Managing Hospital Safety During Nursing Strikes

Picture of Mary Kate McGrath By Mary Kate McGrath


nursing strikes_shutterstock editorial use onlyIn March of 2019, unionized nurses in New York City delivered a formal strike notice to the three largest hospital networks. The notice warned that if the hospital management and the New York State Nurses Union didn’t reach an agreement, 10,000 nurses would not show up to work and picket outside of Montefiore, Mount Sinai, and New-York Presbyterian hospitals, as per Vice. 

The New York State Nurses Association ultimately managed to negotiate with the New York Hospital Alliance on the issue of staffing, and the strike was withdrawn. Insufficient staffing ratios are causing tension in the nursing field across the United States, and hospital safety managers should prevent and prepare for picketing or strikes.

Nurse-to-patient ratios have dominated conversations about healthcare safety. Professionals working in healthcare are statistically more likely to face instances of workplace violence than other industries. In 2016, researchers found that nearly 75% of all workplace assaults occur in healthcare. Many hospitals and healthcare facilities are underfunded and face staffing shortages, which creates even more risk in the workplace. California was the first state with laws that require a required minimum nurse to patient ratio per hospital unit, and it remains the only one to create a mandate on the legal level. Massachusetts is the only other state with a similar law, requiring a 1:1 or 1:2 nurse to patient ratio in the ICU.

In 2018, the Bureau of Labor Statistics reported that education and healthcare workers were most likely to go on strike. In January, Los Angeles public teachers organized a weeklong strike to protest current working conditions and advocate for for capsizes in classrooms, full-time nurses and librarians in schools. The strike impacted classrooms across the state for half a million students in the state, but teachers were able to negotiate with the state for their conditions. Administrators could have avoided the disruption by coming to the table sooner, and the strike could be just the first from unions in similar workplaces. 

Staffing is an issue that is becoming increasingly contentious in hospitals and healthcare facilities across the United States. In 2018, nurses in hospitals run HCA, one of the countries largest healthcare providers, picketed and threatened to strike in five states, according to the New York Times. Hundreds of nurses staged a walk-out in Vermont to call attention to staffing issues earlier in the year as well. These strikes can disrupt hospital or facility operations, if not halt them entirely. 

How To Prioritize Safety During A Nursing Strike

Putting together a long-term, a sustainable safety plan is the goal of any hospital or healthcare facility. Patient-to-nurse ratios should be a consideration as part of comprehensive healthcare security, and hospital managers should work with employees to find ways to reduce the burden on doctors and nurses. If these issues are left unaddressed, it creates an increasing strain on nursing teams and compromises patient safety. The notice and picketing in New York suggests that nursing unions will continue to use strikes to advocate for patient-to-nurse limits if concerns are unheard, and hospital safety managers can prevent that eventuality by creating a dialogue with nurses.

Hospitals have a responsibility to supply patients with uninterrupted healthcare, even should a strike occur. Transparency is key during a nursing strike, so if changes in treatment are inevitable, this must be communicated to patients. Make sure that parents are informed of changes in staffing, whether this is care from nurses or doctors. Patients will appreciate the autonomy to make informed decisions amid staffing disruptions. If a patient is better served at a different healthcare facility during the strike, hospitals should coordinate a transfer of care. Preparing EMS or ambulance teams ahead of the strike will help avoid further inconvenience for patients and workers. 

The number one thing hospitals can do to avoid compromising patient safety is address nursing concerns before a labor strike occurs. If a nursing union is calling for the health care system to hire more nurses amid staffing shortages, it is a signal to administration that patient safety might be jeopardized. Walk-outs and strikes are often a last resort for nurses - they don’t want to disrupt patient care or hospital operations as much as hospital administrations don't. These situations occur when communication does not occur. A comprehensive safety plan benefits all hospital workers, and if hospital administration collaborates with nurses on procedural matters, there will be fewer issues in the long term.

Leveraging Technology To Reduce Nursing Burden

Technology can be a powerful tool for maintaining hospital operations during a nurse strike, and a mass notification system can help tackle communication challenges. Notifying doctors, surgeons, and staff that personnel will be missing during the period of the strike is essential for both worker and patient safety. The ecosystem of every hospital department depends on nurse coverage, and it’s critical that any changes in staffing be communicated.

Some mass notification systems also have an automated polling module that allows nursing supervisors and other management personnel to solicit information from a select group of nurses and other staff through SMS text, email and voice calls and send automated follow-up notifications based on their responses. Healthcare personnel can use the polling module to fill a staffing shortage quickly by sending out a quota poll to nursing personnel that automatically concludes after a certain amount of required responses are reached. 


A mass notification system can also keep the community informed if a strike or picket will disrupt hospital hours. The planned picketing around the three main hospitals in New York City would have had the potential to disrupt commutes and other foot traffic, which can create greater safety risks. Changes in hospital traffic should be communicated to residents, and keeping all informed will prevent further chaos or disorganization in the neighborhood. 

The mass notification system can also help reduce burden of nurse to patient ratios in the long term. This tool can enable RN and department managers to make sure nurses are serving patients within their area of expertise and speed up communication between nursing teams. The facility can reduce time spent on bureaucracy and communication, and ensure that every patient is receiving the best possible care without putting a major strain on staff. This can help the hospital take full advantage of personnel and resources, which helps reduce the burden on nurses who are already overworked. 

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Mary Kate McGrath

Written by Mary Kate McGrath

Mary Kate is a content specialist and social media manager for the Rave Mobile Safety team. She writes about public safety for the state & local and education spheres.


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