On Saturday, the New York State Nurses Association (NYSNA) announced the ratification of a contract at NewYork-Presbyterian Hospital in Manhattan, ending a six-week strike by more than 4,000 nurses. This was the last of four facilities still on strike following a vote just over a week before, in which NewYork-Presbyterian nurses overwhelmingly rejected their tentative agreement.

The new contract does not adequately address the nurses’ demands, including safe staffing, and the nurses will soon find themselves fighting management again over the same issues. NYSNA secured the ratification not because of genuine enthusiasm for the deal, but because the union bureaucrats isolated the nurses on the picket line in below-freezing temperatures, while withholding strike pay.

Voting for the tentative agreement took place only hours after it was announced on Friday, giving the nurses no time to read, discuss and consider the agreement. There was no meaningful democratic oversight to ensure the integrity of the ballot. Each worker received a link to an online ballot and was urged not to share the link with anyone else. This instruction suggests that anyone with a link could have cast a ballot for someone else.

NYSNA acknowledged workers’ “valid concerns” about the previous online vote, which was conducted over Surveymonkey, a platform which is unsuitable for secure, audited elections. Instead of explaining what measures they were taking to ensure the integrity of the vote this weekend, NYSNA urged the nurses to take screenshots of their ballots. Tellingly, the union justified the vulnerable electronic voting procedure by stating that it “helps expedite getting to results” and “helps to ensure a speedy return to work.” NYSNA thus admitted that its main concern was not the legitimacy of the vote but nurses’ swift return to work to satisfy management.

The union claims 93 percent of nurses voted to ratify the tentative agreement but gave no vote totals. Regardless of turnout, the ratification reflects the nurses’ lack of confidence in NYSNA’s ability to negotiate a better agreement. The nurses are still angry that the union leadership violated NYSNA’s own bylaws in the previous vote, rejecting the recommendation of its own executive committee and forced a vote on a substandard agreement.

In the new contract, NewYork-Presbyterian pledges to hire a handful more nurses, prioritizing the emergency department and catheterization lab, which are two of the hospital’s worst-staffed units. At Montefiore Medical Center and Mount Sinai hospitals, the other facilities which participated in the strike, new contracts ratified last week provided for only a few dozen new jobs. Mount Sinai Hospital agreed to hire only 30 additional full-time workers, when the nurses had demanded 700 new hires.

The contract also provides for regularly scheduled arbitration to resolve staffing disputes “more quickly.” But the speed with which an arbitrator reaches a decision is irrelevant, since NewYork-Presbyterian routinely files lawsuits against arbitration awards related to understaffing. Already this year, an arbitrator awarded about $400,000 to nurses for staffing violations, but the hospital has appealed the decision and refused to pay a dime while its appeal is pending.

NYSNA proclaimed that the new agreement protects its members’ health benefits, which was a major demand during the strike. But the agreement initiates a project “to seek out and achieve savings” related to health benefits. Despite language about “respecting the current benefits or their equivalent,” the contract opens the door to future changes to network management, out-of-network rules or prescription costs for branded drugs.

The agreement provides annual raises totaling about 12 percent over three years, the same as the previous deal nurses rejected and far below the 30 percent which the nurses originally demanded. These wages also will be eaten up by monthly parking costs of as much as $201.62.

NYSNA falsely claims that the contract protects immigrant patients and nurses. In fact, the agreement states that if a government agent or law enforcement officer asks about a patient or staff member, nurses should contact their supervisor. “Hospital management, not the employee, will oversee any interaction with law enforcement,” it states. Thus, nurses are protected from having to turn in their coworkers or patients to Immigration and Customs Enforcement (ICE); management will do it for them.

NYSNA also stated that the new agreement includes a “safeguard against artificial intelligence.” The agreement provides that a nurse who disagrees with recommendations given by AI may use his or her clinical judgment. It does not, however, prevent AI from eliminating nurses’ jobs. Instead, it states that “in the event that artificial intelligence technology directly causes a diminishment in the current levels of employees,” then management and NYSNA “will meet and discuss, in good faith, methods to avoid such impacts.” This careful phrasing provides “discussions” but no concrete job protections.

The new contract does not resolve any of the issues over which nurses fought admirably for six weeks. Their struggle will continue, albeit in a different form, and it is essential that the nurses draw the lessons of this experience.

The main obstacle that the nurses face is NYSNA, which did everything possible to weaken and betray them. The more powerful the nurses’ position, the more shamelessly the union strove to undermine them. NewYork-Presbyterian was one of 15 hospitals in New York City and Long Island whose contracts expired the same day last month. Instead of waging a powerful, united fight, NYSNA withdrew strike notices at 11 hospitals without even having reached agreements at the time.

Unable to prevent strikes at four of these hospitals, NYSNA withheld strike pay to starve its members into submission. After several weeks, the union reached tentative agreements with three of the hospitals, sent nurses back to work and left its members at NewYork-Presbyterian stranded.

In a flagrant act of bullying, NYSNA tried to force the NewYork-Presbyterian workers to ratify an agreement that the executive committee had already rejected. When the nurses overwhelmingly voted it down, NYSNA retaliated against them by temporarily stopping food deliveries to the picket line and stopping daily strike updates.

Only one week ago, local bargaining committee head Beth Loudin took part in a demonstration outside NYSNA headquarters calling for President Nancy Hagans to be disciplined. But now, Loudin has issued statements alongside Hagans praising the new deal, which is little different from the previous one.

The New York nurses’ strike took place amid an upsurge of walkouts, and healthcare workers have tremendous potential power. The ongoing strike of 31,000 healthcare workers at Kaiser Permanente facilities in California and Hawaii has been reinforced by more than 500 operating engineers, who walked out today. About 700 nurses and case workers at Henry Ford Genesys Hospital in Michigan have been on strike for nearly six months. These strikes demonstrate the potential for healthcare workers to launch a national fight to defend medical science and patients’ rights against attacks by management, ICE and the state.

NYSNA’s betrayal, however, shows that this movement requires new organizations and a new strategy. Healthcare workers everywhere must form rank-and-file committees that are independent of the trade union bureaucracy and of both big business political parties. These committees, which workers must control democratically, will provide the organizational means for formulating demands, developing a strategy and uniting struggles across state, national and industrial boundaries.