PORT WASHINGTON, N.Y. — When thousands of New York City nurses walked off the job last month in the city’s largest strike of its kind in decades, 9-year-old Logan Coyle was a patient in the cancer unit at NewYork-Presbyterian’s children’s hospital in Manhattan.

Logan was recovering from his latest setback in a two-year battle with advanced liver cancer that has already included chemotherapy and a complex triple transplant of a liver, pancreas and small intestine.

But as the nurses formed their picket outside the hospital, he walked to his window and held up a handmade sign: “Proud of My Primaries.”

Morgan Bieler, one of Logan’s longtime, primary nurses, said the sight was a jolt of encouragement in those early, uncertain hours of the walkout, which, at the outset, involved roughly 15,000 nurses across some of the city’s most prestigious hospitals.

“In that moment, it kind of reinforced like, ‘This is why we’re doing this’,” she said recently. “If he can fight for as long as he has and as hard as he has, then we could fight this.”

But nearly a month on, more than 4,000 nurses in the NewYork-Presbyterian system are the last on the picket line.

Jeff Coyle, Logan’s father, says it’s “infuriating” that some of the city’s most vulnerable patients are caught in the middle of the bitter dispute over salaries, staffing levels, workplace safety, health care and other contractual issues.

“Every single day that this drags on is a severe impact to us,” he said. “We are the collateral damage of this strike.”

On Monday, the nurses’ union reached tentative deals with two other major systems, Mount Sinai and Montefiore. Those proposals, if approved in membership votes this week, would see unionized nurses at those hospitals return to work by Saturday.

Negotiations at NewYork-Presbyterian, though, have been bumpier.

Late Tuesday, the nurses’ union said it was calling on its NewYork-Presbyterian members to vote on a proposal accepted by hospital administrators but rejected by the union’s bargaining committee.

The union said the deal “delivers the same contract priorities” its negotiators reached with the other hospital systems, including a 12% pay raise over three years.

“The simple fact is, we’ve reached the end of negotiations,” Pat Kane, the union’s executive director, said in a video message sent to NewYork-Presbyterian nurses that was provided to The Associated Press.

“You deserve to vote on it. You have fought so hard to get to this point,” Nancy Hagans, the union’s president, added in the video.

Logan returned home Saturday after having a tumor removed near his spine. But he said he noticed the difference between his regular nurses and the temporary replacements almost immediately.

Routine things like blood draws and lab tests took longer than normal for the replacement nurses. Gone also were the steady rounds of familiar faces dropping by, oftentimes just for a chat or to read a book.

“I like that they come in and color with you so I’m not spending my whole day on the screen in my iPad world,” he said Tuesday in the family’s home in Port Washington, about 25 miles (40 kilometers) from Manhattan in suburban Long Island.

“I wouldn’t want to be back there for another month without them,” added Logan, who also has a twin sister, Riley. “I would feel more safer if they were all back.”

Logan’s mom, Rebecca, says she spent more sleepless nights at her son’s bedside than previous hospital stays because the temporary nurses cycling in and out every few days came with varying levels of experience.

“I was just constantly up, checking to make sure that something was running appropriately or waiting for a medicine to arrive or waiting for fluids to arrive or a blood product,” she said. “I felt like I had to be so vigilant.”

Bieler says she worries daily about her long-term patients still at the hospital.

She said bone marrow transplants and chemotherapy treatments have been delayed or canceled entirely for some because of the staffing challenges.

“We’re not the only pawns in this, is my point,” Bieler said. “They’re playing with children’s lives, and I can’t imagine how frustrating that is for our community.”

Spokespersons for NewYork-Presbyterian didn’t immediately comment Tuesday, but the hospital systems have insisted their operations are running smoothly, with organ transplants and other complex procedures largely uninterrupted.

As for Logan, Bieler says caring for the upbeat, endlessly positive boy changed her outlook on life.

“He’s always the best version of himself, and he faces everything with a smile,” she said. “I don’t think I would be the nurse, let alone the person I am today, without him and his family.”

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Follow Philip Marcelo at https://x.com/philmarcelo