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Thousands of nurses tired of working with too many patients will walk out of hospitals in a 4-state strike

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As the autoworker strike continues to garner national attention, nurses across the US are planning a strike of their own.

More than 6,500 nurses in hospitals around California, Arizona, Florida, and Illinois are expected to go on strike today. The walkout would be the first nurse strike in Arizona and the first hospital registered-nurse strike in Florida.

Nurses who are part of the National Nurses United union are asking for better nurse retention and nurse-to-patient ratios. Most nurses who will be participating in the strike are employed with Tenet Healthcare, a multinational health-services company that operates 65 hospitals and 500 other healthcare facilities.

Four nurses told Business Insider they had been negotiating with Tenet over their contract for over a year and hadn't received the concessions they're demanding.

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"The strike is first and foremost about patient care and patient advocacy," Dominique Hamilton, a registered nurse at St. Mary's Hospital in Arizona, said. "We want the hospital to invest in the nursing staff, and we want to have more input into the recruitment and retainment of experienced" registered nurses.

In a statement provided to Business Insider, a Tenet spokesman, Allan Koenig, said the company had been negotiating a new contract for the past few months in good faith and was disappointed nurses had chosen to strike. "We value our relationship with all our employees, and we are committed to resolving the contract negotiations," Koenig said.

Nurses who work for the University of Chicago Medical Center plan to strike for five days over nurse-to-patient ratios. These nurses are not affiliated with Tenet but are part of the NNU union. About 2,200 nurses from the University of Chicago are expected to go on strike.

"We're disheartened that we had to get to this point," Sharon O'Keefe, the University of Chicago Medical Center president, said in a release. "We worked long and hard negotiating with the help of a federal mediator and had hoped union leadership would meet us halfway."

Why nurses are going on strike

Unionized nurses say hospitals assign more patients than they can reasonably care for in a day.

Assigning nurses too many patients leads to worse patient care, Linda Aikens, a longtime researcher who is now a professor at the University of Pennsylvania, told Business Insider. Research from Australia suggests that when nurses don't have more than four patients at a time, it can save lives and lead to less readmission.

Yet just 18% of nurses believe their nurse-to-patient ratios — or the number of patients a hospital assigns them — are safe, according to a 2019 survey of Illinois nurses. Plus, nurses burn out quicker when assigned too many patients, which leads to high rates of turnover.

Yajaira Roman, a registered nurse in Florida, says her hospital has nurses working with eight patients in a day.

"Our patient ratio is one of our major issues here — we're asking those numbers be decreased," Roman said, adding: "That way we can give the patient the optimal care they deserve."

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Nursing is one of the fastest-growing professions in the US. While there was once a shortage of nurses, many younger nurses have joined the field, Peter Buerhaus, a professor of nursing at the Montana State University College of Nursing, told Business Insider. The issue, however, is that the average age of a nurse is 51, indicating a lot of experienced nurses are likely to be retiring soon.

Buerhaus said this could lead to a slight decline in patient care.

"The reason why we are striking is because we are advocating for our patients so they can get optimal care," said Gina Rittenhouse, a registered nurse for the San Ramon Regional Medical Center in California. "We want the hospital to take steps to strengthen the recruitment and retention of experienced nurses."

Correction: A previous version of this story said nurses in Texas were going on strike. Though El Paso Nurses plan to hand out flyers and conduct public outreach, they are under contract and cannot legally strike.

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Allana Akhtar was a senior health reporter for Insider, where she covers the emerging wellness industry and general health topics. During the COVID-19 pandemic, Allana wrote extensively about nurses, mask mandates, the vaccine rollout, and disparities in access to health. Her articles include features on nurses needing to re-use PPE in the early days of the pandemic, ones who struggled to get paid time off after getting COVID-19, and those who left bedside care after grueling pandemic working conditions. Allana also spoke to flight attendants and retail workers who faced violence as they enforced mask mandates, and community health workers who said they struggled to receive equitable vaccine access during the initial rollout. Allana now reports on emerging trends within the wellness industry, including the Westernization of indigenous medicine and dangerous wellness trends spread through social media. She also writes about plastic surgery, racial disparities in healthcare, and breaking health news. Allana has won numerous awards for her work, including the Best News Story by the Michigan Press Association in 2015, Best Reporter Covering Nurses in 2019, and the Morris and Lola Wasserstein Award for her contribution to the the University of Michigan's student paper as an Honors student. Before Insider, Allana wrote for USA TODAY, US News & World Report, Money Magazine, Health Magazine, Jalopnik, and more. You can email her at aakhtar@bjinnox.com, call/text her at (646) 376-6058, or follow her on Instagram, TikTok, Twitter, and LinkedIn. Secure tips line: Signal # 248 760 0208'We're grossly unprepared': Nurses share their frustration as the coronavirus spreads with little direction from the government or hospitals on how to mitigate it'Sexy nurse' costumes demean one of the most in-demand professions in American life — and they're a bestseller on Amazon right nowFlight attendants describe 'unprecedented' violence as travel returns and passenger aggression soarsG/O Media fired a queer employee of color who wore crop tops, shorts, and heels to work, violating a brand-new dress code that others say they routinely violated without being punishedContractors at controversial startup Rev say they worked long hours for little pay, feared they could lose their job at any time, and had to transcribe interviews with sexual-abuse survivors without warning