Boston nurses authorize an open-ended strike as staffing firms see demand return

Nurses at Brigham and Women's Hospital in Boston have voted to authorize an open-ended strike, raising the stakes in a contract fight that already produced a walkout this summer. For hospital leaders elsewhere, it is a reminder of how quickly labor disputes turn into staffing problems, and of how much hospitals still lean on outside staffing when they do.

What happened

According to WBUR, 93% of voting nurses backed the authorization: 2,986 in favor and 215 against. The Massachusetts Nurses Association described it as the largest strike vote in the state's history. No date has been set, and the union is required to give 10 days' notice before walking out.

This would not be the first stoppage. A strike in July became a five-day stoppage, with the hospital bringing in replacement nurses for the duration.

The open issues, per WBUR, include cost-of-living increases, health insurance, limits on the use of travel nurses, and patient care protections. Mass General Brigham, the hospital's parent system, says its offer includes 5% annual step raises on a 20-step scale, and it has proposed 2.5% for nurses at the top step. Nurses at Boston Medical Center voted earlier this month to authorize a three-day strike of their own.

The staffing picture behind it

Strikes show how much outside staffing still matters. Replacement and travel nurses remain the standard way to keep units open during a walkout.

A Sept. 25 overview from staffing platform Medely summarizes the Staffing Industry Analysts forecast released this month. After three straight years of contraction, U.S. healthcare staffing is projected to grow about 1% in 2026, to $39.0 billion, and about 3% in 2027, to $40.1 billion. Travel nursing is forecast to grow about 2% in 2026 and 3% in 2027.

The same overview says per diem nursing revenue is expected to fall about 7% in 2026 as hospitals shift hours from costly travel contracts to local per diem clinicians. Travel staff, it notes, still make sense for strike coverage, seasonal surges, and hard-to-fill specialties. It also cites the 2026 NSI National Health Care Retention report: registered nurse turnover of 17.6%, an RN vacancy rate of 8.6%, and an average of 43 unfilled RN positions per hospital.

Why the travel nurse question matters

Limits on travel nurses show up on the bargaining table because staff nurses often see agency pay rates next to their own. For hospitals, travel staff fill gaps fast but cost more and can widen pay gaps on the unit. How Brigham and its nurses settle that point is worth watching for any system negotiating contracts in the next year.

What this means for your hiring

Plan strike coverage before you need it. If you have a contract expiring, confirm which agencies can supply replacement staff and how much notice they need. Ten days goes quickly.
Price your offers against the market, not last year. Step raises and top-of-scale pay are central in Boston. Check where your posted pay sits against local wages for each role.
Build your own flexible pool. The shift toward local per diem suggests many hospitals see it as cheaper and steadier than travel contracts. Former employees and part-timers are often the fastest place to start.
Watch turnover as closely as vacancies. A 17.6% RN turnover rate means you need to keep hiring just to stay even.

For a data-backed read on how hard a specific nursing role will be to fill in your area, see our sample reports.

Sources

Curious how hard your own opening will be to fill? Run the free Hire-Difficulty Check, and our sample reports show what you get.