removed near his spine, but his family said they noticed early differences between his regular nurses and temporary replacements. Logan said routine care such as blood draws and lab tests took longer than normal, and he described fewer opportunities for familiar nurses to stop by, sometimes just to talk or read. In their home in Port Washington on Long Island, about 25 miles from Manhattan, Logan said he hoped the familiar staff would return and he linked that continuity to feeling safer.

Logan’s mother, Rebecca Coyle, said she spent more sleepless nights during this hospital stay than previous times because temporary nurses cycled in and out every few days, and she described feeling constantly alert to ensure medicines, fluids and blood products arrived and that care stayed on track. She said she had to be vigilant as varying experience levels came with the rotating staffing.

Bieler said caring for Logan during the strike had shaped her perspective, describing him as upbeat and positive. She said Logan always showed the best version of himself and faced everything with a smile, adding that his resilience and his family changed the outlook she brought to her work after the walkout began.