Nurses: If NYC Can Spend Millions on Temps — It Can Pay Staff Better

Nurses rally outside Lincoln Hospital in the Bronx this week. Photos by Steve Wishnia.

By Steve Wishnia

Nurses at the city’s 11 public hospitals are finally reporting “significant progress” in contract talks with the New York City Health + Hospitals agency, their union says.

In talks June 23, the New York State Nurses Association said in a statement, both sides agreed to an escalated calendar of bargaining sessions in July, with the goal of reaching a contract deal by Aug. 1. Their current agreement expired Mar. 2.

The main unresolved issues, it said, are “safe staffing and pay parity to resolve the crisis of understaffing and high turnover” in the city’s public-health system. NYSNA represents about 8,000 nurses at the city’s public hospitals and other facilities, from municipal nursing homes to jails, where they care for both prisoners and guards.

NYC H+H, the union says, loses so many nurses to the private sector’s higher salaries that it has to hire temporary nurses to fill the gap—and it is spending more money on that than it would cost to pay full-time nurses the same as what they get in at private hospitals.

“The city is spending billions of dollars for a company called RightSourcing,” NYSNA executive director Pat Kane told Work-Bites before a rally outside Lincoln Hospital in the South Bronx June 22. “They can’t compete with the private sector.”

Nurses at NYC Health + Hospitals facilities and mayoral agencies are paid on average 20-25% less than nurses at private hospitals. They start at about $84,700 a year, according to the union, while nurses in the private sector average about $104,600, and the gap gets wider as they gain experience.

The result, according to a NYSNA spokesperson, is that 40% of newly hired nurses leave in their first year on the job. At private hospitals, 15% is considered high.

NYC H+H, says Kane, “will hire nurses out of school. That’s a good thing.” But because so many quickly leave, “we’ve become a training ground for the elite.”

According to figures NYC H+H provided to city Comptroller Brad Lander’s office this month, it spent $589.9 million on temporary registered-nurse staffing in the 2022 fiscal year, and has already spent $401.8 million in fiscal 2023. The number of hours worked by temp nurses has more than tripled since 2019. Their average pay is $163.50 an hour, which is more than three times as much as what staff nurses make including benefits, NYSNA says.

That is “unsustainable and offensive to hardworking Health + Hospitals nurses,” Sonia Lawrence, NYSNA’s director for NYC H+H and mayoral-agency facilities, told the Lincoln Hospital rally.

“Right now we have more temp nurses than regular staff in the evenings,” said Musu King, head of the union’s bargaining unit at Lincoln.

NYC H+H did not respond to phone and email messages from Work-Bites.

The amount of funding in the city budget is not the main issue, according to the union. Most of the system’s revenues, projected to be about $10.5 billion in the 2023 fiscal year, come from Medicaid, Medicare, and state and federal aid for “safety net” hospitals. The amount directly from the city budget was slightly less than $1.8 billion, according to a March report by the City Council’s Finance Division.

The union wants to revive a dormant provision in the contract that guarantees pay parity with major private hospitals. It has been suspended in agreements reached since 1995.

The 1970 occupation’s legacy

Sonia Lawrence, a nurse at Lincoln for 30 years, was escorted out of the hospital before the rally. She said she was told it was because she was not on the schedule for the day — although, she noted, she’d been there with no problem two days before.

“We are not terrorists.” Nurses rallying throughout the city for pay parity and safe staffing are facing institutionalized backlash.

Police blocked both the hospital’s main entrance and its driveway with metal barricades, leaving only a narrow opening. A car with its lights flashing sat behind the barricades. “I’ve lived in this community my entire life, and I’ve never seen a police car blocking the entrance,” Assemblymember Amanda Septimo (D-Bronx) told the rally.

Lincoln’s current facility was built in part because of an illegal protest. In 1970, the Young Lords, a Puerto Rican version of the Black Panthers, occupied the old Lincoln Hospital on East 141st Street for 12 hours. Young Lords health lieutenant Gloria Cruz called the hospital, in a building that had been condemned in the 1940s, a “butcher shop that kills patients and frustrates workers from serving these patients.”

The hospital’s administrator told the New York Times during the takeover that the Young Lords were “trying to dramatize a situation which is critical.” Their demands included no cuts in staff or services, more drug-addiction treatment and testing for lead poisoning, building a new hospital, and a bill of rights for patients.

That, Kane told the rally, was the origin of the Patients’ Bill of Rights that is now widely posted on hospital walls, although “it’s been watered down.”

The new building, at East 149th Street and Morris Avenue, opened in 1976. “The Young Lords can take credit for this,” Dr. Oliver Fein of Physicians for a National Health Program told Work-Bites. His wife was a resident at Lincoln in the 1970s.

Under a single-payer health-care system, he says, staffing levels would be the same at all hospitals in the city, because they all “would be in one system.”

A problem with the current system, he explains, is that the city hospitals treat a much larger proportion of patients on Medicaid, and Medicare and especially Medicaid “under-reimburse the institutions.”

All single-payer legislation talks about paying doctors more, Fein says. The New York Health Act—a bill to set up a state single-payer system that was stopped in 2021 by last-minute opposition from an alliance of insurance companies, business groups, and the city public-sector unions that are now pushing to privatize their retired members’ Medicare coverage—“very explicitly talks about increasing payments to physicians,” he says. “That’s why we always talk about improved Medicare for All.”