Nurses at Maine Medical Center are divided into pro- and anti-union camps as the first union vote by them in more than 20 years looms amid a pandemic that has upended society and heaped stress on workers at the state’s largest hospital.

If nurses decide to organize, it would nearly double the unionized workforce among Maine nurses, who have long been on the front lines in battling COVID-19, a disease that has killed more than 725 people in Maine and tested the critical care capacity of the state’s health care system.

Ballots will be sent out to nurses on March 29 and must be returned by April 27 for an April 29 count at the National Labor Relations Board. The Maine State Nurses Association, the state arm of National Nurses United, currently represents about 2,000 nurses at Northern Light Eastern Maine Medical Center in Bangor, hospitals in Houlton, Millinocket, Calais and other small, rural hospitals and health care providers.

If nurses at Maine Med, the Scarborough Surgery Center and Urgent Care Plus in Portland vote to unionize, the Maine State Nurses Association would gain 1,900 union members. The last effort to unionize Maine Med nurses that went to a vote was in 2000, when affiliation with the Service Employees International Union was rejected by a tally of 622-509.

Grey Marcoux, 36, a nurse who works on Maine Med’s geriatric psychiatry unit, said nurses want more influence in a number of areas, including staffing levels and scheduling.

“We nurses are organizing to have a strong and real voice in patient care at the hospital,” Marcoux said. She said one area where nurses want change is in split shift requirements. “Split shifts make it mandatory for a nurse to be working during the days and nights,” Marcoux said. “This sort of shift leads to fatigue and poor patient care.”

While the effort to unionize at Maine Med does not appear to be directly tied to the pandemic, it has highlighted the need for proper staffing and good pay and benefits to retain nurses, said Marcoux, who started working at the hospital in June. Maine has weathered the pandemic better than most states, but Maine Med has still seen surges in hospitalizations and deaths, especially during the COVID-19 peak in late December through mid-January.

Clay Holtzman, a spokesman for Maine Med, said the hospital has added 50 full-time equivalent nursing positions to its workforce during the past year, and the decision to do so was made before the union filed a petition for an election with the National Labor Relations Board in January.

“Maine Medical Center has been aggressively recruiting to address the shortage of nurses, which is a national problem and a challenge to all health care providers,” Holtzman said. “These efforts include an extensive marketing and recruiting campaign, competitive signing bonuses and maximizing opportunities with traveling nurses.”

Overall during the past year, the hospital has hired more than 300 full-time and part-time nurses to grow the staff and replace vacant positions, Holtzman said, and increased traveling nurses from 22 to 49.

The hospital would not provide average salary information for its nurses. However, federal labor statistics show that registered nurses in Maine earn an average of $69,760 a year.

Representatives of the Maine State Nurses Association declined to comment on the union organizing drive.

The pandemic is correlated with an increase in overall unionization in Maine, according to the U.S. Bureau of Labor Statistics. The state’s unionized workforce has grown from 69,000 workers in all job categories, or 11.8 percent of the workforce in 2019, to 82,000 workers, or 14.7 percent of the workforce in 2020.

The health care industry accounted for 16 percent of organizing petitions before the NLRB in 2020, a modest gain from a 14 percent share of petitions in 2019, according to Kaiser Health News.

Some national media outlets have reported anecdotally that more union organizing has taken place during the pandemic, but the full extent to which the coronavirus has fueled unionization won’t be known until more data comes in. Nationally, union membership increased by 0.5 percent of the total workforce, from 10.3 percent in 2019 to 10.8 percent, in 2020.

However, the Bureau of Labor Statistics noted that it was largely due to a greater plummet in nonunion employment compared to union employment as the economy shed jobs during the pandemic.

Maine Med management has led a campaign against unionizing, hiring Florida-based Reliant Labor Consultants to try to persuade nurses not to join the union. The move has generated controversy, including a rebuke from Gov. Janet Mills, when members of the out-of-state consulting team were given COVID-19 vaccinations in January against state policy to vaccinate only Maine residents.

On the pro-union side, the group Friends of Maine Med Nurses released a letter from supporters and hosted a news conference to back up the unionizing effort.

Matthew Beck, an organizer of the Friends of Maine Med nurses, said he wanted the nurses to know that they have “community support. I wanted them to know that they are not isolated, not alone.”

However, Amy Caswell-Lee, a Maine Med nurse who works with patients who need surgery or other medical care, said a union is not needed.

“We already have everything that (National Nurses United) has promised,” Caswell-Lee said. “We have a say in everything that we want to have a say in. If you want to have a say in something, you can speak up and have your voice heard.”

Caswell-Lee said when she noticed some deficiencies in how patients with substance use disorder were treated, she joined a hospital committee, which made improvements to patient care. Caswell-Lee also said she’s pleased with her pay and benefits. When she had to quarantine during the pandemic because of an exposure to COVID-19, the hospital’s policies took care of employees, she said.

“I had to go home and quarantine for 14 days (in March 2020),” Caswell-Lee said. “I was paid during quarantine, and I didn’t have to use any sick days or paid time off.”

Lisa Huntress-Beecher, another Maine Med nurse, said she has no complaints about scheduling, pay, benefits or staffing and is against unionizing.

“We have a lot of autonomy in scheduling right now,” Huntress-Beecher said. “I can ask who is available to switch if I need to switch shifts, and if they can’t I can ask my managers and they will step up and help us figure it out.”

During a big snowstorm this winter, she said, nurses were invited to stay for free at nearby hotels, and given free breakfast and lunch. Huntress-Beecher said that from what she’s seen management works on optimizing staffing depending on which areas of the hospital have the greatest need, which can change during the pandemic.

“I understand nurses can became frustrated because there’s a national nursing shortage and a global pandemic, both of which can’t be controlled by bringing in a union,” Huntress-Beecher said.

Holtzman said the hospital “has always provided flexibility in scheduling to its nurses, accommodating schedule requests to the greatest extent possible.”

But Marcoux, who supports unionization, said a union would give nurses the means to collectively bargain for improved working conditions on a hospital-wide scale.

“Union members will be able to do this with a collective voice,” Marcoux said. “Policies will be implemented with our input.”

Marcoux said the union would be “better able to retain more qualified nurses, which will lead to better staffing for ourselves and our patients.”

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