Op-Ed | NYC public hospital nurses need pay parity with the private sector

Nurses, local politicians and other medical staff rally outside of Lincoln Hospital on March 2, 2023, for pay increases on par with their private sector counterparts.
Photo ET Rodriguez

New York City is home to the largest public health system in the country, caring for 1.4 million New Yorkers each year, regardless of ability to pay or immigration status. Our public hospitals are the safety-net that working-class and immigrant communities depend on. But our public hospitals are under incredible strain, facing an understaffing crisis worse than we’ve ever seen before.

The city is hemorrhaging nurses from hospitals run by NYC Health + Hospitals and the mayoral agencies. With low pay and chronic crisis-level understaffing, nurses are quitting in droves and either retiring early or going to the private sector where they can make a better living. To maintain quality care for our city’s most vulnerable patients, we must take action to retain trained, experienced nurses at the bedside.

There is a simple solution: Our public hospital nurses need wages that are competitive with the private sector.

Nearly 9,000 public sector nurses, members of the New York State Nurses Association (NYSNA), are bargaining a new union contract and are calling on the city to live up to its promise to implement pay equity with the private sector. The city’s contract with the nurses, which expired on March 2, has a clause committing to pay parity between the public and private sector, but that clause has been on pause for far too long.

NYSNA’s private sector nurses captured our city’s heart with a successful strike, and raised standards higher than ever before. The public sector hasn’t kept up with those standards for working conditions and pay – and we’re falling further behind. A new nursing graduate in the public sector will now make $19,000 a year less than her private-sector counterpart. That has to change.

With a NYC budget of more than $100 billion and a proposed state budget of roughly $220 billion, we can find the funds to stabilize nurse staffing. The patients that rely on our public hospitals for care deserve nothing less.

Our city’s public sector nurses are used to being asked to do more with less. They bore the brunt of the COVID-19 pandemic and have done more than anyone to keep our city safe – as of October 2022, they distributed 1.75 million COVID vaccine doses. Nurses in our city’s public outpatient clinics have given more COVID treatments than any other health system, preventing hundreds of deaths and thousands of hospitalizations.

Our 11 public hospitals make up almost 20% of our citywide hospital beds, operate the largest hospital-based clinic system in the city, and provide almost half of all Level I emergency trauma care and acute in-patient mental health services in our city. City health care workers also keep first responders like police and firefighters healthy and provide direct care to New Yorkers who receive assistance from agencies like Child Services, the Department of Social Services and other programs providing homeless services and mental health crisis services.

As private sector hospitals downsize and eliminate less profitable services like mental health care, labor and delivery, and emergency and trauma care, New York City’s public health care system continues to provide these essential services. And as the federal government reduces financial support for COVID-19 testing, treatment and vaccination, NYC Health+Hospitals will continue to fulfill its mission to care for all New Yorkers. They will do it at a financial loss, so we all can gain a measure of health and security.

Our city’s inability to retain experienced nurses threatens those essential services. While NYC Health+Hospitals continues to hire new nurses, few stay for the long-run. On some units the most senior nurse, who is training and mentoring new hires, has only one year of experience because turnover is so high.

Our city’s hospitals fill staffing gaps with travel nurses paid two or three times the salaries of staff nurses. In the Bronx, Lincoln Hospital’s Level 1 Trauma Center is now largely staffed by travel and agency nurses who are not familiar with hospital policies or the patient population we serve.

Keeping nurses’ pay this low is costing the city. We’re spending too much from our city and state coffers on expensive temporary travel nurses, and on recruitment and training for new nurses that immediately leave for higher paying jobs in the private sector.

Health and pay equity should be a priority of every decision-maker in our city and state. We’re calling for pay parity as a matter of survival for our city and its public health system.

Sonia Lawrence is a nurse at Lincoln Hospital and the president of NYSNA’s H+H/Mayorals Executive Council. Jumaane Williams is the New York City public advocate.