Nursing Strikes in Several States - California, HI, and New York. What it all means and why it's important.

Right now, nursing labor disputes across New York, California, and Hawaii feel less like isolated events and more like a system-wide stress test. When multiple regions are striking or preparing to strike at the same time, it’s not just a contract dispute anymore when nurses are already stretched thin.

In New York, the strike is no longer theoretical. As of mid-January 2026, thousands of nurses represented by the New York State Nurses Association walked out of multiple hospitals across New York City, including facilities within the Mount Sinai, Montefiore, and New York-Presbyterian systems. The strike began on January 12 and has continued into its second week, with negotiations restarting intermittently but without a comprehensive resolution. Nurses have been vocal about staffing ratios, workplace safety, and benefits, while hospitals maintain that they are continuing operations through the use of temporary replacement staff. From the outside, the lights are on and the doors are open—but anyone who has ever worked a unit held together with travelers and emergency staffing knows that “open” is not the same as “stable.”

Meanwhile, California and Hawaii are bracing for what could become one of the largest coordinated healthcare strikes in recent years. Tens of thousands of nurses and healthcare professionals at Kaiser Permanente facilities have issued notice of an open-ended strike scheduled to begin January 26, 2026. The planned walkout would affect hospitals and clinics across both states, with union leadership citing staffing levels, access to timely care, wages, and bargaining practices as core issues. Kaiser, on the other hand, has publicly framed the dispute as largely economic and has emphasized its contingency plans to maintain patient safety if the strike proceeds. At the time of writing, this situation remains a “strike pending” scenario—no resolution has been announced, and both sides are digging in.

As these disputes unfold, one of the most emotionally charged questions nurses face is whether to cross the picket line. This decision is rarely philosophical and almost never simple. Nurses who cross often do so because they need immediate income, or feel a deeply ingrained ethical pull to remain at the bedside. For some, strike pay does not come close to covering the cost of living, particularly in high-cost regions like New York City, California, and Hawaii. In those moments, the decision feels less like a labor stance and more like choosing between oxygen and principle.

At the same time, crossing a picket line can carry significant personal and professional consequences. Relationships with colleagues may fracture in ways that do not easily heal once the strike ends. Union members who cross may face internal disciplinary processes depending on the union’s bylaws. There is also the patient safety reality that replacement staffing, while legally permissible and operationally necessary for hospitals, often lacks unit-specific familiarity. Policies, workflows, and subtle patient cues can be missed. From a nursing standpoint, the patient may technically be monitored, but the margin for error grows thinner.

For nurses weighing this decision, it can help to think in familiar clinical terms. Assessment means taking an honest look at finances, family responsibilities, and professional risk. Diagnosis means naming what is truly driving the decision—fear, necessity, ethics, or exhaustion. Planning involves deciding how to act intentionally rather than reactively, and evaluation comes later, when the dust settles and lessons are learned. There is no universal right answer, only informed ones.

Behind all of this is a question hospitals rarely want discussed publicly: what do strikes actually cost medical centers? The answer is far more complex than “higher wages.” During active strikes, hospitals may pay replacement nurses rates reported as high as several thousand dollars per week per nurse, particularly in high-demand urban markets. I read $9,000/week. That figure does not include agency fees, travel and housing expenses, onboarding costs, or the overtime required for managers and supervisors to maintain coverage. Elective procedures, which are often the financial backbone of hospital operations, may be postponed or cancelled due to staffing instability, further eroding revenue.

Operational inefficiencies also multiply. Running a hospital with large numbers of temporary staff slows throughput, increases reliance on workarounds, and diverts leadership attention away from quality improvement and risk reduction. Even when adverse events do not make headlines, near-misses and system strain quietly accumulate. In past large-scale strikes, replacement staffing costs alone have reached tens of millions of dollars per week, offering a sobering reference point for how quickly financial losses can escalate. Why don’t they just pay nurses a fair wage rather than paying these exacerbated costs?

The hidden costs may be even greater. Prolonged labor disputes can damage a hospital’s reputation, make recruitment more difficult, increase long-term reliance on agency staff, and deepen turnover once the strike ends. In healthcare, winning a contract battle while losing the trust of your workforce is a short-term victory with long-term consequences.

As of now, New York nurses remain on strike, while California and Hawaii nurses are watching the calendar inch toward January 26. For nurses across the country, these events are being closely watched not just as labor actions, but as signals of how much strain the healthcare system can absorb before something gives. Like any patient under prolonged stress, the system may keep compensating—until it can’t.