Understaffing at NYU Langone Hospital—Brooklyn is putting intensive care patients at risk and violating state law, according to the hospital’s nursing union. 

The union, the Federation of Nurses, said that nurses filed more than 2,000 short-staffing incident reports over 18 months in an Aug. 25 complaint letter to the New York State Department of Health. In response to the letter, department officials visited the facility the following week, but NYU Langone still did not fully address understaffing issues, according to the union. 

The union, a branch of the United Federation of Teachers, represents around 1,000 nurses at NYU Langone. The hospital allegedly only adjusted ratios while investigators were touring units, according to union head Anne Goldman.

“The moment the health department left, so did the ratios,” Goldman said. “They’re not a luxury — they’re essential. As someone who worked in an ICU, if I’m not able to look at your monitor … I can miss your bleeding, I can miss the assessment of your healing. All of that matters, because time-sensitive interventions are critical to the work we do.”

According to union spokesperson Alison Gendar, nurses filed an additional 29 staffing grievances on Aug. 28, while health department investigators were still looking into other areas of the hospital. Investigations at the hospital are ongoing.

The New York State Department of Health did not respond to requests for comment.

Research into lower nurse-to-patient ratios has shown improved patient outcomes, and the nurses’ union at NYU Langone alleged that increased caseloads for nurses have led to increases in nurse turnover and patient injuries. The hospital is projected to have 40% more falls in 2023 than in 2022 — data the union alleges came from the hospital’s internal records.

The hospital denied all allegations in an email to WSN. According to NYU Langone spokesperson Steve Ritea, the union chose to make a public case out of their staffing grievances after walking away from mediation with the university.

“The number of falls, including those with injuries as well as pressure injuries projected in Brooklyn, are actually a fraction of what UFT alleges and has decreased from prior years,” Ritea wrote. “Working with UFT, we were one of the first hospitals to establish staffing ratios in 2016 … Sharing patently false information with the public to advance their own agenda is pernicious, harmful to patients and disingenuous to the entire healthcare community.”

Under a rule approved by the health department on June 29, hospitals must ensure that intensive care units are staffed with at least one registered nurse for every two patients in critical condition. Hospitals must also post and abide by annual staffing plans detailing the expected average number of patients and providers, which are approved by an internal staffing committee and the health department. 

A late 2022 arbitration agreement — a legally binding document for resolving contract disputes — found that NYU Langone had broken nurses’ contracts by understaffing in 2020 and 2021. The agreement also ordered the hospital to meet with the union in late March 2023 to resolve similar outstanding grievances. While the settlement forced NYU Langone to pay $137,500 among 250 nurses, Goldman said that there were thousands of grievances left to address. 

After monthslong negotiation efforts, the union returned to arbitration for the remaining grievances. It hoped that reporting short staffing to the health department would lead to consequences for the hospital and, ultimately, improved patient outcomes.

While NYU Langone has disputed the data cited in the letter, Goldman said that the hospital did not communicate any concerns about the data prior to the publication, which was drawn from reports submitted by nurses and their supervisors, and recorded by the medical center.

The Federation of Nurses has been concerned about short staffing at NYU Langone for years. Its 2016 contract included the first mention of staffing ratios, and its 2018 contract established a 1-to-5 ratio of nurses to patients in medical units. The 2020 and 2022 contracts further solidified staffing as an important issue for nurses, with the latter creating the arbitration board that would eventually rule against NYU Langone. 

Goldman, who has been at the head of negotiations for these contracts, hopes that the union’s yearslong push for enforcement will eventually result in the hospital being held accountable for staffing deficiencies.

“It’s not a quick process,” Goldman said. “I always say it’s like seatbelts. Nobody ever wanted to wear them until you had to, and now you can’t even buy a car without it.”

Contact Tori Morales at [email protected].