BANGOR,  Maine — With hundreds of nurses picketing outside in a cold rain for increased staff, administrators at Eastern Maine Medical Center said Monday that a three-day nursing work stoppage that began Saturday morning and is scheduled to wrap up at 7 Tuesday morning has proceeded smoothly and without any significant disruptions in patient care.
About 215 registered nurses from around the country were brought to Bangor to replace EMMC staff nurses during the work stoppage.
“Skilled nurses stepped onto the floors and immediately began providing excellent care. They were completely in sync with our expectations and worked seamlessly alongside our staff,” Lorraine Rodgerson, EMMC’s vice president and chief nursing officer, said in a prepared statement released Monday afternoon.
The hospital’s unwillingness to include specified baseline staffing levels in a new three-year contract has been a deal breaker for EMMC nurses, who maintain that the hospital consistently understaffs nurses, leaving patients at risk for medical complications and contributing to nurses’ dissatisfaction with their jobs.
The nurses delivered a strike notice Nov. 10. The hospital promptly announced it would impose an additional two-day lockout, citing cost efficiencies related to bringing in replacement nurses to work during the strike.
Replacement nurses took over at patients’ bedsides Saturday morning after the staff nurses signed out at the end of the night shift.
“I was on the floors all weekend,” Rodgerson said Monday. “Most patients did not realize there was anything unusual going on … the replacement nurses have done an incredible job.”
The hospital did make a decision to close the newborn nursery over the three days and initiated a “rooming-in” policy that kept newborns in their mothers’ rooms.
Another reflection of stress during the work stoppage was the diversion of some patients from the hospital’s emergency department and the decision to send some acutely ill patients transferring from smaller community hospitals to nearby St. Joseph Hospital in Bangor or other facilities in southern Maine.
Dr. Norman Dinerman, a specialist in emergency medicine and the medical director of EMMC’s transport and access management systems, said the hospital started a “selected diversion” of both transfer and emergency patients Thursday evening. That decision reflected the hospital’s “extra-high” census of 326 inpatients as well as the anticipation of replacement nurses coming in to work Saturday, Dinerman said.

Friday afternoon, the diversion status was changed to affect only some emergency ambulance patients, and by Saturday evening, EMMC was accepting both transfer and emergency patients normally.
A spokeswoman for St. Joseph Hospital said the 100-bed facility experienced a busy weekend but nothing out of the ordinary.
Despite a run of serious cases in the emergency department, including three patients who required emergency heart catheterizations, the process of working with replacement nurses was “surprisingly smooth,” Dinerman said.
“I think that’s because physiology and disease are the same everywhere on the face of the earth,” he said.
Outside on the sidewalks along State Street and Hancock Streets, striking nurses and their supporters began arriving shortly after 6 a.m. Monday to demonstrate their solidarity and their commitment to increasing staff levels.
“They cut back the total number of nurses, then they cut back the hours,” said nurse Bobbi Coombs of Hampden, who works on the fifth-floor orthopedic unit and has practiced at EMMC for 23 years. “It is getting harder and harder to provide the care we want to give.”
Emergency department nurse Cecile Martin of the Millinocket Regional Hospital, where staff nurses also are unionized, said several nurses from that facility came to the Bangor demonstration to support their colleagues.
Martin, who has practiced at the Millinocket hospital for 43 years, said nursing has always been a high-stress job. But recent trends in staffing have made things tougher, she said.
“Staffing has gotten much worse, particularly in these big hospitals,” she said. “It’s all about looking good on paper. But the people who really deliver the care are out here today.”
A noontime rally drew supporters from other labor unions, including United Steel Workers and the Maine AFL-CIO.
Although Gov. John Baldacci last week urged the two sides to resume negotiations “as soon as possible,” the next scheduled bargaining session with a federal mediator is Monday, Nov. 29. Vanessa Sylvester of the Maine State Nurses Association said nurses remain open and would meet sooner if the hospital indicates interest.
But Greg Howat of the hospital’s negotiating team said the Nov. 29 date will allow both sides an important opportunity for “self-reflection” after the drama of the three-day work stoppage. Unless the federal mediator calls the two sides together beforehand, he said the hospital is unlikely to initiate a meeting.
Howat said the hospital has no intention of including staffing levels in the nurses’ new contract.
With the nation’s health care regulatory and financial landscape changing, he said, hospital administrators must retain control over staffing decisions.
“Hopefully, the other side will abandon their staffing proposal,” he said. “But in this instance, both sides may be of the opinion there’s nothing that can change. Then we’ll just have to see what happens.”

Meg Haskell is a curious second-career journalist with two grown sons, a background in health care and a penchant for new experiences. She lives in Stockton Springs. Email her at