Jill Crank misses her patients terribly. And she is worried about them.

“The last thing I want is for them to think I abandoned them,” Jill said. “I’m afraid they might not know what to do.”

During almost nine years as a nurse practitioner at Chase Brexton Health Care in Baltimore, and more recently as their Assistant Medical Director, Jill had a caseload of about 600 clients. It included patients, largely from the LGBT community, who were being helped with mental health issues, HIV treatment and prevention, transgender health, and addiction and recovery services.

They are the kind of patients who rely on the trust built between them and their healthcare provider. They are often awash in social stigma and barriers to quality care. They count on people like Jill Crank.

“They trusted me, yes,” Jill says. She is still finding it difficult to discuss them without getting emotional. “That trust translated into our making positive decisions about their health together. So many of them were in the middle of life-changing issues, like choosing to recover from addiction or deciding on new HIV treatment. These issues are not easily resolved by a quick fix-it visit with a new provider.”

Those crucial relationships were abruptly broken last week, when Jill and four other management-level employees at Chase Brexton, the largest provider of clinical services to Baltimore’s most vulnerable populations, were unceremoniously fired from their jobs.

All five employees had exemplary records of service, some dating back decades. They have been honored for their work, received glowing performance reviews, and had virtually no warning their careers at Chase Brexton were about to end.

That end came as the result of a chillingly vindictive move on the part of Chase Brexton senior management. With a union organizing effort underway by employees — who cite an unreasonable workload that is having an effect on the quality of patient care – senior management evidently tried one of the oldest, and most cruelly transparent, tricks in the playbook. They fired managers (who are not eligible to join the union themselves but might be seen as supportive of the change) in an apparent effort to intimidate those seeking to join the union.

To speak to those five employees, who were interviewed individually for this story, is to hear a litany of confusion and heartbreak. The word “devastated” is used by all of them. Without exception, they mention a deep concern for their patients, who were notified of the disappearance of their provider without explanation.