Don't Forget Healthcare: The Real Story of Healthcare Worker Advocacy

When hospital executives frame worker strikes as "political theater" or "symbolic crusades," they fundamentally misunderstand what's driving healthcare professionals to take such dramatic action. A recent commentary from a hospital CEO regarding an ongoing behavioral health facility strike exemplifies this disconnect, reducing legitimate workforce concerns to strategic maneuvering while overlooking the profound changes that have reshaped healthcare delivery since the pandemic.

The Pandemic Changed Everything

The COVID-19 pandemic didn't just test our healthcare system, it fundamentally altered it. As nursing ethics expert Dr. Cynda Rushton observed during the crisis, nurses found themselves making "high-stakes decisions for patients and their own personal lives" under unprecedented conditions. The pandemic forced healthcare workers to expand their ethical framework beyond individual patient care to consider "maximizing the good for more people and minimizing harm" when resources became scarce (Pearce, 2020).

But here's what many hospital administrators seem to have forgotten: that crisis mindset never truly ended. The "new normal" that emerged from the pandemic has become a permanent state of heightened pressure, increased workloads, and moral distress that continues to challenge healthcare professionals daily.

The Numbers Tell a Different Story

Recent data from the Georgetown University Health Finance Initiative reveals that healthcare worker strikes have more than tripled from 2020 to 2023, with 2024 numbers exceeding even those record levels. Healthcare industry tracking shows that seventeen healthcare strikes have already been reported in 2025 as of mid-June, indicating the trend is accelerating rather than slowing (Becker's Hospital Review, 2025). This isn't coincidence, it's the inevitable result of what researchers call "hangovers from the global crisis: staffing shortages that have led to higher workloads, increased professional liability as overworked employees with heavier workloads pose greater risks to patient safety, and record rates of staff burnout" (Davis, 2024).

The scope of this movement is staggering. In 2023 alone, the Kaiser Permanente strike involved over 75,000 workers, the largest healthcare strike in U.S. history. These aren't isolated incidents or strategic campaigns; they represent hundreds of thousands of healthcare professionals across nearly twenty states who have reached a breaking point.

There Are Significantly Deeper Issues Underlying Healthcare Teams' Decisions to Strike

While executives often frame these disputes as primarily about compensation, the reality is far more complex. Healthcare workers are grappling with what Dr. Rushton identified as "moral distress" which is defined as the gap between what they can do and what they believe they should do for their patients. This distress has only intensified as pandemic-era accommodations have expired while the high-pressure environment remains.

The strikes encompass demands for higher staffing levels, better working conditions, and more responsive management precisely because these factors directly impact patient care quality. When a CEO dismisses these concerns as "political theater," they're essentially arguing that advocating for patient safety through adequate staffing is somehow inappropriate.

This disconnect becomes even more troubling when viewed through the lens of what Dr. Wendy Dean, co-founder of Moral Injury of Healthcare, describes as the fundamental difference between burnout and moral injury. While burnout manifests as exhaustion and decreased productivity, moral injury occurs when healthcare workers "perpetrate, bear witness to, or fail to prevent an act that transgresses our deeply held moral beliefs" (Dean & Talbot, 2019). In healthcare, that deeply held belief is the oath to put patients first, yet clinicians increasingly find themselves "forced to consider the demands of other stakeholders—the electronic medical record, the insurers, the hospital, the health care system, even our own financial security—before the needs of our patients."

Dr. Dean's research reveals that healthcare workers often report the concept of moral injury aligns more closely with their experience than burnout. As she explains, "Clinicians and healthcare teams as a whole feel paralyzed. They have taken an oath to put patients first, but the priorities and regulations of the healthcare system put them at odds with that oath" (DDW News, 2024). This creates what she calls a "breakdown in the fabric of a community" that cannot be addressed with individual-level solutions like mindfulness training, but requires systemic change.

The Unique Challenges of Mental Health Care

Behavioral health facilities present additional complexities that deserve recognition. Mental health professionals face distinct challenges that extend beyond the already demanding work of healthcare delivery. They provide care for society's most vulnerable populations while navigating persistent stigma that affects both their patients and, often, their own professional standing within the broader healthcare community.

Healthcare workers in behavioral health settings entered the pandemic already managing higher rates of workplace violence, longer patient stays due to limited community resources, and the emotional weight of treating patients whose conditions are often misunderstood by society. During COVID-19, these professionals not only faced the same personal health risks and family concerns as all healthcare workers, but also managed the compounded mental health crisis that emerged from isolation, economic stress, and social upheaval.

The irony is particularly stark in mental health settings: professionals trained to recognize and treat trauma, depression, and anxiety in others were simultaneously processing their own pandemic-related stress while maintaining therapeutic relationships with patients experiencing heightened distress. They witnessed families struggling with unprecedented challenges while managing their own family concerns about exposure, childcare disruptions, and economic uncertainty.

Yet these professionals continued to show up, often serving as the sole consistent support for patients whose community connections had been severed by public health restrictions. They adapted therapeutic practices, maintained crisis intervention services, and provided stability for vulnerable populations during society's most unstable period. This isn't about healthcare workers seeking sympathy—it's about recognizing that sustainable mental health services require sustainable working conditions for the professionals providing them.

When mental health workers advocate for adequate staffing and safe working conditions, they're advocating for their patients' welfare as much as their own. Overworked, understaffed mental health teams cannot provide the quality of care that vulnerable populations deserve, particularly when those populations face increased stigma and reduced access to community supports.

The Cost of Dismissing Healthcare Workers

The Georgetown analysis points to a troubling pattern: healthcare organizations that view worker advocacy as strategic manipulation rather than legitimate professional concern are missing opportunities for meaningful reform. The research suggests that "less has been written or said about what tradeoffs are ahead to put things right between health systems and health workers" (Davis, 2024).

This dismissive attitude ignores the fundamental reality that healthcare workers remember being called "essential" during the pandemic. They recall the widespread acknowledgment that they deserved compensation commensurate with their vital services and working conditions that allow them to care for their own families in the communities where they serve patients.

The most concerning aspect of framing worker advocacy as "political theater" is that it fundamentally misunderstands the motivation behind these actions. Healthcare professionals aren't striking because they want to abandon their patients—they're striking because they believe current conditions prevent them from providing the quality of care their patients deserve.

As Dr. Rushton noted, even during the pandemic's darkest days, "what I know about clinicians is that in a crisis, they show up." The fact that these dedicated professionals are now walking off the job should be a wake-up call, not a reason to question their motives.

The Real Stakes

When hospital executives characterize strikes as strategic campaigns rather than responses to legitimate workplace concerns, they miss the opportunity to address the root causes driving healthcare professionals away from the bedside. The "vicious cycle" identified by researchers—where understaffing leads to higher workloads, which increases burnout, which drives more people away, creating even more understaffing—cannot be broken through dismissive rhetoric.

The healthcare workforce crisis predates any union campaign, and it will persist long after current contract negotiations conclude unless healthcare organizations acknowledge that their workers' concerns are legitimate and require systemic solutions.

Moving Beyond the Blame Game

Healthcare organizations that successfully navigate these challenges will be those that view worker advocacy as partnership rather than opposition. The most successful contract negotiations have resulted in wage gains exceeding 20-30% over contract terms, suggesting that organizations willing to invest in their workforce can find sustainable solutions.

The question isn't whether healthcare workers deserve better conditions and compensation as the pandemic clearly demonstrated their essential value. The question is whether healthcare organizations will recognize that investing in their workforce is investing in patient care quality and community health.

Healthcare workers aren't asking for special treatment; they're asking for the respect, support, and resources necessary to do their jobs effectively. Dismissing these requests as "political theater" not only disrespects the professionals who dedicate their lives to patient care but also undermines the very mission these organizations claim to serve.

The path forward requires honest acknowledgment of the challenges healthcare workers face, genuine commitment to addressing systemic issues, and recognition that worker advocacy ultimately serves the same goal as hospital administration: ensuring the best possible care for patients and communities.

References:

Becker's Hospital Review. (2025, June 16). 17 healthcare strikes in 2025. Retrieved from https://www.beckershospitalreview.com/hr/7-healthcare-strikes-in-2025/

Davis, C. B. (2024, November). After the pandemic, nurses and other healthcare workers are demanding more ... and getting it. Georgetown University Health Finance Initiative.

DDW News. (2024, May 17). It's time to rethink physician workplace distress by focusing on moral injury. Retrieved from https://news.ddw.org/news/its-time-to-rethink-physician-workplace-distress-by-focusing-on-moral-injury/

Dean, W., & Talbot, S. (2019). Reframing clinician distress: Moral injury not burnout. Federal Practitioner, 36(9), 400-402.

Pearce, K. (2020, April 6). In fight against COVID-19, nurses face high-stakes decisions, moral distress. Johns Hopkins University.