About half of the nurses in the emergency department at Northern Maine Medical Center in Fort Kent have resigned, straining emergency care for patients at the 25-bed critical access hospital and worsening staff morale, said Ami Maxwell, a registered nurse in the emergency department and leader of the hospital’s nursing union.
In June, the emergency department had 13 registered nurses. Ten worked full time, and three worked flexible, per-diem shifts as needed. Since then, five full-time nurses and one per-diem nurse have left the hospital or put in their notice, said Maxwell and Kim Paradis, a nurse of 24 years who worked her last shift at the Fort Kent hospital on Saturday, Sept. 26.
In addition to the nurses, the emergency department’s manager abruptly left in June, the nurses said. Both Maxwell and Paradis said the hospital did not provide an explanation why.
“Everybody wants to leave,” Maxwell said.
Then, on Sept. 6, the hospital eliminated the waiting room clerk position responsible for checking patients into the emergency department at night, Maxwell and Paradis said.
Now the remaining nurses and other staff — who are trained on the registration process, according to the hospital — are responsible for checking in patients who may be experiencing an emergency. The next-closest emergency room is in Caribou, nearly an hour’s drive away.
When a patient walks in through the doors of the emergency department between 11 p.m. and 7 a.m., an electronic ding sounds in the back area where nurses and other staff are working, to alert them to come to the waiting room, Maxwell said.
The dual responsibilities are a danger to patients, she said, because nurses can’t respond to multiple significant traumas at the same time.
“We care about our patients, and they’re asking us to do things that we know are wildly unsafe,” Maxwell said.
The Maine Monitor asked the hospital what it was doing to ensure patient safety in the wake of the clerk’s departure.
In a written statement, the hospital responded, “Northern Maine Medical Center maintains a staffing model designed to provide safe, continuous emergency care 24 hours a day, seven days a week, ensuring patients have access to care at all times.”
The hospital did not respond to The Monitor’s request for an interview with Chief Nursing Officer Jennifer Albert.
Hospital spokesperson Pam Sime declined to comment on personnel matters. However, she said the hospital hires contract staff in the event of an unexpected staff departure to maintain coverage until a replacement is recruited.
Maxwell said the emergency department has taken on three contract nurses so far. Last week, Maxwell said, she trained the travel nurse who replaced her former coworker — a fellow nurse who was also a close friend.
Still, Maxwell and Paradis said they are concerned about patient safety, particularly overnight, from 11 p.m. to 7 a.m.
The hospital’s emergency department is staffed during this time by two registered nurses, one nurse practitioner or physician assistant, one physician, one security officer and a nurse supervisor, who does not take on an assigned patient load, according to the hospital’s statement.
Sime said a small number of patients come through the department overnight. It averages 19 patient visits per day — and one to two patient visits at night.
Last week, the hospital told employees it would cut overnight staff in the emergency department further, moving from two registered nurses to one nurse and a nurse technician, Maxwell said. The hospital scrapped the change, however, after criticism from staff, she said.
“[It is] not a model we are moving to,” Sime confirmed.
The hospital previously had only one registered nurse on staff overnight until 2023, when it added another nurse, according to the hospital’s statement.
Tension between the hospital’s administration and nursing staff has remained palpable after nurses voted to unionize and join the Maine State Nurses Association more than two years ago, Maxwell and Paradis said. Since then, nurses alleged intimidation and retaliation from the hospital, according to reporting by the Bangor Daily News.
After they unionized, communication between nursing staff and hospital administrators became severely limited, and the workplace became more toxic, Paradis said.
“I just didn’t recognize the place that I once worked at,” she said of her decision to leave the hospital.
Hospital spokespeople did not respond to questions from The Monitor about whether they agreed that there was low morale and how the hospital aims to treat employees.
The hospital and nurses agreed on a contract in May. The contract set out a standardized process to address staff grievances, protections from being fired without just cause and a pay raise, but not the nurse-to-patient ratios the union wanted, Maxwell said.
Financial challenges have added strain.
Northern Maine Medical Center maintained in its statement that its financial position has “vastly improved, year over year.” However, the hospital ended its 2025 fiscal year with $3.6 million in losses — its largest revenue loss since at least 2002, excluding 2005 and 2006 when data was not available, according to its tax forms. The hospital brought in more than $84.8 million in revenue, but its expenses topped $88.4 million in 2025.
It also lost $18,000 in fiscal year 2024 and $3.5 million in 2023. The hospital had a positive net income of $5.3 million in 2022.
The hospital said it has taken steps in response, including converting to critical access hospital status, a designation that helps rural health care facilities stay viable through special Medicaid reimbursements. It said it has “developed strategic partnerships to share costs.” And it has grown some specialty services for emergency patients.
In 2023, the hospital shuttered the obstetrics unit, citing a continuing decline in the birth rate alongside staff shortages at the hospital, following a similar trend across the state. Officials told The Monitor the decision was not financially related.
A year later, the hospital abruptly closed its child adolescent psychology unit to cut costs. The decision came as a shock to nurses, who told the Bangor Daily News they were not warned of the change. The closure prompted calls from nursing staff for more transparency from administrators.