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Left to right: Leah Bauer, MD; Jorie Catlin, PMHNP; Alyssa Rouleau, PMHNP; Sara Jacobson, PMHNP; David Dettmann, DO

Providers at Mid Coast Hospital’s inpatient behavioral health unit have long been challenged with demanding shifts and rigid on-call schedules, which sometimes resulted in burnout and low morale. Dr. Leah Bauer noticed the effect this had on her colleagues and worked with the care team to find an innovative way to mitigate the stress. The result is a rotating schedule that gives every NP seven days off every three weeks. The change has been a resounding success.

The idea first came to Leah in 2021 during COVID, when providers were seeing more acute care cases throughout the hospital. The additional stress was taking its toll on staff in the behavioral health unit, and Bauer wanted to find a solution for the sake of both her colleagues and their patients. After almost a year of testing and planning, a new team schedule was fully implemented in October of 2022. NPs work five days, followed by two days off, then they work seven days, followed by seven days off. Three NPs are rotated through the schedule, so there is always an NP on duty. The staff is flexible and supportive of each other, filling in gaps and covering shifts, when needed. There are fewer hand-offs, too, which means more consistency for patients and their families. The unit physicians are better able to focus on consults and specialized care, while the NPs cover the day-to-day inpatient behavioral health patient needs.

“We have seen a dramatic improvement in efficiency and effectiveness of care – including higher patient and staff satisfaction – since transitioning to this new provider model. Our NPs and the model they created are fantastic, and we are grateful to have them on our team.”

– Mackenzie Dufresne, RN (nurse manager)

Mid Coast behavioral health NPs say their supervisors have rallied around the new schedule and there is a lot of communication within the care team to make it work. Managers and staff agree that the new model helps with patient care continuity, particularly through weekend coverage, and they are hopeful that the improved work-life balance will attract new providers in the future.

Next Steps

The Mid Coast team believes their program could work for many other units. A similar model is currently being trialed at Spring Harbor Hospital.


  • Leah Bauer, MD
  • Jorie Catlin, PMHNP
  • David Dettmann, DO
  • McKensie Dufresne, RN, Nurse Manager
  • Sara Jacobson, NP
  • Alyssa Rouleau, PMHNP

Our Purpose

MaineHealth Innovation builds connections to drive diversity of thought, educates to produce creative problem-solvers and funds to accelerate ideas. By leveraging the ideas, insights and expertise of all care team members to develop novel solutions to our unmet care needs, we are working together so our communities are the healthiest in America.

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