Nurses at Eastern Maine Medical Center and the management of the Bangor hospital have called in a Federal mediator to help negotiate a contract.

The mediator presided over talks Thursday in which both sides tried to reach common ground over disagreements that included what sort of medical activities should be conducted by nurse assistants.

Hospital executives want a free hand in determining how to use those workers, who are paid less than RNs, while the nurses’ union argues some duties should be reserved for RNs because of patient safety concerns.

“… there are some activities, such as patient assessment, insertion of catheters and education, which should only be done by a registered nurse,” said a document made available to nurses.

“Unit 1 [the EMMC unit of the Maine State Nurses’ Association] feels this is a serious patient safety issue,” the document states.

Neither hospital management, nor the nurse’s union would comment. Representatives of each side said they had mutually agreed to a gag order that prevented comment to the press unless each had notified the other 24 hours before speaking to the media, they said.

Additional meetings with the mediator are tentatively scheduled for September 18 and September 24, according to the information made available to nurses.

The use of unregistered nurses has proliferated across the nation as hospital executives have looked to cut labor costs. The cost cutting has been driven by health maintenance organizations and other entities looking to reduce medical care costs. Cuts to Medicare reimbursements have also spurred budget cuts in hospitals.

Maine’s hospitals have been particularly vocal about the budgetary problems foisted on them by the 1997 Balanced Budget Act. That legislation changed Medicare reimbursement formulas to make Maine’s reimbursement rate the worst in the nation.

Amendments to the act have improved reimbursement for care from 80 cents to 88 cents on the dollar today, according to the Maine Hospital Association. Still, Maine’s reimbursement rate is still 46th in the nation, and the pain from impending cuts is expected to be significant, a spokesman for the Maine Hospital Association said.