Optimism is waning as contract negotiations have grown contentious between Down East Community Hospital administrators and the Maine State Nurses Association. 

The previous agreement expired Oct. 18 for DECH’s roughly 50 nurses and techs, who share a contract. As talks drag on, the employees are working under the terms of the previous two-year agreement. 

A December negotiation session ended with the sides unable to hammer out a deal. Union representatives said DECH isn’t budging and a strike possibility looms.

Both sides said when negotiations began in mid-September, there was steady progress on issues such as longer break times for nurses working 12-hour shifts.

But as the union pushed for a bigger salary bump and more definitive language for other non-economic issues, such as part-time staffing and traveling nurses, talks broke down, according to Roberta Alley, DECH’s chief nursing representative and negotiating team member.  

Alley said hospital officials at the Dec. 19 session gave a “take-it-or-leave-it” proposal the union considered far from acceptable, failing to address issues she and other union representatives believe cause patient safety concerns that prompt veteran nurses to flee for other jobs.

Alley said the membership is willing to walk out if necessary.

“This is our hospital. This is our community,” Alley said in an interview with The Maine Monitor. “We all care about our community, and we just want our hospital to be a place where people want to come work.”

Alley said morale at DECH is at an all-time low, citing staffing shortages she believes could be remedied, at least in part, by contract language that would permit more part-time nurses and curb the use of traveling nurses.

But Alley said the hospital made it clear in December it was unwilling to move on what union officials call “more definitive language.” 

C.J. Betit is a labor representative for the state and national nurses’ associations (MSNA/NNOC/NNU), and a member of the bargaining team. In a Dec. 27 social media post, he said the hospital’s stance amounted to an ultimatum.

Betit also said in his post that the union was presented in December with what DECH officials called their “last, best and final offer” on non-economic issues, saying future compensation would hinge on the union taking the deal. 

Julie Hixon, the DECH communications director, did not directly respond to Betit’s post in an email, but said the hospital will continue to negotiate in good faith. She added that DECH has financial limitations. 

“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.”

Relations between DECH and its nurses at the Machias-based facility have grown increasingly strained because of staffing shortages, caused in part by the COVID pandemic, and an increase in the number of traveling nurses.  

Also, last June the hospital decided to merge its medical surgery and obstetrics departments, which Alley said will require nurses without specialized OB training to sometimes work on potentially high-risk OB deliveries.

The hospital’s decision to have nurses flex across both departments was highly unusual in the industry, according to the union.

But DECH officials said it was the only way to preserve prenatal care and births in the far-flung county, where women can travel as much as two hours each way for OB services at other hospitals. Calais Community Hospital, also operated by DECH, was forced to close its OB unit in 2018 before DECH acquired the bankrupt facility.

Due to increasing costs in obstetrics and declining births statewide, roughly 12,000 in 2021, at least nine other Maine hospitals closed their OB departments in the past 15 years, including Northern Maine Medical Center last summer. 

Alley said DECH’s decision to merge the departments was presented to the nurses basically as a done deal, outside the contract terms. Forty nurses working at the hospital in Calais have a separate contract that expires in May. Negotiations have not begun, according to union officials.

Although she supports keeping the availability of obstetrics in rural Washington County, Alley said many DECH nurses are not comfortable working with highly specialized OB cases. She said although the department merger has not been fully implemented, some nurses have left, voicing safety concerns.

Staffing shortages also added to their concerns over safety, as well as fatigue from added duties, and lagging pay. The nursing staff has about 20 vacancies. 

Alley said DECH’s most recent economic proposal offered meager salary increases (1% — .5% — 1%), far less than the minimum of 5% the nurses are seeking as a first-year bump to compensate for added workloads during the COVID surge.

Some other hospitals statewide, such as Northern Light AR Gould Hospital in Presque Isle, which ratified its nursing contract last July, agreed to an initial pay increase of nearly 9%, according to National Nurses United.

But DECH officials argue the small independent hospital in Machias has fewer resources, with  reduced reimbursement rates failing to keep up with costs. They also pointed to recently proposed reimbursement changes at the state level.

Hixon, the DECH’s communications director, wrote that over the last five years the company has made significant strides in compensation for union employees.  

DECH nurses start at $30.90 per hour, ranging to as much as $44 per hour for nurses employed for 23 years or more, according to union officials. Alley said a 1% hike would do little to boost those salaries, especially given inflation.

Hixon in turn added that the salary offer is just one part of the overall compensation a union member receives.  

“Referencing just one small piece of our discussions and their compensation can paint a different picture than the actual negotiation with a union,” Hixon wrote. She did not elaborate about compensations beyond salaries and benefits.

Still, Alley said increasing pay on par with other hospitals is a big part of what’s needed to keep and attract nurses in the poor rural community. As numbers continue to dwindle due to poor morale, Alley said concerns over patient safety only grows.

The concerns are so great, according to Alley, that if contract offers do not address them, there is unanimous support among the union membership to walk out until they do.

“We still feel like there’s room for movement,” Alley said. “But you know, we feel that it could go either way.”

A bill making its way through the state legislature, L.D. 1639, could force hospitals to more appropriately align staffing and patient ratios.  But that could also decrease  the demand for traveling nurses, who often earn three times as much as staff nurses, by encouraging local nurses to take permanent positions at hospitals close to home, according to a representative for  Sen. Stacy Brenner (D-Cumberland), who sponsored the bill If passed, the bill could, conceivably,  lessen the financial burden on small, struggling hospitals such as DECH. 

Meanwhile, both sides in the Down East Community Hospital negotiations have indicated that talks could be nearing an impasse. They are scheduled to meet again Jan. 17.