On January 12, 15,000 nurses in the New York State Nurses Association (NYSNA) went on strike against below-inflation wages, unsafe staffing levels, inadequate healthcare benefits and widespread workplace violence.
The strike won broad support among workers, students and more thoughtful middle-class layers, who are themselves confronting the rapid growth of inequality, which the deepening crisis in healthcare reflects. Taking place alongside a strike of 33,000 healthcare workers in California, it was part of a broader upsurge of the working class. It also coincided with mass demonstrations against the deployment of ICE to Minneapolis, where the question of a general strike against Trump became a topic of wide discussion.
But in spite of the powerful position nurses were in, the struggle was undermined by the NYSNA bureaucracy, which isolated the strike and shut it down after 41 days. Returning nurses now confront a management bent on retaliation and contracts that resolve none of the issues that drove them onto the picket lines.
The new agreements contain below-inflation wages, and health benefits so inadequate that many nurses cannot afford treatment in the units where they work. They include language on artificial intelligence that does nothing to prevent hospitals from replacing nurses with it. And the provisions on workplace violence are so weak that they merely call for committees to review violent incidents—after they have already occurred.
The struggle demonstrates, once again, that workers’ struggles against the corporate oligarchy requires at the same time a fight against the trade union apparatus, which is joined at the hip with management and the pro-capitalist Democratic and Republican parties.
This task will become all the more urgent as opposition continues to build this year to impossible living conditions and the fascistic Trump administration ripping up democracy at home while waging a criminal war in Iran. It is the working class who will be made to foot the bill for the tens of billions being spent on murdering Iranian schoolchildren and civilians. The Trump White House has not even ruled out reinstating the draft to prepare for a ground invasion.
How NYSNA officials sabotaged nurses’ power
From the outset, once nurses voted overwhelmingly for a strike, NYSNA officials moved to prevent a broader and more powerful walkout. They canceled strike notices at 11 of the 15 hospitals whose contracts expired on December 31, before agreements were even reached.
As a result, only four hospitals ultimately struck: Montefiore, Mount Sinai, Mount Sinai Morningside and West, and NewYork-Presbyterian (NYP). While it was still the largest nurses’ strike in the city’s history, it could have been 6,000 nurses stronger had they acted on the democratic will of the rank and file rather than on the interests of the hospitals and the state.
NYSNA compounded this isolation by withholding strike pay from nurses who picketed in below-freezing temperatures. It also ignored opportunities to broaden the struggle by uniting with healthcare workers on strike at Kaiser Permanente in California and Hawaii, as well as with the growing wave of worker militancy across the country.
Nurses, meanwhile, understood they were in a fight against broader forces. Many spoke about the US attack on Venezuela and the ICE murders that had shaken healthcare workers nationally; one of the victims, Alex Pretti, being a nurse.
They increasingly drew connections between their strike and the anti-ICE and anti-war protests spreading across the country, seeing all of these as part of a broader struggle in defense of democratic rights. The significance that their strike was taking place in New York City, the most unequal city in America and the center of the global financial system, was not lost on nurses.
Mount Sinai claimed that meeting the nurses’ demands would cost the hospital $1.6 billion over the three-year life of the contract. Yet the hospitals are overseen by boards dominated by billionaire financiers and corporate executives for whom such sums are pocket change.
Nurses reject first sellout attempt
After 29 days, after management had threatened to fire nurses en masse, union officials announced tentative agreements at three of the four hospitals and moved to force a snap vote to shut down the strike.
With voting already underway at Mount Sinai, Mount Sinai West and Montefiore, NYSNA president Nancy Hagans, scoffing at union bylaws, went behind the backs of the NewYork-Presbyterian bargaining unit—the last holdout—and reached an agreement with management. This provoked outrage among nurses and brought the conflict between the rank and file and the union leadership into the open.
More than 1,500 nurses signed a petition demanding Hagans’ resignation. Several dozen marched to NYSNA offices to deliver it to her in person, only to find that she had been alerted to the protest and stayed away from her office that day.
NYSNA officials hoped that weeks without strike pay or health coverage and the thought of having to go back on the picket line alone would persuade NYP nurses to approve the agreement. Instead, they rejected it with contempt, with 70 percent voting against.
However, NYSNA was eventually able to manufacture a vote to ratify an almost identical deal. But this was not a collapse of militancy but a vote of no confidence in Hagans and the NYSNA leadership.
The role of the union bureaucrats—and the Democrats
The conflict that emerged between the rank-and-file nurses and the NYSNA leadership was not simply the product of the personal decisions of individual officials, but the expression of opposed social interests of the union apparatus and the workers they claim to represent. The trade union bureaucracy has been transformed into an instrument for suppressing the class struggle and enforcing the dictates of the corporations and the state.
Behind the union bureaucracy stood the Democratic Party, which was hostile to the strike. Governor Kathy Hochul declared a state of emergency, allowing hospitals to bring in out-of-state scab nurses while denouncing the strike as a threat to patient care. When militant nurses marched on the governor’s mansion in Albany, the union leadership rushed to distance itself from the demonstration, making it clear they had not authorized it.
Throughout the strike, union officials arranged almost daily visits to the picket lines by low-level Democratic politicians who offered empty words of support through a bullhorn before fleeing the cold. Mayor and self-described “democratic socialist” Zohran Mamdani also appeared twice on the picket lines. But later at a demonstration, a dozen nurses protesting the contract were arrested by police.
Mamdani, meanwhile, worked behind the scenes with city officials and other federal mediators to help broker a settlement acceptable to hospital management. A key role was likely played by his deputy mayor for “Economic Justice” Julie Su, the former Labor Secretary in the Biden White House who played a key role in blocking or shutting down strikes among railroaders, dockworkers and Boeing workers.
The role of the World Socialist Web Site
Throughout the strike, reporters for the World Socialist Web Site spoke with nurses on the picket lines, distributed articles and discussed the strategy needed to advance their struggle. Videos of these discussions circulated widely online, drawing hundreds of thousands of views. They allowed supporters of the strike to hear nurses’ demands and grievances, and relayed greetings of solidarity among workers in California, Minnesota and New York.
Two well-attended online meetings of rank-and-file nurses and healthcare workers were organized to discuss how the strike could be expanded and united with the struggles of healthcare workers and other sections of the working class confronting similar attacks. A statement issued at the first of these meetings declared:
“Healthcare workers defend life. When wealthy executives starve hospitals of staff and resources, they endanger patients; when the state kills a nurse in the streets, it signals that no one in the working class is safe from repression. Our struggle for staffing ratios, living wages and full benefits is inseparable from the defense of democratic rights.”
The central lesson of the strike is the need for a new strategy based on the independent organization of rank-and-file nurses. Control of the struggle must be taken out of the hands of the union bureaucracy and placed in organizations democratically run by workers themselves. Such organizations must seek to expand the fight beyond individual hospitals, uniting nurses with healthcare workers and other sections of the working class confronting layoffs, austerity and repression.
The International Workers Alliance of Rank-and-File Committees is fighting to build this movement on a world scale. In the United Auto Workers, Mack Trucks worker Will Lehman is running for president on an insurgent platform to transfer power from the pro-corporate union apparatus to rank-and-file workers themselves.
Above all, the struggle must reject the claim that the needs of patients and healthcare workers must be subordinated to the profits of hospital systems and their billionaire trustees. Healthcare is a social right, and its defense requires the political independence of the working class from both corporate parties.