Yale News

As the COVID-19 pandemic led the University to augment its public health infrastructure, Yale staffed its initiatives with a number of temporary workers sourced through staffing agencies like interim pologne. These registered nurses do not receive benefits because they do not work at Yale full-time, which some say leads to high turnover. 

While permanent full-time Yale employees are typically eligible for benefits such as paid time off, retirement funding and health insurance, temporary full-time workers with the “COVID-19 Result, Resource and Clinical Surveillance RN” designation are not eligible for any of these benefits. Two employees within Yale Health’s COVID-19 workforce, Tiffany Hsu and Denise Arnott, said that the temporary workforce has faced retention issues, as staff members leave for permanent full-time jobs that offer benefits. According to Nanci Fortgang, Yale Health Chief Clinical Operations Officer, permanent employees are paid an annual salary and are required to work a specific number of hours. Their salaries are budgeted through the University. Temporary positions, Fortgang explained, are “per diem” roles that are paid on an hourly basis the number of hours an employee works — and these hours are flexible. 

“Yale University especially likes to push their New Haven hiring initiative, which is hiring locally in a town where Yale is already taking over and at the same time … trying to say they’re investing in the people,” Hsu said. “But if that just means only temporary jobs, I think that it’s a little bit shortsighted.”

Fortgang explained that the COVID-19 pandemic created many temporary positions due to the sudden importance of vaccine clinics, testing sites, contact tracing, infection care management and COVID-19 resource support. She added that it is a widespread hope from a public health standpoint that these positions stay temporary, as that would mean COVID’s presence goes down.

Fortgang added that temporary workers are able to apply for permanent positions within Yale Health. 

Hsu had been working full time as an emergency nurse at the Yale New Haven Hospital, a job for which she was receiving benefits. In January, she supplemented this job with a part-time job at Yale Health. In April, Hsu quit her full-time job at the hospital to become a full-time — yet temporary and unbenefited — COVID-19 resource nurse at Yale Health.

Arnott began working in the same role, a temporary yet full-time COVID-19 resource nurse at Yale Health, in August. 

They both work at the Campus COVID Resource Line. Their team is a “daily telephone service for students, staff, faculty, as well as retirees,” Hsu said. They are responsible for answering all COVID-19-related questions for the Yale community, such as inquiries about potential exposures or the availability of booster shots.

Both Hsu and Arnott told the News that their temporary team is experiencing retention issues, specifically due to the lack of a clear route to benefits for those in the COVID-19 temporary workforce. Hsu added that when jobs become available in student health, acute care, OB-GYN or specialty services — all in Yale Health — many COVID-19 nurses transfer there. 

Fortgang told the News that the pandemic created staffing shortages for many divisions across the University, and that Yale Health experiences “intermittent staffing challenges” in both permanent and temporary positions.

“They’ve had problems with retention because they’re not offering benefits for a full-time employee,” Arnott said. “So we have gone through episodes of not [having] enough people there. … I think that that’s something that they need to examine [because] if they want to go forward and kind of get a core group that stays, they would have to offer benefits too.”

Hsu, who has been at her post since April, said she is considered one of the more senior nurses in this role and explained that she is often responsible for training new nurses. Hsu also said that there is “such a need” for temporary COVID-19 resource nurses and that their labor is “always in high demand.”

She added that it is important to have a “consistent” workforce to provide the “best, most up-to-date” advice for the Yale community — yet many nurses have been “lost” because they can receive benefits through other positions.

“If Yale provided any benefits, I wouldn’t have to leave,” Hsu said. “Instead, there’s a cycle of more new nurses that are coming in and everyone’s picking up a shift here or there. But there’s really no institutional knowledge that is retained with this revolving door, and I think it could be easily solved by having a couple of full time employees. There are people that are interested and willing to dedicate themselves.”

While Hsu said she was aware that the position did not offer benefits when she applied, she told the News that she was surprised by how the position lacked a clear path to becoming a permanent employee.

Arnott recounted a conversation she had with Yale Health Clinical Manager Jeffrey Stay, in which she asked him when Yale Health was going to hire the temporary nurses into permanent full-time employees. Stay did not respond to a request for comment on Thursday.

“His explanation was, until [Yale] makes [the Campus COVID Resource Line] a department, they cannot hire us,” Arnott said.

On Dec. 7, after the News asked the University for comment, Stay emailed all temporary RNs to remind them that “staff should not engage in conversation with reporters.” Stay wrote that calls and emails from the media be referred to Yale Health’s administrators.

Fortgang emphasized that temporary RNs are eligible to apply for any opening or vacancy at Yale Health. She said that Yale Health has hired registered nurses from temporary positions into permanent roles in the Specialty Care, Internal Medicine, Pediatrics, Allergy and Immunizations, Endoscopy, OB-GYN and Student Health departments. 

Still, Arnott explained that there were positive aspects of the job. She acknowledged that “for the most part, everybody’s very, very pleasant.”

“It’s a really pleasant environment,” Arnott said. “The job is community nursing, which I love.”

Arnott stressed that the University was transparent with the position’s designation as unbenefited. But as someone with significant underlying health issues, Arnott said that she instead prioritized the non-face-to-face aspect of the job. Further, as a single mother with three children and an aging mother, Arnott said she appreciated how she did not need to ask for permission to take time off in the role.

Hsu also recognized some advantages of the temporary position. She noted that it provided significant flexibility in that if there was a day that she wanted to work, she could simply “come and pick it up and record those hours.”

“We have provided opportunities for temporary RN work at Yale Health for over a decade,” Fortgang wrote in a statement to the News. “It has proved very beneficial, providing us with outstanding temporary nurses and in turn, providing the students with experience in the clinical setting: truly a win/win.”

The COVID resource line is available seven days a week at 203-432-6604.