Most people are familiar with the concept of a union-led strike. But in healthcare, many may not realize that strikes can occur here as well, with nursing strikes particularly emerging more and more.
These strikes, often originating from issues with compensation, staffing, and workplace conditions, can have a significant impact on healthcare systems, patients, and staff recruitment. This was recently seen on October 14, 2025, where over 31,000 nurses and other healthcare professionals walked out of facilities in California and Hawaii.
This isn’t an isolated event. In 2025, there have been over 28 healthcare strikes in the U.S. This growing wave of action highlights why it's important to recognize the reasons behind nursing strikes.
Understanding nursing strikes
Nursing unions originated in the 1940s, and the number of unionized nurses has increased over time, with unions now representing nurses in all 50 states. Nursing strikes, which have become more visible in recent years, can present many difficulties.
These strikes are typically the result of various complaints, usually around inadequate staffing levels, unsafe working conditions, or other contract disagreements. The outcomes can vary widely, from short-term work stoppages to prolonged strikes that cause a significant disruption of healthcare services.
In 2024 alone, nursing strikes occurred in New York, California, Hawaii, Oregon, Illinois, Michigan, and other states. Some of these states experienced multiple strikes.
Why nurses strike
Nursing strikes don’t happen out of nowhere. They’re often the result of long-standing issues despite repeated efforts to negotiate or resolve them. Here are some common reasons nursing strikes occur:
1. Unsafe staffing levels
Short staffing is consistently the number one issue behind nursing strikes. And research shows that inadequate nurse-to-patient ratios increase the risk of errors, delay treatments, and compromise care.
The nursing shortage has been an issue for many years and will likely continue to be for some time. Factors such as an aging population, increased healthcare needs of the population, and retirement all contribute to this shortage, and retention is often affected. Nurses are often forced to work through breaks or stay long after their shifts end just to ensure patients are safe. Over time, this becomes unsustainable.
2. Burnout and moral injury
Nursing is an emotionally and physically demanding profession, which can lead to burnout and moral injury. These are real problems in the workforce, and keeping nurses in their positions in high-stress environments becomes difficult. These factors, combined with staffing issues, compound and make burnout and moral injury even more difficult problems to solve.
In the Nurse.com Nurse Salary and Work-Life Report, 59% of nurses said they experienced burnout within the last two years, while 24% said they experienced moral injury or ethical dilemmas. The emotional toll of being unable to meet patients' needs can be devastating. Nursing strikes are sometimes the only way nurses feel heard when internal advocacy efforts fail.
3. Wage stagnation and benefit cuts
Contracts between a nurse union and the healthcare system often address things such as compensation, benefits, and staffing ratios. Disagreements between healthcare systems and nursing unions can escalate into strikes, disrupting healthcare operations and possibly affecting patient care.
While inflation rises, nurses in different regions are seeing stagnant wages, cuts to retirement benefits, and increased healthcare premiums. Many strikes are a response to financial proposals that seemingly undervalue nurses’ work and fail to reflect the increasing demands of the job.
Nurse.com’s report highlighted this, showing that 34% of nurses were dissatisfied or very dissatisfied with their current salary. This growing dissatisfaction is driving more nurses to speak out, calling for fair pay that matches their skills and keeps pace with the growing cost of living.
4. Unsafe work environments
According to the American Nurses Association, two nurses per hour are assaulted in acute care settings. And in Nurse.com’s report, 64% of nurses said they were subjected to verbal abuse by a patient or family member.
Workplace violence, bullying, incivility, lack of support staff, and forced overtime are some of the major causes of unsafe work environments and some reasons nurses cite when voting to strike. These aren’t just an inconvenience. They can lead to medical errors and staff injury.
5. Lack of respect or voice
Nurses are highly trained professionals, yet many feel they’re excluded from decision-making processes that directly affect patient care. Our report highlighted that 54% of nurses feel unheard, which has negatively impacted their mental health. Striking is often a last-resort attempt to gain a seat at the table and demand a voice in policies and workflows.
Nurses want to feel like a valued part of the healthcare system. Fostering strong relationships between healthcare facilities and nursing staff is one way for this to happen. Open communication and encouraging collaboration can improve nurse satisfaction and may reduce the likelihood of strikes.
How strikes affect nurses and patient care
Going on strike is never an easy decision. Many may worry about their patients, professional reputation, or even job security.
Here’s what you should know:
- Striking doesn’t mean abandoning patients. Notices are typically provided in advance (often five to 10 days), giving employers time to plan coverage.
- It often leads to better contracts. Strikes can result in improved staffing ratios, better pay, and safer conditions.
- It shows collective strength. Many patients and communities recognize that nurses are fighting not just for themselves, but for safer, better care.
How nurses can drive change
While strikes are powerful tools, some nurses may seek change through other means. Here are some other proactive ways to make a difference:
- Get involved in shared governance or nurse councils at your facility.
- Advocate for legislation like mandated staffing ratios and workplace violence prevention laws.
- Support nursing organizations that lobby for change at the state and national levels.
- Speak up, report unsafe practices, and hold leadership accountable.
Final thoughts on nursing strikes
The frequency of nursing strikes reflects a growing awareness that the current system often fails nurses and patients alike. As frontline caregivers, nurses have unique insight into what needs to change, and the power to make it happen. Whether through legislative action or speaking up at the bedside, your voice matters.
