The nurses, represented by United Steelworkers (USW) Local 4-200, walked out over what they called unsafe and unfair labor practices. The central demand was enforceable nurse-to-patient staffing ratios. Wages and rising insurance costs were also on the table, but staffing drove the dispute from the start.
What the Contract Includes
The ratified agreement commits RWJUH to hire 70 more full- and part-time nurses and adds new enforcement guidelines for staffing levels. Nurses receive a raise of 3.5 percent in each of the three contract years, roughly tracking inflation at the time. The deal also caps insurance costs and adds public health emergency planning language.
USW Local 4-200 President Judy Danella told members the bargaining committee unanimously recommended ratification. "This agreement was hard-fought, but our sacrifice ultimately paid off with a fair contract that addresses nurses' most urgent concerns," she said.
Why It Took Four Months
This was the first strike by RWJUH nurses since 2006. Negotiations were tense throughout. One month into the walkout, the hospital canceled the health insurance of all 1,700 striking nurses, though it remained self-insured. Nurses could continue coverage through COBRA, but the move hardened the dispute.
"It wasn't just a walkout, it was a sacrifice," said Hummad Syed, BSN, RN, an ICU nurse at RWJUH who struck from day one. "We were away from the bedside for 125 days, without pay, without health insurance. We spent our summer on the picket line."
Nurses were barred from working anywhere across the 11-hospital RWJ Barnabas system during the strike, so many picked up per diem or contract shifts elsewhere. In late October, Senator Bernie Sanders held a Senate Health, Education, Labor and Pensions Committee hearing near the picket line and spent much of it criticizing hospital leaders, who declined to attend.
Hospital administrators maintained that staffing was already strong. "Staffing at RWJUH is not just proper, but among the highest in New Jersey," spokeswoman Wendy Gottsegen said in October, citing 170 more nurses on staff than required and proposals that met or exceeded California's staffing levels. The union disagreed, and the strike continued until staffing enforcement was written into the contract.
The strike cost RWJ Barnabas Health more than $120 million in replacement labor.
What Comes Next
RWJUH nurses say they plan to keep pushing for staffing standards at the state level, organizing support for legislation (Assembly Bill A4536 and Senate Bill S304) that would set minimum registered nurse staffing standards across the state, such as one nurse for every five patients on a medical or surgical unit and one for every two in critical care (New Jersey Legislature).
"RWJUH backed us into a corner, and it unleashed something in us," Syed said. "We've realized that unions are only as powerful as their members, and ours has come out significantly stronger."
Frequently Asked Questions
How long did the RWJUH nurses strike last? It began on August 4, 2023, and ran more than four months. Nurses ratified a three-year contract on December 15, 2023, and returned to work by January 1, 2024.
How many nurses went on strike and how did the vote go? About 1,700 nurses, represented by United Steelworkers Local 4-200, walked out. They approved the final contract by an 88 percent vote.
What was the strike actually about? Enforceable nurse-to-patient staffing ratios were the central demand. Wages and rising insurance costs were also on the table, but staffing drove the dispute from the start.
What did the nurses win? The contract commits the hospital to hire 70 more full- and part-time nurses, adds staffing enforcement language, gives 3.5 percent raises in each of three years, caps insurance costs, and adds public health emergency planning.
Is New Jersey passing a staffing ratio law? Not yet. Nurses are backing state legislation (Assembly Bill A4536 and Senate Bill S304) that would set minimum RN staffing standards, but those bills have not become law.