As president of NYSNA and a long-time nurse at Maimonides Medical Center in Brooklyn, I know intimately the pain of understaffing. I’ve seen the horrible toll of understaffing on patients, nurses, and our communities. Hospitals are not addressing the staffing crisis or the economy. They’re simply not doing enough to address inflation and other economic issues bearing down on workers. These are issues I’ve spoken on for years. While many of us are tired, we cannot get discouraged. We will win if we fight back. As nurses, we must be strong, stand up to management and demand our worth.

My hospital system is one of the 12 private sector New York City hospitals where nurses’ contract expired on Dec. 31. These contract negotiations are one of the few opportunities we have to address persistent understaffing and its deleterious impact on the nursing profession as well as the people who rely on us for care. We stand up not only for our profession, but for the people who rely on us for care.

That’s why I joined over 100 colleagues on the steps of City Hall on Nov. 30 to sound the alarm about the nursing crisis in New York City’s hospitals. Many of our hospitals are more understaffed than they have ever been. We faced understaffing before and during the COVID-19 pandemic, but things have become even worse. Many healthcare employers froze hiring during the pandemic, leaving many vacancies when nurses retired or resigned. They had to have seen that coming, and if they didn’t, that’s an even bigger problem.

Now, we don’t have enough nurses to meet demand. For instance, there are thousands of nurses in New York who have been so traumatized and so poorly treated that they are no longer willing to consider or accept hospital jobs. When there aren’t enough nurses and their patient assignments are too heavy, nurses leave the bedside. Unless these issues are addressed, we’ll be unable to recruit more nurses into the profession or retain the ones we do have. While hospitals could immediately step in and help stabilize the situation, many are unwilling to invest the necessary resources. They have chosen profits over patients. By ignoring contractual staffing ratios and the requirements to improve staffing under the new state staffing law, hospitals are demonstrating their desire for profits over people.

Failing to Hire and Retain

Understaffing did not pop up out of the blue. Hospitals could have monitored trends and made adjustments. Instead, hospitals did not do enough to hire and retain nurses. Now some facilities have hundreds of nurse vacancies. The severe and chronic understaffing impacts the morale of the nurses who have sacrificed and stayed at the bedside. They are asked to do the impossible nearly every shift. That creates moral distress when they go home to their families knowing they are unable to provide the safe, quality care to their patients — the way we are trained to do.

The quality of care that patients receive when there is severe understaffing is compromised and can even be unsafe. That is why NYSNA nurses have demanded better for us and our patients.

They Can Afford Safe Patient Care

You cannot tell me that in the richest city in the country, in hospitals where CEOs earn an average of over $1 million a year, where top executives gave themselves $73 million in salary hikes and bonuses during the first and deadliest year of the pandemic, that hospitals cannot afford safe patient care. You cannot tell me that after spending millions in advertising that hailed nurses as essential and as heroes of the COVID-19 pandemic that these hospitals cannot afford to maintain good-quality healthcare for frontline nurses. It is a lie, and it’s one that we do not have to fall for.

They Must Do Better

New York City’s hospitals can and must do better. But left to their own devices — without state and city elected officials’ oversight and accountability — healthcare employers will do the bare minimum. Without our intervention and advocacy, our patients will not get the care they need. It is imperative that hospitals are held accountable for:

• Staffing to the bare minimum.
• Reducing healthcare to the bare minimum.
• Treating nurses as expendable, not essential.
• Prioritizing profits over patients.

• Further, NYSNA is urging several steps to address the registered nurse shortage in New York City:
• New York City-area hospitals must agree to fair contracts with their nurses in the current round of bargaining. They must increase RN pay rates.
• They must improve staffing levels and nurse-to-patient ratios.
• Hospitals are nonprofits that don’t pay taxes and are not supposed to hoard money — New York City should look at hospitals’ tax exemptions and use its zoning and regulatory power to make them improve working conditions and patient care.
• Hospitals must stop relying on temporary staffing and use the huge amounts of money they pay for temps to build up their permanent workforce.
• New York City should push hospitals to increase tuition support, mentorships, apprenticeships and other programs to address racial and social inequities and recruit local youths to work in its hospitals.
• Most importantly, hospitals need to listen to and respect their nurses.
• History has taught us that many hospital systems won’t automatically do what is right. They need oversight. They need accountability. And they need to be mandated to do what is right for nurses, patients and the broader community.

Choose Something Different

At the New York City Council oversight hearing, more than a dozen New York City nurses from throughout the five boroughs spoke about the working conditions, understaffing and potential healthcare cuts that could further cripple the public health system. This is not a function of chance; it is a matter of choice. And healthcare employers have the potential to choose something different.

And if they continue down the current path, 17,000 nurses at 12 New York City hospitals will continue to rise up and demand change. They have contracts that expired on Dec. 31 and will do whatever it takes to improve the lives of their colleagues, families, patients and communities.