Jeremiah Hayden by Jeremiah Hayden

Nurses at Legacy Emanuel hospital are raising alarm bells, saying hospital policies accommodating immigration enforcement agents violate the code of ethics they swore to uphold.

The Oregon Nurses Association (ONA) sent a letter to Legacy Emanuel President Bahaa Wanly on December 10, outlining concerns over the hospital’s compliance with state and federal law, as well as its own policies.

“Despite Legacy’s policies largely reflecting appropriate compliance with statutory obligations, there is a growing gap between Legacy’s written policies and the actual practices nurses are witnessing,” said the letter, signed by ONA attorney Thomas Doyle. “As a result, ONA bargaining unit members and their patients are being placed at risk.”

The letter comes as multiple Legacy staff members spoke to the Mercury on condition of anonymity over the past two weeks, saying they feared retaliation for speaking to the media without authorization.

They said US Department of Homeland Security (DHS) and Immigration and Customs Enforcement (ICE) agents bring detainees to Legacy almost daily, often to treat injuries sustained during violent immigration arrests. Medical staff says ICE agents have been permitted to stay bedside with patients, even during private, clinical conversations and treatments requiring sensitive attention. Nurses say they’re concerned Legacy’s policies around immigration enforcement are unethical, harm public health, and damage the organization’s reputation in the community.

ONA’s letter said practices at Legacy may violate the Health Insurance Portability and Accountability Act (HIPPA) standards by allowing agents to listen in during confidential medical care, and may also violate the organization’s own policies.

“Legacy cannot simultaneously claim to follow HIPAA and Legacy’s own non-public area designations, while allowing effectively unlimited, unregulated officer presence in clinical spaces,” the letter said.

A Legacy Health spokesperson said the implication in ONA’s letter that the hospital has experienced a substantial increase in law enforcement, including ICE, in their facilities is not true.

“We are disappointed with ONA’s approach to publicly share a letter through the media this morning that we received late yesterday, before we had the opportunity to respond with accurate data and information,” the spokesperson said in an emailed statement. “This approach of sharing incomplete and misleading information perpetuates misinformation and creates additional fear and confusion for our people and for patients who rely on us for care, potentially causing patients to delay emergency care.”

Documents obtained by the Mercury show administrative staff believes the immigration enforcement agencies have selected the emergency department at Emanuel hospital as a “go to” site for caring for people in their custody.

“This should be seen as an opportunity to provide the best care for a vulnerable patient population, rather than a burden,” said an email sent to staff in November and obtained by the Mercury. “I am confident that we can provide the most compassionate and thorough care in the region regardless of the challenges we face along the way.”

However, multiple Legacy staff members tell a different story, saying the hospital narrowly interprets its role in caring for patients, creating a culture of fear of advocating for patients in ICE custody. Staff are also told they cannot distribute cards informing patients of their rights under the US Constitution—commonly called “red cards.”

Blaire Glennon, a registered nurse at Emanuel hospital, raised concerns during public testimony in a November 19 Portland City Council meeting.

She said executive staff told medical staff to treat immigration agents like any other law enforcement agency, that staff cannot contact a patient’s family until after they leave the hospital, and that they cannot provide legal resources to patients.

“Our hotels, hospitals, and the Macadam ICE facility are providing infrastructure for ICE to operate,” Glennon said.

Other sources spoke to the Mercury, sharing similar concerns. They said Legacy could choose a different path that would not help facilitate President Donald Trump’s hardline immigration approach, but instead, the hospital’s policies erode the trust necessary to do their work.

“We have an obligation to the public, to ethical practice, to our patients, that just feel completely violated,” a source told the Mercury.

They said the hospital frequently works with different law enforcement agencies, including Portland Police Bureau, and said those agencies are usually understanding about the role of the hospital.

“With ICE, it has been drastically different than that,” they said.

Sources said patient care has been disrupted by agents, who have obstructed standard care practice, blocking medical staff from placing IVs in patients’ arms, and shackling patients to beds despite them posing no danger to themselves or others. In another instance, agents facilitated a discharge after one night in the hospital’s care, earlier than medically necessary, according to a nurse on scene.

“That person, had they been a regular member of the public whose rights are being respected, I guess they would have probably stayed at least three days,” they said.

Still, video obtained by the Mercury from a December 4 staff town hall shows administrative staff wants to stay off the Trump administration’s radar, not rock the boat, and maintain relationships with officials—largely due to funding concerns.

“We don't want to risk funding cuts, and there's risk to that, so we're really trying to navigate the waters as smoothly as possible,” a Legacy vice president, said.

Sources who spoke to the Mercury said agents often remain in the room with patients, even while medical staff are providing sensitive care.

An internal “Law Enforcement (LE) Process FAQ” document, updated November 3, obtained by the Mercury says clinical team members can ask any law enforcement officer to leave the room, but the officer can say no. The FAQ also notes that officer refusal should be documented.

Isa Peña, the director of strategy at Innovation Law Lab, said statewide immigration defense networks and family members have recently reported an uptick in people brought to hospitals for injuries sustained during violent arrest. Injuries have included broken bones, and glass in patients’ eyes from agents breaking their car windows during arrest.

Peña compared local hospitals’ choice allowing federal agents to remain in patients’ rooms to instances of domestic violence, saying hospitals do not allow domestic violence abusers to stay in the room with the survivor.

“They’re essentially allowing the person who has injured this person to be in the room as this individual is trying to seek medical care,” Peña said. “That is, I think, really really concerning.”

The practice also has a chilling effect on the broader community. Similar to the drop in students going to school when ICE agents appear there, vulnerable people may not seek medical care because they are afraid of what might happen at the facility.

“People should be able to go to the doctor without fear of losing their loved one or being detained at the hospital,” Peña said.

The Legacy spokesperson said in a statement that law enforcement officers have not come to its facilities for enforcement actions.

Still, ONA’s letter to Wanly, Legacy’s president, said that while Legacy’s written policies recognize that hospitals must remain places of healing, not enforcement, its practices must live up to its words.

“We are asking you, as LEMC President, to acknowledge these gaps and to work with nurses, other frontline staff and their union to close them before a serious incident, lawsuit, or regulatory action forces the issue in a far more adversarial setting,” the letter said.

Legacy said in a statement that staff can report concerns about violations internally.

“We have internal processes for our staff to follow if they believe there has been a policy or HIPAA violation(s) so they can report the incident, and we can investigate,” the spokesperson said. “This reporting can be done anonymously to ensure that every employee feels safe submitting a report on behalf of a patient or themselves.”

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