On Wednesday, nurses at New York-Presbyterian Hospital overwhelmingly rejected the sellout contract which leaders of the New York State Nurses Association (NYSNA) tried to impose through an entirely illegitimate vote. Out of approximately 4,200 NewYork-Presbyterian (NYP) nurses who were eligible to cast ballots, 3,099 voted to reject the deal and 867 voted to approve it.

The rebuke to the NYSNA bureaucracy is all the more signficant because union officials sought to isolate the NYP nurses from their more than 10,000 counterparts at the Mt. Sinai and Montefiore hospital systems, who were part of the powerful month-long strike. NYSNA officials claimed their deal was ratified by a wide margin by nurses at the other hospital systems during voting Tuesday and Wednesday.

But those snap votes were far from free and democratic and nurses are questioning the reported results. NYSNA officials conducted voting online through the SurveyMonkey platform. This system is completely unsuitable for formal, legally binding voting procedures because it lacks the necessary security, auditability, and voter verification controls, with no independent oversight. At Mount Sinai, exactly 3,000 “yes” votes were reported—a suspiciously round figure.

At NYP, top NYSNA officials blatantaly violated the union’s bylaws by holding the vote over the heads of the local executive committee, which had previously rejected the deal. The three-year proposal does not even come close to meet the members’ central demands on staffing, wages and healthcare coverage.

Responding to the NYP nurses outrage, NYSNA President Nancy Hagans and Executive Director Pat Kane tried to strong-arm nurses to ratify the deal in a video and email sent to them before the sham vote.

With the height of cynicism, Hagans declared, “As a democratic, member-led union that responds to its members, we are moving forward with a vote on tentative contracts at all four hospitals with the goal of returning all nurses to work as soon as possible.” Kane added arrogantly, “The simple fact is that we’ve reached the end of negotiations.”

At a protest held outside the NYSNA headquarters Wednesday, a NICU nurse with 20 years at NYP told the WSWS said the vote is “illegal” because “our executive committee did not sign off” on the deal. Top NYSNA officials, another nurse said, “went above members that were elected that represent our interests to force a vote,” adding that the move was “a violation of their own bylaws.”

Rank-and-file nurses have delivered a blow to the union bureaucracy, hospital management, Democratic Governor Kathy Hochul and New York City Mayor Zohran Mamdani, who had also conspired to end the strike. The walkout has inspired a mood of resistance from workers throughout the city, dominated by a corporate and financial oligarchy which claims there is no money to address workers’ most elemental needs.

But to win their strike, rank-and-file nurses must take the conduct of the battle into their own hands. This means demanding the removal of all union officials who conducted this stab in the back and the establishment of a rank-and-file strike committee, consisting of the most militant and trusted hospital and clinic floor nurses, to oversee negotations and the conduct of the strike.

This perspective was raised at Tuesday’s online meeting sponsored by the New York Rank-and-File Healthcare Workers Committee. Held the night before the vote, the meeting adopted a resolution calling on nurses to reject the sellout contracts and the NYSNA bureaucracy’s anti-democratic moves, and continue the strike under new leadership organized from below.

A rank-and-file strike committee of NYP nurses should call on their co-workers at the other hospitals to reject the NYSNA bureaucracy’s betrayal and resume the strike until all nurses win their legitimate demands. No contract can be considered binding unless nurses receive the full text and adequate time to discuss, and the vote is overseen by workers to ensure its integrity.

Nurses must move quickly to hold mass meetings to elect representatives to a network of rank-and-file strike committees at all four hospitals. This is the necessary first step to continue the strike and prepare for its expansion to the other 11 hospitals which NYSNA refused to call out on strike.

Appeals must be made to the working class across New York City and the country, including by sending out flying pickets to transit worker locations, UPS, Amazon and other major workplaces. And New York nurses must establish lines of contact with the striking Kaiser Permanente workers and other healthcare workers to coordinate a national movement in defense of public health.

The conflict is an open confrontation between the rank and file and the union apparatus, which acted in defiance of the will of the membership, aligning itself with management’s demand to shut down the strike.

It is also a direct conflict with the Democratic Party, including its left-talking operatives like Mamdani, Alexandria Ocasio-Cortez and Bernie Sanders. Both Sanders and AOC posted messages on X hailing the sellout agreements reached by the NYSNA bureaucracy, with AOC writing:

Congratulations to the 10,000+ @nynurses who have reached an agreement with Mount Sinai and Montefiore hospitals! This is what happens when working people refuse to compromise their dignity. When we fight, we WIN. Solidarity as they ratify this new agreement.

The rejection at NYP testifies to a growing mood of resistance in the working class. Strikes and protests are breaking out across the country. More than 31,000 healthcare workers at Kaiser Permanente on the West Coast are engaged in a three-week long strike. Teachers in San Francisco launched a strike on Monday. In the mass protests against Trump and the murders by ICE, the question of a general strike is being openly raised.

Nurses are discussing broader unity and even general strike action. Tuesday’s online meeting of the New York Healthcare Workers Rank-and-File Committee brought together nurses and other workers to defeat the NYSNA sellout and mobilize the full strength of the working class to win their demands.

As Katy Kinner, a Michigan nurse and a leader of the Healthcare Workers Rank-and-File Committee, said at the end of her report to the online meeeting:

“Healthcare workers do not simply want to strike—they want to win. Winning safe staffing requires a political perspective that confronts the root causes of this crisis: the grotesque concentration of wealth and the subordination of healthcare to private profit. No one will fight for this except workers themselves. Join and build the rank-and-file committee now.”

For information on joining the New York Healthcare Workers Rank-and-File Committee, fill out the form below.