BANGOR – Unionized nurses at Eastern Maine Medical Center say they’re chronically overworked, putting patients at risk and contributing to the profession’s high burnout rate. And though EMMC maintains it staffs comparatively more nurses than most hospitals, data collected from Maine hospitals since 2006 show the nurses may have good reason to feel overwhelmed.

According to a recent statement from the hospital, EMMC staffs more generously than a nationally accepted model recommends, “because administration acknowledges that our nurses care for some of the sickest, most clinically demanding patients in Maine.”

But staffing data collected from all Maine hospitals since January 2006 shows that EMMC has a recent history of providing less nursing care than other similar hospitals in Maine.

Comparing Maine’s four largest hospitals – EMMC, Central Maine Medical Center in Lewiston, Maine Medical Center in Portland, and MaineGeneral Medical Center in Augusta and Waterville – EMMC in the first three quarters of 2006 staffed fewer than average registered nurse hours and below-average overall nursing care hours per “patient day.” A patient day is a measurement that reflects the needs of an average inpatient over 24 hours.

The numbers at EMMC improved between October and December 2006.

The information comes from the Maine Quality Forum, a state agency that collects and compares hospital performance data. According to the agency, between January and September 2006 EMMC provided just 5.81 RN hours per patient day, compared to an average of 6.31 RN hours per patient day provided by the peer group. During that same time period, Maine Medical Center provided 6.34 hours of RN care, CMMC provided 7.02 hours of RN care and MaineGeneral provided 6.60 hours of RN care.

In the final three months of 2006, EMMC provided 6.94 hours of RN care compared to the average 6.86 hours.

Also during the first three quarters of the year, EMMC provided lower than average total nursing care hours – including RNs, licensed practical nurses and nursing assistants – according to the quality forum data. With the peer group averaging 8.82 total nursing care hours per patient day, EMMC provided 7.93 hours. MMC provided 9.23 hours, CMMC provided 9.83 hours and MaineGeneral provided 8.43 hours.

In the final quarter of 2006, EMMC provided 9.42 hours of total nursing care compared to the 9.52 average, according to the state agency.

More recent data is not available from MQF.

On Wednesday, Lorraine Rodgerson, vice president and chief nursing officer at EMMC, said increased nursing care hours in the final quarter of 2006 reflect the increased severity of patient needs at the hospital. As smaller hospitals in the area have cut back on services, she said, EMMC is accepting a growing number of northern Maine’s sickest patients, a trend she expects to continue into the foreseeable future.

Rodgerson maintained that EMMC staffs “better than most” hospitals in Maine, using a nationally accepted formula to determine baseline staffing needs for each unit and then adding or cutting back according to how many beds are filled, how much care those patients require and other factors. It’s that kind of staffing flexibility, Rodgerson said, that has led to EMMC’s consistently high patient satisfaction scores as well as its low rates of nursing-related problems such as bedsores.

“Our nurses are doing a very fine job,” she said.

But regardless of how EMMC stacks up in comparison to other hospitals, it’s evident that nurses there feel staffing is inadequate. After months of negotiation, the hospital’s 870 unionized nurses announced their intention to stage a 24-hour walk-out on Oct. 17, a threat that seems likely to materialize if a last-minute meeting today doesn’t result in a compromise.

Chief among the nurses’ demands is the formation of a committee made up of only staff nurses that would make staffing recommendations directly to the hospital’s chief nursing officer. Hospital negotiators have said they won’t even consider a staffing committee that bypasses nurse managers, calling it an unacceptable departure from the institution’s “culture of inclusion” and an irresponsible challenge to its bottom line as a business.

But according to Dr. Dennis Shubert, former chairman of the hospital’s department of surgery and former director of the Maine Quality Forum, the nurses’ repeated strike votes reflect their “very deep concerns” regarding staffing levels.

As a former administrator, Shubert this week called the idea of allowing direct-care nurses to set their own staffing levels “intolerable.” But, he added, the MQF data is clear that EMMC has a pattern of staffing at lower levels than similar hospitals.

“If I’m a nurse working in this institution, there will be periods when I’m feeling pretty overwhelmed,” he said.

Judy Brown, a staff nurse at EMMC and president of the hospital’s nursing union, said Wednesday that there’s no question that her colleagues are being asked to do too much.

“Why else would so many nurses be so upset?’ she asked. While she said she was unaware of any scientific studies that show the effectiveness of staff-nurse-only staffing committees at improving either patient care or job satisfaction among nurses, Brown said it’s common sense that both would benefit.

“We’re not going in [to today’s meeting] with anything new,” she said. “But we’re willing to talk.” The union has already made significant changes to its original demand for the staffing committee, she noted, but the hospital remains dead-set against the notion.

At EMMC, Vice President for Communications Jill McDonald acknowledged that nurses at times experience job-related stress, regardless of the apparent adequacy of staffing levels.

“You can’t say someone doesn’t feel too busy; that’s not fair,” she said. While the hospital cannot accept the staffing committee the union has proposed, she said, EMMC is committed to working with nurses to ensure quality patient care, job satisfaction, and the hospital’s fiscal responsibility.