On July 8, 2026, 4,000 nurses employed by Boston’s Brigham and Women’s Hospital—including those from the emergency department (ED)—went on strike, concerned about wage stagnation and understaffing. The hospital—which had received 10 days’ warning from the nurses —a legally required amount of notice—hired 1,300 temporary replacement nurses to fill in.

Even so, the hospital might not have run quite as efficiently and effectively as it normally had: A patient had a ‘code blue OB’ and was actively birthing outside the hospital shortly after picketing began and the one of the negotiators for the nurses’ union had to cross the line at the end of the day-long strike to ensure the patient received timely care.¹

Hospital strikes are no longer rare. Though strikes in the United States overall were down nearly 16 percent in 2024, a report from Cornell’s School of Industrial and Labor Relations and the University of Illinois School of Labor and Employment Relations found that work stoppages in the health care industry jumped nearly 60 percent during the same year—and the number of striking workers increased more than 150 percent.^2,3

Emergency departments need to be prepared for workplace walkouts, particularly because some studies have suggested that patient mortality rates rise during hospital strikes. One such report, published in JAMA Network Open in July, found a statistically significant, if modest, increase during a physician trainee walkout in South Korea.⁶ A 2010 analysis that looked specifically at nurses’ strikes—50 of them in New York state—found an increased mortality rate of about 20 percent.⁷

Advance Planning Is Key

Ahead of the unusually lengthy and widespread New York strike, which involved nearly 15,000 nurses across multiple hospitals, one of the affected hospitals, New York Presbyterian (NYP), readied itself for the disruption first and foremost by hiring people to fill in, according to Chris McStay, MD, vice chair of operations in the department of emergency medicine at NYP’s Columbia University Irving Medical Center in New York City.

Dr. McStay

“Our team replaced the entire nursing workforce [that went on strike] with agency or travel nurses,” said Dr. McStay. NYP relied on a large staffing company to hire and onboard the replacements. But the temporary workers also needed to be rapidly oriented to their new environment. To that end, Dr. McStay said, “We deployed some physician assistants to assist new travel nurses with our triage process.”