Nurses at Robert Wood Johnson University Hospital picketed outside the hospital in New Brunswick on Aug. 30, 2023. The nurses have been on strike since Aug. 4, with contract negotiations stalled over the union’s demands for a lower nurse-to-patient ratio. (Dana DiFilippo | New Jersey Monitor)
Kelsey Khan only lasted a year as a bedside nurse.
She had so many patients to juggle that the stress drove her to transfer to the operating room, where she could focus on one patient at a time.
That’s why the Piscataway resident has taken to the picket lines this past month outside Robert Wood Johnson University Hospital in New Brunswick, where 1,700 nurses walked off the job on Aug. 4 in protest over high nurse-to-patient ratios and unmet wage demands.
“Many nurses are running from the bedside within our first year because we’re so burned out,” said Khan, who’s been a registered nurse for two years. “I lasted one year, and I said I couldn’t take it anymore. And I did not want to leave — I love bedside nursing.”
Today marks the start of the fifth week of their strike for a contract that includes mandatory minimum staffing ratios and better benefits and pay. With negotiations stalled, union leaders have called on Gov. Phil Murphy to intervene, as he did to end Rutgers University’s faculty strike last spring.
Judy Danella, a staff nurse there for 28 years, is president of United Steelworkers Local 4-200, which represents the hospital’s nurses.
“We’re not 100 miles apart. We might be a yard apart instead of the entire football field. Somebody has to bridge the gap. Somebody has to bring the sides together. I think people look to Murphy as the governor, because he did step into the Rutgers strike,” Danella said.
Negotiations started in April. The nurses’ contract expired June 30 and was extended to July 21, and nurses went on strike Aug. 4. Since the most recent bargaining session Aug. 16, the two sides are now at an impasse.
RWJBarnabas Health is the largest health care system in the state and employs the most nurses statewide. The 620-bed Robert Wood Johnson University Hospital in New Brunswick is its biggest hospital. The ongoing strike is nurses’ first since 2006, when they were off the job for about 25 days, Danella said.
A hospital spokeswoman said the administration “did everything it could to avoid a strike.”
“The hospital agreed to and signed a memorandum of agreement on July 13, which included the union’s core staffing proposal and compensation settlement. The union leaders signed it and agreed to recommend the MOA to its membership, but did not. It was voted down by the nurses and a notice to strike was presented to the hospital,” spokeswoman Wendy Gottsegen said.
The governor dodged a News 12 reporter’s question on a live news broadcast Thursday night on whether he would intervene in the strike, repeating one of his favorite refrains: “I’m a labor guy.”
“I’m frustrated by this, frankly. This should be resolved,” Murphy said. “Let’s get this thing fixed and get it solved. Let these heroes get back to work, unburden them with the concerns that go with the strike and all the challenges that they’re currently going through.”
A Murphy spokeswoman earlier also declined to say whether he would act to resolve the dispute.
“The governor remains a strong proponent of organized labor and believes employees deserve a seat at the table when negotiating labor matters,” spokeswoman Christi Peace said. “The administration encourages both parties to maintain an open dialogue and will continue to remain engaged with them as they work towards a fair and acceptable resolution to these negotiations.”
Both sides have made proposals and counter-proposals and accused the other of refusing to negotiate in good faith.
Gottsegen said hospital officials offered to enter binding arbitration or participate in a federal mediation and conciliation board of inquiry, but the union refused both.
Danella said hospital administrators won’t commit to enforceable nurse-to-patient ratios and have fallen short of their other demands.
Gottsegen said Robert Wood Johnson nurses are the highest paid in the state, but Danella disputes that.
“They’ll tell you we’re greedy, and we’re the highest paid, we’re all of that. We are not. We’ve looked at other hospitals. One of my colleagues just interviewed up by where she lives in Morristown, and she will get paid probably $3 an hour more than I get here,” Danella said.
No negotiations are currently scheduled.
Growing nurse shortage
The strike comes during a severe and worsening nurse shortage, both nationally and in New Jersey.
The National Center for Health Workforce Analysis predicted in 2017 that New Jersey would be short 11,400 nurses by 2030, which would make it among the top four states with the worst nurse shortages.
The actual shortage is probably even worse, though, because the pandemic drove so many nurses out the door, those in the profession say.
A March report by the Health Professionals and Allied Employees union found that more than a third of New Jersey’s nurses left the bedside in the past three years. And the New Jersey Collaborating Center predicts more than 18,000 New Jersey nurses will retire by 2025.
With too few nurses, those in hospitals must care for far more patients than they can handle, they say.
Robert Wood Johnson University Hospital nurses sometimes have to tend to nine patients at a time in the emergency department, three in the intensive care unit, and six on medical-surgical floors, said nurse Roshan Reyes, who walked the picket line Wednesday.
That’s more than the one to six patients per nurse national advocates advise, depending on how acute a patient’s condition is. Patients with overburdened nurses are likelier to die, experience infections or other complications, and stay longer in the hospital, according to HPAE.
“On many shifts, comfort, compassion, and education are put aside to prioritize simply keeping a person alive,” Reyes said. “It should not be this way. Many people have become nurses because they want to provide care for others, but the way we are overloaded with patients, it has become a task-driven profession. We work hard all day to ensure that all of our tasks are completed in a 12-hour time window — sometimes without any break in between. Then we go home, exhausted, wondering if we could have done better.”
Newer nurses with less than a year of experience have been assigned charge duties, while nurses who have just completed training are getting assigned to train new hires, Reyes added.
“These are the reasons why the turnover rate is so high. Nurses are burned out,” she said.
Khan said she typically was tasked with caring for six patients per shift and regularly had to make tough decisions on which to prioritize.
“I’ve had patients sitting in their urine for hours when I go in there because I’ve been preoccupied with other patients. That’s not right. That’s a humanity thing,” Khan said. “This strike is about safe staffing, point-blank, period.”
Gottsegen said the hospital has added 200 staff nurse positions since 2022 and reduced its nurse vacancy rate to nearly half the national average.
“We understand and recognize the toll the pandemic took on our nurses and have worked aggressively to address staffing,” she said.
Officials said they also agreed to the union’s requested ratio “standards” and offered to pay $20 an hour to nurses who work shifts where staffing falls below those standards.
But standards are not mandates, and the $20 hourly bonus does nothing to reduce overwork, Danella said.
“I work on a stroke floor. Many of them can’t move, many of them have to get out of bed, many of them need to be fed, many of them need to be bathed, many of them are full-care patients,” Danella said. “I’ve been a nurse here 28 years. I can pretty much handle my role. But the new nurses, they’re overwhelmed. It’s just too hard to do. They’re walking away at a time when we already have a problem with nurse retention in this state.”
Federal and state lawmakers both have introduced legislation that would mandate minimum staffing ratios for nursing.
But the bill in New Jersey has been introduced 11 times since 2003 without passing, so Danella has little faith it’ll move this legislative session either.
Dozens of nurses have picketed outside the hospital around the clock every day since the strike started. Near the emergency room entrance, nurses blow horns and bang on drums, while a block away, nurses wave signs at passing motorists and chant things like “let’s kick ass for the working class!” and “safe staffing saves lives!” as they wait for good news from union leaders.
Several lawmakers have dropped by the picket line to show solidarity, and Sen. Bernie Sanders last week threw his support behind the striking nurses, too.
While the nurses marched outside, the hospital hired 1,000 replacement nurses at a cost of more than $45 million.
Officials urged striking nurses to return to work, noting that their health insurance coverage ends Friday.
“We have said all along that no one benefits from a strike — least of all our nurses,” Gottsegen said. “We hope the union considers the impact a prolonged strike is having on our nurses and their families.”
Danella has considered that, and she’s experiencing the impact herself. But she said the strike has created a camaraderie and unity among nurses across the hospital, who say they remain committed to the fight until they get what they want.
“Eventually, there has to be a light at the end of the tunnel. We want to be inside working,” she said. “If we have safe staffing, then nurses wouldn’t be burned out, nurses would not leave the bedside in the droves that they’re leaving, and the nurse — and the patient — would benefit.”
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