Nurses on strike: The impact on patient care and safety


​A series of nurse strikes at major U.S. health systems ended Monday, some before they had even begun, though the potential for thousands of nurses to be off the job raised concerns about the impact of such strikes on patient care and patient safety.

The jury is still out on the issue, according to an article from Minnesota Public Radio, but a 2012 review of 50 nursing strikes over the course of 20 years in New York found that the likelihood of readmissions and patient death both increased when a strike occurred. However, the four strikes that ended this week were not analogous to those studied in the New York case, according to MPR, as the average strike in that study lasted longer than a month.

Hospitals will typically replace striking nurses with temporary or replacement nurses. Although staff nurses will argue that the replacement nurses endanger patient safety because they aren't familiar with the hospital's protocols, procedures and equipment, hospital management will say union nurses endanger patients first by going on strike, Jon Christianson, a professor at the University of Minnesota's School of Public Health, told the publication.

At Allina Health in Minneapolis, nurses planned a seven-day strike and returned to work Sunday, according to a second MPR article. Over the course of that week, more than 4,800 staff nurses were replaced by 1,400 temporary workers. While full-time staff at Abbott Northwestern Hospital lin Minneapolis recieve more than a month of training, according to MPR, their temporary replacements saw just days of training before they went to work.

Tracy Mitcham, one of the replacement nurses, told the Minneapolis StarTribune that many of the replacement nurses are not experienced enough or were placed in units where they had no training. “There are some nurses working out of their scope of practice that are completely lost,” Mitchum told the newspaper. She left her role as a replacement and joined the picketers, according to the article.

The Minnesota Nurses Association echoed Mitchum's concerns, according to the article, but an Allina spokesman said that no threats to patient safety were found during the course of the strike.

Joanne Spetz, a professor in the School of Nursing at the University of California in San Francisco, told MPR that it's hard for replacement nurses to provide the same level of care, as they're new to the layout and protocols of the hospital. The difference may not be huge, she said, but it is noticable. "You know, if you had a choice of having your knee replacement now or waiting until the strike is over, you may as well wait," she told MPR. 

Nurse strikes at Allina Health in Minnesota, Brigham and Women’s Hospital in Massachusetts and Kaiser Permanente’s Los Angeles Medical Center were all coordinated by the same national labor union, National Nurses United, according to The Boston Globe. A fourth possible strike was also averted last week, according to the Santa Cruz Sentinel, at Watsonville Community Hospital in California.

- read the first MPR article
- read the second MPR article
- check out The Globe article
- view the Sentinel coverage