LEWISTON – The special care nursery and pediatric inpatient unit at Central Maine Medical Center have fully reopened after staffing shortages forced both units to close in October, hospital officials confirmed this week.
The pediatric unit fully reopened Wednesday. The unit shares a floor with the adult inpatient unit, and pediatric capacity can flex from no beds, as was the case when admissions were halted, to up to 10, Dr. Rebecca Brakeley, director of pediatric hospitalists at CMMC, said Thursday. The unit typically hovers around five to six beds.
The special care nursery, or neonatal intensive care unit, reopened April 10. Hospital officials announced its reopening in an internal newsletter dated April 18 but made no public announcement. Elaine Law, the nurse leader for the maternity, postpartum and special care nursery units, confirmed its reopening in an interview Wednesday.
The units were able to reopen after the hospital was able to make new hires and retrain some staff to serve on those units.
CMMC’s special care nursery is one of two Level II special delivery and neonatal care units in Maine, along with MaineGeneral Medical Center in Augusta. Level II special care nurseries, according to designations set by the American Academy of Pediatrics, are equipped to care for babies born no earlier than 32 weeks and at least 1,500 grams, or a little more than three pounds.
There are two Level III/IV neonatal intensive care units in the state for babies born before 32 weeks or that weigh less than 1,500 grams or with critical illness, at Maine Medical Center in Portland and Eastern Maine Medical Center in Bangor.
While the special care nursery was closed, laboring mothers were usually sent to either MaineMed or EMMC to deliver, if possible. Preterm babies born at CMMC were stabilized and transported, Brakeley said. That protocol was the same before the unit closed if a baby was born before 32 weeks or critically ill.
The nursery and pediatric unit closed Oct. 25 and Oct. 12, respectively, of last year.
“This action is being taken due to resignations of key staff that exacerbated an already fragile health care workforce,” hospital officials said in a statement Oct. 12 confirming that the hospital had temporarily halted pediatric admissions.
“Like many hospitals across the state and the country, we were impacted by COVID in ways that we just could not anticipate so we made the decision to kind of focus our attentions on some of the biggest services that we could support, like the maternity unit and whatnot. So, we decided to temporarily suspend the special care nursery admission services and the pediatric services,” Law said.
“Many of our nurses were cross-trained to labor (and) so we did continue to have special care nursery-capable nurses in house 24/7 but their skill might have been used to the other specialty that we cross-train in and that’s labor and delivery,” she said.
Dr. Joe Anderson, a pediatric hospitalist, said that the pediatric unit is relatively small compared to the larger hospitals in Maine.
“Part of being a smaller community hospital is that you recognize that since we didn’t have, you know, as many admissions say as like Barbara Bush Children’s Hospital (at MaineMed), it made sense to kind of pull care to those places that are bigger when we were really getting hit hard with COVID,” Anderson said.
At the time the units closed, COVID-19 cases and hospitalizations were beginning to tick up thanks to the highly contagious delta variant, while hospitals, CMMC included, were concerned about losing staff over the COVID-19 vaccine requirement for health care workers.
Over the course of the five to six months the units were closed, Law said pediatrics and maternity staff focused on continuing education to maintain skills and to cross-train staff for neonatal care. Additionally, like many other hospitals, CMMC has struggled to recruit additional nurses, “but we’ve gotten lucky in the last few months and have really gotten some wonderful talent in,” she said.
CMMC will soon become the only hospital in the Lewiston-Auburn area with maternity services. Last month, St. Mary’s Regional Medical Center in Lewiston announced it is closing its maternity and women’s health services at the end of July.
Most of St. Mary’s 50-person staff is expected to go to CMMC following the closure.
Send questions/comments to the editors.
