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NEW YORK — Thousands of nurses in three hospital systems in New York City went on strike Monday after negotiations through the weekend failed to yield breakthroughs in their contract disputes.

“Nurses on strike! … Fair contract now!” they shouted on a picket line outside NewYork-Presbyterian Hospital’s campus in Upper Manhattan. Others picketed at hospitals in the Mount Sinai and Montefiore systems, where a 2023 nursing strike fed off pandemic-era frustrations and led to a deal to boost staffing and pay.

“And now, it’s how they’re treating us: They don’t want to give us a fair contract, and they don’t want to give us safe staffing, and now they’re trying to roll back on our benefits,” emergency department nurse Tristan Castillo said as she picketed Monday outside Mount Sinai West.

About 15,000 nurses are involved in the strike, according to their union, the New York State Nurses Association. The hospitals remained open, hiring droves of temporary nurses to try to fill the labor gap.

The strike involves private, nonprofit hospitals, not city-run ones. But the strike, which the union casts as lifesaving essential workers fighting hospital executives who make millions of dollars a year, could be a significant early test of Mayor Zohran Mamdani’s new administration.

The democratic socialist campaigned on a pro-worker platform and struck a similar note while visiting nurses on the NewYork-Presbyterian picket line Monday.

“These executives are not having difficulty making ends meet,” said Mamdani, who extolled nurses’ work and said they were seeking “dignity, respect, and the fair pay and treatment that they deserve. They should settle for nothing less.”

Some other Democratic city and state politicians also visited striking nurses, while Gov. Kathy Hochul sent state health officials to the hospitals to keep watch over patient care. She called in a statement for the sides to negotiate a deal that “recognizes the essential work nurses do.”

The strike, which comes during a severe flu season, could potentially force the hospitals to transfer patients, cancel procedures, or divert ambulances. It could also put a strain on city hospitals not involved in the contract dispute, as patients avoid the medical centers hit by the strike.

The nurses’ demands vary by hospital, but the major issues include staffing levels and workplace safety. The union says hospitals have given nurses unmanageable workloads.

Nurses also want better security measures in the workplace, citing incidents such as an episode last week when a man with a sharp object barricaded himself in a Brooklyn hospital room and was then killed by police.

The union also wants limitations on hospitals’ use of artificial intelligence.

The hospitals say that they’ve been working to improve staffing levels but say that the union’s demands overall are too costly.

After the nurses gave notice Jan. 2 of the looming strike, the hospitals hired temporary nurses, vowed to “do whatever is necessary to minimize disruptions,” and said they were prepared to deliver care no matter how long the strike lasts. Mount Sinai said in a statement Monday it had lined up 1,400 temporary nurses.

Mount Sinai said the union was making “extreme economic demands.” Montefiore spokesperson Joe Solmonese said the union was pressing “$3.6 billion in reckless demands,” including exorbitant raises. The union hasn’t publicly disclosed its salary proposal.

NewYork-Presbyterian accused the union of staging a strike to “create disruption.”

“We’re ready to keep negotiating a fair and reasonable contract that reflects our respect for our nurses and the critical role they play, and also recognizes the challenging realities of today’s healthcare environment,” the hospital said.

Each medical center is negotiating with the union independently. Several other private hospitals in and near New York City reached deals in recent days to avert a possible strike.

The three-day strike in 2023 resulted in a deal raising pay 19% over three years at Mount Sinai and Montefiore. The pact also included staffing improvements, though the union and hospitals now disagree about how much progress has been made, or whether the hospitals are retreating from staffing guarantees.

The sides also dispute whether the hospitals are trying to reduce health benefits. Mount Sinai, for instance, says its proposals would cut costs without changing coverage.

The Trevor Project, known for its hotline for LGBTQ+ youth, received $45 million from billionaire and author MacKenzie Scott at the end of 2025, the organization said Monday.

The gift is the largest in the organization’s history but also a major boon following years of management turmoil, layoffs, and the loss of significant federal funding over the summer.

“I literally could not believe it and it took some time. I actually gasped,” said Jaymes Black, CEO of the Trevor Project, when they were notified of Scott’s gift.

Scott, whose fortune largely comes from her ex-husband, Amazon founder Jeff Bezos, gave more than $7 billion to nonprofits in 2025, but this gift to the Trevor Project was not included among the donations she disclosed on her website in December. Scott previously gave the Trevor Project $6 million in 2020.

In July, the Trump administration stopped providing specific support for gay, trans, and gender nonconforming young people who called the 988 National Suicide & Crisis Lifeline. The Trevor Project was one of the organizations staffing that option and lost $25 million in funding, the nonprofit said.

The Trevor Project continues to run an independent hotline for LGBTQ+ young people that Black said reaches about 250,000 young people annually, but they served another 250,000 callers through the 988 Press 3 option, which was tailored for LGBTQ+ young people.

The U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) reported more than 1.5 million contacts were routed through the service between September 2022 and July 2025.

The Trevor Project has gone through years of internal turmoil after exploding in size from an organization with an annual budget around $4 million in 2016 to over $83 million in 2023, according to its public tax returns. The nonprofit’s board removed its CEO in 2022 and has gone through a series of layoffs, including one in July. Black said the project’s 2026 budget was $47 million.

“We are a smaller organization than we were before,” Black said. “And we will continue to be really intentional and really mindful around growth and what growth really means for the organization.”

After it lost the 988 funding, the Trevor Project launched an emergency fundraiser that brought in $20 million to date, Black said, which they also hope Scott saw as proof that the organization was determined to stick around and make it through this period.

“MacKenzie Scott’s folks were clear, like this gift was made for long-term impact,” Black said, adding that they would take their time deciding how to use the funds.

Thad Calabrese, a professor at New York University who researches nonprofit financial management, said it’s not at all uncommon for nonprofits that grow very quickly to run into financial problems. But he also said the cuts and general instability in especially federal funding for nonprofits has upended many organizations’ business models.

“Academic research has often viewed public funding as very stable, as a signal to donors that you’ve arrived as an organization, but the reality is you are now also open to changing political fortunes,” he said.

He said research is also unclear about whether diversifying an organization’s revenue streams is always a better financial strategy.

“You’re less dependent upon a few funders, but on the other hand, if you have a lot of different revenue streams, do you have the management capacity for that?” Calabrese asked, speaking generally and not commenting specifically on the Trevor Project.

Scott has distinguished herself among the biggest individual donors by giving large, unrestricted gifts to nonprofits, often with a focus on equity or social justice. With the exception of an open call in 2023, she does not ask for project proposals nor accept applications.

Despite the size of her gifts, which now often exceed the recipient organization’s annual budget, research from the Center for Effective Philanthropy has found that concerns about nonprofits misusing Scott’s funds or growing unsustainably have largely not been born out. That may be because Scott’s team, the members of which are largely unknown, conducts extensive research on organizations before making grants.

In an essay announcing her 2025 gifts, Scott said, “The potential of peaceful, non-transactional contribution has long been underestimated, often on the basis that it is not financially self-sustaining, or that some of its benefits are hard to track. But what if these imagined liabilities are actually assets? … What if the fact that some of our organizations are vulnerable can itself be a powerful engine for our generosity?”

Black called Scott’s second gift “a powerful validation” of the Trevor Project’s mission and impact, saying, “We’re calling this our turnaround story.”