Morgan Starkweather, a pediatric occupational therapist, acknowledges supporters after speaking at a rally on Friday in Portland. Staff photo by Michele McDonald/Staff Editor

Nurses and clinicians who provide at-home health services for MaineHealth in Portland have issued a vote of no confidence in the facility’s senior leadership team.

Sixty-five of 70 nurses, social workers, pathologists, administrators, and occupational and physical therapists who currently work at MaineHealth Care at Home are calling for the removal of its clinical leadership team and the reinstatement of two longtime pediatric nurses who were recently fired.

“This situation is unacceptable and cannot continue. We believe that our relationship with these leaders is irreparable. We want MHCAH to return to the core values that have made our agency a place that clinicians want to work,” the employees wrote to MaineHealth.

The vote of no confidence follows what nurses and union leaders say are nearly two years of conflict with MHCAH’s clinical leadership team about communication, scheduling, work culture and resources. Those disagreements, the nurses and clinicians say, have led to a decline in health care quality and long patient waitlists, and have harmed employee morale.

“It’s a systemic issue of poor management, lack of respect. And it’s created a really hostile, abusive work environment,” said Morgan Starkweather, a pediatric occupational therapist who gathered with others at a rally Friday afternoon at the MHCAH headquarters in Portland.

“There’s a real fear of retaliation. And there’s still a fear of retaliation, even though people are in a union.”

After speaking at a rally Friday, Morgan Starkweather, a pediatric occupational therapist, center right, gets a hug from MaryBeth Gagne, a pediatric nurse for 32 years for MaineHealth Care at Home until she was terminated on July 7. Staff photo by Michele McDonald/Staff Editor

Around 60 employees gathered at the rally in Portland on Friday to inform the public about the vote and call on MaineHealth to respond to their concerns.

Two of the people who made speeches during the rally were among six caregivers on the pediatric team who were suspended recently.

The nurses and therapists say they were suspended in mid-June because of a Department of Health and Human Services investigation “due to allegations of provision of inadequate care and the potential neglect of one of our patients,” Starkweather said.

Three providers, including Starkweather, have since been reinstated.

“The biggest thing that was so distressing, besides the maltreatment from management, was how it affected my patients. I never got to hand them off, I never got to say, ‘I won’t be here for a little while,'” she said.

Starkweather said 19 of her pediatric patients’ families were neglected or did not receive any care in the near month she was barred from working.

But not all of the employees have returned. One person resigned and two pediatric nurses who had been working at MHCAH for over 30 years were fired. That includes the union’s chief steward, MaryBeth Gagne.

“And we need them all back. We are a team, we’ve always worked together in tandem,” said physical therapist Theresa Cunniff. “This is the first time something so horrendous has happened here.”

Now, Gagne and Starkweather allege that DHHS informed them the pediatrics team was not actually under investigation. Rather, they say, DHHS was investigating the patients’ at-home caregivers.

This has led the union and the six employees under disciplinary action to believe they were targeted for being vocal about concerns with management leadership.

“I was always the face in the front, bringing all these issues to them that we’ve worked on that have not been dealt with,” Gagne said.

MaineHealth issued a statement on Friday afternoon saying that disciplinary action is “being reviewed by the union’s collective bargaining agreement and under the requirements of the State Board of Licensing for nurses.”

Pediatric nurse Mary Beth Gagne, center, speaks at a rally of MaineHealth Care at Home nurses and clinicians and their union supporters in Portland on Friday. Staff photo by Michele McDonald/Staff Editor

However, DHHS and MaineHealth did not respond to questions about what the agency was investigating, why there was disciplinary action against six of the nine providers on the pediatric team, or why the two women were fired.

While the vote of no confidence is the union’s immediate reaction to the disciplinary action, employees say they are also advocating for the care of their patients. Providers held signs at the rally reading “protect patients, trust nurses” and “patient care comes first.”

“I don’t think (the leadership team) understands what it is we do and how complex it is,” said Pam Adler, an adult occupational therapist. “We don’t just treat a diagnosis that’s on a discharge summary that comes home from the hospital. We are treating sometimes family dynamics, addiction dynamics, homelessness, socio-economic barriers, such as transportation to doctor’s appointments, lack of access to their medications or medical devices that they need (and) safety risks in the home.”

The nurses and a union representative declined to comment on what would happen next if MaineHealth does not take action.

“We just strongly believe that change will come and has to come,” Adler said. “If MaineHealth and MaineHealth Care at Home are going to adhere to their guiding principles for making this the most healthy community in the country, then I think something has to happen.”