March 9, 2023

Over the past few years, strike action in hospitals has seemingly made more headlines nationwide. Unions are voting in favor of strikes for safer staffing ratios, better wages and benefits, and retention plans. Many nurses say they feel burned out by the impacts of COVID-19 and an overworked healthcare system.

According to Bloomberg Law, hundreds of union contracts are expiring this year. Health systems nationwide are working on new terms with nurses’ unions. At the negotiation table, reaching agreements that work for both sides hasn’t been easy. Here are just a few hospital strikes organized over the past six months.

By definition, labor strikes are designed to disrupt care delivery. So, as more nurse strikes pop up in major cities across the US, the question arises: what are the effects of these nurse strikes?

Here, we take a look at the effects of increasingly common strikes. 

Effects on Healthcare Systems

During a nurse strike, healthcare systems can take a big financial hit. The most expensive recent example happened in 2016 when nurses at Allina Health in Minnesota went on strike — twice. The two strikes of 7 and 41 days cost the health system $171 million. 

Moreover, even the threat of a nurse strike may cost millions. That same year, Brigham and Women’s Hospital in Boston spent more than $8 million preparing for a strike that it averted. It also lost another $16 million in revenue.

Effects on Hospitals

A nurses’ strike may negatively affect the hospital in a few ways.

  • Finances: Often, hospitals must replace striking nurses with temporary staff. Bringing in replacements can cost millions of dollars in recruiting, travel expenses, and bonuses. 
  • Reputation: In many communities, nurses are respected and appreciated. When hospitals fail to reach agreements with their nurses’ union, The public may view them negatively. Strikes are negative publicity.
  • Patient Care: Replacement nurses are often unfamiliar with the protocols and layout of the facility. Arguably, they may not be able to provide the same level of care as the nurses on strike.

Abbott Northwestern Hospital in Minneapolis is an example of how a nurse’s strike could compromise patient safety. During a strike in 2016, a temporary nurse administered the wrong medication to a patient in the emergency room. The patient was subsequently admitted to the intensive care unit, and the hospital was placed in “immediate jeopardy” by the Centers for Medicare and Medicaid Services.

Effects on Staff

A federal law under the National Labor Relations Act protects nurses who choose to strike. Also, nurses cannot be charged with patient abandonment. Still, that doesn’t mean the staff is unaffected when labor disputes lead to strikes.

Going without pay is difficult for anyone. And many nurses fall into the category of nearly two-thirds of Americans who live paycheck to paycheck. Many unions have strike funds that give financial assistance to members. However, they may only give nurses a few hundred dollars instead of the thousands they could see from normal wages.

Sometimes, even after the strike ends, nurses must wait to return to work. A “lockout” happens when a strike has officially ended, but management continues to use replacements through the end of their contracts instead of calling everyone back to work right away. 

Effects on Patients

Perhaps the most controversial issue with nurse strikes is their effects on patients. 

In 2010, researchers examined the effects of nursing strikes in New York on patient care and outcomes. They found these startling statistics:

  • In-hospital mortality increased by 19.4 percent during strikes.
  • Hospital readmissions rose by 6.5 percent for patients admitted during the strike period.
  • Hospitals that hired replacement nurses performed the same as those that did not hire substitute staff. 

A later study in 2012 looked at the effects of nursing strikes in New York state and found the overall effect to be the same. The hospital death rate during a strike increased to an 18% higher risk of death. In this study, many of the hospitals did not use replacement workers. 

A recently published international study found that strikes have a negligible impact on patient well-being. 

The effects of strike action on patient care, quality, and safety remain a point of contention in healthcare.

The Takeaway

The uptick in nursing strikes and unrest among healthcare workers today has begged the question, what are the effects on patients, nurses, hospitals and health systems? More importantly, are they worth it? 

When you look at the evidence, it is possible to find negative consequences for all parties involved. It seems that everyone loses in some way. Yet, when labor disputes end in a strike, both sides often say it was their only option. 

By: Sarah Falcone