Bellows, Jackson join Houlton nurses striking for more overnight emergency room staffing

Nurses at Houlton Regional Hospital are on strike this week to protest what they say are insufficient staffing levels in the emergency department. 

The Maine State Nurses Association said the 55 nurses represented by the union will strike for four days this week and are calling on management to specifically increase overnight staffing in the emergency room.

“We want to have three nurses at all times in the ER, so we’re trying to convey that to management,” said Erin Mitchell, a registered nurse at the hospital and a member of the union bargaining committee. “It’s very important to have staff that’s available at all times. When critical patients come in, it’s hard to manage them if you don’t have enough nurses.”

The union said the ER typically has 3-4 nurses on staff during the day, but only two nurses from 11 p.m. to 9 a.m.

Mitchell said serious cases in the ER can often require two nurses, which then leaves no one to check on other patients. 

“And it’s hard to call people in, because once you have an emergent situation that requires more than two, you’re calling in the middle of the night, who’s gonna answer their phone, who’s gonna be able to get there in enough time to be able to help you,” Mitchell said.

The striking nurses were joined Wednesday morning by Democratic gubernatorial candidates Troy Jackson and Shenna Bellows, who said they supported the higher staffing levels the union called for.

“In my life I’ve been in the hospital a lot with my heart, and I have a lot of respect for the doctors, but really it’s the nurses that come in, tell you what’s going on, make you feel better,” said Jackson, who has had multiple heart surgeries and who was endorsed by the nurses union.

Bellows said the problems in Houlton are not unique, and are happening at other hospitals across Maine. 

“​​The challenges here in Houlton — the closure of the birthing center, the reduction in workforce at a critical moment, and the refusal to engage in a fair contract that supports nurses and safe patient-nurse ratios — is indicative of some of our larger systemic failures,” Bellows said. 

Nurses at Houlton Regional have been working without a contract since late 2024.

In a press release, the hospital called the decision to strike “disappointing” and said management is committed to negotiating in good faith and honoring the mediation process. 

“We value our nurses and the contributions they make to providing exemplary care to those we serve,” the statement said. “Nursing leadership works extremely hard every day and every shift to ensure that safe staffing is achieved.”

The union’s previous contract expired Nov. 30, 2024, and they have been negotiating the new contract for over a year and a half. 

Nurses raised staffing concerns last year, after the hospital closed labor and delivery services, and the union reached an agreement with the hospital to have three nurses working in the ER at all times. 

But shortly after, the hospital signed a management service agreement with Northern Maine Medical Center to provide executive management for Houlton. And since then, the union said the new leadership is not honoring that staffing agreement. 

The hospital said the staffing decision is driven by the fiscal situation of the organization.

“A year ago, Houlton Regional Hospital operations and financial outcomes were not sustainable,” the release stated. “Together, the entire hospital team has worked diligently to develop a turnaround strategy focusing on our community healthcare needs.”

The hospital statement said the organization has offered a 21% pay increase over the three-year contract period, and the staffing levels are within national benchmarks. 

Despite failure of patient ratio bill, Maine nurses union celebrates progress in staffing fight

“It is unfortunate that the union continues to make allegations that the hospital staffing is unsafe, however, we are utilizing the same staffing model that has been in place for many years that resulted in good quality outcomes,” the hospital said in the release.

Nurse-to-patient staffing ratios have been an ongoing issue in the state. In 2024, a legislative proposal to establish minimum staffing requirements was shelved after initially passing the Maine Senate. 

Registered Nurse Beth Cook, also on the bargaining committee, said striking is a last ditch effort, and the union has been trying to negotiate with management to solve the issue. 

Cook said it’s stressful for nurses to manage patients when there’s only two people working.

“It’s just a lot. You want to give people focused, attentive care,” she said. “No one likes to be seen in the ER and have long wait times, no one likes to be seen in the ER and have wait times between updates.”

Cook said the low staffing makes it challenging to manage the small details that make people feel cared about. 

“It’s not that we’re not rising to the occasion, it’s not that we’re not able to save your life and give you the care that you need here at Houlton Regional Hospital, but we want to be able to keep that community feel where it doesn’t feel rushed, you don’t feel forgotten about,” Cooke said.