Yale New Haven Health employees won’t receive “hazard pay” during the Covid-19 pandemic — but they will receive a “COVID-19 Recognition Award,” which comes with a 5 percent pay bump based on total hours worked in the run-up to and during the public health crisis.
That financial boost was announced in a letter sent by the regional health care system’s top officials to staff Tuesday afternoon.
It comes on the heels of a push by nurses, clinical techs, and other YNHH staff and community members for YNHH to pay “hazard pay” to its employees because of dramatic shifts in the quantity and quality of their work brought on by the novel coronavirus outbreak. (See more below.)
The announcement also comes on the same day that YNHH top officials said during a coronavirus-related virtual town hall that roughly 1,000 employees have either tested positive for the coronavirus or are symptomatic and awaiting test results, and that just over 600 remain out of work throughout the regional health care system.
Over 11,000 people had signed this hazard pay petition on Change.org as of Tuesday afternoon.
“There are many well-deserved superlatives — from amazing to exceptional — that describe our Yale New Haven Health System team. It is with great pride and admiration that we thank you for making an incredible difference during these unprecedented times-every day, on every shift, and across our Health System,” reads the letter, which is signed by nine top YNHH officials, include CEO Marna Borgstrom and President Richard D’Aquila.
“Therefore, and with deep gratitude, we are pleased to announce that YNHHS employees will receive a “COVID-19 Recognition Award.”
The letter, which can be read in full here, states that the award will be included in employees’ May 21 pay.
It will be equal to 5 percent of earnings associated with an employee’s total hours worked between the first pay period of the calendar year and May 9, “in recognition of your extraordinary participating in helping our System care for patients afflicted with COVID-19.”
This payment will be made to full-time, part-time and casual staff up to and including manager, but not to leaders at the director level and above.
“This COVID-19 Recognition Award reflects our philosophy to reward exemplary performance and acknowledges that by working together and in partnership across the Health System, our System staff are doing a remarkable job addressing the challenges of the COVID-19 pandemic,” the letter reads.
“Many employees have taken on extra shifts, covered shifts at other hospitals, or have temporarily assumed different roles based on their background and skills. In every situation, you have stepped forward and in the true definition of a hero, rushed toward the challenge, not away from it. Our patients and your colleagues appreciate it, and as your leaders, we could not be more grateful.”
Following is an earlier version of this story.
Hospital Workers Push For Hazard Pay
Thomas Breen photos
Nurses, colleagues outside YNHH as firefighters rally in support.
Over 9,300 people so far have signed a petition for Yale New Haven Hospital to pay nurses, clinical techs, respiratory therapists, and other health care providers hazard pay as they contend with the spread of Covid-19.
The online petition was launched on the website Change.org a week ago by Kathryn Cupo, a New Haven native who has worked as an ICU nurse at YNHH’s St. Raphael’s Campus for the past year and a half.
As of Monday morning, the petition had logged 9,372 signatures of support, with a quickly approaching goal of 10,000 near in sight.
Click here to read the petition.
Cupo and a fellow St. Raphael’s intensive care unit clinical tech who asked to remain anonymous said this form of emergency compensation would go a long way towards recognizing the expanded job responsibilities, extraordinary stress, and personal exposure to harm that they and their colleagues have had to take on during the pandemic.
In an hour-long phone interview Saturday afternoon, Cupo and and the fellow tech said that the calls for Covid-19 hazard pay for YNHH health care providers stem from a dramatic shift in both the quantity and quality of work since the start of the novel coronavirus outbreak.
The two described inadequate supplies of personal protective equipment (PPE) like N95 respirators, face shields, and gowns. They spoke of expanded job responsibilities that now see nurses doing trash, linen and sharps container removal in addition to direct care; higher than normal nurse-to-patient ratios, with some ICU nurses asked to tend to three patients at once; and the indefinite suspension of paid time off for vacation time that had been scheduled a year in advance. They said staffers have received sometimes unclear, always quickly changing instruction from supervisors about how best to use new equipment, how best to ration PPE, how best to protect the safety of workers and patients alike.
They also spoke of the ever-present concern that showing up to work now means risking one’s own life, as well as the lives of friends and family at home.
“I think ultimately it’s a tangible way that, in this stressful time, we can feel more recognized, more respected and valued,” Cupo said about hazard pay.
She said that nurses, clinical techs, respiratory therapists, and other YNHH health care providers all continue to show up to work, day in and day out, to perform their life-saving duties with care and attention.
“We did not sign up to come to work without the equipment that we need and lack of preparedness from above,” she said.
Cupo and the ICU clinical tech said they do not blame YNHH as an institution for creating any kind of uniquely stressful or dangerous environment during this crisis.
They recognized that hospitals around the world are struggling with nearly identical problems: Not enough PPE; not enough staff; a quickly evolving and expanding pandemic; and the stress of balancing workplace safety with providing the best patient care possible.
“Stop and Shop has paid their workers 10 percent more,” Cupo pointed out. She said Yale University has also provided a pay bump for essential employees.
“What we are asking is simple,” the YNHH hazard pay petition reads. “We will continue to show up, but we will not be silent about our experiences and we will not stand in the line of fire without support. We want hazard pay. We demand to know that we are in this together and that means fair pay!”
When asked about hazard pay, Vin Petrini, YNHH’s senior vice president for communications, reiterated a response that YNHH President and CEO Marna Borgstrom gave in a recent virtual town hall: That hospital workers entered the health care field knowing that it entails a certain amount of crisis management, and that the hospital system is developing an alternative means of recognizing its employees for their exceptional dedication and quality of work.
“Meeting the challenges of this health crisis head on is the essence of why people have chosen healthcare as a profession,” he told the Independent in an email statement Thursday evening. “Staff and employees throughout Yale New Haven Health are dedicated and courageous and make us proud every day.
“We have reviewed industry practice and found that very few peer hospitals offer ‘hazard pay.’ However, unlike most healthcare organizations, Yale New Haven Health offers annual performance bonuses and opportunities for special achievement awards for all of our employees – even in more traditional times. Rather than offering ‘hazard pay,’ we are reviewing other opportunities to recognize our staff and employees for their exemplary work in the midst of this international pandemic.”
“It’s An Emotional Roller Coaster”
YNHH workers at support rally.
Cupo said that rules governing PPE usage in her ICU have changed significantly since she saw her first Covid-19 “rule-out” on March 14. (A “rule-out” is a patient who has been tested for the novel coronavirus and is still awaiting lab results to determine whether that person is positive or negative.)
The very next day, she said, she showed up for work and was told she could use only one mask and one face shield for each patient she takes care of. That requirement subsequently changed to apply to any patient who is a rule-out or anyone who has tested positive.
Typically, she said, nurses don a new set of PPE every time they enter a room with a patient, and discard that PPE and wash their hands every time they leave.
“There was a week at least during which I wore the same face shield and N95 for three different [12-hour] shifts,” she said. “By the time it was my third shift, it felt degraded just by the act of me breathing in it.”
The clinical tech recalled going four shifts without changing a mask at the very start of the pandemic in mid-March. She said the elastic snapped on one of her masks.
“They told us to ‘use our discretion’ as to when a new mask would be needed,” she said.
As of now, they both said, the hospital’s rule is that employees wear a single mask for no longer than one 12-hour shift at at a time — and that they place their face shields, N95s, and droplet masks in different paper bags at the end of each shift for subsequent “reprocessing,” or cleaning with vaporized hydrogen peroxide for potential future re-use if the hospital runs out of PPE
They said that nurses who do not have access to N95 masks that fit properly are reusing controlled air purifying respirators (CAPRs), which are mini negative-air pressure helmets with single-use face shields.
And that nurses routinely wear the same yellow contact gowns in between patient rooms so as to preserve that now-rationed PPE.
And that nurses have stopped swabbing for the superbug MRSA in an effort to preserve PPE.
“There’s a lot of changes happening that make us feel unsafe,” Cupo said.
As for instructions, “it’s essentially like a game of telephone,” she said, with nurses inundated by emails with new guidelines on a regular basis.
For a while, the hospital had called off safety huddles, Cupo said, in order to follow social distancing guidelines. This made communication between staff extremely difficult. “At a time when there was most confusion, we hadn’t been getting clear information.”
The ICU has subsequently reinstituted safety huddles for front-line workers to share information about potential problems for patients and staff.
Both workers praised the hospital for providing staff with iPhones allowing nurses to communicate with patients without entering a room, and allowing them to set up FaceTime calls between patients and family members no longer allowed to visit.
“It’s an emotional roller coaster,” the clinical tech said about coming to work each day during the pandemic.
“There’s so much fear and stress, and rightly so,” said Cupo. “We have the sickest of the sick in our ICU. We have people who are on ventilators, who are unresponsive, who may be paralyzed or in extremely uncomfortable positions. That in itself is a very stressful thing.”
Add on top of that limited PPE and reduced physical interactions between providers and patients and family members, and that stress is amped up to another level.
Crying At A Remote Family Reunion
The clinical tech said that one recent interaction with a patient who fortunately recovered from Covid-19 exemplified the “emotional roller coaster” that is work for ICU staff during this pandemic.
She said that the woman was in the ICU at St. Raphael’s at the same time that her husband also had Covid-19 and was in the ICU at YNHH’s York Street campus.
Her husband had to be intubated because of the seriousness of his illness, she said. And, two days after the wife said she was so grateful she did not require intubation, she too had to receive the same level of medical intervention.
“Thankfully, she turned a corner and was able to get the tube out,” the tech said.
Her husband also recovered and was subsequently discharged from the hospital.
By the time that the wife no longer required intubation, she wanted to FaceTime with her recently released husband and their daughter, who lives in Florida.
So the clinical tech set up the FaceTime call from inside the ICU patient’s room.
The minute the daughter saw her mom’s face, the tech said, the daughter burst into tears from relief. The father did the same. And so did the mother, still a patient in the ICU but now on the mend.
Overcome by emotion at the remote family reunion, the clinical tech started crying as well.
That relief soon turned to panic and stress because the tech’s tears made her mask wet, shifted the mask and loosened the seal around her mouth, and led to her face mask starting to fog up with her own breath.
“I can’t touch [my mask] because my hands are contaminated,” she recalled. “It was like being punched in the gut” — knowing that two parents had gotten so ill with their daughter unable to visit, knowing that they have now recovered and are so relieved, and knowing that her mask had shifted as she was crying, potentially exposing herself to the virus during such a reunion.
The tech said she ultimately took off her mask, wet with tears and sweat, after her visit with the patient ended. She had had it on for almost an hour straight.
She placed it back in its paper bag, knowing that she still had roughly three-and-a-half hours to go on her shift.
“It dried, sort of,” she recalled. She then put it back on to complete her shift.
“It’s those things that kind of get to you,” she said. “A lot of emotions.”
Balancing Care, Safety, PPE
Cupo said she experienced a similar push and pull of how best to provide care and empathy while also protecting worker safety and rationing PPE in her recent treatment of an elderly man whom she described as “just the sweetest thing in the world.”
Someone “probably more active than I am, and very healthy otherwise, but unfortunately contracted the virus” and ultimately needed to be intubated, a state that he stayed in for several weeks.
She said that his central line had retracted and that the ICU staff had resorted to using peripheral IV’s as they spoke — through FaceTime — with family about what to do next.
“In any other circumstance, we probably would have been able to [put in a new central line] quickly and give the family the time they need to make decisions” about whether or not to transfer the man to hospice.
But doing such otherwise quick work requires extensive use of PPE, she said, and so everything “was on standstill” until the family decided on the next move.
“His care was not being optimized because of the fact that we were in this limbo,” she said.
The family ultimately decided they wanted a second opinion.
Eventually, staff did put in a new central line, and the man remains alive, though his condition is extremely fragile.
“It’s hard to balance,” she said, referring to staff exposure, use of PPE, care provided to patients, and input provided by family members through a phone or FaceTime.
Oftentimes nurses are left trying to get information to family and patients through a phone camera, or yelling through the window of a patient room’s door.
“It’s emotional,” she said. “This is unfortunately what we see a lot of.”
Hazard pay, she said, would represent a recognition by management that these are not typical times, and that staff are being asked to go “above and beyond what our job description says.”
Nurses and techs will continue to do just that, she said. And they deserve pay commensurate to the work they’re being asked to perform.
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Wouldn't it be a better use of money to have Yale New Haven Hospital system put their funds towards purchasing more PPE, rather than hazard pay? Much better to actually protect the workers, than to just give them extra money? It was my understanding that the enormous demand on PPE worldwide was making it more expensive to purchase, and YNHH needs any extra money they have to purchase as much PPE as they can. Plus, with elective surgeries on pause during the pandemic, the hospital system has less funds than they used to have before the pandemic?