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• 1 media/provident nurses class 1940s cropped.jpg media/i061182_pm.jpg 2022-08-22T18:18:58+00:00 Provident Hospital and Training School, 1930-1966 69 image_header 2024-07-17T01:22:40+00:00

  THE GREAT DEPRESSION YEARS
  
  
  The Great Depression created massive unemployment and poverty which disproportionately impacted Black Americans. 
  
  Of the ten largest cities in the U.S., Chicago was hit hardest by the Depression and, similar to other cities, Black residents fared the worst. These were mostly Black Southerners who had moved to Chicago as part of the ongoing Great Migration in the hopes of finding economic opportunities and better racial conditions outside of the South. Yet they found themselves mostly concentrated in unskilled and service work, positions that were most likely to be cut during economic difficulties. The Great Depression worsened the already demoralizing situation for working-class Black Chicagoans, who were stuck in a system designed to keep them as a permanent underclass.1
  
  After his election in 1932, President Franklin Roosevelt passed a comprehensive national program , known as the “New Deal,” that was meant to provide immediate economic help and to prevent similar disasters in the future. To pass the New Deal, Roosevelt relied on the support of white Southern Democrats in Congress who were committed to maintaining the Jim Crow system, and he gave into many of their racist demands. Thus while the New Deal helped many white Americans begin to recover economically, Black Americans continued to struggle.
  
  Black Chicagoans were shut out of many newly created government jobs. New Deal legislation that increased labor protections excluded domestic workers, one of the most common jobs for Black Chicagoans at the time. When the government raised wages as part of the New Deal, Chicago employers fired Black workers first. In 1939, Black Chicagoans made up 40% of those receiving public aid.2
  
  When the government funded home mortgages, officials refused to give Black people the funds to buy homes in white Chicago neighborhoods. Despite demonstrations and protests for affordable and decent housing by working class Black Chicagoans, the Republican Party, which Blacks overwhelmingly supported, did nothing to assist them. Black Chicagoans found themselves trapped in segregated, overcrowded housing with poor sanitation, where diseases spread quickly.3     
  
  And yet, most Chicago hospitals refused to admit Black patients. This left many with just two options for healthcare: Provident Hospital or Cook County Hospital. Historian Timuel Black recalled that “Provident was often the safest, and sometimes the only, place to go.”4

  Throughout the Depression era, Provident remained committed to treating all patients, regardless of their race or ability to pay, even though this resulted in serious financial strain for the hospital. Meanwhile, Chicago’s Black population continued to increase. The number of yearly visits to Provident’s clinic increased by more than thirty-five percent between 1936 to 1938, from 71,410 to 111,192.5 Due to growing demand for health care coupled with staffing shortages, Provident Hospital’s student and graduate nurses6 provided much of the care for these patients, while often taking on responsibilities which were routinely completed by orderlies or maids at other hospitals.7
  
  In 1933, Provident began an affiliation with the University of Chicago (UChicago) Hospital.8 Provident’s board hoped to use UChicago’s resources to restart their postgraduate intern training program for doctors, as well as to improve the training of their nurses and social workers.9 UChicago, meanwhile, hoped to send their Black medical students to complete their clinical training at Provident, because the UChicago Hospital barred Black doctors.10 As part of this agreement, Provident agreed to raise money for a substantial endowment and to move into a larger, newly renovated hospital facility. Provident also bought two nearby apartment buildings to house student nurses.11 These apartments provided communal housing, allowing students to develop a supportive, tight-knit community amongst themselves.12
  The UChicago affiliation expanded Provident’s access to resources but was heavily criticized. The agreement required that UChicago supervise the hiring and functioning of Provident’s hospital staff, including physicians and nurses, implying that Provident could only qualify as a quality teaching hospital with oversight from a wealthy, white-controlled institution.13 In addition to the hardships created by the Depression, the affiliation also created new financial burdens for Provident.Prominent Black physicians and organizations criticized what they saw as a “’Jim Crow’ set-up,”14 in which Provident could be viewed as supporting UChicago’s racially discriminatory policies against their Black medical students. The controversy meant that some members of the Black community stopped seeking care at Provident, and that the hospital began to struggle to attract graduates from the top Black medical schools.15 The affiliation formally ended in 1944.16
  
  During this tumultuous period, the nursing school steadily recruited bright students and provided high-quality training. The program became a three-year accredited course in the 1930’s, including a year of preparatory classes and two years of coursework and clinical practice in various specialties including surgery, obstetrics, mental health, and infectious diseases. This model was typical for most (white) training schools nationally at the time. The school also developed nurse training affiliations with the Chicago Visiting Nurses Association, Chicago Lying-In Hospital, and the Cook County School of Nursing, thus providing students with more opportunities to develop specialized skills and knowledge.17 
  
  Faith Davis noted that when she left Chicago after graduating from the school, she found that:
   
   

  “[t]he reputation of Provident went across the country.” Even white physicians “knew that, if you were from Provident, you had it.”18

  
  Graduates of Provident took on leading roles in their field, especially in public health nursing, which was often the most prestigious work available to Black nurses in this era. (Learn more about Black nurses in public health nursing here). Provident graduates, such as Carrie. E. Bullock and Claudia Durham, became nurse leaders at Black hospitals and nursing schools, and in the National Association for Colored Graduate Nurses (NACGN).19

  Provident graduates demonstrated a sustained commitment to their school. The Alumni Association, led by nurses such as Thelma Brown and Ruby Adams, organized an annual alumni homecoming and an annual spring dance for the Black community, raising funds to help maintain Provident’s facilities and provide scholarships for student nurses. 20

  WORLD WAR TWO (1941-1945)
  
  The outbreak of World War II presented challenges and opportunities for Provident hospital.  The government invested capital and resources in industry as part of the war effort, expanding factories and creating new jobs that continued to draw Black Americans to Chicago from the South.21 Similar to the Black Southerners who came to Chicago before them, many of these new arrivals continued to face discrimination and poverty. They too relied on Provident for their healthcare needs. In 1941, only around thirty five percent of Provident’s patients paid for services.22 This dynamic deepened the longstanding issues that Provident had faced since its founding, as the hospital tried to serve many high-need patients without enough funding from the government or philanthropists. Indeed, white philanthropists tended to criticize the quality of care at Provident, while ignoring the tremendous number of patients the hospital was expected to treat, because other hospitals would not accept them. Meanwhile, members of the Black community continued to support the hospital as much as they could.

  This difficult reality had serious consequences for Provident’s nurses. A Chicago Defender article explained that at Provident “[e]xpenses are cut to the bone. Anything that does not deal with feeding and treating patients is shaved to the nub. Salaries are no exception.” Yet Provident’s student and graduate nurses understood their work as part of a racial solidarity effort. The Defender stated that:“[t]he Negro [sic] child born today, who can expect to die 10 years before a white child born at the same hour, can thank [these doctors and nurses] that the gap is not wider.”23  Betty Gross, a Provident graduate who later became the Director of Nursing, noted that:
   

  “[w]orking at Provident was a privilege. It was our hospital. It was a facility that saved lives – the only place where blacks knew that they would receive care, no matter what…In some ways, Provident was the social epitome of the black community.”24

  Yet Provident’s nurses were not always willing to accept their working conditions, especially when it reflected gender inequity. In September 1945, thirty nurses went on strike, stating that hospital administrators had cut their pay and vacation time and were refusing to bargain with their union. The medical director argued that Provident was a non-profit organization that ran a deficit and was doing the best it could for its nurses. The nurses noted that janitors, handymen, and yard men started out at higher salaries than they did. All Provident staff sacrificed to keep the institution running, but female staff seemed to bear more of the burden. Additionally, one of the striking nurses’ demands was “full maintenance for married nurses who do not live in the nurses’ home,” indicating that Provident administrators were likely following gender norms of the time, which dictated that married women were not considered primary breadwinners and thus did not need a full salary.25 The strike ended after ten days, and the historical record has left few clues about how it was resolved. One researcher noted that hospital administrators raised the nurses’ salaries to meet the minimum range recommended by the Illinois Department of Nurses, which was still below the nurses’ demands.26

  The Bolton Act of 1943, which emerged as part of the war effort, (learn more here) provided expanded funding for Provident. This legislation created the U.S. Cadet Nurse Corps, through which the federal government paid for the tuition and living expenses of nursing students who agreed to be placed, upon graduation, in certain high-need areas due to the massive shortage left by trained (white) nurses who were deployed overseas in support of the war. Due to the relentless  work of the NACGN and other Black nurse leaders, such as Estelle Massey, Black nurses were not excluded from this tremendous financial opportunity based on race.27 Provident began participating in this program in 1943 and purchased an additional building to house the Cadet Nurses near the existing nurse residences.28 Marilyn Danzy attended Provident as a Cadet Nurse and reflected that “[i]t was a wonderful program for me because my family didn’t really have any money and I doubt whether I would have been able to even get into school without something like that.”29 Provident not only trained crucial healthcare practitioners; the school also provided a unique opportunity for Black women from low-income backgrounds to attain a middle-class profession, and the upward mobility that came with it.

  THE POST-WAR YEARS
  

  In the late 1940’s, Provident continued to struggle financially while providing vital healthcare services.30 While other hospitals began to incorporate the use of new labor-saving devices, Provident could not afford to buy this new equipment, even though it would have cut their long-term costs.31 Nonetheless, the number of patient visits continued to increase as Provident remained an anchor of the Black community.
  
  Berlean Burris, a participant in our Black Nurses in Chicago oral history project who graduated from Provident nursing school in 1959, noted that it was not just low-income Black patients who relied on the hospital. “[We] had the best, the brightest Black physicians at Provident Hospital,” she recalled, “and they would bring their patients there and you know it was just so exciting to see these middle-class women coming in to have babies."
  
  On reflecting about the hospital’s community, Marilyn Danzy described a family-like environment that included not just the nurses and doctors, but also “people in the kitchen, people in the laundry. Everybody was friendly to everybody. You felt like you were appreciated.”32

   

  
  

  The 1950’s were an era of growth and promise for Provident. In 1950 the hospital received government funding to upgrade their equipment and buildings.33 A grant from the Ford Foundation in 1958 allowed the nursing school to expand its facilities.34 Berlean Burris recalled that faculty nurses at the time expected an extremely high level of professionalism and academic skill from the student nurses. More than half of the student nurses who started the program with Burris did not manage to complete it because of the difficulty of the coursework. In 1958 the nursing school earned accreditation from the National League of Nursing, an impressive feat that required intensive effort from all the school’s departments, and an accomplishment that signaled and recognized the high-quality training of Provident nurses.35 Dr. Annie Lawrence, a participant in our oral history project who served as the director of the school of nursing in the 1950’s and early 1960’s, played a key role in the accreditation process and recalled the achievement with pride.
  
  The combination of an underfunded hospital and a rigorous training program produced highly skilled nurses. Another one of Dr. Lawrence’s proudest moments from her time as the nursing school’s director was when a Provident student, Rolinda Robin Skyles, was elected president of the Student Nurses Association of Illinois in 1959, the first Black student nurse to reach the position.36 Sandra Johnson, a Provident graduate, recalled that her fellow student nurses would say that “once you’ve been trained at Provident, you can work anyplace…we as nurses had to provide quality nursing care with few of the resources that other hospitals took for granted.”37

   

  As had been true since the school’s founding, students often came to Provident from low-income backgrounds, and they received rigorous training at the hospital in a warm, supportive atmosphere. Johnson recalled that relatives of patients often brought baked goods to hospital staff to express their gratitude for the quality care. Dr. Lawrence described how she regularly set aside a portion of her paycheck in cash in a drawer for students who needed money to buy basic hygiene supplies like menstrual pads.

   

  THE 1960'S & THE ERA OF INTEGRATION
  

  The 1960’s brought changes in nursing education and healthcare that would hurt both the hospital and nursing school. For years white nurse leaders had advocated moving nurse training from hospital-based to university-based programs that would focus on students’ learning needs over a hospital’s operational needs. Black nurse leaders supported the notion of improving the state of nursing education but were wary of how this would create additional barriers for Black nurses.38
  
  By the 1960’s, this shift was well under way, greatly reducing the number of applicants to hospital-based programs like Provident. Even more significantly, the hard-earned victories of the Civil Rights Movement (including the advocacy of Black nurses) forced open the doors of white nursing schools, medical schools, and hospitals to Black Americans. Many of the most talented Black students began applying to white institutions, while Black doctors began practicing at white hospitals. Black patients often followed their physicians to these wealthier, white institutions.39 As Betty Gross, the director of the nursing school in this era, recalls, “If, at the point of integration, white staff came to us as much as we had gone to them, then I would call that integration. But the situation was that blacks left our professional staff without the possibility of high-quality replacement, something that hurt us greatly.”40
  
  As the nursing school began receiving fewer applicants, administrators tried accepting students with weaker educational credentials, implementing tutoring programs with the hope of helping those students succeed. Gross explained that eventually she decided that it would be better to close the school while it was still in its prime, rather than to significantly lower the school’s standards.41 Dr. Lawrence noted that both Black and white hospital-based nursing schools were closing in this era because the general shift towards university-based, degree-granting programs also meant that Provident was now offering a program that would make graduates less competitive in the job market. One Provident administrator described closing the nursing school as the hardest choice he ever made in his position.42
  
  Provident Training School closed in 1966, graduating its final class of 12 students. The school, long considered the country’s top Black nurse training program, graduated around 700 nurses over the course of its existence.43 The nursing school had opened at a time when Black women had few professional opportunities and Black Chicagoans had few options for accessing healthcare. Provident’s graduates defied society’s expectations of them, earning professional degrees and treating their community when no one else would.

• 1 2023-12-12T21:44:13+00:00 Access to Quality Healthcare: The Jim Crow Years (1870’s-1960’s) 3 plain 2023-12-12T21:45:52+00:00 In the early twentieth century, disease and death was increasing among Black Americans at an alarming rate compared to their white counterparts. The federal government had created hospitals to treat Black Americans after the Civil War, but many of those had disappeared by 1877 due to lack of funding and government support and an end to the Reconstruction Era of U.S. history. Black people living in the rural South lived far from most medical care. Black Americans seeking new opportunities in northern cities like Chicago found themselves living in crowded, segregated communities where disease spread quickly.  Black patients often could not be admitted to public hospitals or were sent to segregated wards. Most hospitals refused to train Black nurses or doctors, yet many white healthcare workers refused to care for Black patients. When they could get hospital treatment, Black people were often treated by racist white medical staff, creating deep distrust in the Black community regarding the healthcare system.
  
  Black physicians, nurses, their communities, and their white allies responded by creating a network of Black hospitals and nurse training schools, including Provident Hospital on the southside of Chicago. Black nurses often did most of the day-to-day labor of caring for patients at these hospitals. Provident accepted all patients, regardless of their race or their ability to pay for services, meaning that it was the only option for many Black Chicagoans. Even middle class Black Chicagoans went to Provident, because they appreciated receiving treatment from healthcare staff who treated them with respect and understood their racial and cultural background. Black nurses also provided healthcare access within Black communities as part of public health agencies. Public health nurses visited people who could not get to hospitals and provided health education that was sensitive to the specific needs of members of the Black community. Learn more about the history of Black nurses’ public health work here.
  
  
  The passage of Medicare and Medicaid in 1965, in the midst of the Civil Rights movement, dramatically changed access to healthcare for Black Americans. Civil Rights activists, including members of the National Association for Colored Graduate Nurses, had pushed for years to eliminate Jim Crow laws. In 1964, President Johnson and Congress passed the Civil Rights Act, which prohibited discrimination in employment, public places, and federally funded programs. This meant that when the federal government created the Medicare and Medicaid programs the following year, any hospital that discriminated based on race would not receive reimbursement for treating patients with Medicare or Medicaid. The Office of Equal Health Opportunity recruited thousands of volunteers, including government employees and Civil Rights organizers, who traveled to hospitals all over the country to ensure they followed anti-discrimination laws and eligible for federal funds. Due to their efforts, a thousand hospitals integrated in less than four months.1
  
  While a huge victory for Americans, integration of hospitals led to a sharp decline in funding and patient visits at historically Black-run hospitals like Provident. Middle-class Black patients and staff moved to better-funded white hospitals, but white patients and doctors did not choose Black hospitals. Thus as many traditional Black healthcare institutions lost resources and even began to close their doors, the fight for access to healthcare would take a different form.