As the ongoing nursing shortage continues to strain hospitals across the United States, recent labor developments in New York City are sending a clear message: nurses are demanding improved working conditions, safer staffing levels, and long‑term stability. For hospital systems that rely on international nurses and visa sponsorship to close critical staffing gaps, these changes have serious implications.
At VisaMadeEZ, an immigration law firm focused exclusively on helping healthcare organizations hire international nurses, we closely monitor labor trends that affect nurse staffing, recruitment, and compliance. The latest news from New York City highlights how contractual changes can intersect with international nurse recruitment strategies and why hospitals need to align their workforce planning with both union dynamics and immigration law.
Below is a breakdown of the developments and what they may mean for U.S. hospitals, especially those considering global nurse recruitment to stabilize their workforce.
Safety-Net Hospitals in NYC Avert Strike with Tentative Agreements
Nurses at seven New York City safety‑net hospitals have withdrawn their 10‑day strike notices after reaching tentative contract agreements with their employers. These facilities serve some of the city’s most vulnerable patient populations and often face financial challenges, high acuity, and persistent staffing shortages.
The hospitals where strike notices have been rescinded and tentative agreements reached include:
- Flushing Hospital Medical Center
- Maimonides Medical Center
- One Brooklyn Health’s Interfaith Medical Center
- One Brooklyn Health’s Kingsbrook Jewish Medical Center
- Richmond University Medical Center
- The Brooklyn Hospital Center
- Wyckoff Heights Medical Center
These institutions are critical safety‑net providers and have historically struggled with staffing pressures. Many of them either currently rely on, or will need to rely on, international registered nurses and visa sponsorship to maintain safe staffing levels in the long term.
Key Contract Provisions: Safe Staffing, AI, Violence Protections, and Pensions
According to the New York State Nurses Association (NYSNA), the tentative agreements include enhanced protections and structural improvements that will affect how hospitals plan and deploy their nursing workforce. The provisions reportedly include:
- Stronger safe staffing measures and enforcement tools
These agreements reinforce nurse‑to‑patient staffing standards and introduce or strengthen enforcement mechanisms. From a workforce planning perspective, this can increase the urgency for hospitals to fill vacancies, including through international nurse recruitment on visas such as the EB‑3 green card or TN (for eligible Canadian and Mexican nurses).
- Protections from workplace violence
Healthcare workplace violence remains a major concern in high‑acuity and safety‑net environments. Enhanced contractual protections may improve retention, but will not completely eliminate staffing needs. International nurses entering the U.S. labor market will expect clear policies and safe working conditions as part of their employment.
- Pension continuity without cuts
Preserving benefits can help with retention of U.S. and foreign‑trained nurses alike. Stable, predictable benefits packages can also make hospitals more attractive employers in a competitive global nursing market.
- Contract language related to artificial intelligence (AI)
The union has emphasized language ensuring that AI tools do not replace bedside care and that a nurse remains physically present for patient care. As hospitals adopt technology to improve documentation or monitoring, these provisions reinforce that human nurses—domestic and international will remain central to patient care delivery.
For healthcare employers, these terms don’t simply affect labor costs. They influence recruitment strategies, timelines, and the volume of nurses needed. Hospitals that plan early and leverage international nursing recruitment can better comply with safe staffing requirements while maintaining continuity of care.
Five Major NYC Hospitals Still Face Possible January 12 Strike
While seven safety‑net hospitals averted a strike, negotiations are still underway at several large institutions where NYSNA-represented nurses could still walk out if no agreements are reached. Thousands of nurses at the following New York City hospitals remain poised to strike:
- BronxCare Health System
- Montefiore Medical Center
- Mount Sinai Hospital
- Mount Sinai Morningside and Mount Sinai West
- NewYork‑Presbyterian Hospital Columbia University Medical Center
These organizations are among the largest employers of nurses in the region and serve as major teaching and tertiary care centers. Many already utilize international nurses, and some sponsor foreign‑educated RNs for immigrant visas to address ongoing shortages.
A potential strike at these institutions could:
- Intensify the demand for travel nurses
- Increase reliance on per diem and agency staff
- Encourage a long‑term pivot toward more robust international nurse recruitment and visa sponsorship (EB‑3, H‑1B where applicable, and other options)
Hospitals that have not yet formalized a global nurse recruitment strategy may find themselves at a disadvantage compared with systems that already maintain stable pipelines of internationally trained nurses.
Northwell Health Hospitals Also Facing Potential Strike
In addition to the New York City institutions above, NYSNA-represented nurses at Northwell Health’s Huntington, Plainview, and Syosset Hospitals (based in New Hyde Park, N.Y.) delivered 10‑day strike notices on January 2. These nurses are also preparing to strike on January 12 if no tentative agreements are reached.
For systems like Northwell Health, which operate across multiple regions and service lines, labor actions may:
- Drive increased competition for local nursing talent
- Make long‑term visa sponsorship of international nurses a more attractive stabilizing strategy
- Require a careful balance between contingency staffing and investments in permanent nurse hires, both domestic and international
Union Perspective: Safety-Net Hospitals “Doing the Right Thing”
NYSNA President Nancy Hagans, BSN, RN a Maimonides nurse has publicly praised the safety‑net hospitals for taking meaningful steps to protect both nurses and patients. She emphasized:
- Guarantees of healthcare benefits for nurses
- Stronger safe staffing standards
- Expanded protections from workplace violence
She also called on New York City’s wealthiest hospitals to follow the lead of these safety‑net facilities.
NYSNA represents more than 42,000 members and is affiliated with National Nurses United, the largest union of registered nurses in the U.S., with over 225,000 members nationwide. As these organizations advocate for improved staffing ratios and better working conditions, U.S. hospitals may increasingly look beyond national borders to meet nurse staffing demands in a sustainable and compliant way.
From an immigration law perspective, this environment reinforces the value of:
- Building longer‑term nurse staffing pipelines through EB‑3 immigrant visas
- Strategically using temporary options (such as TN or H‑1B where applicable)
- Ensuring employment terms for international nurses align with union contracts, fair wage requirements, and federal regulations
How Hospitals Are Responding: Statements from Safety-Net Facilities
Several of the safety‑net hospitals that reached tentative agreements after strike notices were rescinded highlighted ongoing negotiations and a shared commitment to patient care. Their public statements provide insight into how hospitals are balancing labor relations and care delivery:
- Wyckoff Heights Medical Center emphasized that it is “very happy to have avoided a strike” and is “continuing to negotiate actively and in good faith,” while focusing on high‑quality care for the community.
- Maimonides Health stated that it has resolved many key contract issues and is working toward a final agreement that both rewards nurses and recognizes the financial pressures facing safety‑net hospitals.
- Richmond University Medical Center noted that avoiding a strike allows for uninterrupted patient care and reaffirmed its commitment to a fair and sustainable agreement with nurses.
- One Brooklyn Health System described the withdrawal of strike notices as a reflection of progress and reiterated its goal of reaching a “prompt and sustainable resolution” that supports nurses within the realities of a safety‑net budget.
- Flushing Hospital Medical Center confirmed only that the strike notice was withdrawn.
These statements underscore a recurring theme: hospitals are attempting to balance financial constraints with the need to retain and attract nurses in an intensely competitive labor market. International nurses, when properly sponsored and supported, can be a critical component of that balance.
Major Systems Push Back: Joint Statement from Montefiore, Mount Sinai, and NewYork-Presbyterian
In contrast, three of New York City’s largest hospital systems Montefiore Medical Center, Mount Sinai, and NewYork‑Presbyterian issued a joint statement sharply criticizing NYSNA’s decision to proceed with strike plans at their facilities.
They asserted that NYSNA leadership is “abandoning patients in their time of need” and described the decision to strike as “reckless.” At the same time, they stressed that they:
- Are prepared to minimize disruption to patient care
- Will maintain safe, high‑quality care even in the event of a strike
- Urged NYSNA leadership to reconsider but affirmed readiness to care for patients “whatever the duration” of any strike
This type of public conflict can heighten uncertainty for healthcare organizations, especially when combined with chronic staffing shortages and rising patient demand. Many systems are already activating contingency plans that may include short‑term staffing measures and an expanded focus on international nurse recruitment.
Northwell Health’s Contingency Plans and International Staffing
Northwell Health, addressing potential strike actions at Huntington, Plainview, and Syosset hospitals, has stated that it remains hopeful an agreement will be reached but is proactively preparing. The system has:
- Activated a “comprehensive contingency plan” to maintain patient care
- Indicated it does not anticipate disruption due to steps already taken
- Confirmed the hiring of temporary nursing staff from a New York State‑accredited healthcare service agency should a strike occur
While these contingency measures focus primarily on short‑term coverage, they highlight a broader reality: the pool of available local nurses is limited, and the demand for qualified RNs continues to outpace supply.
For many hospitals, especially those in high‑cost, high‑demand markets like New York, international nurse sponsorship particularly via EB‑3 immigrant visas has become an essential part of long‑term staffing strategy. Contingent staffing can bridge gaps, but sustainable solutions often require building a stable base of permanent nurses, including foreign‑trained professionals.
What This Means for Hospitals Considering International Nurse Recruitment
The labor developments in New York City highlight several trends that matter for hospitals nationwide:
1. Safe staffing requirements are tightening.
Union contracts and state laws are increasingly focusing on enforceable staffing ratios. Hospitals that fail to plan for adequate staffing may face not only strikes but also legal and financial penalties.
2. Nurse retention alone is not enough.
Even with improved benefits and working conditions, the supply‑demand imbalance for RNs remains significant. Domestic training pipelines cannot fully meet current and projected needs, particularly for specialized units and safety‑net facilities.
3. International nurse recruitment is becoming more strategic, not optional.
U.S. hospitals that establish structured programs to sponsor international nurses on EB‑3, TN, or other visa categories are better positioned to stabilize staffing and comply with emerging contractual obligations.
4. Immigration compliance must be integrated with labor relations.
Hospitals employing foreign‑trained nurses must ensure that wages, working conditions, and job duties meet both immigration requirements and the terms of any collective bargaining agreement. Failure to align these areas can create compliance risks.
5. Timing is critical.
Immigration processes especially immigrant visas and green cards for registered nursestake time. Hospitals that wait until a crisis, such as a strike or mass resignations, may find that the visa timeline does not align with immediate staffing needs. Early planning is key.
How VisaMadeEZ Supports Healthcare Organizations
VisaMadeEZ is an immigration law firm that focuses exclusively on assisting healthcare organizations with the recruitment and sponsorship of international nurses. We help hospitals, health systems, and long‑term care providers:
- Design long‑term nurse staffing strategies that integrate international recruitment with domestic hiring
- Navigate EB‑3 immigrant visas and other visa options for registered nurses and allied health professionals
- Ensure full compliance with U.S. immigration law, Department of Labor requirements, and union or contractual obligations
- Coordinate with HR, legal, and nursing leadership to create sustainable pipelines of qualified international RNs
In an environment where union negotiations, staffing mandates, and patient demand are all escalating, a well‑planned international nurse recruitment strategy can be the difference between constant crisis staffing and stable, safe operations.
Planning Ahead: Aligning Labor Strategy and Immigration Strategy
The developments at New York City’s safety‑net and major hospital systems illustrate a broader national reality: nursing workforce challenges are not temporary. They are structural and long‑term.
Hospitals that want to:
- Meet safe staffing standards
- Reduce reliance on costly short‑term agency staffing
- Support both domestic and international nurses with fair, stable working conditions
should be proactively integrating immigration solutions into their overall workforce strategy.
If your organization is considering or expanding the hiring of international nurses, VisaMadeEZ can help you understand your options, build a compliant and efficient sponsorship program, and create a long‑term pipeline of global nursing talent.
Need guidance on building an international nurse recruitment program or sponsoring foreign‑educated nurses?
VisaMadeEZ works with hospitals, health systems, and healthcare employers across the U.S. to develop customized immigration strategies that support safe staffing and high‑quality patient care.
Reach out to our team to discuss how we can support your organization’s nurse staffing goals in today’s rapidly changing healthcare and labor landscape.
