Kaitlyn Smith, left, a critical care nurse, walks through the intensive care unit Friday with Lori Stultz, a team leader and registered nurse at Central Maine Medical Center in Lewiston. Andree Kehn/Sun Journal

National Nurses Week culminates Wednesday with International Nurses Day, a global event that marks the 201st birthday of Florence Nightingale, a British statistician and nurse widely considered the founder of modern nursing. For the second year in a row, National Nurses Week has taken on a renewed meaning as the COVID-19 pandemic has underscored the role that nurses play in patients’ lives at their most vulnerable moments.

In Maine, there are 26,360 nursing professionals as of May 2020, according to the U.S. Bureau of Labor Statistics, including registered nurses, nurse practitioners, licensed practical and vocational nurses, nurse anesthetists, nurse midwives, nursing assistants and nursing instructors. There are approximately 14,160 registered nurses in Maine, or about 2.5% of Maine’s workforce. About 1,140 of them work in the Lewiston-Auburn metropolitan area.

Deacon Denis Mailhot served as Central Maine Medical Center’s Catholic chaplain until last March and said that observing nurses with patients and their families taught him “a new understanding of the word ‘compassion.’”

“I was often humbled during patient room visits by the love and compassion demonstrated by nurses,” he said.

“For me, the word ‘essential’ comes to mind anew because it is what nurses represent to health care.”

But the profession has been on the decline in the state for at least the past 10 years. According to the U.S. Department of Labor, the number of registered nurses in Maine declined by 2.3% in Maine from 2019 to 2020 and by 8% in the L-A metro area, or from 1,240 to 1,140. From 2015 to 2020, the number of registered nurses in the L-A metro area declined by 21.4% and there are 27.6% fewer nurses in 2020 than in 2010. Statewide, there were 3.9% fewer registered nurses than there were in 2010.

The Sun Journal spoke to five nurses from central and western Maine on why they became a nurse, what they love about their job and how the pandemic has impacted them and their work.

Dawn Cormier of New Gloucester, St. Mary’s Regional Medical Center

After some 14 years as a medical assistant at St. Mary’s Regional Medical Center in Lewiston, Cormier decided to pursue what she “always wanted to be” and went back to school for her nursing degree at 42 years old. Cormier now works in the emergency department at St. Mary’s in Lewiston, where she has been since graduating with a bachelor’s degree in nursing two years ago.

Dawn Cormier poses for a photo on Friday in the ambulance bay at St. Mary’s Regional Medical Center in Lewiston, where she works in the emergency department. Andree Kehn/Sun Journal Buy this Photo

“I have always been like the one that tries to help everybody fix things,” Cormier said. Emergency medicine is just like that, “you try to figure out the problem and fix it.”

As an emergency department nurse, Cormier and her colleagues are the first point of contact for patients entering the hospital. Since COVID hit, everything about the fast-paced ER has had to slow down for the safety of both patients and their providers.

“Everything takes longer,” Cormier said. Providers need to don their personal protective equipment, capacity limits mean that nurses are not only nurses but “you’re the lab tech, you’re the radiology tech doing the chest X-ray through the glass. We get all the labs. We are the ER techs. We do what our ER techs would normally do, getting them on monitors and EKGs and all that.”

There’s also the concern that at the end of the day, she could bring home the disease to her family.

But, “it hasn’t stopped me,” said Cormier, who herself is living with an autoimmune disorder that leaves her immunocompromised.

That may be because the patients and the team working alongside her are her favorite things about nursing.

“I’m the first one to run into a COVID room. I am not afraid to take care of the COVID patients.”

Kevin Hodson of Oxford, Stephens Memorial Hospital

Kevin Hodson is an emergency department nurse at Stephens Memorial Hospital in Norway. Contributed / Stephens Memorial Hospital

Though he grew up in a self-described medical family, Kevin Hodson said he “would have never guessed how much I fell in love with nursing and how professionally and personally rewarding that nursing has been to me.”

Hodson has spent his entire career at Stephens Memorial Hospital in Norway, including 23 of his 24 years as a nurse in the emergency department. He said the reason he finds nursing “ultimately rewarding” is to “see the effect that you can have on a community.”

“I think that helps me hold myself to a little bit higher standard. These are the same people that I might see in the store, or at church or wherever you might interact with the rest of the community.”

Living and working in the same community is important for Hodson because it means “you tend to treat them more like family.”

In the emergency department, Hodson said, there’s an “immediate gratification” in working with a patient and their provider team to “develop a care plan for these people and intervene with them.”

He said the critical thinking skills that the job demands motivate him to constantly learn on the job so that he’s always prepared for the fact that “you don’t know what’s coming through the door.”

COVID has complicated his role in the emergency department, just as it has for all medical professionals. Like Cormier, Hodson said that “everything takes more time,” from donning PPE to preparing rooms for turnover.

Then there’s the fact that capacity restrictions have broken down many patients’ support systems, such as having a family member present.

“It heightens my need as a nurse to look out for the patient and to really question and find out what’s going on, because the family is not there to be their liaison,” Hodson said.

There’s an overall “heightened realization that this is real, it’s affected neighbors, it’s affected friends, families and at any time, it could affect us,” he said.

Even though the medical community knows far more about COVID than it did just over a year ago, “the overall unknown really starts to nag on you.”

Anne Marie Mahar of Rumford, Rumford and Bridgton hospitals

Anne Marie Mahar, right, a registered nurse and the infection prevention coordinator at Rumford Hospital, speaks with Paula Cunningham, the hospital’s tech secretary, while doing her rounds on Friday. Andree Kehn/Sun Journal

Anne Marie Mahar has a photo of her mother, a nurse midwife, riding her bike around her hometown of Mississauga, a suburb of Toronto, Ontario, as if she were a character from the BBC period drama “Call the Midwife.” Though her mother was her first exposure to nursing, the 43-year veteran of the profession said that as a kid she didn’t think she would become a nurse.

“When you’re young, we all have ideas about what we’re going to do. So, one of the things I thought I would do was become a nun.”

She volunteered at a residential care facility run by an order of nuns who wanted her to go to nursing school.

“So, I never became a nun. But I did become a nurse,” said Mahar, who began her career at a large hospital in Toronto.

Registered nurse Anne Marie Mahar, the infection prevention coordinator at Rumford Hospital, stands Friday in one of the patient rooms equipped with the negative pressure capability needed to treat COVID cases. Andree Kehn/Sun Journal

Mahar moved to the states and joined the staff at Rumford Hospital 36 years ago and, for the last seven, she’s worked both there and at Bridgton Hospital as their infection prevention coordinator, a role that “has never been as busy as when COVID hit.”

Her role involves a lot of data analysis, working with doctors and nurses and educating the staff to prevent an infection or the spread of a disease from ever happening. Mahar said her job involves everything from promoting hand hygiene to working with doctors to develop protocols that lower catheter-associated urinary tract infections.

When COVID arrived in Maine, the hospitals were prepared to handle an airborne disease “but when it first started, we didn’t know very much about the disease except the horrific images that were coming from China,” Mahar said.

“I’ve never lived through anything like this in my life. And I’ve lived through … HIV, the H1N1 pandemic (but) nothing like this in my life, even Ebola, nothing like this.”

The staff has been doing a “phenomenal job. I’m really proud of the nurses and the staff here and the providers.”

Though things have been tough and lonely at times, “I work from information and science. So, I have comfort from that.”

April Paradis of Industry, Franklin Memorial Hospital

It was the nurses in the outpatient oncology department at Franklin Memorial Hospital in Farmington, where April Paradis worked as a secretary, that inspired her to go to nursing school.

Registered nurse April Paradis stands Thursday in the doorway of a Franklin Memorial Hospital exam room that has been converted into a treatment room. The Farmington hospital has seen demand increase and made changes to accommodate additional patients. Andree Kehn/Sun Journal

“I would have never dreamed I would have been a nurse. It was nothing I was even remotely interested in” until the nurses there spent time teaching her about the profession and led her to pursue nursing herself.

Paradis has been a nurse at FMH for 17 out of the 22 years she’s worked there, including her first five years as a medical surgery nurse and the last 12 in the oncology department.

While the world was adjusting to the pandemic-era reality of mask-wearing, diligently washing hands and staying away from sick people, those things were already old hat for the providers in her department.

“This is kind of what they do on a normal basis,” Paradis said. “They probably could have taught the public a few things.”

But one of the most difficult impacts that COVID has had on her and her patients was not allowing family members to be present during long treatments.

For her personally, “probably the worst was just the anticipation,” of not knowing what was going to happen and navigating patient care for an already vulnerable population with all the unknowns.

Those patients there “rely so much on us. We know so much about them and their lives and their family that we’re able to give so much to all of them,” Paradis said.

“It’s really a very fulfilling place to work.”

Kaitlyn Smith of Standish, Central Maine Medical Center

It was Kaitlyn Smith’s younger sister who influenced her to become a nurse. Smith was only about 8 years old when her sister became very ill with leukemia.

Registered nurse Kaitlyn Smith stands Friday in the hallway of the intensive care unit at Central Maine Medical Center in Lewiston. Andree Kehn/Sun Journal

“(I was) young enough to not recognize the severity, but old enough to think that what the nurses were doing was really cool.”

Smith has been a critical care nurse for 14 years, working at Central Maine Medical Center in Lewiston for the last six and at Mercy Hospital in Portland before that.

As a nurse in the intensive care unit, Smith is working with the most critically ill patients in the hospital. And with COVID, “it has completely changed our work.”

“It was very scary when COVID first hit,” Smith said. “I think now that we’ve been given all kinds of education and standards to follow, we’re empowered by that knowledge. So, I think it’s safe to say that we’re not as frightened as we first were a year ago.”

Still, the pandemic has complicated her work in other ways. Putting on and taking off PPE, for one thing, is not something critical care nurses are necessarily used to doing on a regular basis.

“If our patient starts to decompensate, we’re running into the room. You can’t do that,” she said. “Now you have to take a step back and take those extra minutes to protect yourself before you go in and care for the patient.”

Smith said that the disease “has a face and a name to anybody that’s actually caring for the patients.” For every patient that has lost their life to COVID, “that impacts every nurse at the bedside deeply.”

Despite how challenging COVID is, Smith was quick to say that she loves “everything about my job,” especially working in critical care.

“I just love the wealth of knowledge that this form of nursing has given me,” she said. “From the second I learned critical care, I never looked back.”