New York City’s largest-ever nurses’ strike entered its third day Wednesday, with negotiations appearing at a standstill and nearly 15,000 nurses continuing to walk picket lines at three major private hospital systems.

The strike involves nurses at Mount Sinai Health System, Montefiore Health System, and NewYork-Presbyterian, and has centered largely on staffing levels, working conditions and patient safety.

Hospital officials and union leaders traded sharp accusations Wednesday, particularly over a disputed proposal related to substance use protections for nurses.

Montefiore criticized what it described as “reckless demands” from the New York State Nurses Association (NYSNA), including a proposal the hospital said would prevent nurses from being terminated even if they were found to be impaired by drugs or alcohol while on the job.

“NYSNA leadership’s demand that a nurse not be terminated if found to be compromised by drugs or alcohol while on the job is another example of putting their own self-interest before patient safety,” Montefiore officials said in a statement.

The union rejected that characterization, saying Montefiore was “blatantly mischaracterizing” a basic workplace proposal that would provide protections for nurses dealing with substance use disorders. NYSNA said similar provisions have already been adopted at other hospitals across New York State and are intended to support treatment and recovery, not shield impaired workers from accountability.

All three hospital systems have emphasized that patient care is continuing despite the walkout.

Montefiore Einstein circulated a memo from President and CEO Philip Ozuah assuring staff and patients that operations remain intact.

“Our Montefiore Einstein colleagues have rallied as a team to ensure the continued provision of the highest quality of care for all who seek us out at their most vulnerable,” Ozuah wrote. “We have not canceled even one patient’s access to care.”

Mount Sinai said the number of nurses choosing not to participate in the strike has increased, stating that the share of nurses reporting to work rose from 20 percent to 23 percent.

With neither side signaling an imminent breakthrough, the strike shows no immediate sign of ending, prolonging a labor standoff that has drawn national attention to staffing pressures and working conditions inside some of the country’s largest hospital systems.

(AP)