xt77h41jjf5t https://exploreuk.uky.edu/dips/xt77h41jjf5t/data/mets.xml The Frontier Nursing Service, Inc. 1938 bulletins  English The Frontier Nursing Service, Inc. Contact the Special Collections Research Center for information regarding rights and use of this collection. Frontier Nursing Service Quarterly Bulletins The Quarterly Bulletin of The Frontier Nursing Service, Inc., Vol. XIII, No. 3, Winter 1938 text The Quarterly Bulletin of The Frontier Nursing Service, Inc., Vol. XIII, No. 3, Winter 1938 1938 2014 true xt77h41jjf5t section xt77h41jjf5t Th Q t l B ll t` f
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Gainsborough 1484 STUDY OF AN OLD HORSE
Published quarterly by the Frontier Nursing Service, Lexington, Ky. 1
“Entered as second class nwtter June 30, 1926, dt the Post O]j‘ice at
Lexington, Ky., under the Act of March 3, 1879."
Copyright 1938 Frontier Nursing Service, Inc.

1 From
A by Adamnan (A. D. 679-704)
r ’ Translated from the Latin by Wentworth Huyshe
After this the Saint goes out of the granary, and, return-
~ ing to the monastery, sits down half-way at the place where
` afterwards a cross, fixed in a millstone, and standing to this
‘ day, is to be seen at the roadside. And while the Saint, weary
with age as I have said, rested there, sitting for a little while,
behold the white horse, a faithful servant, runs up to him, the
one which used to carry the milk pails to and fro between the
byre and the monastery. He, coming up to the Saint, wonderful
to tell, lays his head against his breast—inspired, as I believe,
by God, by whose dispensation every animal has sense to per-
I ceive things according as its Creator Himself has ordained-
knowing that his master was soon about to leave him, and that
, he would see him no more, began to whinny and to shed copious
H tears into the lap of the Saint as though he had been a man,
I and weeping and foaming at the mouth. And the attendant, seeing
, this, began to drive away the weeping mourner, but the Saint
I forbade him, saying: "Let him alone, let him alone, for he loves
5* me. Let him pour out the tears of his bitter lamentation into
A ’ this my bosom. Lo! now, thou, man as thou art, and possessing
a rational soul, couldst in no Wise know anything about my
  departure hence save what I myself have just now told thee:
I but to this brute beast, devoid of reason, the Creator Himself
. has clearly in some way revealed that his master is about to
i _ go away from him." And so saying, he blessed his servant the
} horse as it sadly turned to go away from him.

A We were the friendly beasts--
We knew this Jesus well.
Full forty days and nights *7,
The Lord with us did dwell. i
Lean limb and padded paw,
We followed in His track- °
And not a claw unsheathed,
And not a lip writhed back!
We watched with gentle eyes
When down He laid Him; HI
No jackal in the land   ·
A Would have betrayed Him.
Our tongues had licked the dust Q
From His worn sandal— "
We brought our round-eyed young '
For Him to fondle.
Lion and leopard and wolf-
We would have ministered to Him.
We were the friendly beasts- ‘
His own kind slew Him! ‘l
Sara Henderson Hay  
The Christian Science Publishing Society . `
Boston . `{

 is r·RoN·1·1ER NURSING snavrcn 2
"‘Keep thou my heart, till summer comes again,
` O little cabin, folded in God’s hills."
- This Bulletin goes to press in early January. I am taking
the copy down with me as I leave the mountains for a string
of Eastern engagements which will not be written up until
,7, the Spring Bulletin. We have put a lot about animals in this
. issue. At some time during the year—but I don’t remember
when—we Americans have a ‘“Be Kind to Animals Week." It
= is one of those many irritating weeks that are thrust at us in the
midst of our diurnal rounds. Fortunately, most of us appre-
ciate our animals; and we here in the hills find that we draw
I particularly close to them when the rough weather sets in. The
I horse or mule that struggles on through a blinding snow storm,
j' . with icy water under foot, or deep mud and mire—-such an
' animal has shared the day’s toil and peril with you; and how
· could he be less than a friend? The dog that follows after,
· ' swimming the river in your wake, just for the fun of it,—such
a dog has his honored place on the rug before the fire when
the day is done.
‘ To get out of the mountains now from Wendover is easier
than it was in the early years. I have to ride only some three
` or four miles before reaching the new motor road. I remember
`I one January, in the days when it was twenty-three horseback
I » miles to Hazard, when I had to go out at the tag-end of one
.  of our worst blizzards. I started of alone, on that loved horse
I of mine called Teddy Bear, on whom I rode thousands of miles
alone, and who fell off a clif and killed himself a little later.
, We had the trail to ourselves for the iirst six or seven miles;
and then we heard an immense jingling and clanging of harness,
  and met the U. S. mail—iirst class only—coming in by mule
  · pack. The mail carrier rode the leading mule, and three others
_ followed, laden with sacks.
I After that we rode for miles without meeting a living soul,
i until by arrangement we met up with a reluctant plumber, who

was coming in to mend frozen pipes, and who brought a friend P
with him because he dared not make the trip alone. We swapped .
horses, so that Teddy Bear could get back to his own barn for
the night, and I rode one Roddy Mac, a much less exhilarating . 1
companion, during the rest of the long day.
The skies cleared, and the sun came out over a snow-white I
and desolate looking world. The travel under foot was abomi-
nable. The horse kept breaking through the ice of the creeks. Q
V Finally, I decided to take a short cut of which I knew, and _ 1
get out of the beds of the creeks by crossing a lonely mountain,  
which would cut oif three miles. We toiled up to the summit of J
the mountain, Roddy Mac and I, and just as we reached the  
top the sun set, with a panorama of color such as I have rarely Z
seen. Night descended fast. We were pushed for time, to get
Roddy Mac to a stable and me to an evening train. It was im-
possible to ride down the mountain. We both slid on our l
haunches, and I reflected that if one of us broke a leg, we could Q
lie there until a thaw before any one came that way. t
At last, in pitch blackness, we got to the foot of the  
mountain, and hit the main trail again just above the mining  
town. Suddenly I saw in the darkness ahead the flares from i
the lights on miners’ caps. It gave me such a friendly feeling l
to know there were human beings near at hand. As I pushed  
toward them, they all dispersed and ran away. In a moment I i
knew why. There came a thundering blast, and rocks and earth  
fell all about us. There was nothing to do but keep going, Q
which we did. Roddy Mac was stabled, and I got my train-  
but only just!  
In the New York papers, at the time of the blizzards two U
years ago, written up with big headlines, was the story of a
young woman, seriously injured, who had to be carried more ;
than a mile on a stretcher through the snow, because her ambu- *`
lance was unable to reach the hospital. "Nearly two feet of E
snow," shouted the papers, "Cars stalled all along the road". . . `
"The Ambulance surgeon and his driver walked with the `
stretcher." {
At the close of an article by Dr. Kooser in this issue, there t
is a vivid description of a common experience in the mountains “

—that of transporting a woman in childbirth some eight or
ten miles by stretcher through a winter storm. Such is winter
_ in America’s lingering frontiers—the sort of thing that Gals-
I worthy calls "Nature with a small ‘n’." But to most of us who
live here, the winter has a charm that a smiling, summer
I country never brings.
  The Chicago Council on Foreign Relations
Presents the Case tor China
Note: We had the high privilege of listening on November fifth to
~ this address—a most statesmanlike speech on foreign relations. The point
i of view of the statesman and of the Christian are reconciled in the con-
  cluding lines, which we quote. The italics are ours.
a "The second issue comes home to us, as Chinese, caught in
g an international struggle. When you have an international
j struggle on your hands, you naturally feel you want to defend
g your country and go on hating the enemy. I have seen it here.
, I have met it on every hand, expressions of sympathy for China.
i At the same time, I have seen alongside the rising sympathy with
{ China also a growing sense of resentment toward Japan and the
l Japanese people. Do not let us do that; because, if we do that,
  we commit the same mistake that we did in the European
  war, because by hating, we made ourselves unyit for peace.
· Therefore, in this particular situation that I find myself
U caught, I have been helped through this experience to see
very clearly the one essential qualification of a peacemaker and
,| that is the attitude that I see in Christ when he fought the wrong
i in people—he never hated the wrongdoer.
. "If you can catch some of this spirit of hating the wrong but
. not hating the people in which the wrong seems to be, you will
make yourselves the true peacemakers whom Christ preached of
in his Sermon on the Mount." l
i Lecture Reporting Service, sent us through the _
courtesy of Mrs. Charles W. Dempster of Chicago.

An Epitaph to a Dog  
To the memory of Pincher his lamented dog this monument  
was raised by his master, Montague Gore, as a last pledge of I
p their long and reciprocal attachment, and as a mark of his deep  
regret for one who had been through many years his hearty i
companion by day, his watchful guard by night, in whom were » 
displayed all the noblest qualities of his race, friendship without {
flattery, fidelity untainted by interest, gratitude abiding, unerr-
ing sagacity, love of his master undivided, intense, which age l
could not chill, nor lingering disease enfeeble, the passion that  
ruled his life and was extinguished only by death. (July, 1850.) I
Contributed from England. G
Characteristics ot Intelligence  
What are the characteristics of an intelligent person? Are l
there any general qualities common to the intelligentsia as a
group? Prof. Walter B. Pitkin, of Columbia University, in The
Psychology of Achievement, points out ten of the "strongest '
general characteristics of a highly intelligent person." Here is
his list:
"Lively curiosity toward many matters. . l
"A desire to investigate some of these matters for oneself.
"Str0ng trend to analyze whatever one thinks about and,
as a result, to perceive the factors of the matter in their inter-
"Fairly active imagination, at least in some subjects. ‘
"Unusually even performance over long periods; little ten- 3
dency to deviate much from one’s usual level of skill. O
"Clear understanding of one’s chief desires and aspirations;
hence concentration on dominant interest. l
"Memory somewhat better than average and decidedly
, ` selective. ' i
"Patience with details, based on a grasp of their importance. l
"Interest in reflection and observation much stronger than l
interest in handling things or managing people. i
"Distinctly modest self-appraisal, often even to the point of
belittling oneself."
—From The Churchman. {

rnoivrinn NURSING smavicn 7
g (Condensed)
l (Presented to Members of the Eastern Division of the Kentucky State
_ Association of Registered Nurses.)
l By E John H. Kooser, M. D., Medical Director of the
l Frontier Nursing Service.
[ It is quite an unusual experience for me to speak to a group
J of nurses. I consider it a privilege and trust that my remarks
l will be as profitable to you as the experience will be to me. The
  relation of nurse to physician, and physician to nurse, has been
I and is a very close one, exemplified particularly well by the
it motto of the State of Kentucky, "United we stand. Divided we
l fall." Such a basic concept is necessary for an organization
such as the Frontier Nursing Service, where the viewpoint of
the nurse-midwife and the doctor is necessarily one of co-
' operation in a program for prevention and conservatism.
Not only a rural viewpoint, but an ultra rural one is our ~
p immediate consideration. As most of you know, this organiza-
tion emphasizes mother and baby. Within our territory any
expectant mother who wants the nurse-midwife is cared for
by the Service. Needless to say, we cannot care for all cases
outside our territory, but within our elastic geographic boun-
daries we do the best we can. It is a business-much like set-
I ting our house in order. We arrange to the best of our capacities
l and abilities, then accept what comes. We are fully aware of
’ our limitations; we attempt to alter our shortcomings. If we
{ can improve coming generations by our work, we shall have
' served our purpose. _
Practically, our system works as follows. Mrs. X is "ex-
pectin’." She usually comes to the clinic to be registered by ‘
i the nurse-midwife, or if this is not feasible, she may be taken
up at home. Registration includes a brief family legend, name
of creek, and number of miles from center. The latter is quite

` important, not only for the nurse, but also for me—if the
patient lives Hve miles from Bowlington Center, if the month I
is January, and if the nurse calls me at Hyden—23 horseback
miles away. History taking includes brief notes as to past
illnesses—rheumatism, acute contagions, and recurrent upper
respiratory infections. Special note is made of menstrual cycle,
‘ diet, and general habits. Physical examination is of two parts,
general and specific .... Other items include weight, height of ,
fundus, temperature, pulse rate, position, blood pressure, foetal x.
heart sounds, foetal movements and urine examination. The l
items just enumerated are part of each subsequent examination,  
the scale of visits for normal cases being monthly for the first `
six months, every two weeks for months seven and eight, and_
weekly for the last month.
A registration is not complete without an arrangement in
regard to the five dollar fee, and the way in which it is to be
paid. The more aHluent pay in cash, the others in kind. Many
babies are paid for in kind, chiefly labor and produce.
At this point I wish to state that the nurse-midwives are
completely responsible for the normal obstetrical patient. At
first thought, this is fine; but I should remind you that they p
must know the abnormal as well, and for two very good reasons.
In the first place, only by knowing "what is not," will they know
what is normal. In the second place, they must be able to cope .
with an eme1·gency until medical aid arrives. This sounds l
simple; but it takes courage to do a manual removal of the
placenta, or bimanual uterine compression for hemorrhage, ,
knowing the doctor is four to six horseback hours away. . H
Further, I should add that the responsibility of the nurse is
immediately shared when she reports any irregularity to the ·
midwifery supervisor, or to myself. It is then our problem to  
institute correction within our limitations. A complete list A
of do’s and don’ts is supplied each nurse. This is called our I
~ Medical Routine, and is authorized by our Medical Advisory  I
A Committee.  
Every patient with albumin or an elevation in blood pressure 1
is a potential toxemia until proven otherwise. Due to our lack  .
' I

 · FRONTIER Nnnsmo smrzvxcm 9 .
, of adequate laboratory facilities, which prevents an accurate
grouping of such cases, we have adopted a clinical classification
on the basis of the response of the patient. In our mild group
are those who respond to a given course, prescribed at home.
Our mid-group includes those who must be hospitalized for
special procedure. The severe group includes those who are
active until after the termination of the pregnancy.
1 The subject of toxemia of pregnancy is one of our most
l difficult problems. Our guides, of course, are the blood pressure,
  urine, and general state of the patient. We are aware of
‘ chronic nephritis with pregnancy, hypertension with pregnancy,
as well as the acute fulminating eclamptic, who may literally
flare up over night. We view any early sign or symptom with
alarm; we attempt to explain every change, however mild. This,
I grant you, is a task, with our limited facilities. .
Nursing ingenuity is often taxed severely. Some patients
see the necessity and do everything requested. Others must be
cajoled, and literally "sold the idea" of therapeutic restriction.
We have a few extremes, including a toxemia with B. P. %
. who refused treatment in a very positive manner. She said she
would call when she was "fixin’ to get down." She was true to
her word, and fortunately her course was uneventful.
Every bleeding patient is a placenta previa, until proven
I ·' _ otherwise. Such a condition is always an emergency. We have
l had benign cases, such as cervical bleeding and cervical polypi.
· We have had our share of premature separations, and several
  very active cases of placenta previa centralis.
 I The mountain cardiac is a special problem. The first clue
  to her detection is often found in the registration history. She ·
Q may have had acute rheumatic fever, scarlet fever, chorea, or
é severe tonsilar infections. Again, she may show an accelerated
1 pulse, irregularity, dyspnea, or oedema. Points such as these
I lead to a thorough investigation. An occasional patient is de-

 . 10 THE QUARTERLY Bunnmin I
tected in one of my routine examinations. Such examinations ~
are made at specially arranged prenatal clinics, which I hold y
periodically at Hyden and at the outpost centers. Patients who
are compensating are watched carefully for adverse signs. The
patient with decompensation is the real problem. It is some-
times difficult to convince her of the rationale of rest and proper
medication, for mountain women usually carry on at a full rate
until they drop. Hence, in such cases, after the successful
termination of pregnancy, we advise and carry through steril- I
ization. II
` HosP1TAL
Our hospital plays a unique part in our obstetrical set-up.
We have a small room which is used exclusively for deliveries,
and a small ward, which is reserved primarily for postpartums.
Accessories include a spacious porch, available during the warm
weather, and a separate unit for infectious obstetrical patients  ,
only. Hospital obstetrics are complicated, chiefly due to limited
quarters. Should Brutus send in a premature separation, or
Bowlington a pneumonia, the strain is evident. If an infectious
postpartum appears, that is a hospital emergency, insofar as
it means special duty nurses and quarters for them, in a build-
ing where even the trunk room shares a bed. But whatever
difficulties are involved, once we register a case we assume
full responsibility. ~
The problem of the emergency case can be very difficult. A
We prefer to hospitalize such a patient when possible. If neces- I
sary, the case is managed in the cabin or in the nearest nursing l
center. If the patient cannot come to the hospital, the hospital e
goes to the cabin. I have done several internal versions by I
flash light. I once extracted a placenta manually in a cabin  
· so cold that with the order for "Pituitrin, please, Miss X,"  
Miss X picked up the charged syringe in four pieces. Some I
strength to that pituitrin! On several occasions, every necessary  
item for a transfusion, including centrifuge and microscope, l
was transported to a center by horses. Once the transfusion I
' I

 '  Faoivrma Nonsim; smavrciz 11
_ was done by iiash and lamp light. Once I found a postpartum
extremely dehydrated, due to acute dysentery. An intravenous
l was imperative. She was given one, using saline tablets, boiled
water, and can with tubing whose original use was intended
for vaginal irrigation. And so, I could continue; for to each
of us there falls a due share of the unusual.
It is said, "Necessity is the mother of invention." It is
perhaps our lot to have a good share of necessity. A nurse in
I a cabin must be the mistress of the emergency. It is her lot
i to decide when to call for help. She knows what is required
  of her. The children must be disposed of—a willing neighbor
will see to that. The agitation from the patient’s mother, aunts,
sisters, and visiting granny must be kept well in hand. The
fire must be prosperous; plenty of hot water. The husband is
on his way to the phone. Will he remember to give her horse
a full rein at the ford? I hope he can get the message relayed
. through the exchange. What shall I do if the doctor is out? And,
· now for the several hours until he arrives. And so, you see, the
emergency is not mine alone, but the nurse’s as well. She may
face the above after being out thirty-six hours. Providence -
enters into such situations, dog-tired as one may be. There is
always that emergency energy in reserve; and it appears as it
is needed. I am sure mountain obstetrics has no text book;
but with experience we evolve our routines and procedures.
. Organization usually means records, ledgers, time sheets,
3 office desks; but to me it will always mean Molly Jones. I
answered a knock at the clinic door one wintry afternoon, to
 , iind Stanley. "Yes, I’ve come for the nurse. Molly’s bad off
i as she can be."
, "Poor nurse," I thought, when I saw her and Stanley go
  through the barn; for I knew Sally Sizemore Branch, seven
  hard miles away—two mountains, five branches, and one main
i creek. I felt snug in my warm room, but I wasn’t peaceful long.
; Several hours later—Dry Hill on the phone. Report from the
i nurse about Molly: "Come at once. Bleeding, possible central
I placenta previa." I hurried in my preparations. My horse was

 I .
12 THE QUARTERLY Bunnmrxn  
roughshod; and I squeezed into my bags several specimen tubes, i
one containing normal saline. The mare was excited as usual, l
but my dinner was disturbed also, so we were even. We made
the trip without mishap. {
Our gloom dispelled as we neared the cabin, as it meant
a fire for me, and possibly a stall for the mare, if she could
be easy with her heels for a while. As I heard the report from
the nurse, I thawed externally and chilled internally-—multi- .
para; 37 weeks gestation; moderate, painless bleeding; pulse "`
quick, but of fair volume. After opening my bags, we assembled ix
packing, instruments for packing, and gloves. I examined. A {
brisk hemorrhage verified my Endings. We packed and watched.
The hemorrhage was of short duration. The general condition of
the patient responded to an opiate. We decided to chance it.
Yes, hospital. Well, in short, four people went up and down the
creek, and finally, sixteen volunteer stretcher-bearers. The