Nurses and Community Save Emergency Room on Chicago's South Side
In the midst of a pandemic wreaking havoc on Chicago, a victory was won by nurses and the community served by Provident Hospital. Located on the overwhelmingly black South Side near Washington Park, this institution has a rich history. It was the first hospital in the United States owned and operated by African-Americans, and where the first open heart surgery was performed in 1893 by founder Dr. Daniel Hale Williams.
On Friday, April 3, Cook County Health and Hospital System (CCHHS), the government entity that runs Provident, suddenly announced that the emergency room would be closing for renovations on Monday, for a month. The announcement came on the same weekend that reports were surfacing that African-Americans in Chicago were disproportionately represented in COVID-19 deaths. While making up 30 percent of the city’s population, they were 70 percent of the deaths. Why would an ER be closed in an African-American neighborhood during a pandemic?
Our union, National Nurses United (NNU), immediately pushed managers into bargaining over the impact of the closure. We demanded that they postpone it because of what closure would do to the community. They refused.
We asked what their plan was for those who would invariably show up requiring lifesaving medical services. Management responded that the person stationed at the front desk would call 911. We wondered how this was not a violation of the Emergency Medical Treatment and Labor Act, the federal law that forbids the transfer of unstable patients, and they said they’d get back to us.
We made it clear that we didn’t oppose remodeling, but that there had to be another way. We said that such an action would never occur in a richer and whiter part of town. An ER is not a fast food restaurant: you cannot simply turn the lights off and lock the door because a mouse is discovered in the freezer. People are often brought there when they can’t breathe, and shutting the doors puts lives at risk.
More care is needed in the middle of a pandemic, especially in neighborhoods with people of color.
In cities across the country there are disproportionate deaths from COVID-19 among African-Americans, a reflection of greater rates of medical conditions in this population. It's not that there is a melanin-linked gene that predisposes one to asthma, diabetes, and heart disease. In many cases these diagnoses stem from living in areas with greater pollution, having poor access to healthy foods, inadequate health care, and medication, and the stress that accompanies racism.
Because health care is run for profit, and not human need, it is common for people to share insulin with family members, or to take their blood pressure medication every other day. COVID-19 has exposed the underlying medical apartheid that has existed for decades, if not centuries.
Management then said that the closing was for safety’s sake, because a health care worker had tested positive for the coronavirus. Almost every hospital that treats such patients has had employees test positive, but exactly zero institutions have responded by closing down.
A LONGSTANDING PUBLIC HEALTH EMERGENCY
Washington Park has been chronically under-resourced when it comes to health care, with significant health disparities. In neighboring Hyde Park, home to the University of Chicago and its $8.5 billion endowment, residents have a life expectancy 14 years longer than do those on the “wrong” side of Cottage Grove Avenue. This awful gap should have been a public health emergency long before COVID-19.
After management refused to listen to reason, nurses immediately began organizing. In less than 20 hours, we held a press conference protesting the closing. We highlighted patients, nurses, and teachers at area schools. We collaborated with other unions, such as the Chicago Teachers Union, community organizations, and local politicians.
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We produced a short video and launched a petition which eventually garnered almost 3,000 signatures. The story was pushed out on social media and picked up by many local news sources. An article in the New Yorker magazine, titled The Black Plague, highlighted Provident’s ER closure as an example of the racial disparity that COVID-19 has shined a spotlight on.
The CCHHS announced on Friday, April 17, that the ER would reopen on Monday. NNU had already organized a press conference to deliver the petitions when the good news was delivered. City Council member Rossana Rodriguez joined nurses at the Cook County Building for the action, which we turned into a victory rally, along with a representative from the Kenwood-Oakland Community Organization.
The actions of regular working people resulted in the ER being opened 16 days earlier than planned. Our collective voices lessened the chance of a tragedy. While the ER was closed, people seeking medical care were transferred to different locations, and it was fortunate that no one came to Provident's door requiring lifesaving care.
SENTENCED TO DIE
If the Cook County government was so concerned about safety, it should be focusing energy on the expanding corona crisis in the Cook County Jail.
The largest prison in the country, it became the biggest COVID-19 jail hotspot in the nation in early April (more recently surpassed by a prison in Marion, Ohio). With well over 600 inmates and staff having tested positive as of April 22, six detainees and one officer have died.
Many of the incarcerated have not yet been found guilty of anything and are there because they are too poor to afford bail. They face a potential death sentence, despite Illinois's ending the death penalty in 2011.
When we did re-enter the ER after the two-week closing, it was unclear why it had taken management so long to do so little. No new walls were put up, although they did clean and put on a fresh coat of paint. The start of the day was chaotic, because management had again failed to involve any nurses who work in the ER with planning.
Even more disturbing was that before the refurbishment, we had 16 beds, and now there are only 10. Furthermore, nurses heard from managers that fewer nurses will be scheduled for each shift.
While it was a victory that the ER was reopened, the fight for equity in medical care clearly must continue. We should take confidence from our success, and deepen the connections we made for future struggles.
Dennis Kosuth is a nurse in the ER at Provident Hospital and a member of National Nurses United.