Machias hospital turns to mediation amid union negotiations

The union’s chief nursing representative said wages and concerns about patient safety are the main stumbling blocks.
A small group of picketing nurses.
DECH nurses, including emergency room nurse JJ Walker (front), picket in front of the critical care hospital on the final day of a two-day strike. Photo by Alan Kryszak.

A federal mediator is stepping in after a strike earlier this month by Down East Community Hospital’s 50 nurses and technicians failed to end an impasse.

A new round of negotiations will begin May 16, with the mediator facilitating talks between the hospital and the Maine State Nurses Association.

The Maine State Nurses Association represents 33 nurses and 17 technicians across various departments at DECH, roughly 12 percent of the workforce at the 26-bed facility in Machias. They have been working under the terms of a two-year contract that expired in mid-October.

Already strained talks between the hospital and union, which began in September, again broke down following the two-day strike. The union gave the hospital 10 days written, advance warning of its intent to strike. 

The hospital abruptly canceled a negotiating session scheduled for the day prior to the strike, according to Roberta Alley, the DECH chief nursing representative and negotiating team member. She said DECH subsequently asked that a mediator be brought in for future negotiations. The mediator’s recommendations are non-binding. The union agreed to DECH’s request for mediation.

“Some of the concerns that we’ve had, haven’t really been addressed … concerns about patient safety, and recruitment and retention,” Alley said. “Those concerns didn’t seem to be a priority to (DECH).”

The hospital declined to answer The Maine Monitor’s questions about seeking mediation. Julie Hixon, the DECH spokesperson, said only that it looks forward to continued negotiations.

Alley said higher wages and patient safety are the main stumbling blocks, including staffing levels, patient ratios, and the hospital’s heavy reliance on traveling nurses and technicians. Alley sees all of the issues linked to what the union says are anemic wages. 

The nurses held two rallies in late January to nudge progress and drum up community support. But with only meager progress since then, the union decided to strike. All 50 union members took shifts during the two-day walkout, according to Alley. 

Although there have been two nurses’ strikes at other Maine hospitals, this was the first at a designated critical access hospital in Maine, according to Charles J. Betit, an MSNA labor representative. 

“In addition to per diem workers and travelers, the hospital’s highly qualified nurses, imaging, and lab staff management stepped in to continue the care of our patients during the strike to ensure that care was not disrupted,” Hixon said. 

Hixon said surgery patients were also rescheduled to different days and obstetrics cases were “on diversion,” meaning they were sent to other OB-staffed hospitals during the strike. 

DECH’s decision last year, without union approval, to have nurses flex into the highly specialized OB unit positions is a major concern. Another is the hospital’s reliance on traveling nurses, which the union says hurts recruitment.

The hospital regularly fills staffing shortages with traveling nurses — costing between $180 and $300 per hour per provider, plus the cost of temporary housing. The use of traveling nurses nationwide has risen since the pandemic, a problem exacerbated as some full-time nurses, including some at DECH, leave for the higher-paying traveling positions.

DECH nurses start at $30.90 per hour and go up to $44 per hour, according to union officials. The average wage for a registered nurse in Maine was $84,340 last year, according to state data, or around $41 per hour.

DECH most recently proposed a 1 percent proposed pay increase, well below inflation levels that hover around 3.5 percent. Alley said the offer isn’t enough to recruit or even retain nurses. To be able to continue working in the area, she said some nurses are taking second jobs. 

Currently there are 15 nurse and tech vacancies at DECH. But all imaging positions have been filled due — at least in part — to substantial pay increases — ranging between 13 and 20 percent. DECH granted imaging technicians substantial pay increases outside the bargaining agreement over the last year to remedy severe staffing shortages in those departments, according to the union.

“We had an X-ray department that was completely staffed with travelers and now our X-ray department is completely staffed with full-time people,” Alley said. “So (DECH administrators) know what they need to do.”

According to the nonprofit hospital’s Internal Revenue Service Form 990 filing for 2022, the most recent year available, top administrators at the 501(c)(3) are receiving substantial pay hikes.

Lynette Parr, the chief financial officer, earned $93,128 more from 2020 to 2022, while the salary for Steve Lail, the chief executive officer, increased by $106,258 over the same period, gains of roughly 38 and 48 percent. DECH reported a net income of roughly $16 million in that period.

A sign at the hospital's entrance denotes the name of the hospital and that you are driving towards the emergency room entrance.
The Maine State Nurses Association represents 33 nurses and 17 technicians across various departments at DECH, roughly 12 percent of the workforce at the 26-bed facility in Machias. They have been working under the terms of a two-year contract that expired in mid-October. Photo by Alan Kryszak.

Some health-care advocates believe increased minimum staff ratios would encourage hospitals to offer higher pay to nurses to bolster staffing to meet mandated levels. But a bill that would have mandated higher ratios for nurses statewide failed to pass both houses of the legislature.

Meanwhile, recently enacted federal rules that mandate minimum staffing levels at nursing homes could siphon nursing professionals from an already depleted pool, potentially making it even harder for hospitals to fill vacant positions. With nurses burning out due to shortages and frustrated over lagging pay, strikes around the country are on the rise, NurseJournal.org reports.

DECH previously told The Monitor that rising health-care costs and reduced reimbursements limit their resources even as health-care needs in Washington County – the poorest in the state – have increased. Over the past decade, DECH has tripled the size of its emergency room, and expanded primary and specialty care.

“As a small, independent hospital organization, we are crucial to the well-being of Washington County communities,” Hixon said. “The decisions we make must be financially sustainable, so the hospital’s future is not put into jeopardy.”

Bargaining headaches will soon double for DECH. A union contract with nurses and lab technicians at its sister hospital in Calais will expire May 31. Negotiations are just beginning.

Correction: Because of an error introduced during the editing process, this story has been updated to clarify that a bill that would have mandated higher ratios for nurses statewide failed to pass both houses of the legislature. It has also been updated to correct the designation of critical access hospitals.

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Joyce Kryszak

As the Washington County reporter for The Maine Monitor, Joyce Kryszak writes stories crucial to the people of this remarkable, rural, coastal community. A Buffalo, New York transplant, Joyce previously reported for NPR and its affiliates, Voice of America, New England News Collaborative, The Environment Report, Native Voice, Buffalo News, and Down East Magazine. Her in-depth reporting on government, social justice, cultural affairs, and the environment earned her an Edward R. Murrow Regional Award, dozens of Associated Press awards, and Maine Press Association awards. Joyce, her husband, Alan, and their Great Pyrenees, Kashmir, live, work, and hike all over Downeast Maine.
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