HOULTON, Maine — A fourth negotiation session Thursday evening, this one overseen by a federal mediator, failed to resolve a contract dispute between about 100 unionized nurses and administrators at Houlton Regional Hospital.
A fifth meeting has been scheduled for January even though an extension of the existing contract will expire on Dec. 31. The nurses agreed to the extension after their contract expired earlier this fall. Negotiations between the two parties started in November.
“We are pretty disappointed with the results of the meeting today,” Maine State Nurses Association spokeswoman Vanessa Sylvester said Thursday evening. “We will be passing out leaflets in the community this weekend to educate people about the work we do and the safety issues we are facing.”
The registered nurses, who are represented by the Maine State Nurses Association-National Nurses United, have pinpointed several areas where they would like to see changes in the agreement.
Major issues, they say, include safe staffing in the acute care unit, the long-term care unit and the emergency department. In particular, nurses would like to have additional positions in the emergency department and long-term care on key shifts and at night.
Dawn Kerekes, a registered nurse in the emergency department, said she considers that department to be the community’s “gateway” to the hospital.
“We are looking for staffing levels that will ensure patient safety — that is our top priority,” she said. “Having appropriate staff is also a safety issue for nurses and ancillary staff.”
“I think that staffing in the emergency department is an issue that is important both to the nurses and to the community,” Sylvester said. “Additional nurses equal additional safety and shorter wait times for patients.”
According to Sylvester, nurses in the emergency department have been bitten, hit and spit at while dealing with patients. The Houlton Police Department responds to calls from the hospital, but Sylvester said that response time affects every situation in terms of safety.
“The police can’t always be there right when you need them,” she said.
Tom Moakler, the hospital’s CEO, said Thursday that he was hoping an agreement would be reached soon.
He said that the biggest issue facing his hospital and others across the state is funding. The state owes the facility $4 million for the care it has extended to patients covered by the MaineCare program since 2007. The hospital put together its 2011 budget in October, and for the first time in 14 years, he said, the $44 million budget contains no wage increases. The hospital also is proposing cutting back on matches to employee 403(b) retirement savings plans.
Because of the outstanding bills left unpaid by the state and a decline in the number of patients it usually sees, the hospital already has had to borrow $1 million.
“Given the situation with the state and the cash flow, we just don’t have the money,” Moakler said Thursday. “And we feel that our staff pattern here is adequate, so there is no need for additional staffing.”
He also disputed safety concerns, saying that the hospital’s safety record is “excellent.”
Hospital officials said that the decline in patients was mainly because of the economy, as people who have lost jobs and health insurance have put off receiving care. In some areas, the volume of patients is down 4 or 5 percent. The hospital has seen a decline in emergency room visits and inpatient stays. Because inpatient stays are down, so are the number of tests, such as X-rays and blood work.
Sylvester said that the nurses have heard that there is no money for nurses’ concerns, but added that they were rejecting the argument because of the money the hospital has spent on upgrades and renovations. Work has been done to Houlton Family Practice, which houses a number of physicians offices, its clinic area and the In-formation Systems Department.
While some of that work was made possible through federal grants, the hospital still had to kick in some money, she said.
“If they have money for renovations, they should have money to meet our concerns,” said Sylvester. “Some of our safety concerns would be cost-neutral. We also are not asking for more money. We understand that times are hard and that very few people are getting raises. But valid concerns have been raised and they should be met.”
The Houlton nurses are represented by the same union that covers nurses at The Aroostook Medical Center in Presque Isle and Eastern Maine Medical Center in Bangor. The TAMC nurses recently negotiated a new contract after four months of talks and the threat of a one-day strike.
According to union members, the contract ratified by the TAMC nurses includes “many new patient safety provisions that was the key issue for the nurses.”
After months of negotiations, unionized nurses at EMMC left the bargaining table Wednesday without a contract agreement. Nurses staged a one-day strike on Nov. 22, preceded by a two-day lockout initiated by the hospital. The major disagreement between the two groups includes staffing ratios, health insurance and job protection provisions.