On June 2 at dusk, 40 nurses, hospital workers and community members gathered at Triangle Park in Calais for a candlelight vigil, signaling their disagreement with the Calais Regional Hospital (CRH) board of directors' recent decision to close the obstetrics unit on January 1, 2018.
     he motivations of those who participated in the vigil, the second in a series of events aimed to save the obstetrics unit, ranged from personal to professional. Gena Maloney, a schoolteacher in Woodland, first sprung into action when the closing was announced in late May, sending messages to her friends and mobilizing 50 people to protest at the hospital. "Lots of us had our kids in Calais, and the care was amazing," Maloney explains. "A lot of us are planning to have more kids, and it is scary to go to Bangor or Machias."
     Expectant mother Miranda Turner of Robbinston, who participated in the hospital protest, shared her anxieties at the vigil. During her son's 2015 birth at CRH, Turner encountered serious complications. Dr. Hatem and his team immediately set to work and successfully resolved the issues. "I am very thankful, and I am scared to go to a different doctor. Machias is 45 minutes away. I would not have made it. I might have died in the ambulance," she says. Turner is hoping she will be able to have her next child, due December 27, at CRH.
     While participants stood in a circle holding lighted candles, facilitator Todd Ricker, labor representative of the Maine State Nurses Association/National Nurse United (MSNA/NNU), addressed the crowd. Describing the vigil as a "solemn event," he assured attendees, "We are prepared to fight. Tonight is only the beginning. The union believes they can win this fight and are committed to putting in the resources needed."
     The fight Ricker refers to is twofold: to save the obstetrics unit and to convince CRH to sever its 25-year affiliation with Quorum Health Resources, a for-profit Tennessee-based company that provides hospitals across the country with management and healthcare consulting services. In 2015, CRH paid Quorum $899,000 for fees and management personnel costs. "We want, as a union, our board of directors to make decisions to benefit our community rather than sending money to Quorum, an out-of-state consultant and their shareholders," said Beth Boomer, a member of the MSNA and registered nurse working in CRH's emergency room and inpatient care.
     For Boomer, a Baileyville native, nursing is a second career. After working 20 years at a paper mill, she completed a nursing degree and returned six years ago to serve her community. "Our presence here at the vigil is trying to show our support and protect our hospital, keep it open to provide required healthcare to serve our communities needs and keep people safe," she explained. "I am a nurse, and I do it to care for people."
     Nurses and community members do not accept the hospital administration's statement that declining admissions and births, a nursing staff shortage and an unsustainable financial burden justify the obstetric unit's closure. "If Calais Regional is losing money, we should manage our departments better to save money and work on public relations and make money so the communities we serve will trust us and utilize our services," Boomer suggested. She strongly encouraged people to educate themselves and pay attention to what is going on. "Over the last several years, Quorum has closed our intensive care unit, special care and pediatrics units. Now the [OB unit]. This leaves us the emergency room, operating room and inpatient care. What department is next, or is it the whole hospital?"
     Nurses at the vigil voiced fears that closing the obstetrics unit will affect operating room services. Currently, CRH's operating room is open round the clock, seven days a week. If emergency cesarean sections no longer are a concern, the operating room may cut back to daytime hours only. Since a women in labor cannot be transferred to another hospital, should the need for an emergency cesarean section arise when the operating room is closed, the procedure will have to be done in the emergency room. On the day of the vigil, Calais' emergency room nurses received notification that they will be getting 12 hours of training in obstetrics, but they argue this is not sufficient and is not safe.
     Lisa Dereszewski, a Princeton resident and online local business owner, is convinced the obstetrics unit closure will have an overall negative impact on the local economy. "I am not sure Calais can recover. Businesses look for good schools and hospitals when deciding where to locate. We must attract businesses." Dereszewski, who has been researching Quorum and their hospital closures nationwide, pointed out, "This is not unique to Calais." She encourages the community to take action. "We have to come up with a game plan, not just say 'no.' We have to address the problems of rural hospitals and build coalitions with organizations like the National Organization for Women and Planned Parenthood."
     According to Ricker, a game plan is what the MSNA/NNU has in mind, alluding to "ongoing strategies and escalation plans." Ricker offered those at the vigil hope, citing the example of Down East Community Hospital (DECH) in Machias, which severed its relationship with Quorum yet assisted in 150 births in 2016 and whose obstetrics unit now is operating "in the black." If CRH proceeds with its plan to close its unit, DECH will be the only hospital in Washington County equipped to deliver babies.