NY Nurse September [All Regions]

New York

nurse September 2018

the official publication of the new york state nurses association

NYC private sector nurses kickoff bargaining “The healthcare New Yorkers deserve�

NYC Bargaining Conference kickoff, September 22

Getting a handle on the financials, pp. 7-10

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New York Nurse september 2018

By Judy SheridanGonzalez, RN, NYSNA President

Care for the caregiver

I Advocating for patients. Advancing the profession.SM Board of Directors President Judy Sheridan-Gonzalez, RN, MSN, FNP First Vice President Anthony Ciampa, RN Second Vice President Karine M. Raymond, RN, MSN Secretary Tracey Kavanagh, RN, BSN Treasurer Patricia Kane, RN Directors at Large Anne Bové, RN, MSN, BC, CCRN, ANP Judith Cutchin, RN Seth Dressekie, RN, MSN, NP Jacqueline Gilbert, RN Nancy Hagans, RN Robin Krinsky, RN Lilia V. Marquez, RN Nella Pineda-Marcon, RN, BC Verginia Stewart, RN Marva Wade, RN Regional Directors Southeastern Yasmine Beausejour, RN Southern Sean Petty, RN Central Marion Enright, RN Lower Hudson/NJ Jayne Cammisa, RN, BSN Western Chiqkena Collins, RN Eastern Martha Wilcox, RN Executive Editor Jill Furillo, RN, BSN, PHN Executive Director Editorial offices located at: 131 W 33rd St., New York, NY 10001 Phone: 212-785-0157 x 159 Email: communications@nysna.org Website: www.nysna.org Subscription rate: $33 per year ISSN (Print) 1934-7588/ISSN (Online) 1934-7596 ©2018, All rights reserved

n a variety of locations throughout the state, local bargaining units are negotiating contracts with employers who show little empathy for us, for patients or for conditions in our communities.

What do we want? It’s simple. l To be treated with respect as human beings, workers and professionals. l To receive the salaries and benefits that allow us to support our families and that recognize the allimportant work we do 24 hours a day, 365 days a year. l To be confident that when we can no longer work these grueling jobs, we can retire with dignity—and that we can survive on a reasonable income and receive the healthcare that we’ve been delivering all these years to others. l To be able to practice our art and science—and do what we do best: care for patients with the resources we need, not serve as surrogate billers in electronic devices. l To ensure that our rights as union members are honored and that we’re not the “fall guys” for a failing system. l To be safe and protected in the “house of healing” and ensure it does not become the “house of horrors.”

Cannon fodder

Soldiers—usually infantry—in a war are called “cannon fodder” when they are considered expendable and are sent to fight in the most dangerous areas, where they are likely to be killed, maimed or wounded.

Nurses and frontline caregivers are the cannon fodder of today’s healthcare system.

Whether it’s a deranged patient, colleague or visitor, we are targets

because we are there, because we are all that they see, because we are the people who cannot do enough without the staff, support, resources and capabilities to make up the difference for a system that doesn’t do enough.

We scramble to demand that our employers make our workplaces safe, protect us, make it clear that violent language, behavior and threats won’t be tolerated, and that attacks against caregivers will be prosecuted—and very few employers do much to accommodate such needs—but we are treating the symptoms, not the causes.

Understaffing, underinsurance, underfunding

We live in a violent and depressed society. As nurses, we know that depression is anger turned inward and abusive behavior is anger turned outward. The frustrations that patients confront have few outlets.

We are the reluctant emissaries of our employers—with no power over the conditions our patients face.

But they don’t know that.

Unfortunately, a number of our patients see us as the obstacles to care, not as the advocates for their needs. Nurse advocates, in fact, actively fight the system by which we are all victimized. But unfortunately, nurses who protest conditions like understaffing and lack of resources, nurses who make demands to improve care or who confront management about outrageous situations are targeted as “troublemakers” and “malcontents” instead of acknowledged as the heroes they truly are.

Then there is the unconscionable lack of funding for mental health services that push so many of our patients into psychotic states, or results in a failure to provide the support care that patients desperately require. Even patients with insurance don’t receive the long-term comprehensive care they require to live fulfilling lives in society.

Silence=Death

This slogan was the mantra of activists during the height of the Continued on page 3

NEW YORK NURSE september 2018

Crisis in healthcare I t all starts on the units. That is where nurses see the results of our society’s conditions.

What exactly do they see? Higher acuities. Yes, Americans are showing up at New York hospitals and hospitals across the country sicker each year. In fact, longevity ticked down 0.1 percent for American males last year (one factor was white men with cardiovascular illness) for the first time in a generation.

This acuity crisis can be tied to many factors, but one is that large numbers of Americans with health insurance do not use their coverage because they simply cannot afford to do so. The Commonwealth Fund figures released annually show no fewer than 30 percent of insured Americans fail to seek medical treatment or fill their prescriptions when ill because, even with insurance, they are still unable to pay for it. Insurance premiums were up 15 percent in New York in 2017, and are expected to far outpace inflation in the coming decade.

Unaffordable healthcare

Morality, human suffering and all notions of empathy aside: the sheer cost of this shortcoming to society is massive. People are getting very sick and losing days on the job or foregoing other productive tasks all because they cannot afford healthcare. And they return to the hospital over and over again because their illness persists.

For those receiving Medicaid, overcrowding at facilities is especially pronounced, as resources are declining.

The federal government is unrelenting in its efforts to cut funds that provide care to underserved communities. That same government has taken aim at eliminating protections for patients with preexisting conditions in what would result in harsh punishment of the sickest. At every turn, federal authorities fail to heed the calls from nurses, other caregivers and public health advocates to support care for those most in need.

Imagine what devoting our nation’s annual healthcare expenditures of $3.3 trillion to real, comprehensive, universal healthcare for the people would do for Americans?

Imagine a system devoted not to profits, but to patients.

In 2015, the five largest healthcare networks in the New York City metro area—excluding the public system—reported that 108 of their executives were paid over $1 million annually, with the average compensation being $2.2 million.

Pay packages resemble Wall Street salaries, with bonus pay comprising a large part of total compensation.

The denial of care has now caught up with us, as millions go without care and become very, very sick.

Nurses have seen it coming, have described it, decried it and have

Caregiver Continued from page 2

AIDS epidemic of the ’80s and ’90s. It was this activism that pushed the government to fund research and care for victims of the horrifying disease. Now, as a result, treatments are available that allow patients to live and to thrive.

There is funding for care and other supports, while never totally adequate, that have changed the paradigm completely and altered the prognosis 180 degrees.

Conditions in our hospitals—for patients and for caregivers—deserve the same level of activism.

Understaffing shortchanges patients and nurses alike.

Only mandatory ratios and limits to visits and productivity can alleviate this problem.

Health insurance companies serve only to deny care, push sick patients out, generate obscene profits and aggravate all of us with tedious electronic medical

“

Don’t equate patients with dollars and cents!”

Rehana Lowton, RN, Brooklyn Hospital Center

made this crisis in New York a very top priority.

From the bedside on their units, they can articulate the medical and social unraveling of our population.

There is no question that Americans in the multitudes are wondering: Why are we so sick?

Why can’t we afford care? Nurses have the answers.

record systems to facilitate it all. Only a single-payer funding mechanism for healthcare—Medicare for All— can begin to address these problems.

People Power

The torments to which our members are subjected, as described above, must be stopped so that nursing becomes a beloved profession that can attract and retain committed caregivers with security both on the job and in the home.

All of these issues can be tackled, albeit to varying degrees, through winning great contracts. But history has proven that to win in negotiations, our members have to be aware, engaged, passionate and “awake.”

Organizing is the caffeine that stimulates the body of NYSNA members to rise up, reach out and speak truth to power. “They” have the money, but we have not only the moral high ground, but the people.

People Power.

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New York Nurse

case study

september 2018

Being admitted to the hallways

“

Our level of concern was extremely high. When flu was detected, we had to rush them from the hallway to an isolation room if one could be found.

I had a case just two months ago.”

Renee Tucker, RN, Montefiore Moses

O

vercrowding in ERs and on hospital floors has become commonplace, with patients spilling over into hallways and creating crisis conditions in many instances. Members at Montefiore, after a series of meetings with management to no avail, went to the public.

The result was an August 5, front page story in the Daily News.

“I’ve seen it a lot of times with older patients,” Monte RN Benny Matthew told Daily News, referring to the practice of putting patients in the hallways. “They sit in the beds for long hours. They go home. And then they come back really sick.”

Montefiore fails to act

City Councilmember Ritchie Torres expressed his outraged to Daily News over the conditions at Monte, saying, “Relegating recipients of Medicaid to cramped and crowded hallways—teeming with sick patients, many of them with infections—creates an environment conducive to more illness, not less.”

Yet, still, Monte management has

taken no action to alleviate these crisis conditions.

Ask Renee Tucker, RN, a 20-year veteran at Monte MedSurg. She cares for three or four hallway patients on a regular basis; sometimes that number swells to six.

Tucker describes shifting in oxygen tanks, dressing wounds with little privacy and ushering patients to bathrooms shared by visitors.

“Last flu season was a tragedy,” Tucker said. “Our level of concern was extremely high. When flu was detected, we had to rush them from the hallway to an isolation room if one could be found. I had a case just two months ago.”

According to the Centers for Disease Control (CDC), the flu season of 2017-18 was “recordbreaking”. “Hospitalization rates this season have been record -breaking.... [It’s been] a high severity, H3N2-predominant season,” reported the CDC. Monte members, as well as Councilmember Torres, have asked Monte management why, given these crowded conditions, additional space has not been prepared. In particular, critics point to underutilized space at the facility on the Monte campus at Westchester Square.

Westchester Square a solution

Against this backdrop, Monte members, other NYSNA nurses, community members and public health advocates are demanding answers from Monte management about its failure to utilize available space to relieve overcrowding. A recent tour of Westchester Square showed clean, empty hospital rooms on several floors.

Monte refuses to take action.

Monte nurses and Councilmember Torres are demanding answers and a plan to address these crisis conditions.

Councilmember Ritchie Torres

NEW YORK NURSE september 2018

Consolidation of hospitals in NYC The Berger Commission

T

en years ago the first Commission on Health Care Facilities in the 21st Century was formed in New York State, but it is more commonly known by the name of its chairman, Stephen Berger. The Berger Commission was formed to address key issues in our healthcare landscape around what was perceived to be excess hospital capacity, and to propose solutions to some of the problems caused by this excess.

It ultimately recommended the closure of several hospitals, as well as the merger of others to form health systems. This, in many ways, accelerated two trends in New York City that had been growing nationally as well—larger wealthier hospitals swallowing up smaller community hospitals and the privatization of public hospitals.

Over the last 10 years, 13 hospitals have closed in the city, the most recent being the partial closure of Beth Israel Medical Center in Manhattan. Many others have

This in many ways accelerated two trends in New York City that had been growing nationally as well—larger wealthier hospitals swallowing up smaller community hospitals and the privatization of public hospitals. merged into just a handful of health systems that are growing increasingly more powerful in their ability to govern how our healthcare delivery system functions.

Hospitals are Consolidating: Health Systems

C

urrently, there are five major voluntary health systems in New York City: Montefiore Health System, NewYorkPresbyterian, Mount Sinai, NYU Langone Health and Northwell Health. Other health systems include Medisys Health Network (anchored by Jamaica and Flushing hospitals), the newly formed One

Brooklyn Health, and our public health system New York Health and Hospitals.

The major systems have largely benefited from the climate nurtured by the Berger Commission, and these systems dominate many aspects of healthcare delivery in New York City. Increasingly, physicians’ practices, ambulatory care centers, freestanding emergency departments and urgent care clinics are all falling under the purview of these systems. Until recently, Northwell Health even had a commercial insurance product that it offered, which favored services provided within its own health system.

Continued on page 6

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New York Nurse September 2018

Hospital consolidation Continued from page 5

We hear a consistent refrain from large healthcare systems in New York City. They tell us that their acquisitions of hospitals and other healthcare resources lead to lower costs for patients and more efficient care delivery both inside and outside the hospital. The larger size and scale of an integrated health system like NewYork-Presbyterian or Northwell Health purportedly gives them more leverage when negotiating reimbursement rates with insurers. Supply chain management becomes more efficient, again as the size of the health system improves negotiating leverage with vendors. Theoretically, according to these systems, this translates to lower costs for patients.

Closures and mergers

Unfortunately, these are not trends that healthcare experts have observed as hospital closures and mergers increased over time. In fact, the cost of healthcare overall has continued to rise, as have hospital bills.

At the site of the former St. Vincent’s Hospital in New York City’s West Village, there now stands a freestanding emergency department with some outpatient

services run by Northwell Health through Lenox Hill Hospital. Local residents have observed that the cost of care at this new facility is very high and the care offered not as comprehensive as the full-service hospital that once stood in its place.

Increased coordination across different types of providers in terms of the provision of care and more efficient movement of patient records across provider types are good outcomes. However, we have seen more signs that our most vulnerable patients are being left behind by these health systems.

Community Hospitals

I

n order to compete in an increasingly consolidated industry, smaller community hospitals face enormous pressures to affiliate or merge with large health systems. The trend of closures and mergers of smaller community hospitals during the Berger era left the remaining unaffiliated hospitals faced with difficult choices.

Today, there are few hospitals that remain truly independent in New York City. The Brooklyn Hospital, New York Community Hospital of Brooklyn, and Wyckoff Heights

Medical Center are among the few.

In fact, the state has several smaller independent hospitals in Brooklyn that now form their own health system, One Brooklyn Health. This system will include Kingsbrook Jewish Medical Center, Interfaith Medical Center, and Brookdale University Hospital Medical Center.

An essential resource

Many of these hospitals are part of our healthcare safety-net. They serve New Yorkers who are underinsured and lack consistent access to primary care. These are also likely to be patients who do not have the means to access the larger, richer healthcare systems that have consolidated resources across the city. In this regard, our community hospitals still play an important role for many New Yorkers. However, the closure and absorption of many of these facilities has led to some serious consequences. For example, Montefiore Medical Center in the Bronx was recently the center of media attention due to overcrowding and patients being boarded in the hallways. A few years ago, Montefiore absorbed the smaller Westchester Square Medical Center, decertified many of its beds, and turned it into a freestanding emergency department at a time when demand for inpatient capacity was growing in the Bronx.

An overloaded public system

T

he public system in New York City—the Health and Hospital Corporation (NYC H+H)— provided care for one in five New Yorkers last year, an enormous number of patients. NYC H+H hospitals and health centers are mainly located near low-income, demographically diverse communities that are primarily communities of color. It meets the needs of uninsured and Medicaid patient populations and, according to an NYSNA report “On Restructuring the NYS Health+Hospitals Corporation,” by Barbara Caress and James Parrott,its financial losses “can be attributed to meeting the unreimbursed and under-reimbursed health needs of these communities.”

The report sets out in detail the burden carried by the public system. NYC H+HC institutions handle for 50 percent of uninsured patient discharges, 80 percent of all uninsured hospital clinic visits and half of all Medicaid patients (up since 2014). The NYC public hospital

system accounts for 30 percent to 60 percent of poorly reimbursed inpatients services to people with psychiatric and substance abuse disorders.

The private healthcare system is shifting the financial burden for caring for New Yorkers without resources to pay or with inadequate insurance or who require Medicaid procedures with low reimbursements to our public hospital system.

“The private system,” write Caress and Parrott, “needs to be made more accountable for the care of all New Yorkers—regardless of ability to pay or medical problem. The broader hospital system in New York City is essentially a single system with multiple managements.”

We must appreciate the critical role of the public system in their caring for New Yorkers and support our brothers and sisters in the invaluable efforts.

New York

nurse special edition | september 2018

the official publication of the new york state nurses association

PRIVATE SECTOR BARGAINING-NYC

A FINANCIAL SNAPSHOT

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New York Nurse September 2018

Big three system financials

T These health systems...have strengthened and consolidated to the point where their command of patient care resources in New York City contributes to their robust patient care margins.

he large healthcare systems that include NYSNA-represented nurses in New York City had strong financial performances. The charts below contain an overview of NewYork-Presbyterian’s, Mount Sinai’s and Montefiore’s financial performance as health systems, which include their operations outside New York City in the greater metro area.

Collectively, these three systems made over $16 billion in patient care revenues in 2017.

In terms of size, Mount Sinai has more certified bed capacity than NewYork-Presbyterian or Montefiore in New York City.

However, as a health system, NewYork-Presbyterian is able to generate more revenues. Overall, these health systems represent 38 percent of the licensed hospital bed capacity in New York City.

This concentration of resources allows them to capture a significant portion of the patient care revenues in the city, which contributes to their overall financial strengths as health systems.

Net Patient Revenue 2015-2017 $9 billion $8 billion $7 billion $6 billion $5 billion $4 billion $3 billion $2 billion $1 billion $0 NewYork-Presbyterian 2015

Mount Sinai 2016

Montefiore 2017

Source: Annual Financial Reports for Montefiore and NewYork-Presbyterian, and the 2017 bond offering for Mount Sinai. Note that Mount Sinai data for 2017 is a projection based on the first nine months of 2017.

In terms of profitability from direct patient care operations, NewYork-Presbyterian dwarfs Mount Sinai and Montefiore.

Overall, what is remarkable is that these health systems are able to have net positive earnings from operations. Many hospitals across the country do not make profits from direct patient care operations1, but instead are profitable due to other endeavors such as supply chain operations, outside investments, licensing and real estate. These health systems, however, have strengthened and consolidated to the point where their command of patient care resources in New York City contributes to their robust patient care margins.

Operating Profits 2015-2017 $450 million $400 million $350 million $300 million $250 million $200 million $150 million $100 million $50 million $0 ($50 million) NewYork-Presbyterian 2015

Mount Sinai 2016

Montefiore

2017

Source: Annual financial reports for Montefiore and NewYork-Presbyterian, and the 2017 bond offering for Mount Sinai. Note that Mount Sinai data for 2017 is a projection based on the first nine months of 2017.

1. http://justcareusa.org/most-hospitalslose-money-on-patient-care/

NEW YORK NURSE

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If you consider the full scope of operations of these health systems, their profit margins are only increasing. NewYork-Presbyterian Healthcare System made nearly $850 million in net profits in 2017. Mount Sinai Health System, after completing its acquisition of Continuum Health Partners in 2014-2015, saw its profit margins increase as the size of the health system increased. Mount Sinai Health System recently announced that they are adding South Nassau Communities Hospital to their health system, giving them a foothold in the Long Island market dominated by Northwell Health.

Montefiore Health System continues to push north into the Hudson Valley, concentrating on building their presence there. Recently, St. John’s Riverside Hospital announced that it is formally entering negotiations to join Montefiore.

Net Profits 2015-2017 $9.50 million

$7.50 million

$5.50 million

Not bargaining:

$3.50 million

NYU Langone

$1.50 million

Despite its very key role in providing healthcare in NYC, NYU takes no part in the bargaining.

$0 ($5 million) NewYork-Presbyterian

Mount Sinai

2015

2016

Montefiore

2017

Source: Annual financial reports for Montefiore and NewYork-Presbyterian, and the 2017 bond offering for Mount Sinai. Note that Mount Sinai data for 2017 is a projection based on the first nine months of 2017.

Other NYC hospitals In contrast to the large health systems anchored by three of our largest employers, our smaller community hospitals do not have as large of an individual market share.

Net Patient Revenue 2015-2017

Caress and Parrott say, “It is, in part, the very existence of NYC H+H that enables the large private hospital networks to operate with huge surpluses.” (see p.

6, bottom) NYU is among hospitals, they report, that “shun” patients who do not support their bottom line— unprofitable patients are directed to public hospitals for care.

$1.2 billion $1.0 billion $.8 billion $.6 billion $.4 billion $.2 billion $0

Kingsbrook

Brooklyn

Flushing 2015

Interfaith Maimonides 2016

NYU Langone Health (that includes a medical school, physicians practices, clinics and hospitals), made a whopping $5.5 billion in patient care revenues in 2017 and reported operational profits of $197 million in 2017. They are also expanding, having merged with Lutheran Hospital in 2015 and with Winthrop University Hospital, Mineola, NY, in 2017.

RUMC

Wyckoff

BronxCare

2017

Source: American Hospital Directory

As you can see, the size and scope of New York’s largest health systems are very different from the size and scope of smaller community hospitals in New York City, some of which belong to smaller health systems or remain unaffiliated.

Some of the total revenues for these hospitals are overshadowed by the profits of their larger “com-

petitors” that are a part of an integrated health system. This does not mean that these hospitals are unsuccessful, but it does demonstrate how concentrated hospital care has become. Also, hospitals in New York City have a symbiotic relationship. A recent study focusing on our public sector hospitals found that the larger, wealthier academic med-

ical centers in New York City that anchor the largest health systems are more selective with the patients they treat and attract higher-paying patients as well. This leaves smaller community hospitals and our public health system to bear an outsized responsibility to care for the underserved. A look at inpatient discharges illustrates this point.

Continued on page 10

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New York Nurse September 2018

Other NYC hospitals Continued from page 9

NewYork-Presbyterian/Weill Cornell

32%

The Medicaid program does not just serve the economically disadvantaged, but a significant portion of Medicaid participants are elderly, disabled, or children.

29%

2% 37%

Medical Discharges

Uninsured Self-Pay Discharges

Commercial Insurance Discharges

Medicare Discharges

Looking at the inpatient discharges from two hospitals side by side, we can see how stark the differences are in patient population at NewYork-Presbyterian/Weill Cornell Medical Center in Upper Manhattan (part of the NewYorkPresbyterian Health System) and Interfaith Medical Center in Central Brooklyn (part of One Brooklyn Health). The discharge data for Presbyterian shows that nearly 70 percent of its inpatient discharges are patients who have access to commercial health insurance or Medicare. These two payer sources are usually stable and reliable sources of income for hospitals. The patient population is also generally comprised of patients who are older and retired (Medicare) and those who have access to commercial health insurance through their employers or through purchase on the Affordable Care Act exchanges.

Low reimbursement rates

Interfaith Inpatient Payor Mix

27% 54% 7% 12%

Medical Discharges

Uninsured Self-Pay Discharges

Commercial Insurance Discharges

Medicare Discharges

Source: NYS Department of Health

In comparison, at Interfaith Medical Center in Brooklyn, 66 percent of its inpatient discharges are patients who are on Medicaid or are self-insured/uninsured. The Medicaid program does not just serve the economically disadvantaged, but a significant portion of Medicaid participants are elderly, disabled, or children. Although Medicaid is considered a reliable payer, its reimbursement rates are generally below cost. Both of these hospitals serve patients in their communities, but hospitals like Interfaith that are smaller and treat our most vulnerable patients are under enormous pressure to join with larger health systems. The creation of One Brooklyn Health was to mitigate some of the challenges these hospitals have faced in the past.

NEW YORK NURSE

uniontk power

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september 2018

PLAN TO WIN

O

ur bargaining kickoff took place on September 22 with leaders representing nearly 18,000 NYSNA members from hospitals around New York City. NYSNA is hard at work coordinating bargaining schedules this fall.

Key to our plan to win is bargaining for common core proposals. As we establish these proposals, we plan to make them central to what nurses need to protect our profession and our patients. Common cores are critical values for interacting with the communities we serve and this should be reflected in our contracts.

What are the Common Core Proposals? They are key values we all share and include: l Safe Staffing Ratios l Workplace Violence and for Health & Safety l Across the Board Wage Increases l Improved and Expanded Health Benefits l Real Retiree Health Benefits l Expanded Tuition Reimbursement

Contract Action Team

Clifford Krinsky, RN, Mount Sinai was an initial speaker at the kickoff.

l Childcare or Elder Care l Paid Family Leave l And more!

On September 27, we took another important step forward. While it pertained directly to the “Big 4”— Montefiore, Mt. Sinai, Mt. Sinai West and St. Luke’s Roosevelt, NewYork-Presbyterian (now referred to as “The Alliance”), it will impact all New York nurses at their bargaining tables. As these contracts are won, these standards are reinforced in all our hospitals across the state.

Contract Action Team The team is a program of democratic, rank-and-file participation in negotiations. Our goal is to unite the Contract Action Team (CAT) and the Bargaining Committee to win outstanding contracts for members.

CAT members have important responsibilities in bargaining. l T o connect the entire membership to the bargaining table, attend bargaining sessions and bring members to testify. l T o participate in vote-taking and abide by the decisions of the majority. l T o keep members fully informed and follow rules of confidentiality. l T o support the Bargaining Committee at the table and follow their lead.

“As nurses, the kick off showed unity in our effort to come together for common goals.”

Nancy Hagans, RN

NYSNA Board Member Nancy Hagans, RN, Maimonides Medical Center, chairs the executive committee of her hospital’s LBU.

l T o mobilize maximum membership attendance at meetings for voting and not undermine the Bargaining Committee with the membership. l T o suggest positive solutions when I see a problem with our strategy or plan of action.

Below: NYC Bargaining kickoff, September 22

“

We want a safe, non-violent workplace.”

Lela Brooks, RN, NewYork-Presbyterian Hospital

NEW YORK NURSE september 2018

Non-Profit US Postage Paid NYSNA

131 West 33rd Street, 4th Floor New York, NY 10001

Three years later: We remember the strike that led to victory!

Management was not budging at Nathan Littauer Hospital (NHL) in Gloversville, NY, insisting upon deep cuts that would greatly jeopardize patient care. At issue were massive cuts to PTO and a hospital insistent that they would make no changes to the offer under any circumstances. They implemented their last, best and final offer.

Faced with such dramatic cuts, the nurses voted to strike for one day in January of 2016. Management then chose to illegally lock out the nurses for four days. The nurses were not phased. We filed charges with the National Labor Relations Board and we won, with all affected nurses being awarded full back pay Shortly thereafter, under the threat of a second strike, management came back to the table, and after a time, signed off on several changes that they had previously said they would never agree to. The result: a contract that was overwhelmingly ratified

by NLH nurses.