Tim Tai

Last month, J., a nurse at Yale New Haven Hospital’s York Street campus, clocked out of her 12-hour overnight shift at 7:23 a.m. — the precise minute the shift was scheduled to end. J., who was granted anonymity for this story due to job security concerns, snapped a photo of the timestamp on her iPhone and left the hospital, exhausted. The day had started short-staffed. It ended the same way.

But when she received her paycheck, she was shorted an hour. The hospital’s timekeeping system had logged her out at 7:22.

“I didn’t understand,” she said. “My manager signed off on my hours. I showed them the screenshot. But they said, ‘It’s what’s in the system.’ And that was the end of it.”

For this nurse, who was hired through an external staffing agency, the discrepancy wasn’t just frustrating. It reflected what she described as a broader dynamic: rigid, institutional policies and cracks in the operational system that, in practice, can leave nurses feeling undervalued.

In recent years, many long-term nurses have left hospitals within the Yale New Haven Health System, or YNHHS, the parent network that includes Yale New Haven Hospital as well as Bridgeport, Greenwich and Lawrence + Memorial hospitals. For this story, the News spoke to 27 different YNHHS nurses who cited burnout, stagnant wages and frustration towards their employer, some of whom are identified by pseudonyms in this story.

To nurses, a pattern becomes apparent: New hires cycle in and out, patient loads grow and experienced nurses, many of whom spent years keeping departments afloat, slowly lose steam and leave the health system.

A workforce transition

“I didn’t leave on bad terms. I left because I realized how broken it was — and no one was fixing it,” said A., a former nurse administrator who was also granted anonymity due to job security concerns.

YNHHS is staffed by over 7,000 long-term nurses, travel nurses, float pool hires, per diem workers and international contract staff — a revolving door that some say undermines consistency, trust and workflow operations. Staff nurses who remain say they are often surrounded by transient colleagues.

Travel nurses, who are employed on short-term contracts, are often hired to fill staffing gaps. They often receive higher wages than permanent workers, despite having no obligation to stay at the hospital long-term.

“Some are great,” said one staff nurse, who wished to remain anonymous due to employment concerns. “Others are just here for the paycheck. And either way, they leave. We’re the ones left behind.”

Ena Williams, former chief nursing officer of Yale New Haven Hospital and current chief nursing executive for the health system, acknowledged the use of contracted staff.

“At the end of the day, we have a responsibility to provide the resources that are needed to take care of patients,” Williams told the News.

Courtney Vose, current chief nursing officer of Yale New Haven Hospital, echoed Williams. “We need to use travelers and international nurses as a stopgap,” she said. “We would really like to have all of our own Yale New Haven Health System nurses.”

Long-term nurses also told the News that high turnover among short-term staff creates significant inefficiencies in workflow. Each time a travel or contract nurse leaves, departments must spend time and resources onboarding a short-lived replacement — often someone unfamiliar with the hospital’s electronic medical records system, equipment, protocols and unit-specific workflows.

“A lot of the times, we’re training someone new every few weeks, and just when they start to get the hang of things, they leave, and we do it all over again,” said a nurse.

No time to rest, no pay for the time

Nurses point to the growing discrepancy between staffing levels and patient needs as a cause for an exacerbated burnout in recent months.

“We have too many patients and not enough nurses. That’s the overall problem. Everyone gets sicker, and you don’t have enough resources to deal with it,” said W., another YNHHS nurse.

The result is an unsustainable working environment. All 27 nurses the News interviewed reported skipping meals and staying hours past clock-out just to catch up on documentation and patient care.

Multiple nurses the News spoke to claim to have been undercompensated by YNHHS’ payroll system. Nurses at YNHHS are automatically docked 30 minutes per shift for a lunch break, even if they never took one. Many say their breaks are interrupted or skipped altogether due to patient needs, yet payroll continues to deduct the time.

This practice is at the center of a federal lawsuit seeking class-action status filed in February by former off-shift administrative manager Ashley Pastor. The suit alleges that YNHH failed to properly compensate employees through automatic meal break deductions and a timekeeping system that rounded employee hours in ways that reduced recorded pay, in violation of federal and state labor laws.

“We work through our meals because there’s no one to cover,” said a former labor and delivery nurse, E. “And if you claim you didn’t take a break, management penalizes you.”

The punishment, some nurses claim, comes in the form of public shame. A nurse at St. Raphael Campus hospital said that, in February, posters were taped to break room doors, listing staff who declared “No Break Taken” — names highlighted, a note scrawled in marker: “All staff must take their breaks.” The News was unable to independently verify this story.

Hospital leadership denies that this kind of retaliation is sanctioned.

“Shaming of any form is never allowed and we will investigate in the unlikely event that this happened,” YNHH spokesperson Dana Marnane wrote to the News. “All employees are encouraged to take their meal breaks — it’s important to have time to eat and recharge.”

According to Marnane, non-exempt or hourly employees are required to document their 30-minute meal breaks at the end of each shift. Managers then review the documentation, she said, and “when an employee has missed their meal break, managers discuss why with the employee.” If the break was missed, she said, “the employee is compensated for that time.”

But nurses say the problem is not encouragement or documentation — it’s feasibility. For many, the inability to take a break is not a matter of choice, it’s a matter of circumstance. Patient admissions can spike unexpectedly. Emergency calls can pull staff across units. And without sufficient coverage, there may be no one to assume responsibility for patients while a nurse steps away.

According to D., a nurse who has worked at Yale New Haven Hospital for over 10 years, uninterrupted 30-minute breaks are rare due to the nature of the job.

“Every night that I work and I punch out that I took my break, yeah — I sit at my desk, I eat my food, and I review charts,” D. said. “But to say I get a 30-minute uninterrupted break where I can do whatever I want? I don’t. I never have.”

Nurses who report missed breaks are often questioned or blamed, they said.

“They’ll say, ‘Why didn’t you get a break? You need to manage your time better,’” D. said. “But no one asks what the hospital is doing to help us take one.”

Labor cuts exacerbate burnout

In March, a mass email signed by Yale New Haven Health CEO Christopher O’Connor and President Pamela Sutton-Wallace outlined a new “operating model” promising agility, integration and system-wide transformation.

Although the restructuring did not directly result in layoffs of bedside nurses, many said it hollowed out the scaffolding that allowed them to do their jobs safely and sustainably.

The restructuring eliminated roles that directly supported nurses: educators, safety nurses and assistant managers.

“It’s a bunch of lies wrapped up in promises,” one nurse said of the restructuring. “While I agree there are too many managers in the pot, what this does is force managers to take on more responsibility for more floors, which they have done in the past. Then that manager is so busy they are never to be found. Not completely by their fault. One person can only do so much.”

In the interview, Williams, the chief nursing executive for the health system, described Yale’s staffing philosophy as one grounded in “ensuring that our teams have the resources they need to get their job done.” That, she said, goes beyond headcounts and includes support roles, equipment and technology.

Another nurse emphasized that the ripple effects go beyond paperwork.

“They gutted our support system,” another nurse, who requested to stay anonymous for fear of losing their job, said. “And then asked us to pick up the pieces.”

With managers now responsible for multiple units, she said, there’s often no one available to assist or monitor patient loads during breaks. Even supportive managers, she explained, are now “stretched so thin they can’t help you.”

“All of it is killing morale,” she added.

Feeling unsafe in the workplace

All 27 nurses the News interviewed described not feeling completely safe in the workplace. Nurses recounted stories of colleagues assaulted by patients, verbally harassed during shifts and finding their cars broken into in hospital parking lots.

“Do I feel safe at work right now? I don’t,” said D. “Anybody can get into that hospital at any time of the day, any way they want, because the security is lackluster.”

Another nurse described an incident on a transplant unit involving a patient whose behavior, including inappropriate exposure and harassment, was repeatedly reported but never meaningfully addressed by management.

“My manager was obviously made aware,” the nurse said, but the patient remained in the unit, going on to physically assault another staff member. Ultimately, the nurse chose to leave YNHH. “I could not work in a place where I was so unsupported,” she said.

In response to questions about the incident and staff safety, the YNHH spokesperson wrote in an email to the News that “any instance of a patient assaulting a staff member is taken extremely seriously. It is reported and investigated and, when appropriate, police are called.”

The spokesperson added that healthcare worker assaults have risen nationwide, prompting the system to implement additional security measures, including required annual de-escalation training.

While Yale piloted metal detectors at Smilow Cancer Hospital, nurses said the effort was not expanded to other sites. Many said they had never participated in live active shooter or de-escalation drills, despite facing violent or aggressive patients on a regular basis. Last month, a man was arrested at Yale New Haven Hospital after allegedly discarding a loaded handgun, according to the New Haven police.

Several nurses emphasized that such incidents are not isolated — they reflect a broader pattern of insufficient safety infrastructure and delayed administrative action.

Hospital leadership pushed back on those claims. “Yes — we conduct regular active shooter drills as well as ones for mass casualty events and other scenarios,” Marnane, the YNHH spokesperson, wrote in an email to the News. “Drills are a requirement by CMS, DPH and the Joint Commission and simply the right thing to do.”

Marnane added that staff complete mandatory video-based training in de-escalation and tools such as the Brøset Violence Checklist, designed to predict inpatient violence in the short term by assessing behaviors such as confusion, irritability and verbal or physical threats. Some nurses said that virtual modules fall short of preparing staff for real-life emergencies.

Outside the hospital, safety concerns also extend to the parking areas. Nurses told the News that their colleagues’ cars — parked in the Sherman-Tyler surface lots, near Yale New Haven Hospital — had their windows smashed, their tires stolen and their personal belongings taken from inside. These lots have long been used by hospital staff during shifts.

“Imagine you just came out of a 12-hour shift caring for other human beings,” one nurse said. “And you can’t even get home because one of your tires is stolen.”

D., however, noted that under Yale’s new chief nursing officer, there have been recent efforts to strengthen protections. D. said plans are underway to roll out metal detectors and armed guards at emergency room entrances and eventually across the hospital. In addition, a new code system for violent patients is in development to enable rapid clinical response.

In an email to the News, Marnane stated YNHH has taken steps to address these risks. Starting last year, after an assault and robbery occurred at one of the surface lots, security officers were posted at the lots around the clock on weekdays, and mobile surveillance units were added. She also cited expanded use of security cameras, emergency call boxes, badge readers and the “ELERTS” phone app. D. told the News he noticed those improvements.

A reactive system in a proactive job

However, nine nurses said these efforts to address security concerns have been trapped in bureaucratic limbo. Administrators had promised new weapons detection systems would be installed across hospital entrances. But months later, they said there has still been no visible progress.

“They said it would happen by summer or fall of 2025,” one nurse noted. “But I don’t think anyone believes that. We have homeless encampments in stairwells. A patient was found dead in an unused office. And still — no urgency.”

According to W., hospital leadership continually falls behind in anticipating and addressing systemic risks.

“It’s a very reactive place to work instead of a proactive place to work,” said W. “Any solution takes a year to design, and another year to implement. By then, you’ve already lost all the people who cared about that problem.”

YNHH spokesperson Marnane told the News that “as with many large projects, [the weapons detection system] is a staged process and improved upon with each installation.” Systems are already in place at Bridgeport and Greenwich Hospitals, she said, with Lawrence + Memorial scheduled to follow in June and installation at YNHH expected to be completed by the end of the summer.

That lag isn’t simply administrative oversight, 15 nurses said. It reflects a deeper cultural flaw: a leadership philosophy that prioritizes optics over urgency, and perfection on paper over practicality on the ground.

“They want to get everything perfect before they act,” W. said. “But nothing is ever perfect — and by the time they try to roll something out, it’s too late. We’ve already lost the staff, lost morale and lost the trust.”

This mode of management — waiting for harm before implementing change — has become a hallmark of how the hospital operates, according to 15 interviewed nurses. The problem isn’t just that leaders react slowly, they said — it’s that they seem unwilling to act until damage has already been done.

What nurses want

All nurses interviewed by the News agreed that their demands for fair pay and a voice in decisions that shape their working lives and basic safety are foundational to workplace integrity.

“They need to invest in us,” B. said. “They need to make this a place where we want to work — and now it’s not a place where we want to work.”

For some nurses, the hospital’s reputation is no longer enough to retain talent — “all the best nurses left,” W. said.

Administrators, nurses say, rely too heavily on numbers and too little on first-hand experience. Staffing matrices, satisfaction scores and national best practices have replaced direct communication and practical observation.

“They make decisions from a suite based on spreadsheets and Press Ganey scores that are absolutely dog shit,” one nurse said. “They sit there and read research articles and think that’s the answer — but they don’t come down and see what we deal with.”

Despite the burnout, the broken systems and the sense of being unheard, many nurses at Yale New Haven Hospital stay.

For some, the decision to stay is grounded in logistics — they are local, they have family nearby or they cannot take on the uncertainty of travel contracts. But for others, it’s because, even now, they believe Yale still offers something worth holding on to. They do stay not because they are blind to the problems, but because they believe in the work.

That emotional calculus — the desire to stay in a job you love while watching it become more difficult to work — is at the heart of the tension at YNHHS. Nurses said they aren’t asking for less work. They’re asking for enough support to keep doing it.

Recognized, but still reckoning

Administrators acknowledge the challenges faced by nurses and insist that the institution is working to meet them. According to Williams, chief nursing executive at YNHHS, and Vose, current chief nursing officer at YNHH, the hospital has continued to invest in its nurses through both longstanding values and new models of care.

Williams described Yale’s staffing philosophy as one grounded in “ensuring that our teams have the resources they need to get their job done.” That, she said, goes beyond headcounts. Staffing strategies are matched not only to patient volume and acuity, but also to the specific environment of each unit, and include consideration for equipment, technology and support roles beyond the bedside.

As the healthcare landscape shifts, leadership says its approach has evolved to offer more flexibility for nurses’ individual needs. This includes expanded access to tuition reimbursement, student loan assistance, professional development opportunities and tailored scheduling pathways.

One of the system’s newest staffing initiatives — virtual nursing — brings experienced nurses into units remotely to assist with documentation-heavy tasks like admissions, discharges and procedure checklists. These nurses, Williams said, allow bedside staff to focus more fully on direct patient care. The health system has also invested in technology integration, enabling nurses to scan IDs, print labels and document care more efficiently at the bedside.

Recruitment, they said, is an ongoing focus, but retention is just as critical. To support long-term staff, the hospital maintains a nursing professional governance structure, which gives nurses direct input on clinical practice decisions. Leaders also conduct annual engagement surveys and use that feedback to shape what Williams called a “menu of support,” including scholarships and growth pathways into roles like charge nurse or educator.

Efforts to boost morale also include new recognition systems. A forthcoming program will allow patients and families to submit direct feedback about nurses and frontline teams — something Vose said was requested directly by staff through shared governance councils. Additionally, YNHH launched a Clinical Nurse Transition Coach program, placing experienced nurses on night and weekend shifts to support new hires at the bedside.

Despite these recognitions, 23 nurses interviewed by the News say their day-to-day experiences still fall short of the ideals. For those on the floor, the question is less about institutional accolades and more about whether the system can evolve to meet their needs, not just in policy, but in practice.

“We are committed to always working to create and improve a space for nurses to practice and practice safely,” Williams said. “Are we perfect? Absolutely not. You tell me where that is — I’ll go there and work myself.”