BANGOR, Maine — By the time most people finish their first first cup of coffee Monday, nurses at Eastern Maine Medical Center will already be picketing outside the hospital.
The nurses are holding a one-day strike, beginning at 7 a.m., to push for changes in patient-to-nurse staffing levels and other items in their pending three-year contract.
“We have been trying since the end of August to get the hospital to talk to us about our staffing concerns, to improve staffing and thus improve patient care,” Judy Brown, president of the nurses union at EMMC, said Sunday. “It’s really sad in many ways that it has to come to this type of demonstration.
“This is not about money,” she said later. “This is about patient care and patient safety.”
Nurses are scheduled to line the sidewalk in front of the hospital at 6 a.m., but will not raise their picket signs until 7 a.m. due to labor laws.
EMMC administrators hired 215 replacement nurses to fill the empty slots during the strike and a two-day lockout held Saturday and Sunday. The union nurses were told not to come to work and to stay off hospital property on those two days.
Contract negotiations that began in July between the 830 EMMC union nurses and hospital administrators stalemated over several key issues, the biggest being nurse-to-patient staffing levels. Health insurance and job protection are among others.
Hospital administrators maintain that staffing levels are adequate to ensure patient safety and that staffing decisions must remain in the hands of managers and administrators.
As part of the three-day work stoppage, ambulance calls from out of town were sent to St. Joseph Hospital on Broadway, and EMMC’s core nursery was closed, officials said.
“Those outlying hospitals that are transferring patients into the area are coming to St. Joseph’s,” Bethany McKnight, spokeswoman for the hospital, said Saturday evening. “They are sending them our way instead of to the Eastern Maine Medical Center’s network.”
Extra staff was put in place at St. Joe’s emergency room and other critical service areas Saturday, McKnight said, and the hospital plans to maintain higher staffing levels during all of EMMC’s work stoppage.
EMMC’s core nursery, which typically is where newborns are sent for observation, was closed, Jill McDonald, EMMC spokeswoman, said Sunday.
“The babies are with their mothers,” she said, adding that rooming babies with their mothers is standard practice in other hospitals. “We decided to do it this way to help the nurses on the wards be more efficient. It’s not a staff issue; it’s an efficiency issue.”
Norm Dinerman, attending physician in the emergency room, said a handful of patients were transferred to other facilities before the replacement nurses began working Saturday and that EMMC is partnering with other health care facilities in the region to ensure patients get the care they need.
“St. Joseph’s has been fabulous,” he said, thanking all agencies that have stepped forward to lend a hand.
EMMC officials contacted Penobscot Regional Communications Center on Friday and asked that ambulance calls to the state’s second-largest hospital be diverted before the lockout Saturday, according to Tracey Erickson, a communications center supervisor.
Such diversions are not uncommon in situations of reduced staff or a full hospital, according to Suzanne Spruce, Eastern Maine Healthcare Systems’ community relations director.
Bangor Fire Assistant Chief Rick Cheverie said Saturday afternoon that the lockout has not caused any issues for his department’s ambulance service.
“As far as I know, it’s business as usual for us,” he said.
A group of EMMC nurses — some dressed in their work scrubs — showed up for work early Saturday morning even though they had received a notice saying they would not be allowed into the hospital.
“We’re not allowed down there,” said a 23-year veteran nurse from Winterport standing on the sidewalk at the corner of State and Hancock streets in front of the hospital. “Trespassing is what they would charge us with. We got a written notice.”
The letter states that “any nurse on the property before Tuesday would be charged with trespassing,” a 19-year veteran EMMC employee from Glenburn said.
The two nurses, who asked not to be identified by name, joined approximately 100 other union nurses and their supporters lining the sidewalk Saturday morning to support nurses who worked the overnight shift, which is the last EMMC-nurse-staffed shift before the two-day lockout and Monday’s strike.
“What was really hard for us was leaving our patients yesterday and knowing we would not be back to care for them,” Cokie Giles, president of the Maine State Nurses Association and an EMMC nurse for 22 years, said Sunday while surrounded by her fellow nurses.
“There has been a lot of tears,” she said. “It’s a very difficult thing to ask nurses to strike and leave patients. That is not in our nature. It’s not in our makeup, but we need more nurses on staff. We need more nurses to care for our patients.”
Around 70 EMMC nurses have volunteered to be on call if the hospital needs them for an emergency, she said, adding that “Eastern Maine is a great place to work, and I’m very proud to work here.”
Brown said she and other union nurses are upset that the hospital barred them from their place of employment.
“The decision by EMMC to lock us out is completely consistent with their behavior throughout this process,” she said in a statement. “Our concerns over the safe staffing of nurses to patients remain ignored.”
No one was arrested for trespassing Saturday morning, and the transition with the replacement nurses was well-organized, McDonald said.
“It went as smoothly as we expected that it would,” she said. “A lot of planning went into it, so we’re glad we did that planning.”
At a 1 p.m. press conference Saturday, Brenda Joslyn, nurse manager for CancerCare of Maine, said, “The agency nurses … jumped right in” and are doing a good job.
Paul Bolin, director of employee relations, said more than 100 of the replacement nurses were working Saturday. McDonald added that the replacement nurses “are being supervised by other nurses on the wards who are not part of the bargaining unit.”
Hospital officials declined to provide the exact number of nurses — both replacement and EMMC nurses — working Saturday afternoon, saying only that there were “enough to do the job,” according to McDonald.
Of the 1,000 or so EMMC nurses, 830 are union members, she said.
To prevent union nurses and their replacements from interacting, EMMC stepped up security in parking areas and at the hospital’s entrance, requiring all who entered to be screened.
“We felt it was prudent” to ensure there was no disruption in patient care, Bolin said. When asked who was being stopped by the screeners, he said, “The nurses who are on strike,” referring to those who are locked out Saturday and Sunday and who plan to strike Monday.
The hospital has declined repeatedly to provide cost figures for hiring the replacements, but officials have said they created cost efficiencies by hiring the replacements for three days instead of just one.
McDonald said she could not give specifics about costs, but she did say, “It’s costing a lot. We’re not even sure what the final number will be.”
An inspector from the Maine Department of Health and Human Services inspected the hospital Saturday “because we’re in an unusual situation,” said McDonald, adding that the inspector left without any comment.
Members of the Eastern Maine Labor Council, the Maine AFL-CIO, state legislators, a newly elected Bangor City Council member and at least one Bangor firefighter stood with the nurses Saturday.
“We’re just here to support the nurses,” said Ron Green, a firefighter-emergency medical technician for Bangor Fire Department, who stood with his wife, Emily. “We, the firefighters, bring patients to the nurses every day and know how understaffed they are.”
Charles Longo Jr., who was elected to the Bangor City Council earlier this month, said he was standing with the nurses because he wanted to “support the people who take care of us.”
“I’m on the side of the patient,” he said.
Sarah Bigney, a staff member of the Maine AFL-CIO, said the organization and fellow union members support what the nurses are doing.
“We’re very proud of the nurses for standing up and being strong in the face of a very tough hospital administration,” Bigney said.
Maine AFL-CIO members, including president Don Berry, will be on hand Monday during the strike, she said.
After the last of the EMMC overnight shift nurses left work Saturday morning, the crowd of supporters stopped for a moment of silence.
“Many of these people came dressed in scrubs because they were scheduled to work this morning,” Giles said. “I want to thank all the people who showed up this morning.”
Locked-out nurses gathered later Saturday morning at the Bangor Motor Inn, which has been dubbed strike central, to organize and prepare picket signs for Monday’s strike.
“We’ll be out there the whole day,” Vanessa Sylvester, coordinator for the nurse’s union, said Sunday. “The nurses are really resolved to have our patient safety issues addressed. It’s not something we want to do.”
In addition to Monday’s strike, union nurses and their supporters will be at the hospital’s front sidewalk early Tuesday “to welcome the first shift of people going in on Tuesday,” she said.
The next round of talks between the union and the hospital is scheduled for Nov. 29.