Lead: On Wednesday, Feb. 11, 2026, nurses represented by the New York State Nurses Association (NYSNA) at NewYork-Presbyterian voted decisively to reject a tentative three-year contract, extending a strike that began on Jan. 12 to 31 days. Out of roughly 4,200 eligible voters, 3,099 opposed the deal while 867 supported it, according to union tallies. The rejection contrasts with ratifications at other systems and deepens a rift between rank-and-file members and NYSNA leadership. The union said the unfair-labor-practice strike and bargaining will continue.
Key Takeaways
- Vote outcome: Approximately 4,200 NewYork-Presbyterian nurses were eligible; 3,099 voted to reject the tentative agreement and 867 voted to approve it.
- Strike duration: Nurses have been on strike since Jan. 12, 2026; the action reached 31 days on Feb. 11, 2026.
- Contrasting ratifications: Nurses at Mount Sinai, Mount Sinai Morningside and West, and Montefiore approved contracts by margins of 87%, 96%, and 85%, respectively, and plan to return to work this weekend.
- Contract terms: The tentative NYP deal matched a 12% salary increase already secured at other systems but did not include the explicit ratio-enforcement language those hospitals’ contracts contained.
- Member unrest: More than 1,500 nurses signed a petition pressing for a formal disciplinary review of NYSNA’s top leadership and demanding a full hearing open to members.
- Financial and operational impact: Hospitals collectively spent about $100 million on travel nurses during the strike; elective procedures were canceled and patients were redirected.
Background
The work stoppage began on Jan. 12, 2026, as nurses across four major New York hospital systems sought enforceable nurse-to-patient ratios and other protections they say are necessary for patient and staff safety. Over six months of bargaining and intermittent actions preceded the coordinated strike; NYSNA argued it had extracted concessions on pay and staffing commitments through mediated talks. Mount Sinai and Montefiore negotiated deals earlier that included language the union called robust on staffing ratios; those contracts set a precedent activists pointed to in demands at NewYork-Presbyterian.
Union governance at NYSNA includes executive committees at each hospital made up of rank-and-file members who participate directly in negotiations and local decision-making. At NewYork-Presbyterian, that executive committee had rejected the mediator’s proposal before leadership moved to put the tentative agreement to a membership-wide vote. The hospital system said it accepted the mediator’s proposal on Feb. 8 and urged members to ratify it as a path back to work.
Main Event
The membership vote at NewYork-Presbyterian concluded on Wednesday evening; the margins favored rejection by more than three to one. Nurses at other systems concluded separate ratification processes the same day, with Mount Sinai campuses and Montefiore voting overwhelmingly to approve their deals and signalling a near-term return to staffing normalcy at those sites. NYSNA announced the continued unfair-labor-practice strike at NewYork-Presbyterian following the tally.
Tensions spilled into open protest hours before the vote count was announced. More than 50 nurses marched from Macy’s on 34th Street to NYSNA’s Midtown headquarters to deliver a petition demanding a disciplinary investigation into top union officials and a transparent hearing for members. Petitioners said the executive director and president of NYSNA directed a vote that local committees had already declined to endorse.
Union leaders Nancy Hagans (president) and Pat Kane (executive director) declined to meet with the small delegation at the union office, according to participants; NYSNA public statements emphasized the importance of letting members see tentative agreements and vote. A NewYork-Presbyterian spokesperson, Angela Karafazli, said the hospital was “disappointed that our nurses did not ratify the mediator’s proposal, which we accepted on Feb. 8,” and that the system was willing to honor the rejected proposal for reconsideration.
Analysis & Implications
The wide rejection at NewYork-Presbyterian highlights a split between local bargaining committees and national or state-level union leadership. When rank-and-file representatives feel bargaining outcomes lack key protections—here, enforceable staffing-ratio language—they may view dollar-based gains, like a 12% raise, as insufficient. That divergence strains union governance and could prompt renewed internal processes to reconcile member demands with leadership strategy.
For the hospital system, the vote prolongs staffing and financial strains. Hospitals redirected patients and canceled elective procedures during the work stoppage and together spent roughly $100 million on travel nurses; a continued strike risks additional operational disruption and costs. Clinically, nurses cite concerns that staffing shortfalls endanger patient care and staff wellbeing, making staffing language not merely contractual but operationally consequential.
Politically and legally, the episode raises questions about union democracy and oversight. Members’ demands for an independent review or a hearing suggest potential challenges to leadership legitimacy if mechanisms for internal accountability are limited or unclear. At the same time, the hospital’s offer to honor the proposal for reconsideration opens a narrow path to settlement, but only if members and leadership can bridge trust gaps about enforcement and implementation.
Comparison & Data
| Hospital/System | Vote Result (Approve % or counts) | Immediate Outcome |
|---|---|---|
| NewYork-Presbyterian | 3,099 reject — 867 approve (approx. 4,200 eligible) | Strike extended; bargaining continues |
| Mount Sinai (campuses) | Approved — 87% reported | Nurses to return to work this weekend |
| Mount Sinai Morningside & West | Approved — 96% reported | Nurses to return to work this weekend |
| Montefiore | Approved — 85% reported | Nurses to return to work this weekend |
The table shows divergent membership decisions across the four systems. While the pay element—a 12% aggregate salary increase—was common to the tentative agreements, the presence or absence of explicit ratio-enforcement clauses appears to have been decisive for NewYork-Presbyterian nurses. The financial toll on hospitals—estimated at roughly $100 million for supplemental staffing—underscores why administrators sought rapid settlements, but cost relief alone did not secure ratification at NYP.
Reactions & Quotes
Union rank-and-file and hospital management offered sharply different public framings. Nurses delivering the petition framed the vote process as top-down and rushed; union leadership framed member voting as the democratic mechanism to conclude talks and restore staffing.
“We believe all striking nurses deserve to see the details of their tentative agreements and get the opportunity to vote on whether to ratify a new contract.”
Nancy Hagans, NYSNA (union statement)
Hagans’ statement emphasized member voting rights as justification for proceeding. Other nurses expressed betrayal and accused leadership of siding with management.
“Unfortunately now we’re at a point in which our union’s senior leadership…have sold us out to management.”
Esteban Barrena, NewYork-Presbyterian nurse
From hospital leadership, the tone was conciliatory but firm about having accepted the mediator’s proposal.
“The past several weeks have been challenging…thank you again to everyone who played a role either big or small to help us navigate these challenges.”
Dr. Brendan Carr, Mount Sinai CEO (staff memo)
Unconfirmed
- Whether NYSNA has an established mechanism that can produce a timely, independent disciplinary hearing with binding authority over its president and executive director remains unclear.
- The precise membership breakdown of the 1,500-plus petition signers by hospital or unit was not publicly documented at the time of reporting.
- It is not yet confirmed whether NewYork-Presbyterian’s offer to “honor the rejected proposal for reconsideration” would include new enforcement language or legal guarantees beyond the original mediator text.
Bottom Line
The NewYork-Presbyterian rejection is a pivotal moment in a months-long dispute over staffing protections and bargaining authority. While comparable pay increases were on the table systemwide, nurses at NYP prioritized enforceable ratio language and local job security provisions—issues they judged unresolved by the mediator’s offer.
Resolving the impasse will require both renewed bargaining and an internal reconciliation within NYSNA to restore member trust. Observers should watch three variables closely: whether NYP and NYSNA can negotiate enforceable ratio enforcement or oversight mechanisms, whether an internal union inquiry satisfies petitioners, and whether continued labor action leads to further operational or political pressure on the hospitals and mediators.
Sources
- THE CITY (local news report)
- Gothamist (local news — reported email materials and coverage)
- New York State Nurses Association (NYSNA) (union official site)