[At the time of this writing all private sector hospitals in bargaining with NYSNA in the NYC area have settled and ratified their contracts, with the exception of Interfaith Medical Center and Wyckoff Heights Medical Center.]
History was made by NYSNA members in the negotiations carried out and contracts won at private sector hospitals in all five boroughs. Multi-employer bargaining was a first for our union, bringing four LBUs representing 8,500 members to the same table, a show of unity and strength that management had not before witnessed. The contract terms on staffing reinforced staffing ratios/grids with new mechanisms for enforcement and timelines for the addition of nurses. One such mechanism is a historic first: informational picketing during the life of the contract, a way to bring staffing, safety and other unresolved issues to the public and press.
All together, the private sector contract victory won by 17,000 members at 12 private sector hospitals in New York City [see list, sidebar right] is a win for NYSNA, for our patients and for the communities we serve. It moves us forward in our fight to ensure our patients receive safe, quality care and that the conditions we need to provide that care are present and protected by contract.
There were no givebacks. Four-year contracts — with some variations — were signed with wage increases of 13.1% (compounded) for the contract term. Healthcare and pension benefits were maintained. In some facilities they were increased and brought into line with other contracts.
“There were no givebacks. Across the board — in wages, benefits, staffing, enforcement, technology, anti-discrimination — this contract touches many bases,” said Karine Raymond, RN, Montefiore Weiler Hospital, and NYSNA board member. “The contract, including tools for enforcement and timelines for new nurse hiring, moves us forward.” Ms. Raymond chaired the LBU at her hospital, one of four that made up the unprecedented multi-employer bargaining group (Montefiore, Mount Sinai, St. Luke’s-Roosevelt and New York Presbyterian).
The contract resulted from months of intensive negotiations commenced in September, 2014; but the roots of this victory go back further, to earlier in 2014 and beyond — to our meetings in facilities on common concerns and issues, interregional meetings and LBU strategic planning, steward trainings, member and community rallies and more. These efforts were an expression of unity, of shared issues and purpose, of speaking with one voice. They added up at NYC’s private sector bargaining this year to a victory for RNs, with great significance for the foundation on which we'll secure our future.
We must now continue to build and strengthen that foundation.
Reinforcing staffing ratios
Staffing was a key demand and that demand was met in very significant ways. By the time our negotiations were concluded, close to 1,000 nurses were added! This large increase includes an increase in hundreds of new budgeted full-time equivalent nurses for the 12 hospitals. The contractual provisions on float pool will provide even more budgeted positions. The staffing ratios/grids in previous contracts, which have lacked enforement, will now be filled and their enforement, through new, enhanced mechanisms of the Professional Practice Committees (PPCs), has been given some new teeth. Timelines for the addition of staff are in the contract and serve to guarantee staffing implementation. Enhanced enforcement at the PPCs is also a critical addition for ensuring management contractual compliance.
New positions mean jobs for nurses looking for employment, including recent graduates seeking a start in the profession. NYSNA is committed to bringing new nurses to our union and sharing with them the experience many of our nurses can impart.
Above and beyond
The FTEs under the contract are above and beyond RN staffing additions achieved during the intensive period leading up to the settlement. In most instances, these additional staff were hired by the hospitals as a result of our efforts in bringing our bargaining demand for safe staffing to the public on bus shelter and ferry adds, print and digital adds and through the largest coordinated informational picketing in the history of NYSNA.
NYSNA stressed that staffing ratios are based upon evidence and supported by professional peer-reviewed studies.
More than a year ago, predating our Biennial meeting, the emphasis on safe staffing grew louder. At meetings in NYC, rallies and member lobbying in Albany and at NYSNA Interregionals throughout New York State, calls for safe staffing were echoed by supportive elected officials and the Working Families Party. Nurses have been pressing these demands within their units and inside their hospitals, and shared their views and experiences with fellow NYSNA members and the community.
A major rally for staffing
On September 17, 2014, as part of NYSNA’s Biennial, 2,000 NYSNA members marched and rallied on West 57th Street in Manhattan outside offices of two industry groups: the Greater New York Hospital Association and the Healthcare Association of New York State. The rally in front of these offices was the largest ever and served to kick off our bargaining campaign in a major way.
Staffing dominated the rally, where a score of NYSNA board members and elected officials spoke, with press present. Reports appeared in the print press and on radio and television, in English and Spanish, underscoring staffing problems and highlighting NSYNA accounts of hospital conditions and the support of elected officials. These reports were picked up by the press nationwide.
Calls for safe staffing grew louder. Hospitals, some with overflowing ERs; crowded Med/Surg, Psych and other units, and many with patient populations exhibiting greater acuities from the pent-up demands of patients priced out of the insurance market in past years, sensed their vulnerabilities under the spotlight of the NYSNA campaign.
During the fall 2014 our bargaining campaign escalated and a number of the hospitals responded to calls for safe staffing, hiring hundreds of RNs.
But it wasn’t enough. There still were not enough nurses to do the job.
Not enough nurses
That message appeared on our ads, at bus shelters in the Bronx, Brooklyn and Manhattan and on the Staten Island Ferry. It was the theme of radio ads in English and Spanish. It was a constant in our outreach to communities, politicians and the press.
“We know our hospitals and we know what our patients need,” said Pat Kane, RN, NYSNA treasurer and Staten Island University Hospital LBU member. “This contract would address the understaffing, or there would be no contract. The unity was strong and it was building.”
Our approach, one that gave the contract historic significance, was to join together the forces of our members from four hospitals for unprecedented private sector, multi-employer bargaining. Nurses from Montefiore, Mount Sinai, St. Luke’s-Roosevelt and New York Presbyterian bargained as one.
The goal was to establish a de facto pattern on key issues: to set a foundation on staffing, wages, benefits, enforcement and other issues for the private sector hospitals in bargaining.
That was accomplished — a major achievement for NYSNA and our members. Other private sector hospitals bargaining with NYSNA in greater New York City (a total of 12) have achieved enhanced staffing ratio/grids through additional FTEs and enlarged float pools, PPCs or like committees, wage increases and continuation of benefits. The contract includes timelines that the hospitals must adhere to for adding staff to support the staffing ratios/grids.
In another first, we won the right to engage in informational picketing during the life of the contract. Informational pickets are a powerful enforcement tool.
“The right to engage in informational picketing during the contract is very, very meaningful,” said Pat Kane, RN. “If management fails to live up to the contract we can, and will, take it to the public. We have already shown that our members come out in great numbers for informational picketing and that the public pays close attention.”
Informational pickets during negotiations
On April 16, in support of our bargaining but with particular emphasis on calls for safe staffing, day-long informational picketing was carried out at the hospitals throughout the city. Thousands of nurses participated at nearly all of the negotiating hospitals and the media paid attention. “No doubt management saw that the public was listening to what we were saying about understaffing,” said Nancy Hagans, RN, of Maimonides Medical Center and LBU chair at the hospital. “The picketing was more than about a contract. It was about our patients and communities getting the care they deserve.”
Patients and families stopped at the picket lines in a show of support. Community groups sent representatives to walk the lines and to make public comments in support. Press reports focused on staffing issues, with quotes from nurses around the city citing examples of staffing shortfalls and the potential harm posed to patients. It was a powerful day of unity, an expression of support for safe staffing and a strong signal to management that NYSNA was moving forward.
The informational picketing was reported by media across the country, including 93 TV stations — from Palm Beach, FL, to Louisville, KY, and Cleveland, OH. At KFMB-CBS in San Diego, CA, the broadcast on safe staffing reported: “The research clearly demonstrates that when nurses take on too many patients illness and health complications increase dramatically.” In all, not including NYC-area coverage, more than 6 million viewers watched these reports.
Still, there was resistance on a range of issues — at times tenacious and acrimonious — across the table, both from the multi-employer group and at the other NYC private sector hospitals.
With progress stalled at multi-employer bargaining, NYSNA and management agreed to introduce a federal government mediation team into the process. From that time forward, this team was helpful to the progress and ultimate resolution of the contracts.
Political support for nurses
From early in our negotiations, support from city and state elected officials came in the form of messages and letters.
More support came on June 1 when the Working Families Party launched a petition (co-branded with NYSNA) which was ultimately signed by 15,000 community members around the state. In addition to these signatures, people wrote in to share personal accounts of their hospital stays and to give words of encouragement and support to NYSNA nurses. The petition paralleled a similar effort earlier in the year carried out by NYSNA’s social media staff that served to gather signatures on the site Change.org in support of safe staffing.
On May 28, an op-ed ran in the New York Times under the headline, “We Need More Nurses,” authored by Alexandra Robbins. The column cited NYSNA nurses, as well as union nurses from other states, on staffing issues. It was yet another signal to management that concerns about hospital conditions and short-staffed RN ranks were growing.
Overwhelming strike authorizations
Despite our best efforts, and shows of support from the public and elected officials, and notwithstanding efforts by mediators to induce agreement, management failed to move forward.
Nurse leaders who were trying to share bargaining updates with coworkers were told to leave their hospitals, even on the occasion of National Nurses Week. NYSNA filed federal unfair labor charges in response.
The prospect of a strike was real. Four months into the multi-employer bargaining, the LBUs agreed to call for a vote for strike authorization. Votes were scheduled at the majority of the hospitals in bargaining.
The results of the vote were overwhelmingly in favor of strike authorization, a powerful expression of the resolute unity of NYSNA nurses. The vote outcome was announced at a press conference on June 3 under the banner “We Need More Nurses.”
“Our patients’ well-being — their very lives — depend on real staffing standards that enable us to do our jobs: to deliver safe quality care,” said NYSNA President Judy Sheridan-Gonzalez, RN, in a statement released that day.
Maimonides RN Nancy Hagans was one of several members who spoke at NYNSA’s press conference. “Like so many of my colleagues here today, my hospital serves thousands of patients throughout Brooklyn,” she told TV, radio and print press. “I spend my days working my shift, being told to see more patients with less support. Basically, I’m asked to make miracles happen each and every day. But it’s been difficult over the last few years as we’ve been asked to do more with less.”
Nurses from across the city in private sector bargaining were present and forthright. Among those present were Mary Ellen Warden, RN, of Mount Sinai Roosevelt Hospital, who spoke in support of her fellow nurses, as did Karine Raymond, RN, of Montefiore Weiler Hospital.
At the press conference NYSNA lawyers described the underpinnings of the charges filed against management by NYSNA.
With this overwhelming strike authorization vote, the prospect of the largest nurse strike in New York City history grew. A city-wide, one-day strike by nurses at the private sector hospitals would require a 10-day notice. That deadline, to give that notice, loomed large and management was well aware of it.
Standing by to trigger that notice, and with charges before the National Labor Relations Board pending, the NYSNA Negotiating Team at the multi-employer bargaining sessions pressed our demands.
Tentative contract settlement
It was at 3 a.m., early in the morning of June 18, that a deal was struck and a Tentative Agreement reached, with assistance by federal mediation.
The terms of the contract, set forth in a Memorandum of Agreement between the multi-employer hospital group and NYSNA, would form a foundation for contracts in bargaining with LBUs at the other private sector hospitals.
There were no givebacks.
The term of the contract was four years: from January 1, 2015, to December 31, 2018, with retroactive pay to January 1. (At some hospitals, ratified terms were shorter.)
Wage increases for the four years totaled 13.1% when compounded. The experience differential step system would also be continued.
Staffing additions amounted to a 4% overall increase in full-time equivalent staff above and beyond existing vacancies and the hundreds recently hired to fill them. These include float pools to cover sick calls and additional staff to be assigned to units. (At some hospitals FTE additions were 6%.)
For the most part, these additions support the staffing ratios/grids that were present in the expired contracts, but in some hospitals, this contract improves upon prior staffing ratios and grids. Timelines for adding staff are also in the contract, a critical element to fulfilling and reinforcing staffing ratios. These additions are key elements of this new contract.
More, float pools will be established where they did not exist and augmented where they do exist. These pools will cover sick calls and other episodic absences. Float pool differential pay will equal 10% extra pay. Float pool positions will be made up of additional budgeted positions.
At the four hospitals in Multi-employer Bargaining, the hospitals agreed to hire 327 total additional FTEs — above and beyond the more than 200 nurses recently hired.
To deal with staffing and other issues under the new contact, Professional Practice Committees (PPCs) are created. They will meet post-ratification to begin the process of assigning new FTEs to existing units. The timeline guarantees under the new contract will be enforced by these PPCs.
In addition, the PPCs operate with an expedited decision-making process and have the authority to improve staffing requirements due to census, acuity or staff mix. In other words, on the basis of these factors, we can call for an enhancement of existing staffing ratios/grids beyond levels set by the contract.
Our new right to engage in informational picketing during the life of the contract has special meaning, as we can reach out to patients, the community and the press regarding staffing and safety issues.
Other improvements in contract language include union leave, an improved Non-discrimination Clause and RN input into technology to “enhance nursing practice.”
On the issues of harassment and workplace violence, the contract calls for the addition of hospital polices for enforcement purposes.
Ratifications by 12 hospitals
The terms of the tentative contract agreement became final for Montefiore, Mount Sinai, St. Luke’s-Roosevelt and New York Presbyterian in ratifications that followed. Local bargaining ensued on facility-specific issues and these, too, were followed by ratifications. The contracts are now in place. The other hospitals — 12 private sector facilities in all — are ratified and in place, as well.
“This is very big win for our nurses and for NYSNA,” said Anthony Ciampa, RN and NYSNA board member. Mr. Ciampa chairs the LBU at New York Presbyterian.
“These were hard-fought negotiations over months — in our units, on the info picket line and at the table. But we emerged with an outstanding new contact and with a stronger union.”
“The multi-employer bargaining took us to another level,” said Karine Raymond, RN. “We worked closely with other LBUs, coordinated our approach, reviewed and voted upon proposals and prevailed. This is the respect we deserve.”
“There were disagreements within individual LBUs and within the multi-employer bargaining group as a whole,” said Mary Ellen Warden, RN. “But we did not allow these differences to interfere. We stayed on course. This is a victory for NYSNA and for patient care.”
At other hospitals in negotiations, the foundation established at the multi-employer level gave added force to their demands, and resulted in additional FTEs and float pools at these hospitals. All together, the 12 hospitals will add 1,000 FTEs, a very large and essential number of positions to fill and reinforce staffing ratios/grids.
This is a profound win for NYSNA and for the communities we serve.
“At my hospital, Staten Island University Hospital, we made tremendous gains in terms of FTEs,” said Pat Kane, RN. “These were challenging negotiations but we met those challenges. I am very proud to be a part of NYSNA.”
Building on this foundation
On the hospital level, PPCs are our way to keep patients safe, enforce our staffing ratios/grids and to carry out our professional responsibilities. The next steps are to ensure that timelines for the addition of staff are met. The next steps are to ensure that all float pool positions are added. With the right to informational picketing, we now have an extra tool to bring patient safety and quality care issues outside the hospital.
The standards set by the NYC private sector contract should inform all our contracts, as we seek to create conditions in all NYSNA-staffed hospitals that protect patient care.
Our ultimate goal is to eliminate healthcare disparities throughout New York State and put in place in every hospital, in every community, safe, quality care for our patients. NYSNA is playing a key leadership role in highlighting and achieving this goal. To get there, we must build on the patient protections that our new contracts provide. We must be active in our communities, bringing our knowledge and expertise to the full array of healthcare issues. We must support public health initiatives at the municipal and state levels. We must build and support alliances with other labor unions, as well as religious, consumer and other community groups committed to issues related to equal access to quality healthcare. Our support of staffing legislation and single payer legislation moves us closer to winning those votes and the establishment of state laws to ensure universal, quality care for all New Yorkers.
NYSNA’s unity is making us stronger.
NYC Private Sector Hospitals with New Contracts
Bronx Lebanon Hospital
Brooklyn Hospital Center
Kingsbrook Jewish Medical Center
Maimonides Medical Center
Montefiore Medical Center*
Mount Sinai Hospital
New York Methodist Hospital
New York Presbyterian Hospital
Richmond University Medical Center
Staten Island University Hospital
St. Luke’s - Roosevelt
*includes (NYC area):
Montefiore Mount Vernon Hospital