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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 12 image_header 2022-11-01T17:20:35+00:00

  THE GREAT DEPRESSION YEARS

  The Great Depression created massive unemployment and poverty. After his election in 1932, President Franklin Roosevelt passed a series of policies, known as the “New Deal,” that were meant to provide immediate economic help and to prevent similar disasters in the future. Yet in order to pass the New Deal, the president relied on the support of white Southern Democrats in Congress who were committed to the Jim Crow system, and he gave in to many of their racist demands. Black workers were shut out of many newly created government jobs, while Black tenant farmers received almost none of the government payments that went to their landowners. New Deal legislation that increased labor protections excluded domestic and agricultural workers, the two most common jobs for Black Americans at the time. Thus while the New Deal helped many white Americans begin to recover economically, Black Americans continued to struggle. 

  In this era many Black Southerners moved to Chicago, part of the ongoing Great Migration in which Black people sought economic opportunity and better racial conditions outside of the South. Both were hard to find in the cities of the Northeast and Midwest. When the government raised wages as part of the New Deal, Chicago employers fired Black workers first. When the government funded home mortgages, officials refused to give Black people the funds to buy homes in white Chicago neighborhoods.1 Black Chicagoans found themselves trapped in segregated, overcrowded housing with poor sanitation, where diseases spread quickly. In 1937, the death rate for Black Americans was three times higher than for the general population.2 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.”3

  Throughout these years of economic hardship, Provident remained committed to treating all patients, regardless of their race or ability to pay, even though this caused the hospital serious financial strain. Meanwhile, Chicago’s Black population continued to climb. The number of yearly visits to Provident’s clinic increased by more than thirty-five percent between 1936 to 1938, from 71,410 to 111,192.4 Due to the growing demand and staffing shortages, Provident Hospital’s student and graduate nurses5 provided much of the care for these patients, while often taking on responsibilities which were routinely completed by orderlies or maids at other hospitals.6

  In 1933, Provident began a controversial affiliation with the University of Chicago’s (UChicago) medical school.7 Provident’s board hoped to restart their postgraduate training program for doctors and to improve their patient care and staff training through UChicago’s resources.8 UChicago, meanwhile, hoped to send their Black medical students to complete their clinical training at Provident, because the UChicago Hospital barred Black doctors.9 As part of this agreement, Provident bought a larger, newly renovated hospital facility on 51st Street, as well as two nearby apartment buildings to house student nurses.10 These apartments provided communal housing, allowing students to develop a supportive, tight-knit community amongst themselves.11

  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, implying that Provident could only qualify as a quality teaching hospital with oversight from a wealthy, white-controlled institution.12 The affiliation also created new financial burdens for Provident. Prominent Black physicians and organizations criticized what they saw as a “’Jim Crow’ set-up,"13 in which Provident could be seen to be supporting UChicago’s racially discriminatory policies against their Black medical students. The controversy meant that Provident began to struggle to attract graduates from the top Black medical schools. The affiliation formally ended in 1944. 15

  During all this tumult, 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.16 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. This was true for a variety of reasons: public health organizations had a history of more inclusive racial politics than other nursing institutions, government agencies sometimes had less freedom than private hospitals to practice racial discrimination, and in the South, white nurses often refused to serve Black patients, forcing local public health agencies to hire Black nurses. Black nurses themselves often preferred working out in the community, where they had more autonomy and faced less racial prejudice than they did in hospitals or in private homes.19 Provident graduates also became nurse leaders at Black hospitals and nursing schools, and in the National Association for Colored Graduate Nurses (NACGN).

  Provident graduates showed a sustained commitment to their school. The Alumni Association 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 a lot of money in industry as part of the war effort, expanding factories and creating new jobs that drew Black Americans to Chicago from the South. Yet many of these new arrivals continued to face discrimination and poverty. Many relied on Provident for their healthcare needs.21 In 1941, only around thirty five percent of Provident’s patients paid for services.22

  This 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 noted 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. But the striking women 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 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, (link to nursing education history page here) provided expanded funding for the nursing school. 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 experienced (white) nurses that deployed overseas in support of the war (link to armed forces page). Thanks to the work of the NACGN and other Black nurse leaders, 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. 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.30 Nonetheless, the number of patient visits continued to increase as Provident remained an anchor of the Black community. Danzy noted that it was not just low-income Black patients who relied on the hospital. “The middle-class blacks also came there…” she explained, “because [that was?] where their black physicians practiced.” Timuel Black similarly stated that “these people could afford to go wherever they wished. But they respected the quality of care and had confidence in the attending physicians [at Provident].” On reflecting about the hospital’s community, 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.”31
  
  

  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.32 A grant from the Ford Foundation in 1958 allowed the nursing school to expand its facilities.33 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.34 Dr. Annie Lawrence (include link here), who participated in our oral history project and 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. Indeed, 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.35 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.”36 
  

  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 many nurse leaders had advocated towards moving nurse training from hospital-based to university-based programs that would focus on students’ learning needs over a hospital’s operational needs. 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.37 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.”38 

  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.39 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.40 Dr. Lawrence (include link here) 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.41

  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.42