Why are so many HCPs going on strike?

Strikes by HCPs have spiked since 2022, including a highly publicized walkout by New York City nurses in January 2023.

The strikes were intended to call attention to low staff-to-patient ratios, poor working conditions, and low pay in hopes of improving the workers’ situations and the level of care provided to their patients.

What lessons can healthcare systems learn from these strikes to help prevent future ones?

Nurse walkout

On January 9, 2023, over 7,000 nurses walked out of Montefiore Bronx and Mount Sinai Hospital to go on strike in hopes of improving patient care by increasing staff-to-patient ratios.

The strike lasted 3 days and concluded with both hospitals agreeing to “concrete enforceable safe staffing ratios”—a historic win for nurses in NYC, according to the New York State Nurses Association (NYSNA).^[]

This strike followed 18 others by employees in the medical field in 2022, as noted by Becker’s Hospital Review.^[]

To get a better understanding of why HCPs are going on strike, MDLinx spoke with Michelle Collins, PhD, CNM, RNC-EFM, FACNM, FAAN, FNAP, Dean of the College of Nursing and Health at Loyola University New Orleans.

Unmet needs of staff and patients

According to Dr. Collins, one of the drivers of the January nurses’ strikes was the demand for better patient care through safer staffing measures.

“Nurses start their shift with the best intention to give the highest quality care to the patients whose care they are assigned,” Dr. Collins said.

Training is lacking

In addition to dealing with unmanageable patient volumes, nurses are navigating assignments in clinical areas for which they lack proper training.

A 2022 survey published by Becker’s Hospital Review found that more than 26% of nurses reportedly lacked the skills to effectively work in clinical areas that they’d been reassigned to.^[] Forty-six percent of nurses were also reassigned to these units without any additional training.

This may have something to do with the nursing shortage, which, according to Dr. Collins, results from the aging baby boomer population, an aging nursing workforce, and a national nursing faculty shortage.

When doctors strike

Doctors, on the other hand, are also no strangers to striking.

According to an article published by The Lancet, doctors in the UK were considering going on strike in 2022 to achieve better pay and working conditions.^[]

The Lancet research showed that as of 2022, trainee doctors in England were reportedly paid 26% less (adjusting for inflation) than they were in 2008. The trainees also felt they were treated poorly, leading to feelings of disillusionment and despair.

As a result, the threat of a strike by the doctors looms, calling into question what must be done to keep HCPs—and their patients—safe and satisfied.

Give them what they want

So, how can US health systems prevent future strikes? The answer—at least in part—may be to give HCPs what they’re asking for.

“They need recognition for what they contribute; they also need to be fairly compensated for the work that they do,” Dr. Collins said, noting the additional importance of safe nurse-patient staffing ratios.

If these needs continue to go unmet, some feel that health systems may ultimately fail. In the UK, for example, in 2022 HCPs called on the British government to recognize that the NHS will not be able to accomplish what it sets out to do if doctors are burnt out and taken for granted.

“The threat of [a strike] should be seen as a signal of a health service under intolerable stress,” the author of the Lancet article wrote.

As HCPs recognize what they need to better serve patients, their efforts to achieve sustainable working conditions may continue in the form of strikes, according to an NPR report.^[]

Nurses return to work

In the meantime, thousands of nurses in New York are back at work.

“Through our unity and by putting it all on the line, we won enforceable safe staffing ratios at both Montefiore and Mount Sinai where nurses went on strike for patient care,” NYSNA President Nancy Hagans, RN, wrote in a statement.

The hospitals expressed their approval for the agreements that resulted from the settlements, according to a New York Times article.^[]

“It is fair and responsible, and it puts patients first,” Mount Sinai said of its agreement in a statement.

Labor actions such as the New York nurses’ strike may send a message to healthcare systems that HCPs are in need of better conditions, lower patient ratios, higher pay, and greater recognition for their efforts. The possible result of happier, better rested, and highly motivated HCPs, as well as improved care for patients, may help to reduce the number of strikes in the future.