Are NYC Nurses' Demands Unreasonable?

What 15,000 Striking Workers Tell Us About Healthcare's Breaking Point and the Need for Collaboration

As nearly 15,000 nurses enter their third week on strike at three of New York City's premier hospital systems, a critical question emerges: Are their demands unreasonable, or are they simply asking for what nurses nationwide desperately need?

The answer reveals an uncomfortable truth for everyone involved.

The National Context

The NYC nurses aren't outliers—they're the visible tip of a national crisis. A 2024 survey by the National Nurses United revealed that 82% of nurses across the country experienced workplace violence in the past year. More alarming: 88% express concern about how staffing shortages harm patient care, up from 73% just one year earlier. Half of all nurse’s report being verbally or physically assaulted by patients or their family members within the past two years.

These aren't abstract statistics. They represent nurses leaving the profession at alarming rates—with 60% reporting they've changed jobs or considered leaving due to violence alone. When one in four nurses is likely to leave their role because of safety concerns, we're witnessing a workforce hemorrhaging its most valuable asset.

The Hospital Perspective: Real Constraints

Hospital executives aren't villains ignoring obvious solutions. Mount Sinai estimates the union's proposals would cost $1.6 billion over three years. These numbers represent real operational constraints that could challenge a hospital's ability to serve its community.

The irony? Both sides want the same thing: sustainable healthcare delivery that serves patients effectively.

The Difficult Middle Ground

Here's where it gets complicated. Research shows that adequate staffing and violence prevention programs actually reduce costs long-term through decreased turnover, fewer injuries, and better patient outcomes. The $30+ billion annual cost of healthcare workplace violence suggests prevention isn't an expense—it's an investment.

As with any investment, however, the ROI isn’t immediate, but it doesn’t have to be so far down the road that the end is not within view from the vantage point of today.

Implementing these changes involves financial decisions, careful strategic planning, and meaningful collaboration with all stakeholders. Granted, successful organizations do not operate as pure democracies. Healthcare executives are trained to lead and to manage the key metrics that make a business viable. Using a sports analogy, they are responsible for creating and revising the organizational “playbooks” necessary for success

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What can we learn from the NFL?

I’ll wager that you wouldn’t see the NFL as having any connection to the strike (and they don’t, literally). But the concept of a playbook lends itself to a nice analogy.

NFL Playbook Creation: A Collaborative Process

NFL playbooks are rarely dictated from the top down. Instead, they emerge through intensive collaboration between coaches and players at every level. Offensive and defensive coordinators provide the strategic framework, but position coaches contribute specialized concepts, and veteran players actively shape what makes it into the final playbook.

This isn't courtesy; it's necessity. Players provide critical feedback during installation: "I can't execute that route at full speed" or "That protection scheme leaves me exposed." Smart coaches listen. Peyton Manning essentially co-designed offenses. Tom Brady regularly met with coordinators to discuss what worked and what to cut. Russell Wilson helped develop Seattle's scramble-drill concepts based on what he could execute under pressure.

The playbook evolves weekly through film study sessions where players and coaches jointly identify what succeeded, what failed, and what adjustments are needed. The most successful teams recognize that the people executing the plays possess irreplaceable knowledge about what actually works on the field.

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The NFL playbook analogy does miss one critical component: Playbooks do not win championships. Execution, accountability, and decision velocity win championships. More on that in a follow-up blog coming soon.

What the Public Loses When Healthcare Organizations Don't Collaborate

Without collaboration, healthcare organizations can devolve into an “us vs. them” culture. Rather than the organization as a whole winning, the players and coaches begin to see their relationships as “win or lose” propositions.

In New York, If nurses "lose," patients inherit exhausted, traumatized caregivers working in unsafe conditions—or no caregivers at all, as more leave the profession. If hospital executives "lose," financial instability could force service reductions or closures, devastating communities.

The tension is real on both sides. Hospital leaders genuinely struggle with operational viability. Nurses and other frontline staff genuinely face daily violence and incredible workloads. Both sides may be trapped in a system that hasn't adequately considered the human toll and the cascading financial impacts of workplace violence. 

The question isn't whether NYC nurses' demands are reasonable—it's whether we can afford the consequences of not addressing them the right way.

About David Brake

DAVID is the Co-founder and CEO of OPTICS for Healthcare, an AI-first company dedicated to creating safer healthcare environments for staff, patients, and the public. The OPTICS platform was designed to revolutionize how healthcare organizations approach facility assessments, enabling them to conduct comprehensive current-state evaluations, generate detailed gap analyses, and develop customized workplace violence policies and action-specific operational playbooks.