Mapping Care Project: The History of Black Nurses in Chicago

Provident Hospital & Black Self-Determination

Lesson Title:  Provident Hospital & Black Self-Determination
Subject(s): U.S. History
Grade: 6-8
Keywords: racism, integration, activism, healthcare justice, intersectionality, Black self-determination, Black excellence
Time: 2-4 45 minute class periods
Jump Straight to Activity Plan
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Essential Questions:

Learning Objectives 

Standards:


Introduction:

In this lesson, students will explore the history of the creation of Black hospitals and nursing schools during the Jim Crow period, largely through the voices of the Black nurses who passed through Provident Hospital, one of the most famous of these institutions, located in the Bronzeville neighborhood of Chicago. 

This lesson can be a standalone lesson that would fit within units about Jim Crow or healthcare justice. 

Within the Teaching Care sequence, this lesson follows a lesson that describes the conditions of healthcare care access and nursing education for Black Americans in the beginning of the Jim Crow era. 

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Activity Plan:

1) Introductory activity:  

2) Historical Context: reading or lecture about the founding of Provident.

3) Concept Mapping  students build a concept map about “structural racism in healthcare” OR “Black self-determination” using information from each oral history.

4) Extension: Structured Academic Controversy:  Students work with a partner to list the advantages and disadvantages of historically Black institutions as a path towards equity for the Black community.
Pairs of students form groups of four to compare their lists, notice similarities and differences, and come to a consensus about the question.

Assessments 

Materials

Historical & Conceptual Context (for Teachers, adapted from Mapping Care website)

The first nursing schools in the U.S. emerged in the 1870’s in the wake of the widespread illness and death experienced during the Civil War. Wealthy white women nurses founded these schools based on the model of Florence Nightingale, who saw nursing as a profession for white middle and upper-class unmarried women.

By the 1890’s, scientific medical advances led to a massive expansion of hospitals. Hospital administrators and physicians (most of whom were male) realized that student nurses provided a source of cheap skilled labor. They created nurse training programs based in hospitals, which soon became the primary nursing education model until the 1960-1970’s.

Student nurses in hospital programs worked long hours running most of the hospitals’ operations, with little classroom instruction. These new hospital-based programs emerged during the beginnings of the Jim Crow era and they practiced racial discrimination like many other institutions at the time, denying admission to Black students.

Racism in the healthcare system also affected Black patients. Black Americans were rejected from public hospitals or were sent to segregated wards. They were often treated by racist white medical staff, creating a deep distrust of the healthcare system. Certain statistics indicate that medical advances were improving white Americans’ health outcomes at the beginning of the 1900’s, but the health of Black Americans was deteriorating.

Black physicians, their communities, and their white allies responded to these realities by creating a network of Black hospitals and nurse training schools. Some Black physicians founded these institutions because they cared about training Black nurses, and some because they needed a place to treat patients and build their own careers. Many were concerned about racial healthcare disparities. Black communities, particularly Black women, played a critical role in forming and sustaining these institutions. Black women’s clubs recruited nursing students, organized collections of hospital supplies, and raised funds to pay salaries and improve facilities.

These Black hospitals and nursing schools filled a crucial gap. They provided healthcare access for Black communities while creating paths into the middle class for young Black women in a time when they faced rampant employment discrimination. Yet these schools, like all-white hospital training programs, required that students work long, unpaid hours as part of their training. The labor of Black nurses and nursing students was crucial for these hospitals that served as the cornerstone of African American healthcare during the Jim Crow years.

Some of the most famous Black hospital and nurse training programs included: Mercy Hospital (Philadelphia), Harlem Hospital (New York), Freedman’s Hospital (Washington D.C.), Flint-Goodridge Hospital (New Orleans), John A. Andrew Hospital (Tuskegee, Alabama), and Provident Hospital in Chicago.

Dr. Daniel Hale Williams founded Provident Hospital and Training School in 1891 in response to the reality that Chicago had no schools of nursing that admitted Black nurses, no hospitals where Black doctors could practice, and few hospitals that admitted Black patients.

 

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Introductory Activity

Content Option #1: Black Self Determination

Show students this image of the Provident graduating class of 1904 & this image of Illinois Training School for Nurses graduating class of 1890 (all-white nursing school in Chicago)
 
Ask students:Explain that we often learn about the fight against segregation as the main way that Black people fought for equality, but there have also been many Black people who focused on creating and running institutions for themselves as a means of achieving justice & equity.

This is sometimes referred to as “Black self-determination.” Help students break down meaning of the term by looking at its parts. 

Content Option #2: Structural Racism in Healthcare

Show students the following quote:

“The system is broken. System was broken before…All the different things that we knew as people in public health and people in nursing, you know it exists, but to see the sheer amount of illness and death in communities of color, in particular, that are all the result of systemic racism and structural barriers to care, to dignity, to financial and social mobility, it was really hard.”


- Karelle Webb, on managing infection control at a network of community health centers in Chicago during the COVID-19 pandemic.

Ask students to write down 1 reaction and 1 question. Lead discussion about what Webb meant at the end of her quote and introduce students to the term “structural racism,” and how it impacts healthcare,  which they will use to build their concept map. 

Resource for teaching structural racism versus other forms of racism

Skills Option: Practicing Concept Mapping

Distribute a blank concept map to students (or have them draw their own on a piece of paper)

Project a concept map on the board for students to copy from. Use a word that they are familiar with and will have robust ideas about. 
Examples: “racism,” “social media,” “bullying,” “gender,” “healthy.” 
Explain that you will work together as a class to create a definition for the word. Note that a complete definition would usually answer questions like: 
• Category: What is it?
• Characteristics or properties: What is it like?
• Illustrations: What are some examples of it?

Work with students to develop a robust definition so they have an example to use during independent work. 

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If teaching standalone lesson: Explain that today students will be examining the question of racism in U.S. institutions through the perspective of Black nurses. This will provide a different point of view that is often not as studied about the Jim Crow era. 

If teaching within Teaching Care sequence: Explain that in the previous lesson, students learned about the many interrelated factors that impacted Black Americans’ health during the Jim Crow era. In this lesson, students will learn about one way that Black Americans responded to these realities: by creating their own hospitals and nursing schools. 

Emphasize that by the end of this lesson, students will be using concept mapping to describe how racism affects health. 

Historical Context 

Summarize key historical realities that led to the founding of Provident in one of these ways:

Concept Mapping with Stories

Oral Histories here. 

Explain to students that they will now learn more about Provident through the voices of different Black students and nurses who studied and worked there in different time periods. They will be using these stories to better understand “Black self-determination.”

Distribute a blank concept map to students (or have them draw their own on a piece of paper).

Read/Listen to stories in one of the following ways:

* Recommended to play audio/video clips for students twice:
First time: Encourage students to just listen
Second time: encourage students to write down questions. After playing, discuss any questions students have to clear up confusion.
Then give students to time to add to their concept map. 


Summary of Stories:

Additional stories for classes that will use the Structured Academic Controversy: 

Structured Academic Controversy

Note that it’s important to emphasize to students that an SAC is a structured discussion, rather than a debate. The goal is not to win, but to push each other to develop both sides of the argument. Explain to students that the structure is important because it ensures a respectful conversation in which all participants get a chance to express their perspectives and evidence.

Pre-teach vocabulary:
Show students the following quote:
“ Ironically it was integration that hurt Provident…We were always open to treating whites in the hospital, although very few came…But it was at the professional level that the problem came -in the departure of black medical staff. 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.”
- Betty Gross, Director of Nursing at Provident Hospital

Explain that among scholars and activists, there is an ongoing debate about the best way to achieve racial equity, and whether integration was good for the Black community. Students will develop their own opinions about this debate by considering the stories they already reviewed from Black nurses who spent time at Provident.

Divide up students into groups of four, with two students being assigned to Side A and two of the students assigned to Side B. Side A will develop a list of advantages and Side B will develop a list of disadvantages of historically Black institutions like Provident as a path towards equity for the Black community.

Distribute the SAC protocol to students.

Confirm their understanding of the essential question. 

Review the SAC protocol with students. 

Once students have completed their SAC activity using the protocol, pairs of students form groups of four to compare their lists, notice similarities and differences, and come to a consensus about the question.

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