South Florida nurses cancel strike, will vote on new deal. How it may improve care
Ahead of a planned strike, registered nurses at three South Florida hospitals recently in turmoil have secured a potential deal that includes better pay and safer staffing measures.
The nurses at Palmetto General Hospital in Hialeah, Coral Gables Hospital and Florida Medical Center in Lauderdale Lakes were prepared to strike Friday after ongoing contract negotiations had stalled with the facilities’ relatively new operators.
A breakthrough was made Thursday after months of negotiating, a win for nurses who said they faced challenging working conditions at the hospitals long before Healthcare Systems of America, or HSA, took over operations from cash-crunched Steward Health Care System in 2024. Nurses at the three hospitals are expected to vote soon on the proposed contract.
“We were ready to show HSA management that we are serious about safe staffing with our strike,” Lazaro Garcia, a registered nurse who works in the ICU at Palmetto General Hospital, said in a statement. “Safely staffing every unit on every shift is the number one way to improve patient care and working conditions at our hospitals. We’re glad to have safe staffing measures in this new deal.”
South Florida nurses secure safer staffing levels
Studies show that when registered nurses are forced to care for too many patients at one time, patients are at a higher risk for preventable medical errors, complications, falls, injuries and death. When a registered nurse has to care for more than four surgical patients at a time, for example, the risk of a patient dying within 30 days goes up by 7 percent, according to the union.
Yet there are no federal mandates regulating the number of patients a registered nurse can care for at one time in U.S. hospitals. Every hospital differs in the nurse-to-patient ratio they maintain.
For nurses like Garcia, patient safety and retaining nurses was top of mind when contract negotiations with HSA began in August.
The proposed three-year contract tries to limit how many patients an RN can care for at a time to reduce patient safety risk, according to Garcia, who serves as Palmetto’s chief representative for National Nurses United.
Before a RN in the ICU can be assigned a third patient, for example, the supervising nurse would need to take on two patients of their own, Garcia told the Miami Herald on Friday afternoon. Besides managing workload, Garcia hopes the new rule will push management to increase staffing, which in turn is expected to improve patient care.
“Safe patient care means safe staffing,” Patrice Aljoe, a registered nurse at Florida Medical Center in Broward County, said in a statement announcing the tentative agreement. “That means figuring out how much care patients need, and staffing our hospitals based on that. New measures in our contract are going to empower nurses to take even better care of our patients.”
Under the contract, if ratified, RNs are also expected to get at least an annual 4% raise for the first two years, with at least a 4.25% raise in the third year, according to Garcia. Nurses may see additional raises through other factors, such as shift differentials, according to National Nurses United.
Over 1,000 registered nurses at the three hospitals are represented by National Nurses United, a union that represents more than 224,000 registered nurses in the country. And healthcare workers at the former Steward hospitals haven’t had it easy.
Doctors and nurses at Steward’s hospitals said they struggled to provide patient care while facing cutbacks, layoffs, shutdowns, and problems with supplies, equipment and delayed payments to vendors and workers, including in Miami-Dade and Broward counties.
In 2024, Healthcare Systems of America took over the operations of Palmetto General, Hialeah Hospital, Coral Gables Hospital, Florida Medical Center and North Shore Medical Center in North Miami-Dade as part of a deal Steward made with its landlord in court to thin debt after filing for Chapter 11 bankruptcy.
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At first, nurses at the hospitals were hopeful things would change under new operators. But in January 2025, about four months after HSA took over operations, frustrated nurses told the Miami Herald that not much had changed as they demonstrated outside Palmetto General, calling for the hiring of more nurses, safe staffing on every shift and in every unit, and better equipment, pay and health insurance.
“We had hoped that HSA would take the chance to improve on Steward’s old practices,” Garcia said in a late December news release, announcing the initial plans for a Jan. 9 strike. “Unfortunately, what we’re seeing is basically Steward 2.0. Nurses are fighting for what we need to take care of our patients in our new contract, and the number one thing is safe staffing. More nurses on every unit means fewer patients for each nurse, and that means safer care for everyone, as we know from data, research, and our experience at the bedside.”
The Herald has contacted Healthcare Systems of America for comment.
The calls for more staffing come as the country is facing a nationwide nursing shortage, with hospitals competing to hire and retain nurses.
The American Association of Colleges of Nursing says there’s a variety of factors causing the shortage, including nursing school enrollment not growing fast enough to meet projected demand, retirement, and insufficient staffing leading nurses to leave the profession because of high stress and lack of job satisfaction. Others, like National Nurses United, say the shortage isn’t because of a lack of nurses but rather because nurses want better working conditions.
On Friday, Garcia told the Herald that RNs are still giving HSA the “benefit of the doubt” to see if things improve in the coming months. But “we are also going to be here ready to fight back for the patients,” he said.
“We do it for the safety of our community, and we hope the community supports us on this journey,” Garcia added.
This story was originally published January 9, 2026 at 4:50 PM.
