“Front Row Seat to All That’s Wrong”: School Nurse Organizing in Chicago

Interview With Dennis Kosuth

March 7, 2021

The Chicago Teachers Union (CTU) continues to place community health and wellness at the top of their agenda in their fight for workers, school resources, and the common good. This was most recently visible in their 2019 strike, through which they won a nurse and social worker in every school, alongside a restructured pay scale for support staff and an improved pipeline for nurses, social workers and case managers. Now, during the global Covid-19 health crisis, the CTU continues to build upon this previous work as they advocate for nurse’s working conditions and student access to health care.

This interview explores the working conditions and advocacy, protest, and resistance efforts of school nurses in Chicago during the Covid-19 pandemic, through the eyes of a rank-and-file member of the CTU. Here, Rhiannon Maton, an assistant professor at SUNY Cortland, talks with Dennis Kosuth, a CTU member and school nurse in Chicago Public Schools.

What is your current position in Chicago Public Schools (CPS)?

I am a school nurse. This is my 5th year working in the schools, [and before this] I worked in hospitals. One day a week I also go to a hospital and do an 8-hour shift.

It must provide you with a unique vantage point on health care to work as a nurse in both schools and a hospital in Chicago. Why did you decide to primarily focus on working in schools during the past few years?

So I worked in the emergency room at County. And there, it was like a front row seat to everything that’s wrong with our healthcare system. Seeing the outcomes of not having access to healthcare, seeing the outcomes of privatized healthcare. And it was, as you can imagine, horrifying. And, naïvely, I thought that I would go into school nursing with the idea that if we could only educate people, if you could only teach people about the importance of healthy habits, learning about health, that would somehow make a difference. Getting people on the one end versus the other. But it was naïve to think that you could actually do that, because when I got in there I was given so many responsibilities. It was impossible for me to actually to execute that.

Can you tell me more about what your job as a school nurse entails, in general?

So my job as it is right now is mostly just paperwork. I’m clicking boxes. I’m crossing t’s and dotting i’s. As part of my job, I’m not providing as much education as I had been trained to do, to be honest with you. [Once I was working in schools] it was like, “No, that’s not your job. You’re going to sit in front of a computer. You’re going to tick boxes.”

It’s not unimportant work, like making sure kids are immunized, and having their asthma medicine. But if I have 6, 5, 4 schools, that’s all I’m going to be able to do. I’m not going to have time to do education. So I think CTU has correctly fought for more nurses in the schools. And that’s something that we’re also trying to build up so that we can play the role that really is needed in our communities.

Let’s get back to the CTU’s struggle to advocate for school health care in a minute. But first, I would like to know more about how your work has changed, resulting from Covid-19. What does a day in the life of a CPS nurse look like currently?

I mean, it’s not that different. The big difference is that I can now do more in, my opinion, than I could before. Because the problems before, when I had 6 schools, I was physically at 1 school a day and I would have to go to another school. So that’s an hour that’s just dead because I’m traveling between schools for meetings. Now I can just go from meeting to meeting in a matter of seconds. So I’m still doing the same job that I’ve been doing before, which is again, mostly paperwork and assessments of students. So I talk to students on the phone, or through Google Meets, parents, doctor’s office, etc. I can check all their compliance with their shots and exams and whatnot. That’s all the same.

The 1 thing that’s very different this year is actually what I was taught to do when I became a certified school nurse. I’m classified as an educator within the eyes of the state. So what I went to school for was like, “Here’s how you teach health.” But when I got into CPS they’re like, “No, you’re not going to do any teaching. You’re going to sit behind the computer and do all this paperwork because you have 3, 4, 5, 6 schools. You just have to stay on top of the paperwork.” Because they get money for providing services for kids through Medicaid, because that’s how there’s a big amount of funding that comes through that. So all that teaching stuff that you learn how to do, forget about that.

But the one thing that’s been really different this year is that I have gone into dozens of classrooms and done health education. Like for Disney [Magnet School], it’s such a huge school, it’s like 1500 students, I’ve taught almost every single class, 40 or 50 classrooms worth of health education on coronavirus. So I put lessons together, I was able to jump on these classes and teach these kids about where this virus comes from, how we can manage it, how we can reduce transmission. It’s not that PE teachers or health teachers can’t do that, it’s just that I think that nurses are better suited for that job in a sense of being able to talk about those things in a way that helps students understand, “Here’s why you should do this, and not just wear a mask just because they told you so, but let’s go to the actual reasoning behind that.”

The news in the past month or two has shown that the federal government and many districts across the U.S. are putting increased emphasis on sending students and educators back into schools. This is the case in Los Angeles, Chicago, Philadelphia, and numerous locations nationwide. Why do you think that your district, CPS, is putting so much emphasis on opening school doors in the midst of a global health crisis?

CPS is spending all this energy, all this funding, they go to all this time for, again, a very small group of people. If you look at who’s signing up to do the in-person, the loudest voices were in the neighborhoods that were the whitest and the wealthiest. So all this talk that CPS had of, “We care about Black and brown children, we care about the poor children who are falling behind.” It’s like, then why aren’t you focusing on them? I mean, let’s get real, who’s dying from coronavirus? Who’s testing positive? It’s not the rich white people in Lincoln Park.

The people who are not sending their kids are the ones who’ve seen their family members die. [People] who work essential jobs, who have seen the impact of this disease, and whose kids have asthma, diabetes, sickle cell. They’re not sending their kids in the school because they’ve seen the effects of this disease. They don’t want to risk that for themselves or the multi-generational people that live in their household. So this talk about equity, it was really frustrating because it just didn’t match up with what was happening.

The Chicago Teachers Union has made national headlines lately for taking a strong stand in advocating for both education workers and local students and their families during the pandemic. What are some of the union’s current healthcare priorities during Covid-19?

I think the CTU’s work is guided by looking at how our working conditions are, what impacts students’ learning conditions, and vice versa. You can’t separate one from the other. And so in my purview as a nurse, if you have students who don’t have access to healthcare, who don’t have access to healthy foods, whose families are insecure when it comes to housing, who maybe have stressors in their lives, they’re not going to be in a position to be learning and growing and progressing as well educationally. And so, we’ve seen it as our mission to try and look at those things as a group, and to say that if we’re going to have positive experiences with students learning, we have to make sure that they have proper housing. They have access to food.

One of the things that we were fighting for prior to coronavirus even coming about was to have more nurses in the schools. Illinois is the 5th worst state when it comes to the number of nurses per the number of students. I think that predominantly has to do with Chicago because it’s the biggest district in the state by far. And during our strike [in 2019], that was 1 of the things that we were really pushing on, saying, “We need to have more nurses in schools.” There’s plenty of studies that show the more nurses you have in school, the better attendance will be, the better compliance will be with asthma. Or certain medical conditions can definitely be improved by having that professional in the schools.

And so, we continue to push on that. We’re continuing to advocate to have nurses not only involved in the schools, but have more of them. When I was in my school nursing program, I spent a day in a suburban district bordering Chicago which had multiple nurses in one medium sized school. Having a nurse in every school every day is hardly an aberration, it comes down to resources and priority. We need to refocus resources on providing care where it can make a tangible difference.

And I think that can make a difference for having to transition back into either hybrid or in-person learning where nurses can play an important role. I think part of the reason you see such poor compliance when it comes to wearing masks, or social, or safe distancing as it were across the country is because [of] a level of ignorance that exists, not to the fault of individuals per se, but a lack of education that has been given to them through their primary and secondary education. Most people don’t have nurses in their schools throughout their time.

Let’s talk a little more about the push for in-person learning in schools by the district. Why do you think that the district is pushing so hard to reopen schools?

What I think is even more clear now is that if the district is truly concerned about remote learning and education, then let’s focus on that. Let’s make that better. Why are there huge numbers of students who haven’t engaged in remote learning? Why are people just missing in action? How do we solve that problem? Because the idea that somehow just opening the front doors of the school is going to bring all those students in who have been struggling, it’s just not actually true.

For example, with pre-K and cluster, less than 20 percent of students who had the option to come in actually showed up. The vast majority of students decided, or families decided, to stay remote. I think it underlined for us the importance of the focus needs to be on the 80 percent, not on the smaller group. And if there is a smaller group [that] needs to come in, let’s talk about it. Let’s figure out a solution for these people. But just an across-the-district reopening, in my opinion, just didn’t make sense then. It still doesn’t make sense now.

It sounds like you are saying that only 20 percent of families want to send their children back to school in CPS, and that because of this, that time and money would be better spent by helping train teachers to hone their remote instruction technique. I have been talking with educators in Los Angeles, who have been echoing this same idea. I would like to hear more about your perspective on the recent agreement between CTU and CPS on reopening school buildings. Can you tell me about your assessment of this agreement?

I personally voted against the Tentative Framework and advised others to do the same. I believe we could have continued to organize and work remotely. It was unclear if the mayor would actually have locked us out, as that would have cut the vast majority of parents off from what they wanted: remote learning. Our fight for safety had solid backing from parents, community organizations, and almost all of City Council.

Improvements to remote learning could have been a key issue to negotiate around. Many students certainly have fallen through the cracks. They need further intervention to get participation back on track, and their issues will not be solved by simply resuming in-person learning.

I understand the reasons why a majority of CTU members voted yes, and many of them are excellent trade union activists. They believed we had gotten as much as we were going to get from the Board, and were not confident in our collective ability to carry the struggle further. It is worth acknowledging that if the Tentative Framework had been rejected by a slim majority, it would have been a challenging organizing environment, especially if a strike had been provoked.

That being said, a strike for safety and improved remote learning would have sharpened the question for the post-Trump era: can the Democratic Party deliver what our communities deserve, and are unions able to successfully fight for those things? This deeper question remains unanswered, and will define the struggles to come.

Let’s talk more about the CTU’s recent mobilizing efforts. Chicago made national headlines during its 2019 strike for its ongoing push for common good demands, including the push to get more nurses in Chicago schools. Can you tell me more about your current personal experiences of protest and resistance in Chicago amidst the district’s push to reopen schools?

So the CTU really started mobilizing over winter break around this [push by Chicago Public Schools to restart in-person schooling]. I think one of the things that really set a tone was the 1st day where a group of teachers at Brentano Elementary in Logan Square organized a teach-out, saying that, “We want to teach. We want to do what’s right for our students. We don’t think that it’s necessary for us to be in buildings, we can do our job remotely. We don’t think it’s safe to be in buildings with the positivity rates, with the fact that there are new strains coming in.” I think on [January] 4th is when those teachers started doing this teach-out and then that got replicated across the district.

Me personally, what I decided to do, I joined some of my coworkers on that first day in front of one of my schools. So the 2 social workers and myself, we taught outside on that Monday. Then I basically stayed out and worked outside for the rest of the week at my various schools. Then on Monday the 11th the principal came out and said, “You can’t be out here. You have to come in the building or you have to go somewhere else. You can’t stay outside the building.” Even though I had told him, saying, “I am happy to help in any way with a student who is sick. I’ve got all my equipment there. Is there’s a sick student there?” They basically said, “No, we don’t want you out here. You can’t be outside anymore.” So from then on I worked from home.

It was cold out, so I don’t know if they’re worried that it looks bad, is my guess. But it’s just like, “How am I hurting anybody?” The vast majority of my job [presently] is on a computer. I monitor students’ health records for special ed. I talk to parents on the phone. I talk to the doctor’s office on the phone. I receive faxes. My job is basically a computer job. It’s not my choice, it’s how CPS’s structured. If I had one school, I could definitely have a lot more time for interaction with students, but that’s just not the job that they’ve had me do. So why they want me, who does a computer job, to be physically in the building, doesn’t make any sense to me. It’s just like, “All you’re doing is creating more possible vectors for transmission of this deadly disease.”

It seems counterintuitive that as a nurse, you would continue to be primarily tasked with data entry and telephone-related tasks during a global health pandemic. I had expected to hear that you were more frequently working directly with your students and their families. Why do you think this is?

I think part of the problem is that they have this plan that they had put forward, doesn’t have enough nurses and so they were like, “Well, we’re going to have our Care Room Attendants take care of anyone who’s suspected of coronavirus.” So they would find volunteers and they would pay them an incentive to volunteer to be working with students who are suspected of COVID. I looked at the training they did, it’s pretty embarrassing. These people watched this 40 minute video and then magically they’ve become a health care professional.

Again, it’s nothing against people who are bus aides, security – I certainly couldn’t do their job. But what makes you think that you could do a 40-minute online video training and then, “Oh, you’re qualified to assess the student?” Furthermore, putting on and taking off PPE, wearing a mask properly, all those things are something you learn with return demonstration. The fact you just watch a video and say, “Okay, you’re great. Go ahead and hopefully you’ve put this equipment on safely and protect yourself.”

It sounds like the district is hiring underpaid and undertrained employees to work directly with students who are expressing Covid-19 symptoms, rather than differently utilizing school nurses or other trained health professionals. Can you tell me more about whether or not there are gaps in care for students in Chicago Public Schools right now? What needs to be done to protect the health of Chicago students and families?

I think there’s still all the same problems that we had before COVID exists. They have exacerbated the problems. I mean, you have students who’ve lost family members and where’s the mental health care being offered for them? I mean, there’s all this human cry about the mental health of students is breaking down. Absolutely, this is a fricking pandemic. A lot of people’s mental health is breaking down. What is this city doing to actually fix that?

I don’t know if you’ve followed the news in Chicago, but they are talking about closing down this big hospital, Mercy Hospital, which is a hospital in the South Side [and] serves predominantly African American patients. They’ve shut the ER down, they stopped taking ambulances, which is basically a huge part of their volume. They’ve just declared bankruptcy. This is a hospital on the South Side, 50,000 ER visits every year, thousands of babies born there, down to the Bronzeville, Chinatown neighborhood. These communities that have been suffering are suffering even more.

Whether it’s psychologically, economically, physically, on an education standpoint, and there’s no solutions being put forward that will actually help them. It comes down to the way that healthcare is structured in our country, which is unfortunately around profit rather than meeting the needs. We spend more per capita on healthcare than any country on the planet and have some of the worst outcomes. People in this country pay more and live shorter lives. So I don’t know how that makes any sense. And particularly with people of color, the outcomes are even worse.

Can you tell me more about how nurses are pushing back to advocate for safe and healthy schools?

One thing that’s been impressive is coworkers who I did not know were activists, or were not particularly vocal, or outspoken about workplace issues, just stepping up and doing all kinds of stuff that typically nurses wouldn’t do. I think that they were pushed into that situation because of the coronavirus and having their own experiences. I’ve met many nurses over the past several months in organizing this who were on ventilators themselves for coronavirus, who’ve lost several family members, there’s 1 that lost 3 family members just in her own house. Not her own house, but these are cousins, and aunts, and uncles to this disease. So there was a lot of, I think, understandable impact that this had and pushed people to become involved.

So one thing that we did is we wrote a statement that just says, “Here’s why health professionals in schools don’t think in-person really makes sense.” We had 165 nurses sign onto it. So we did a press conference and actually went and attempted to deliver it to the mayor a couple of weeks ago.

You mentioned that nurses have been stepping up to do new organizing-oriented tasks that they didn’t do previously. Can you tell me more about what the Chicago school nurses have been up to?

So the thing that would happen frequently would be press conferences or appearance events. [For example] we [said to our union], “We want nurses to interact directly with parents. We want to talk about our concerns with parents.” So CTU put this together, and we had a panel of 4 nurses talk directly to parents about what they think this, going through some of the reasonings. Why we don’t think schools are safe. Going through what CPS hasn’t planned, because CPS is pretty opaque with parents as far as, “Here’s what we got going on.”

So people just became more confident to speak openly and publicly about what they thought about stuff. A lot of times I think, and again, this is only my 5th year there. One thing I noticed as far as nurse activism, there was some reticence, like worried about being singled out, or concerns about retribution for managers if we do speak out. In previous experiences, there’s been a lot of, I don’t know, if it’s excuses or just other reasons to not get involved, and a lot of those melted away. So there was a whole new layer of nurses who now see themselves as active members of their community when it comes to advocating for health.

Thank you for your time, Dennis. It has been my honor to talk with you and hear about your experiences nursing and organizing in Chicago.
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Rhiannon Maton, Ph.D., is an Assistant Professor at SUNY Cortland. Maton, a former active supporting member of Philadelphia’s Caucus of Working Educators, researches teacher activism and union organizing, and has been published in journals including Curriculum Inquiry and Workplace: A Journal For Academic Labor.

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