Nurses at Stroger Hospital hit the picket lines at 8 a.m., all dressed in red and holding signs in protest.
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They said the hospital is short-staffed, and that's why they're striking.
"When you have short staffing, you're not able to take care of your patients the way you need to," Stroger Hospital Critical Care nurse Ishante Norris said. "You can't give them their medications in a timely fashion."
More than 1,200 Cook County Health nurses planned to walk off the job for a one-day strike.
They said the hospital system is short hundreds of nurses.
They lined Damen Avenue in solidarity, as many cars drove by, honking in support.
"There are other issues on the table," Stroger Critical Care nurse Falguni Dave said. "You know, obviously we as health care workers also need our health care; we need to make sure that our mental and physical state is in the right place so that we can care for the others."
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In a statement from the nurses' union they said:
"We have far too few nurses working in our hospitals and clinics and we have witnessed a reduction of services over the last 10 years that have left many patients with few - if any - options...Cook County must address our staffing crisis now."
Cook County Health, which runs Stroger and Provident hospitals, postponed some elective surgeries and rescheduled appointments. It also augmented nursing staff in priority areas like the ER in anticipation of the strike.
Stroger will still accept trauma cases Thursday, but its ER is on ambulance bypass for the time being.
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Cook County Health released its own statement without addressing the nurses' staffing sticking point, saying:
"Cook County Health remains dedicated to providing safe, life-saving care during this job action and beyond to meet the needs of our patients."
Many of the nurses on strike said they felt disrespected by the negotiations, stressing they're not only speaking out for themselves.
"We want our voices heard because we are speaking up for our patients," Stroger charge nurse Bernadine Okeh said.
Meanwhile, on Friday, about 2,500 other Cook County workers are planning their own strike, with no end date announced.