JTffiS JlfiSST STATE DKPT. OF EDUCATION ' Ji I 1 -IMI RJSPOST OK A SURTST OF SIOHTT-FIVK SMBHAL HOSPITALS IK NSW J1RSEI REPORT 00 fl SORVEY O F ¥ n £ a™ ■ Conducted by State of tNey Jersey, Department of Education , Division Against Discrimination Newark State of New Jersey Department of Education Division Against Discrimination 1060 Broad Street Newark 2 Study authorized by: 'tate Council Against Discrimination Dr. Robert C. Clothier, Chairman Harry R. Bell, Vice-Chairman James Ke rney, Jr. Louis Mrroiante Jacob Stern Herbert H. Tate J. Margaret Warner Report approved by; State Comission on Civil rights Dr. Robert ,:f. rran Router, Chairman Joseph S. Picking Meyer Pcsin Jacob Stern Herbert H. Tate J. Margaret Warner Stephen W. Waterbury Study conducted under supervision of; John H. Bosshart Commissioner of Education Joseph L. Bustard Assistant Commissioner of Education and Birector, Division Against Discrimination Harold A. Lett Assis tan t Direct or lyra A. Blakeslee Educational Director prepared by: Isham B. Jones Field Representalive November, 19u9 State of New Jersey Department of Education Division Against Discrimination Newark POKE W 0 H D The State Council Against Discrimination, in keeping with the provisions of Chapter 169 of the Laws of 19h5> authorized the Division Against Discrimination to make a survey of general hospitals in New Jersey. The purpose of the survey was to ascer- tain the facts regarding practices of general hospitals in New Jersey as they relate to minority grouos. At that time, the State Council was charged with the responsibility of being concerned with problems of discrimination in all or specific fields of human relationships. Since then, Chapter 169 has been amended by Chapter 11 of the Laws of 191*9. One of these amendments gives to the Commissioner of Education with the approval of the State Commission on Civil Rihts, the authority to issue results of investigation and research. This applies particularly to pro je cts tending to promote gone will and to minimize or eliminate discrimination because of race, creed, color, national origin or ancestry. It is hoped that this study will help to accomplish the above. 2 Scone and Method of Survey The purpose of the study was to determine the availability of facilities for treatment of minority group patients as well as employment and professional training opportunities for minority group members. The Division confined this particular study to general hospitals that received some financial assistance from public contributions and tax funds. This study did not include federal, state or county institutions. It should also be understood that most hospitals are "private” institutions, in that they art owned and controlled by sectarian or other non-profit organizations or corporations, Accordingly, t 'ey are-exempt from the • legal provisions of the Laws Against Discrimination, Experience has taught the Division that a statement of policy does net necessarily mean adherence by everyone effected by such a policy. This inquiry, therefore, has been conducted upon a plane of objectivity uninfluenced by rumor, reports or suspicions. Before ascertaining the nature and extent of hospital relations and practices, it was necessary to seek the classification and number of general hospitals in Dew Jersey. The Division received the cooperation of the Mew Jersey ':ospital Association throughout the survey. TTelpful data were secured from the Journal of the American Medical Association of August 19 U8. Contacts were also made with the New Jersey Department of TTealth and the State Deoartment of Institutions and Agencies. From all sources a total of general hospitals, covering 21 counties, was listed and included in this survey. A monthly bulletin of the New Jersey Hospital Association carried an article informing hospitals that a field survey would be initiated by the Division Against Discrimination requesting their co- operation. Throughout this study the reader will find greater emphasis placed upon the status of Negroes in the general hospital picture in New Jersey than upon any other minority group; This is due to the more readily available information growing out of traditional racial practices. In using the term ’’other minority groups!’ it will be noted that Jews and Italians are referred to directly in some parts of this report, Italians as a national origin group have been mentioned speci- fically: (l) as the largest national, origin group in Few Jersey• (2) as that group most widely distributed throughout the State; (3) as the national origin group encountering discrimination with greater frequency in some sections of the State. The Treatment and Reception of Patients The standards of health maintained by the citizens of New Jersey, as in any state, are determined largely by the availability of medical care facilities. This survey revealed that 89 hospitals located in 21 counties of Mew Jersey, were able to offer a total of lit, 779 beds and 2,996 bassinets to Nerr Jersey citizens. Negroes, who constitute a total of 226,973 or per cent of New Jersey’s 1,160,169 people, according to the 19I4O United States census, have access to 8U of the 89 hospitals housing 96,3 per cent of the beds included in this survey. However, Negroes did not have access to all of these beds. Further analysis of the 8U hospitals that received Negroes as patients, disclosed the fact that the percentage of beds available to Negroes is lower than a preliminary examination of the data seemed to indicate. Fox'* instance, in two hospitals Negroes were not admitted as ward patients although other minorities were so received. The number of beds involved in these situations was not available at this ooint. The number of hospital beds available for Negroes grew less when it was ascertained that 1.3 of the 85 hospitals do not .permit Negroes to have semi-private rooms. One other hospital., in the past, had allowed Negroes to have semi-private rooms, but such service is not extended at present. Four other hospitals have made semi-private rooms available to Negroes occasionally, but only nif absolutely necessary”. In one of the 85 hospitals which had no ward accommodations, Negroes were placed in a separate section. It is easily understandable from these facts how difficult it is to state with any certainty the number of beds available for Negroes in New Jersey. This problem was further complicated by economic considerations. Some families do not have the necessary financial means to demand semi- private or private room service. In 77 of the 8? hospitals surveyed, Negroes and whites were placed in the same wards. This practice was carried out generally with- out any difficulty. Six hospitals segregated Negro patients from white by placing them in separate wards. Two other hospitals had no wards. The placing of Negro and white patients in the same semi-private room seemed to constitute a problem for a number of hospitals. In of the 8.5 hospitals, Negroes and whites were permitted to share semi-private rooms, but 2£ hospitals would not mix Negro and white patients. Four other hospitals occasionally placed colored and white patients together in a semi-private room, and the policies of two other hospitals were not ascertained. Typical statements of some of the hospital officials who have experienced no difficulties or problems resulting from the mixing of Negro and white in semi-private rooms follow: ’’Only once in a while do we hear any objections from white patients when a Negro is placed in the same semi-private room, .Te don’t do a thing about it.” ”1 never had any situation develop where a white patient objected too seriously if a Negro patient was placed in the same room,” ”No fuss is made when semi-private mixing occurs,” In those hospitals where whites and Negroes were placed in the same semi-private room and objections arose, or where the hospital offi- cials were reluctant to pursue such a policy the following statements were recorded; ’’Negroes are placed in semi-private rooms only when there is no objection from the white patient,” "bhen a Negro patient applies for a semi-private- room he is given a private room at semi-private rates. This is due to objection of white patients to Negro visitors - too many,” This latter practice is discriminatory in nature toward, white patients who must pay private rates for private rooms. The statement was made in several instances that ’’Negroes have too many visitors.” AVAILABILITY OF HOSPITAL FACILITIES EARNS AVAILABLE EARNS ASSIGNMENT Admitted 77 Not Admitted 2 Non-Segregated • Segregated Each symbol represents 10 hospitals where Negroes are admitted or not admitted to wards. Each symbol represents 10 hospitals where Negroes are admitted to wards on a non- segregated or segregated basis. Jews and Italians were admitted to all wards. SEMI-PRIVATE ROOMS AVAILABLE SEMI-PRIVATE ROOM ASSIGN!ITT Admitted 66 Not Admitted 1 A Non-Segregated 'SL Segregated 12i_ : Each symbol represents 10 hospitals where Negroes are admitted or not admitted to semi-private rooms. macn symool represents 10 hospitals where Negroes are admitted to semi-private rooms on a non-segregated or a segregated basis. Italians were assigned to semi-private rooms in all hospitals. Jews were assign- ed semi-private rooms in iiL hospitals. The policy of one hospital regarding Jewish patients in sei i-privat ■■ rooms was nrvK <5+.si-! r>rl AVAILABILITY OF HOSPITAL FACILITIES PRIVATE ROOFS Admitted 78 Not .Admitted h Each symbol represents 10 hospitals where Negroes are admitted to private rooms. Jews and Italians are admitted to private rooms in all hospitals. let, the practice of porrr.lttin-.' only two or three visitors to see a patient at the same title was rigidly enforced in this particular hospital. This is considered generally to be good administrative practice, Negro patients were admitted to private rooms in ?8 of the hospitals while only a hospitals would not accent Negroes in private rooms. Three additional hospitals occasionally admitted Negroes to private rooms, but did so only "if absolutely necessary",• employment of Qualified Nurses Gc/ernor Driscoll's Committee on Civil Liberties reported on April 22, 19li.9, that: "Discrimination against doctors, nurses and internes in hospitals varies in different parts of the State, public hospitals maintained solely by taxation have been obliged to do away with discrimination because of the pressure of public opinion since the law against discrimination covers all such public institutions, "Most hospitals, however, are quasi-public institutions. They get their money from the public but exercise private control over their facilities. They are admitting Ne to nurses in increasing numbers, but a majority of them still refuse even courtesy privileges to women doctors and Newro doctors,"” 1. civil Liberties in New Jersey - A report submitted to the Honorable Alfred A, Driscoll, April 22, 191+3 - p. 16. Before 19h09 general hospitals employing Kearo nurses were so few in number as to be ne eligible. In January lSJk7, a survey made by the forrr.er Urban Colored Population Commission reported that 21 of Ilk hospitals studied, employed Negro nurses, .Vithin a two-year period, hospital officials had so changed their policies and attitudes that 37 of the 6k hospitals surveyed by the Division Against Discrimination employed Negro graduate nurses. This trend indicates a tremendous advance in the thinking and practices of hospital administrators regarding the practicability of engaging Negro nurses. The number of hospitals that have employed Ne*ro nurses durirr that period is even more significant upon further examination of the data. The- Ur'-an Commission figures - 21 of Ilk hospitals employing Ne’:ro nurses in January 19k? - included federal, state, county and municipal hospitals, whereas the Division’s study embraced general hospitals, only two of which are supported entirely by public funds. During that two-year period not only has the number of Negro I nurses increased, but the period has witnessed the promotion of Negro nurses to supervisory positions. In at least three instances, Negro nurses were supervisors in maternity wards. The technique of introducin' professional Nowro nurses has been no different nor more difficult than methods employers have used in introducing minority group workers into industrial .jobs. Some hospi- tal officials hired the Negro graduate nurse first and then informed the medical staff and the Board of Trustees. In one instance where this procedure was followed, one of the medical staff members dramatically displayed his displeasure by boycottin the hospital, and when he 8 realized his displeasure was the result of prejudice, just as dramatically, he returned to the hospital, taking up where he had left off. In many areas of employment, employers have stated on occasion that their white help would walk off the job if Negroes were employed. Contrary to these predictions, none of the white employees have quit work when Negroes were employed. Experiences in several hospitals where employees were reported to have uttered similar threats, were the same. Other hospital officials simply announced to the staff that Negro nurses would start working at the hospital, and said no more. In a few instances, the hospital officials consulted with the nurses for opinions as to whether or not Negro nurses should be hired. An interesting story was told by one official: "One day I received, a telephone call. Tne caller stated that she had noticed the hospital ad in the local paper and wanted to knew if the hospital would hire a Negro nurse. The person was in- formed to come to the hospital to discuss the matter. After the interview was over I thought that I would hire her. "I told a director of another hospital about my selection. She wanted to know what the nurses' reactions would be would they work with her. She thought that I should ask all my nurses first before hiring the colored nurse. "I said to myself: ‘Suppose all of them had said, "No, — don't employ any Negro nurses". Then, where 'would I be?‘ "I hired this colored nurse and she became one of the best- liked nurses by all of the patients and the nurses themselves. Later on we hired a second, Negro nurse. ie never had any problem at .any time along this line." MINORITY REGISTERED NURSES IN HOSPITALS NEGRO Not Enroloyed 93 Emoloyed " 21 1957 Each symbol represents 5 hospitals* These hospitals include federal, state, county, city and general hospitals. Statistics taken from study by Urban Colored Population Commission of hospitals in New Jersey 19.57. NEGRO Employed 37 Not Enroloyed 36 1959 Each symbol represents 5 hospitals, JETISH Employed 59 Not Employed 12 1959 Each symbol represents 5 hospitals. The current survey of hospitals by the Division An ainst Discrimination included only 85 general hospitals, exclusive of governmental institutions. MINORITY REGISTERED NURSES IN HOSPITALS ITALIAN Employed 62 Not Employed 7' 19U9 Each symbol represents S hospitals. In addition to the 37 hospitals mentioned above, six other hospitals had in the past employed Negro nurses, although none were employed at the time of the survey. Thirty-six other hospitals have never engaged Negro nurses and 12 and 7 hospitals, respectively, have never employed Jewish and Italian nurses. Jewish nurses were found in 59 hospitals and Italian nurses in 62.*;:- It was found that in some hospitals Jewish girls did not apply for employment because the hospital was predominately of a different religious faith. However, some of these sectarian hospitals did employ Jewish nurses. Explanations given as to why no Negro nurses were employed followed these trends: "Don't recall any in the neighborhood." "None ever apply or in vicinity." One hospital official stated that she would like to employ Negro nurses but that she was afraid of the reactions that might occur in the com- munity and among the nurses. Another hospital administrator did not employ any Negro nurses because he "did not have single rooms for them in the nurses 1 quarters". Doctors' Privileges and Training of Internes Along with the increased employment opportunities for Negro graduate nurses that occurred during the period 19l'7-li9j there also developed expanded openings for Negro doctors to participate in courtesy privileges and staff memberships. Negro doctors enjoyed courtesy privileges in l.i6 of 83 hospitals that had courtesy staffs and were medical staff members in 19 of 0I4. hospitals having staff divisions. In 19h7, the -;:-The reader will note that all job classifications and services under con- sideration in this text are not to be found in all of the 85 hospitals studied, i.e., schools of nursing, courtesy staffs, clinical staffs, resi- dent physicians, etc. The policies of hospitals not accounted for were of little or no significance to the purposes of this study and in some instan- ces, were unattainable at the time of this survey. study of the Urban Colored Population Commission revealed that Negro doctors had courtesy privileges in only 28 of 11.a hospitals. Other minority group doctors were granted courtesy and staff privileges in nearly all of the hospitals. Seventy-six of 8,3 hospitals extended courtesy privileges to Jerri.sh physicians and those same courtesies ■were nranted to Italian doctors in 79 of the 83 hospitals. Staff memberships mere granted to 71 and Jewish and Italian doctors respectively. There were 36 hospitals in which Negroes were not in attendance as courtesy physicians; Jewish physicians in five hospitals, and Italian doctors in one hospital. Negro physicians were not staff members in 62 hospitals,# In all instances where members of minority groups are not included in courtesy and service staffs, it must be remembered that this does not necessarily indicate discrimination, ilso, it must be borne in mind that in many areas of the State, Ner.ro specialists are not available for staff services. There are some areas in Her; Jersey, such as Sussex, 7/arren and Ocean Counties, that have no Negro doctors. In several such instances hospital officials have indicated that their facilities were open to Negro physicians, and some of these had Negro graduate nurses employed. Other hospitals have stated that no Jewish, Negro or Italian doctors were on their staffs because none of them applied, or were livin' in the vicinity. These explanations seemed to be correct in regard to some hospitals, with the followin statement expressing the sentiments of several administrators with specific reference to Negro doctors; "7e would gladly take Negro doctors if they would only apply.” In some cases, explanations of this nature seemed evasive since public hospitals ■>'-See footnote Page 9. COURTESY PRIVILEGES EXTENDED TO MINORITY PHYSICIANS NEGRO In Attendance U6 Not in Attendance 36 Each symbol represents 10 hospitals. JETL3H In Attendance 76 Not in Attendance P Each symbol represents 10 hospitals. ITALIAM In Attendance 79 Mot in Attendance • 1 Eath symbol represents 10 hospitals. STAFF PRIVILEGES EXTENDED TO MINORITY PHYSICIANS NEGRO In Attendance 19 Not in Attendance 62 Each symbol represents 10 hospitals. JETFSH In Attendance 71 Not in Attendance 7 Each symbol represents 10 hospitals. IT iLI \i' In attendance 75 Nob in attendance )4 Each symbol represent3 10 hospitals. 11 in the same area extended courtesy and staff privileges to all qualified professional medical r;$t* in the community, including members of these minorities. Hospitals having Negro physicians on their staffs reported no frictions or tensions developin as a result of their presence. One medical director stated; "Te never have any friction or problems. The Keg.ro doctor is a fine one." Still another hospital official commented; "The Negro doctor is one of the most ethical men on the staff. That reminds me, I must- call him and ask if he can serve as a resident physician tonight. You see, ’vs have no regular resident physician, bach one of our staff doctors must serve a night as a resident physician." In the interview- er's presence, the Negro doctor was called and asked if he would be willing to serve as a resident physician for that night. He replied that he would and was listed accordingly. One severe handicap that faced negro ohysicians in some com- munities was evidence of disapproval by medical men and hospital officials of alleged aggressiveness and articulateness of he ro doctors regarding civil liberties in their home towns. In some such circumstances, liegro physicians have been penalized by denial of professional recognition or cooperation. Another hospital director revealed that "young doctors will have to serve in a clinic first. After this period of service, they wl.il be appointed to other positions in the hospital". 12 Negro physicians served in 7 clinics, whereas Jewish doctors were clinical staff members in 30 hospitals and Italian doctors in 32 of the hospitals surveyed#. These minority groups were not in attendance in 31i 7 and 5 clinics, respectively.* One of the largest general hospitals in the State of New Jersey#* maintains some of the best administrative practices and policies in extending medical care to minority groups# Negro doctors, besides having courtesy privileges, clinical assignments, and medical staff membership, also enjoyed training opportunities as internes and resident physicians as well# Similarly, Jewish, Italian and other minority group doctors were represented on the professional staffs,# In only one other hospital were Negroes serving in the capacity as internes, but in no other hospital as full time resident doctors* Negroes as well as other minorities were engaged in this hospital as technicians, registered nurses and nurse trainees# Minority group workers were also employed as attendants and cooks. The survey indicated that of the 85 hospitals visited, 33 of them, did not have interne staffs and 22 did not have resident staffs# Of the 52 hospitals having interne staffs, h3 have never had Negro internes# It was ’’unknown11 in five additional hospitals if Negroes had been or would be acceptable as internes. In two other hospitals, Negro doctors had formerly served as internes; however, no Negroes were sc employed at present# Only two of the 52 hospitals currently had Negroes as internes. *S-eo footnote Page 9# *#Hame will be furnished on request. CLINICAL PRIVILEGES EXTENDED TO 1IN0RITY PHYSICIANS NEGRO In Attendance 7 Not in Attendance 31 Each symbol represents £ hospitals. jf; non In Attendance '30 Not in Attendance 7 Each symbol represents £ hospitals. ITALIAN In Attendance 32 Not in Attendance Each symbol represents hospitals. INTERNE PRIVILEGES EXTENDED TO MINORITY PHYSICIANS NEGRO In Attendance 2 Not in Attendance U3 Each symbol represents hospitals. JEWISH In Attendance 33 Not in Attendance 10 Each symbol represents 5, hospitals. ITALIAN In Attendance 31 Not in Attendance 10 Each symbol represents 5 hospitals. RESIDENT PRIVILEGES EXTENDED TO MINORITY PHYSICIANS N5GR0 In Attendance 1 Not in Attendance 36 Each symbol reoresents £ hospitals. JE7JSH In Attendance 2 5 Not in Attendance 13 Each symbol represents 5 hospitals. ITALIAN In Attendance 2h Not in Attendance 12 Each symbol represents £ hosoitals. Thirty-three of the 92 hospitals had Jewish internes, while Italians were internes in 31 hospitals. Ten hospitals had neither Jewish nor Italian internes in attendance. In the remaining number, information was not given as to any clear-cut policy in relation to other minorities. In two hospitals Jewish internes were formerly engaged, but are not at present. Resident staff physicians were utilized in 63 of the 8.9 hospitals covered by this report. It has. already been indicated that only one hospital had a full time Negro resident physician. Twenty-five hospitals had Jewish resident doctors and 21* hospitals had Italian resident physicians. Thirty-eight hospitals admitted they had no Negro residents; 13 stated there were no Jewish resident doctors, and 12 hospitals reported no Italian doctors in attendance,w Educational Opportunities for Nurse Training The most noteworthy changes in recognition of minorities in toe field of medical care and education occurred in nurse training schools. Opportunities for Negro girls to become registered nurses in New Jersey institutions increased ICO per cent during the two-year period from 191*7 to 191*9. In 191*7 the study of the Urban Colored Population Commission reported that eight schools of nursing accepted Negro girls. The number of nursing schools revealed by the survey of the Division Against Dis- crimination indicated that 16 hospitals, of a total of 1*9 having nursing schools, enrolled Negro students by 191*9• -x-3ee footnote Page 9* This encouraging trend forecasts greater employment gains for Negro registered nurses while opening up a vast reservoir of trainees and graduate: nurses in a field that has experienced serious labor shortages. It ’’dll also serve as 1 stimulant to increase greater participation of Negroes in ail professional and technical capacities in the hospitals of the State. ---Another one of the more forward-looking institutions realized that fever administrative problems were encountered if discrimination of all kinds were banned. Negro student nurses are being accepted from a number of states along the Eastern Seaboard, Interneships and resi- dencies are held by Chinese doctors as well as by physicians of more numerous minorities. The administration had decreased its maintenance cost and had improved staff relationships between professional and non- professional help by maintaining one dining room. At Christmastime these excellent relationships were strengthened by a joint party of professional find non-professional staff people. The table below indicates practices in regard to nurse training in I40 hospitals having schools of nursing in the total of the 6:> hospitals covered by the survey. Hospitals Negroes Jews Italians Schools Enrolling 16 32 28 Hospitals not Enrolling 28 7 0 Hospital Policy Unknown 0 5 17 Once in the oast, not presently 1 1 J) Total No. Nurse Training Schools hS US hc> *Name mil be furnished on request. schools o? nnrss training NEGRO Enrolled 16 Not Enrolled 28 Each symbol represents 8 schools of nursing. JETESH Enrolled 32 Not Enrolled 7 Each symbol represents 8 schools of nursing. ITALIAN Enrolled 28 Not Enrolled Each surnbol represents 8 schools of nursing. The hospital survey made by the Division Against Discrimination in 19U9, revealed there were 1j5 hospitals, of a total of 85 general hospitals, having schools of nursin’. Seventeen (l?) schools of nursing did not divulge whether Italians were or were not enrolled. 15 From the foregoing table it can readily be seen that Negro girls have less opportunity for nurse training than members of other minority groups*. However, it should be pointed out, that some of those 26 hospital schools where no Negro girls were enrolled, could not be charged with discrimination against them. Some of those 28 hospitals have indicated a desire to admit qualified Negro girls, but have been unsuccessful so far because those Negro applicants who applied have not been in the upper half or one—third of high school graduating classes Several of these hospitals employ Negro registered nurses, or extend courtesy or staff privileges to Negro physicians. On the other hand, the statement that TTegro girls have not met minimum requirements was used by some hospital administrators who did not desire Negro student nurses. One hospital official frankly stated that the Board of Trustees and medical staff opposed the training of Negro girls. Statements of many other hospital directors, however, revealed that Negro girls were successfully introduced into the schools and nurses homes with a minimum of difficulty, *ne director stating: "I told the other students that they were going to have colored students last September, 7e didn’t have any trouble and now the colored students are doin excellent work.” Another official reported; ”7c started training Negro girls three years ago. In each one of our classes (from freshman to senior) we have Negro girls, A.Negro girl won the scholarship last year,” 16 Tith reference to the housing of Negro trainees in school dormitories, one director said, nI mado up my mind the best solution would be to place Negro and white girls in the same room. In the begfanning there was some murmuring, but it has all disappeared now". Thi s practice of placing Negro and white student nurses in the same room was also followed by several other hospitals. In some hospitals the Negro girls had individual rooms because all of the student nurses had single rooms. In still another instance, a hospital director did not feel free to accept Negro girls until such time as they could have their own single rooms. Other Areas of Employment Negro nurses’ aides were employed in mere hospitals than were members of any other minority group. Twenty-four of the 35 hospitals sur- veyed did not utilize the services of nurses ’ aides. Negro women were employed in kh of the 6l hospitals using these services, but were excluded froi; liu The table below illustrates the placement of minorities as nurses' aides. Hosoitals Negroes Jews X t s.l il an s Employed hh 39 32 Not Employed 111 13 5 Unkno’.'.T! 1 7 2)4 Eormorly, not at present 1 1 0 Occasionally, if necessary JL J. JL Total 61 6l 61 MINORITY NURSES’-AIDES IN HOSPITALS NEGRO Employed kh Not Employed Ih ’ Each symbol represents 10 hospitals JE7ISH Employed * 19 Not Employed 13 Each symbol represents 10 hospitals. IT ILIA! Employed 32 Not Employed * c Each symbol represents 10 hospitals. 17 During the war years factories opened their doors to women, and many of them left the less lucrative service jobs. Negro women found it more difficult to obtain industrial employment, quit domestic service work, and sought employment in these vacancies left open by white women. The .job of nurses' aides fell in such a category. Ivory year since the war, more and more Negro women have entered this field of service. Among nurses’ aides were found some young girls who wanted to be nurses, but did not have the necessary qualifications or means to enter nursing school. lore Negroes were employed in the capacity of cooks than in any of the other job categories included in this study. Fifty hospitals of a total of 83, employed Negro cooks. This may be seen as a significant side- light on the strength of the racial tradition, even in hospitals where Negro workers are widely accepted if employed in the role of cooks or menials. Negroes were employed in 33 of 77 hospitals as wardmen or orderlies, Jews were hired as wardmen in 27 hospitals and Italians in 39 hospitals, Negroes were not among the employed wardmen in 38 hospitals; Jews were not found in 36; and Italian wardmen were absent in 2h hospital s. Another vocation that has offered Negroes new employment opportunities is that of hospital technicians, Negroes are employee as X-ray technicians, tissue technician, and one is engaged as general laboratory technician. Ten hospitals engage Negro technicians. Jewish and Italian technicians are employed in 37 and 32 hospitals respectively. LINORITI TECHNICIAN'S IN HOIFIT AL3 NEGRO Employed 10 Not Employed 67 Each symbol represents 10 hospitals JEWISH Smoloved 3T Not Employed 31 ' Each svrnbol represents 10 hospitals. IT ALT AI Employed ‘ 52' Not employed 19 ' Each symbol represents 10 hospitals Cf the 6? hospitals where degrees were not employed as technicians some of them indicated their desire to employ them, but have not had applica- tions . Applications A uniform application blank for admission was utilized by most, if nos all, of the schools of nursing. This amplication was cony- righted in 193*3 by the National League of Nursing Education, It contained inquiries as to birthplace, race, and citizenship of applicant. Information was also required as to the birthplace, citizenship, occupation and date of death of the applicant's parents. Besides that information, the names of brothers and sisters, their birthdays, school- in , and occupation were also required and a photo of the applicant was demanded, 'Some applications for interneships wanted to know applicant’s color, race and religion. This information was also requested by some hospitals for nurses, nurses' aides and general hospital help. Other institutions, among them the largest in the State, saw no need for requesting one's race, color or nationalloy when seeking employment. Provisions of the New Jersey Anti-Discrimination Law have declared these questions to be unlawful, but it is to be remembered that these provisions apply only to hospitals that are owned and/or operated by units of government, or that arc profit-making enterprises. General ObservaLions ith the broadening of the democratic processes occurring in New Jersey, It was inevitable that the practices and policies of hosoitals would be influenced. Thes - forces have been created by the passage of the Anti-Discrimination Law, and the new constitutional amendments outlawin';; segre ated schools and militia, and other forms of discrimination. Added impetus to these changes has been given by the recently enacted Civil Mights Law, It *'as noted throughout the survey that changes have occurred In hospital personnel - professional and non-professional - during the two-year period 19 b 7-19.*$. It has been indicated elsewhere that institutions can progress no further nor faster than their administrators and policy-making bodies will permit. A few hospitals have suffered from this condition, arc have not kept up with the passing tide. The atti- tudes, Policies, ana practices of some hospitals seemed to be untouched by all of the procress and charyes made in the field of medical service* One hospital administrator offered the quaint observation that a separate hospital for Negroes ought to be constructed by the city. According to this suggestion, the problem of Negro patients would be solved in this manner. Such a project would not only be segregation and discrimination at its worst, but would also be burdensome upon the public because of increased costs. •/tierever there has neon or is segregation in providing services or facilities, there always have boon serious differentials to the disadvantage of the weaker group and serious increase in cost to all. Despite the mercy-giving features of nospital administration, these differentials have worked to the disadvanta c of America’s racial minorities, as pointed out by the Report of the President’s Committee on Civil Rights: ’’Increased attention is being given throughout the United States to the health needs of our people. Minority groups are sharing in the improvements which are taking place. But there is serious discrimination in the availability of medical care, and many segments of our population do not measure up to the standards of health which have been attained by our people as a whole,,f Further statement of this problem by the President’s Committee presented these facts: ”A more direct cause of unequal opportunity in the field of health is the discriminatory pattern that prevails with respect to medical facilities and personnel, many hospitals will not admit Negro patients. The United States Public Health Service estimates on the basis of a preliminary survey that only approximately If,000 hosoital beds out of a total of one and one-half million beds are presently available to Negroes. It is to bo remembered that in some areas of the Unites States, Negrons are completely denied admission to local hospitals due to pre- vailing racial customs and traditions. Although Now Jersey is not 2. To Secure Those Rights - The Report of the President’s Committee on Civil Rights - Simon and Shuster, Now York, 19)4? - p. 71 3. ibid. To Secure These Rights - p. 73 bound by these same traditions, it has been the purpose of this report to discover the degree to vhich minorities in the State are recipients of full and non-diserfminatory services and opportunities. It is recognized that the amount ana kind of medical care available to a patient depends upon his financial status. To a greater decree than in other minority group experience, many degrees due to low income, cannot afford serai-private and private hospital accommodations, though some Negroes are able to nay for any type of hospital accommodations, 13 hcsoiials did not admit them to semi-private rooms, and four of these 13 hospitals would not permit Negroes to have private rooms. These accommodations were not denied to members of any other minority group. This denial of room service imposes serious restrictions and limitations upon patients whoso nature and degree of illness necessitates a semi-private or private room. In 23 hospitals Negroes and whites would not be placed in the same semi-private rooms. This condition serves to deprive Negroes of the best of hospital facilities where the maximum atmosphere for recovery is obtainable. It is often offered as an*argument in support of racial sc rogation or exclusion that "the hospital must consider the welfare of the patient". This consideration should bo indiscriminate. The welfare of tne Negro patient, or patient of any minority group, is as Important to him, his family and his community, as is that of the majority group patient. Several hospitals that had small maternity sections withhold maternity privileges from Negro mothers. A few other hospitals were 22 reluctant to place Negro and white mothers in the same wards or semi- private rooms because of alleged objections received from white mothers. Ironically enough, Negro nurses were often assigned to maternity sections and were also supervisors of these sections without such objections. It was found in some hospitals shat patients objected to the friendly visits by ministers of a different ~eli,.ious faith. This situ'tier was handled by the listin of church membership of ths patients, and by requesting religious leaders to visit only members of their faith. All trends indicate that mor and more registered Negro nurses will be employed in the hospitals of Jew Jersey. In soma hospitals Negro girls will be enraged as graduate nurses upon comple- tion of their training. Still a few other hospitals having no schools of nursing, revealed that local Negro girls in schools of nursing would be hired if they applied after graduating from school and wore able to meet scholastic requirements. Several of these hospitals wore located in small communities where no Negro physicians were practicing anywhere in the county. The outlook for Negro physicians is v_ry promising. Mere of them are being granted courtesy privileges and staff memberships as the months pass by. Occasionally Negro physicians arc requested to apply for courtesy or staff privileges, dome hospitals have stated that they would accept Negro physicians, but none of them have applied* In a few situations, this statement may be an excuse, in other instances it is a fact. Several hospitals have Indicated that degree internes would be accommodated but reported that to date they have received no applica- tions, It has been pointed out that many doctors want to get training at the very largest hospitals. Opportunities are greater in these hospitals for specialization or diversification. As an extra inducement, residencies are sometimes available in large hospitals whereas the many smaller hospitals do not have residencies. However, it cannot be overlooked that some Negro doctors ere guilty of followin'' the same pattern of thought as do other members of minority groups while seeking employment. If a member of his group is not known to be employed, nor ever seen working at a particular plant, he never applies at that factory for employment. This pattern is often pursued by some Negro doctors graduating from medical schools. They follow the pattern and custom of applying for interneships at these few hospitals that arc known to be interested in Negro internes. Many good hospitals are passed over as a result of such actions, This same observation, to a lesser degree, might apply to the minority registered nurse. As more and mom- Negro physicians become attached to hospitals in the capacities of courtesy and staff members, the greater will be their opportunities to become clinical staff members. In some hospitals it is not possible to serve on the clinical staff until one has advanced above the courtesy level. Still other hospitals have indicated that Negro doctors can become clinical staff members if they make their requests known. In one hospital the trend is to serve in a clinical capacity first, before courtesy and staff privileges are granted. 24 Because of clinic hours, widespread practices of limiting assignments to venereal clinics only, and tho demands of their own private patients, Negro doctors often hesitate to apply for clinical privileges. Jewish and Italian doctors have much less difficulty than Negro doctors in becoming affiliated with hospitals. It was previously pointed out in this study that only five and two hosoitals respectively did not have Jewish and Italian doctors on their courtesy staffs. The health of tho people in the American community is the public's business, to such a serious degree as to lead to interminable debate between two schools of thought in tho Western world, Should ovornment assume a greater share of the responsibility, tho cost and tho dir ction of health programs, or should all of this be left to individual initiative and professional direction? No doubt, tho answer to this question will be found in the extent to which the health protec- tion agencies and facilities in a community are accessible to that so Tient of the community in greatest need of such services. Discrimina- tion against racial and cultural minorities takes many forms, sore of them ultimately being reflected in morbidity and mortality rates as well as needless financial costs to til; total community. Practices affecting members of minority groups have definitely improved in many New Jersey hospitals in the last few years. There is also no doubt practices in New Jersey ps a whole are better than in many other parts of the country. However, there is still room and need for greater improvement in the future. The fact that many of the hospitals reached in the course of this inquiry have advanced in policy and practice would lead to the questions: IThat factors have enabled these institutions to inaugurate democratic practices? V/hat forces have given the insight, the moral courage, the fairness out of which have developed these practices? Conversely, it would be pertinent to ask: How valid are the fears which cause administrators and their Boards to withhold recogni- tion to minorities? These are some of the challenges this survey offers to hospital policy-makers in the State of New Jersey.