On February 17, 2026, Lizette Rivera did not clock in for her regular shift in the ICU at West Anaheim Medical Center in Anaheim, California. Instead, she joined her colleagues on the picket line. It\u2019s a decision that the registered nurse (RN) doesn\u2019t take lightly.<\/p>\n
\u201cNobody ever wants to strike,\u201d Rivera said. \u201cIt\u2019s something that we try to avoid at all costs\u2026we always hope that we can settle something before having to strike.\u201d<\/p>\n
Nurses have been bargaining with West Anaheim Medical Center for a year with no resolution to their concerns about patient care, safe staffing, and retention and recruitment, leaving RNs feeling like a strike was their only option.<\/p>\n
\u201c[Unsafe staffing levels] means that patients aren\u2019t always getting optimal care,\u201d Rivera said. \u201cAppropriate staffing, competitive wages, and competitive benefits would make nurses feel acknowledged, make them feel\u2026appreciated and make them want to stay for the long term and build a career.\u201d<\/p>\n
About Medscape Data<\/p>\n
Medscape continually surveys<\/a> physicians and other medical professionals about key practice challenges and current issues, creating high-impact analyses. For example, the Future of Nurse Unions Report 2025<\/a> found that:<\/p>\n About 14% of the nurses surveyed are union members.47% of nurses in the survey said unions were very effective or effective in representing their interests.More than 42% of surveyed nurses expect unionization to increase over the next 5 years.Behind the Picket Lines<\/p>\n Rivera is not alone on the picket lines. In January of this year, 30,000 nurses walked off the job at Kaiser Permanente<\/a> facilities in California and Hawaii and 15,000 nurses went on strike<\/a> in New York City. Low wages and high turnover have been pervasive issues, leading to unsafe staffing levels and concerns about patient safety in the nurse\u2019s view. In fact, 68.3% of nurses reported<\/a> that there were not enough staff and 77.3% cited workloads that were unsafe for patients.<\/p>\n Rivera received 6 weeks of training when she joined one of the highest-admitting units at West Anaheim Medical Center in 2024. Within 5 months, she was promoted to charge nurse and started training other nurses \u2014 and she was still a recent nursing school graduate.<\/p>\n \u201cIt\u2019s not an appropriate assignment,\u201d she said. \u201cHaving competitive wages and benefits would allow us to retain our nurses rather than have them come in, get minimal experience, and move on to hospitals with better options.\u201d<\/p>\n The impact of low wages, high turnover, and unsafe staffing levels are visible at the bedside and have been linked to poor patient outcomes, including higher risk for preventable infections, falls, and deaths, according to Linda H Aiken, PhD, RN, professor and founding director at the Center for Health Outcomes and Policy Research at the University of Pennsylvania in Philadelphia. These issues are at the root of nursing strikes.<\/p>\n \u201cNurses don\u2019t strike unless they believe their patients are unsafe,\u201d said Aiken. \u201cAnd they strike as a last resort.\u201d<\/p>\n Despite persistent concerns, only two states \u2014 California and Oregon \u2014 have enacted minimum nurse staffing requirements. Aiken noted that the lack of policy guardrails in other states allows unsafe staffing levels to persist and is among the reasons that nurses continue to strike.<\/p>\n Picket Lines and Patient Care<\/p>\n The nurses at West Anaheim Medical Center went on strike in August 2025. The walkout<\/a> was an effort to secure a contract that addressed high turnover, and included improved efforts to attract and retain nursing staff, and required strict adherence to nurse-to-patient ratio requirements.<\/p>\n \u201cWe didn\u2019t want to strike,\u201d Rivera added. \u201cWe were on strike for 1 day to show [the hospital] that we care and we want the attention from management to take us seriously.\u201d<\/p>\n Hospital systems have called nursing strikes \u201cunnecessary [and] disruptive\u201d and referred<\/a> to the RNs requests as \u201cextreme economic demands\u201d that put patients at risk. But RNs do think about how strikes affect their patients; awareness of care disruptions is among the reasons that nursing strikes tend to be time-limited, according to Aiken.<\/p>\n \u201cNurses only strike when it\u2019s absolutely necessary, and they try to keep the time out to a minimum,\u201d Aiken told Medscape Medical News.<\/p>\n