FORT KENT, Maine — Registered nurses at Northern Maine Medical Center in Fort Kent are speaking out against the closure of the hospital’s child adolescent psychiatric unit and demanding more transparency from management.
Staff said they were abruptly told on Sept. 6 that the child psych unit would no longer be taking patients, and that the unit would be closing once its current patients were discharged. The final child was discharged the following Friday, Sept. 13, at which point the unit was permanently closed, according to staff.
No jobs were eliminated as part of the closure but nine nurses who worked in the unit were moved to other parts of the hospital where several had less experience, according to Terry Caron, an RN at NMMC with 12 years of experience in the child psychiatric union.
Caron said the Sept. 6 announcement came as a complete surprise. Caron is also a member of the bargaining unit in the hospital’s nurse’s union which is in contract negotiations with NMMC.
“Just as nurses and the community were not given any notice about the closure of obstetrics services in May 2023, we were not given any notice about the sudden closure of the child adolescent psychiatric unit a few weeks ago,” she said in a statement issued by the Maine State Nurses Association.
NMMC Marketing and Communications Manager Nichole Jandreau sent the BDN a Sept. 6 press release which announced the closure as part of NMMC’s conditional approval to receive designation as a Critical Access Hospital.
She said on Wednesday that all affected employees were notified of the closure before the public announcement via the press release was made.
The critical access designation helps rural hospitals stay viable by reducing their costs through offering fewer services than acute care facilities. It is a federal program administered by the Centers for Medicaid Services. The program limits the number of inpatient beds that a hospital can maintain, and the hospital chooses which beds to eliminate. NMMC, in this case, dropped the child psych unit beds.
The hospital closed its obstetrics unit last year, citing both the declining birth rate and hospital staff shortages. Because of this closure, the next nearest facility for mothers to deliver babies is at Cary Medical Center in Caribou, which is roughly 40 miles away from Fort Kent.
In January, nurses at the hospital voted to unionize and become part of the Maine State Nurses Association and National Nurses Organizing Committee. The union is still in contract negotiations, which began in April.
Bradley Martinez, a full-time RN in the ICU and emergency department for two years who is also on the union bargaining team, said the sudden closure has left his fellow employees feeling nervous about the future.
“I think this is a big reason why us, as nurses, decided to unionize,” Martinez said. “We’ve seen this shifting of services and sudden closures and sudden changes, and we want to maintain the things that we have now. We want to continue to grow and improve the services that we provide our patients in our very small community — who deserve honest, open, and transparent services.”
With the closure of the NMMC child psych unit, there are now no longer any such facilities available for children in Aroostook County. According to the Sept. 6 release from the hospital, 12 percent of the unit’s admissions came from the Fort Kent area whereas the rest were from downstate.
Caron said the closest available inpatient facility would be Northern Light Acadia Hospital in Bangor.
The Fort Kent unit served children between 4 and 17 years old throughout the entire state.
“They could come from as far as York County, down along the border of New Hampshire,” Martinez said.
Martinez said NMMC CEO Jeff Zewe held a forum after the unit’s closure and took employee questions. He said that management was asked how long they’ve known that the child psych unit would need to be closed. According to Martinez, management said they knew about this a year ago when they decided to apply for the critical access designation.
“When asked why they didn’t inform staff previously, maybe six months ago when they were in the [CAH] process, they said they didn’t want to invoke any fear in the staff,” Martinez said. “And here they are, September 6, telling people that in the following week they basically no longer have a job in their preferred unit.”
Jandreau said that management did not notify staff about this earlier because it was still only a potential closure. She said they did not want to invoke fear in case the closure did not end up occurring.
Caron said the closure did not result in the loss of any jobs, however nine out of the 12 nurses who worked in the psychiatric unit were moved to other parts of the hospital. She said this transition has placed many nurses in areas where they do not have as much experience.
“Psych is a specialty, and we go into psych for a reason,” she said. “And just like any other specialty, like OB or OR, you hope that when you have a loved one that goes into the hospital that the nurse caring for your loved one is in the area that they want to be in, not because they’ve just been displaced.”
Specialized work by nurses in the child psych unit included working with families, working with coping skills, helping children handle “big emotions,” or difficult to contain feelings, and how to deal with anger through behavioral modification. They also worked with LGBTQ+ youth and with children on issues such as self-harm and self-esteem.
“We ran the whole gamut of different things,” she said, “from working with kids with ADHD (attention-deficit/hyperactivity disorder), ASD (autism spectrum disorder), ODD (oppositional defiant disorder), depression, anxiety, and a multitude of other things to be able to help them function in their community, their home, and in their school as best as they could.”
