As the nurses’ strike at New Brunswick’s Robert Wood Johnson University Hospital entered its fourth week United Steelworkers Local 4-200 showed no signs of losing their resolve to holdout for safer staffing levels. Energy remains high on the picket line.

Judy Danella is an RN, and president of USW Local 4-200. Danella told InsiderNJ her members were buoyed by the backing from other healthcare unions and the broader community, including a growing list of supportive elected officials who site the nurses’ heroics during COVID as well as the weaknesses in the healthcare system that became so apparent during the pandemic.

“As of right now, there are no new negotiations scheduled,” Danella said.  “We’ve had a candlelight vigil. The hospital just contracted now for more replacement nurses for the next eight weeks and they are bringing in 300 more. If we had this level of staffing before the strike, we wouldn’t have gone out on strike.”

“As of today, we have not been notified of an upcoming mediation session with the union,” said Wendy Gottsegen, a spokesperson for the hospital, in a statement. “Both parties last met August 16 for approximately seven hours with the assistance of two federal mediators. Unfortunately, there was no progress and no further dates for negotiations have been scheduled by the mediators.”

On Saturday, in Asbury Park, Senator Cory Booker told InsiderNJ “this is not just a strike that’s going to have implications for the one hospital system. This is going to have implications for our whole state and potentially our whole nation.”

“I have reached out to the hospital to talk and let it be known my views on this which is that I support our nurses,” Booker said. “We have got to get them a contract that makes sense amidst a nursing crisis not just in our state but around the country. We hailed them as heroes during the pandemic but when it comes to their compensation, the nursing ratios we’ve got to make sure they are being treated like heroes not just in words but in the kind of contract and living circumstances they have.”

Booker continued. “I have been concerned for a long time. Again, the pandemic revealed a lot of challenges from our nursing homes to our hospitals– a lot of the crises we have with supporting the kind of workforce [we need]. It’s just not about them. It’s also about patient [care] quality. It’s patient safety and more…. That’s why it was important for me to come forward quickly and support the nurses.”

At one point during the pandemic, New Jersey had the highest per capita COVID death rate in the world. As of this past spring, the state recorded over 36,000 with 1 in 246 state residents dying of COVID.

Not being prepared for the pandemic had some real consequences, particularly for healthcare professionals who bore the brunt of inadequate infection control in congregate care setting and in hospitals. The Guardian newspapers and Kaiser Health News reported that 3,600 hospital workers died in the first year of the pandemic due to their occupational exposure. 700 of them were from New York and New Jersey. Two-thirds of them were people of color.

“I think when COVID hit everybody was very much surprised and at that point many nurses left the profession—they were afraid of the COVID disease,” Danella said on WBAI earlier this month. “It was an unknown disease and many of them said ‘I don’t want to expose myself or my family to this disease.’”

Last year, the Brookings Institute reported that perhaps as many as four million workers have been sidelined by long COVID. In 2020, the State of New Jersey extended to nurses and other essential workers a Workers Compensation presumption that if they contracted COVID it would be considered a consequence of their workplace exposure.

“The impact of long COVID – and its sometimes-disabling symptoms that can persist for more than a year — has worsened health care’s already severe workforce shortage,” reported WebMD, earlier this year. “Hospitals have turned to training programs, traveling nurses, and emergency room staffing services. While the shortage of clinical workers continues, support workers are also in short supply, with no end in sight.”

RWJUH in New Brunswick is one of a dozen acute care hospitals in the RWJBarnabus system that has a partnership with Rutgers University which makes it the state’s largest academic healthcare system. It has 38,000 employees and $6.6 billion in revenue. RWJUH is one of the state’s three Level 1 Trauma centers which means it handles the most seriously ill patients from several counties.

The system’s recently retired CEO and President Barry Ostrowsky earned $16 million in the second year of the pandemic, making him the highest paid hospital executive in the New York area, according to Crain’s New York.

Last week, Booker and Sen. Robert Menendez wrote Mark Manigan, RWJ Barnabas Health’s president and CEO encouraging him “to move quickly to come to a good faith agreement that provides the nurses with safe standards, quality working conditions, affordable health care, and living wages that support the employees, the hospital community, and your patients.”

The Senators’ letter continued. “From our conversations with nurses, we have come to understand that one of the key issues in this contract dispute is over safe staffing that is jeopardizing quality care. We support a path forward that ensures a collaborative relationship with nurses and honors the dignity of their work, recognizes their right to a safe workplace, and rewards their dedication to the individuals they serve.”

Menendez and Booker urged “a quick resolution” to “ensure that Robert Wood Johnson retains a highly skilled and well supported workforce, but also that the 1,700 devoted nurses can return to their critical work with minimal disruptions to their wellbeing, the wellbeing of their families, and the wellbeing of their communities.”

Back in the spring, HPAE, the state’s largest nurses’ union, with the strong support of the NJ AFL-CIO, launched a statewide campaign to get Trenton to enact nurse-to-patient staffing ratios as was done in California in 2004. In the years since, peer reviewed studies documented that California saw greatly improved patient outcomes, workplace safety, as well as nurse retention.

In a landmark study, six years after California enacted the measure, Dr. Linda Aiken with the University of Pennsylvania School of Nursing found the mandatory staffing ratios had significantly improved patient outcomes and to promote nurse retention. The analysis used data from California and Pennsylvania as well as New Jersey where there were no such nursing standards.

“California hospital nurses cared for one less patient on average than nurses in the other states and two fewer patients in medical and surgical units,” according to the study. “Lower ratios are associated with significantly lower mortality. When nurses’ workloads were in line with California-mandated ratios in all three states, nurses’ burnout and job dissatisfaction were lower, and nurses reported consistently better quality of care.”

The strike comes at time as a national healthcare staffing crisis that’s particularly pronounced in the Northeast. A national survey predicted New Jersey would be shy of 11,400 nurses by 2030, ranking it in the top ten states with a severe shortfall. Also, in that crisis mix Connecticut (27,926), New York (18,784), and Pennsylvania (16,430).