Nurse Burnout and the Brigham Strike That Almost Happened

About 4,000 nurses at Brigham and Women's Hospital in Boston were set to walk off the job at 7 a.m. Thursday, with no end date. Late Wednesday night, with hours to spare, their union and the hospital reached a tentative deal. If you want to understand nurse burnout in 2026, read what those nurses fought for. Pay was only part of it.

The union said it would have been the largest nurses' strike in Massachusetts history, GBH News reported. The deal still needs a ratification vote. But the terms that WBUR reported include new limits on temporary workers and on "floating," the practice of moving nurses to whatever unit is short that day.

I spend a lot of time in rooms with nurses and nurse managers. When nurses are willing to strike over where they get assigned on a Tuesday, a nurse manager should pay attention.

What happened at Brigham and Women's?

This fight ran most of the year. Nurses, represented by the Massachusetts Nurses Association, held a one-day strike on July 8. The hospital then locked them out for four more days, citing contracts with temporary nurses that required five days of work, Boston.com reported. In September, nurses authorized an open-ended strike by a vote of 2,986 to 215. On Oct. 23, they voted down the hospital's offer.

The hospital got ready to stay open without them. About 400 agency nurses started onboarding Tuesday, with another 400 scheduled for Wednesday, per Boston.com. Mass General Brigham's own position was that its nurses are already among the best paid in the market: new graduates start just under $87,000, and about 30% of nurses sit at the top step, earning at least $220,000 a year. The union, for its part, accused hospital officials of spending too much on executive pay and not enough on bedside nurses, WBUR reported.

Gov. Maura Healey and Boston Mayor Michelle Wu got involved too. Their joint statement said the two sides "need to continue to push forward toward a resolution that makes sure our nurses receive a fair contract," per GBH.

According to WBUR, the tentative contract runs through Sept. 30, 2028. The most senior nurses get 2.5% annual raises, everyone else gets a $1,000 bonus, and the 5% yearly step raises for a nurse's first 20 years stay in place. Union leaders also say the deal softens a proposed change to health insurance premiums. The hospital said the agreement falls within the limits of its "last, best and final offer."

Kelly Morgan, a labor and delivery nurse who chairs the nurses' bargaining committee, put it this way: "I'm incredibly proud of the Brigham nurses who stood strong to protect the world-class patient care we provide."

Why do nurses care so much about floating?

If you've never worked a hospital shift, floating sounds harmless. You're a nurse, the unit down the hall needs a nurse, off you go.

Ask a nurse what it's like. You leave the unit where you know the patients, the routines, where the supplies are and which doctor needs a second page. You land somewhere you're the new kid for twelve hours, with a full assignment. It's a bit like a comic getting told five minutes before showtime that tonight they're doing the bachelorette party in the other room instead. You can probably survive it. You won't be at your best, and the people in front of you will notice.

That's why I think the floating limits matter more than the headlines gave them credit for. Pay matters, and nobody should feel guilty about wanting more of it. But nurses who already make good money were still ready to strike over being moved around and over relying on temporary staff. To me, that says the money on its own wasn't keeping people happy. They were also asking for some control over their own work.

Nurse burnout is about control, and the data backs it up

The national numbers say the same thing. In the NCSBN's 2024 National Nursing Workforce Study, released in April 2025, 39.9% of registered nurses said they intend to leave the workforce or retire within five years. Among those leaving for reasons other than retirement, about 41.5% named stress and burnout as the root cause. Workload, understaffing and inadequate pay were the other top reasons.

Pay is on that list. So are workload and understaffing, which is exactly what a nurse feels on a shift where they've been floated to a strange unit with a full assignment. If you're wondering why nurses are leaving, a lot of the answer is in how the shift gets assigned.

I wrote last week about nurse retention strategies for hospitals losing nearly 18% of their nurses a year. The Brigham story is the same problem getting settled at the bargaining table, with a governor and a mayor watching.

What should a nurse manager do after a contract fight?

Once the deal is signed, the nurses who were ready to strike and the managers who were planning around 800 replacement nurses have to work the same unit again. That's the hardest stretch of a contract fight, and it lands on frontline managers, who usually had no say in the bargaining.

If I were running a unit at any hospital coming out of a fight like this one, I'd do some version of this:

• Don't keep score. Who voted which way, who picketed, who posted what. Let it go, out loud, in your first huddle.
• Say what changed. If the new contract limits floating, explain how assignments will work now. Nurses have heard promises before. Show them the new process on paper.
• Ask before you assign. When you do have to move someone, ask first and explain why. People take a bad assignment a lot better when somebody bothered to ask.
• Fix one small thing fast. Pick the most annoying problem on the unit, the broken pump or the supply room nobody restocks, and get it fixed this week. It shows people the place is listening.
• Laugh first. If there's something absurd about the last few months (and there always is), be the first to laugh at your own part in it. A manager who can laugh at themselves is someone nurses will bring bad news to.

That last item is where I come in. The humor that works on a unit gives people a safe way to say the hard thing, and nobody on the unit ends up as the punchline. That's the skill we build in our healthcare humor workshops for nurses and nurse leaders, and it's a big part of what I'd call real nurse supervisor training.

What the nursing shortage of 2026 looks like from Boston

Mass General Brigham lined up more than 800 temporary nurses for this strike, per WBUR. Finding bodies, apparently, is doable. Keeping the 4,000 nurses who already know your patients and your hallways is the hard part, and it gets harder every time they feel like interchangeable parts.

Neither side got everything it wanted. Still, the nurses got something on the table that I'd love every hospital to steal without needing a strike vote: a say in where they work and who they work next to.

More on this: why nurses deserve better from leadership, and how communication moves HCAHPS scores. If your unit is coming out of a hard year, let's talk about a workshop that helps your managers rebuild trust.