xt79w08wbp20 https://exploreuk.uky.edu/dips/xt79w08wbp20/data/mets.xml The Frontier Nursing Service, Inc. 1996 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 Frontier Nursing Service, Vol. 71, No. 4, June - Summer 1996 text Frontier Nursing Service, Vol. 71, No. 4, June - Summer 1996 1996 2014 true xt79w08wbp20 section xt79w08wbp20 FRONTIER NURSING SERVICE . ‘ ' 3 , » Volume 71 Number 4 June - Summer 1996 Q 1 a : ; °‘ · ¤"’°·~... .-·> Q . The Bng House ·--—· vr .,»¤_ gh na N y . ~. . V ~ .. I ’ ·a· ¢=~"»:'P=”•·• 1, V L1 `l ‘· ¢1%Y·°"" N S »» Q \'r , u, / ,..1, , ·’ J e}':’J? 4'»·· ° E ' *9,,, .;.@ Ar`. .n ,~?· , _ $ , _;J_,. W . 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Photo by Dan Eldridge 5/96 Frontier Nursing Service Quarterly Bulletin US ISSN 0016-2116 Published at the end of each quarter by the Frontier Nursing Service, lnc. Wendover, Kentucky 41775 Subscription Price S 5.00 a Year for Donors Subscription Price $12400 a Year for Institutions Edit0r's Office, Wendover, Kentucky 41775 VOLUME 71 NUMBER 4 June Summer 1996 Second-class postage paid at Wendover, KY 41775 and at additional mailing offices. , POSTMASTER: Send address changes to Frontier Nursing Service, Wendover, KY 41775. Copyright Frontier Nursing Service, 1nc.1996/A11 Rights Reserved 1 lj · ty j QUARTERLY BULLETIN 1 I it Field Notes 1 A Correction: In the last issue of the Quarterly Bulletin j' "Field Notes", when I listed those who attended the party in honor ) of Mrs. Breckinridge‘s birthday, I listed Mack Mosley and wife. . This should have been Nick and Kathleen Lewis. N I According to the calendar, Spring did arrive but somehow I it by—passed Leslie County. Perhaps we all blinked in unison at the Q, wrong moment. Everything blossomed but were quickly finished off by snow, sleet, hail, a deluge of rain and some mighty powerful T. winds. We jumped right into summer and are now trying to keep _ up with the grass mowing. At long last the re-wiring of the Garden House got started. I The men began with the courier rooms, proceeded to the attic and are now working on the offices. It was decided to work in my office = first, to see just how long it would take (and how much of a mess F could be made)! In about two days, holes were drilled, two “ conduits were pulled and drop ceiling installed and it was com- I pleted. It took Christine and me just about that long to clean up but , then my office wasn't in pristine condition to stan off with. The i rule at Wendover is; if you don't know what to do with it, put it in * Susie's office. Anyway, the outcome was quite spectacular and V everyone wanted their office done next! All should be finished within a few weeks and we`ll all be a lot more comfortable knowing that the computers won't fade when an air conditioner tums on. March breezed in and with it a number of events. We started with two instructors and two students from Viterbo Col- lege, Wisconsin, here for a three day stay. They steeped them- selves in our history, toured everywhere and spent a day at the Beechfork Clinic. The next week, former courier Damonica Huff L brought her U.K. work team for Tea and Dinner. They came to fi Leslie County to repair houses on their Spring week and for the third year we‘ve been delighted to host an evening for them. Later that week I did a presentation on the history of FNS to the Hazard P Rotary Club and then we had a dinner for the Midwifery Bound I I 2 FRONTIER NURSING SERVICE students and faculty. This event is always such fun, the excitement . of the students finally being where it all started truly is infectious. We also had ten students from Sandy Springs Friends School join us on their intersession (see next page). During their visit, the I · students asked me what I miss from my life before FNS. Easy to answer - sunrises, sunsets, smell of salt air, and Pepperridge Farm cookies. A few days after they retumed home, a large box arrived · with an assortment of 22 varieties of Pepperridge Farm cookies! They freeze well so I'm still treating myself. April was not any less busy. We hosted a Doctor's Appre— ’ ciation dinner, tours for three nursing schools, another exciting I Midwifery Bound and the Spring Board of Govemor's meeting. I This yearl also had the privilege of addressing the DCW's at their I annual champagne brunch honoring the FNS in Washington, DC. S I was delighted to see so many of the DCW's who have come to Kentucky and to meet others that I hope will come in the future. f Last summer I was contacted by Mrs. Clarance J. Smith, President Q of the Virginia Chapter, asking if we had need of knitted baby Q caps. My answer was a definite yes. With about 300 babies bom I each year there was no way I could ever knit that many myself. At the end ofthe Brunch you can imagine how stunned I was when the I Virginia ladies gave me over 150 caps they had knitted! Grateful is simply not adequate to express how I feel. Thank you all from § the very bottom of my heart. May has brought us four more nursing school tours, a sale at Beechfork to raise money for plantings there, another rummage sale at the hospital, two Monday evening Tea and Dinners for CNEP Level III students and a Sunday lunch for a tour from I Minnesota. -Susie H udgins I I I I 5 QUARTERLY BULLET IN 3 1, Susan Moody from the Sandy Spring Friends School wrote the following, describing the student's experiences during their week p at FNS. "It is so healthy to be reminded of the range of life-styles that exist in the United States, rural Kentucky is a world away." - l Thus commented a Sandy Spring Friends School student with us Q on a service intersession for a week in March with the FNS. Q Every year our Quaker school allots a week to intersession activities. Incorporated into the school calendar, intersessions are designated as a time for leaming and reaching out in an entirely different setting. Service is one category of intersession opportu- { nities. All upper school faculty are expected to participate. All i students must complete one service intersession before gradua- l tion. This year my husband, Bill, French teacher and head ofthe Foreign Language Department and I, the Yearbook teacher, de- } cided to head for the mountains. We selected FNS for a number of i reasons: no one from the School had ever been there; we would have the opportunity to see how rural medicine can work under l daunting conditions; and we could complete a service require- ment. Accordingly, after consulting with Susie Hudgins, we selected ten students. Our group was eclectic in many ways. Students were from l the three upper grades (10-l2), four guys and six girls, including l three international students (Ghana, Syria and Thailand). Two had ’ been delivered at home by FNS trained midwives. Growing up in Boston the FNS had always been a part of my family. My great aunt, Mrs. E. A. Codman, had led the local committee for a number of years. Later my sister, Timmy Balch, with her love and knowledge of horses and jeeps, was selected as a courier in 1951. I still remember with awe that she helped deliver -, twins in a mountain cabin two weeks before her eighteenth ( birthday. i We learned through her the technique for surviving a · rising creek without stalling a jeep (drive slowly and steadily). She wrote us of the horses she cared for, and the night rides with the I I l l 4 FRONTIER NURSING SERVICE z nurses to bring medical care up the hollers. She discussed knowing i the locations of many stills - but never reporting them to the local authorities. Likewise, she described driving through angry coalminer picket lines, safely passing through as a neutral and caring "FNSer". These stories stayed with me so it seemed l natural, 45 years later, to select FNS as a place to visit and help. We found it much different from Timmy`s descriptions. The large bam at Wendover is gone. A road now runs through its { former location heading back on up the creek beyond the Big House. The jeeps too, have been superseded by ordinary, albeit s extra—sturdy, cars and trucks. The hollers have roads although after some of our visits back into the hills we weren't too convinced g how passable some of them really are. The Big House is now on the National Registry, and is no one's full time residence anymore. We found no stills nor striking mines. We found some things little changed. We still ate our i evening meals in the dog trot at the Big House and the food was really good. Cassie's circle pie received the biggest compliment _ from our group. The students appreciated the architecture (most { were not familiar with log house construction) and the charm of ( Mrs. Breckin1idge's home. More importantly, the friendliness of the mountain people has remained the same. ·l . W *‘ . i. ll; . _ ,.4 .• 1 ~ .%p, ..._ I 5% l i ?.}= . .... Fe T ; Cu i ; L;_~g(m ;,_ {Er · ·· I ` Q . 2% i - .` i [ _··** ,,,`,¢,. . V · }»=_,.jf__`§i’; .%*4 . _ . ‘ Dinner at Wendover · l l 1 QUARTERLY BULLETIN 5 — We worked for the FNS scraping and painting the porches at Haggin Dorm and nearby Mardi Cottage. The boys still talk l about the fun of loudly singing as they worked, supervised by the I E greatly respected Michael Mase. The first day we females cleaned } up the chapel, badly in need of such. We swept, washed windows s and then oiled the window frames as well as the chairs. As a final l touch some of the group found flowers and arranged them in two l vases on the altar. The next day we joined the painters and scrapers, l as well as doing some gardening around thedorm. Throughout the week, each student had the opportunity to travel with a home health aide or nurse for one day. These visits were definite eye-openers for us all. Everyone commented on the · professionalism and caring of their nurses.wThey also appreciated l the friendliness and interest of the people they visited. A number of other activities gave us some insight into life in Appalachia as well. A fish fry and singing at Sherman Wooton's mountain cabin was a new experience for all of us. Sherman and { his friends were great hosts for us. It was great! A Wednesday l evening Bible study class at the Running Rock Baptist Church was l another first. The weather being cold and rainy on Thursday, we couldn‘t paint so instead visited Berea. We enjoyed the beautiful crafts, as well as the student managed Inn where we ate lunch. We ~ also visited a strip mine where we saw first hand the results of a W mountain leveled to fields. "Terrifying", is how one student described it. ` Haggin Dorm was our home for the week. The dorm was . marvelous, comfortable, wamr with a great kitchen. A We would all like to thank Susie for her time and stories. T She kept us enthralled with her mountain tales in the evening as well as keeping us busy during the days. , We left at the end of the week, hoping that we may have · helped a little - at least the porches looked a lot better. But mainly { ·· we felt that we had gained a small insight into life in the Appala- = chians in the mid 90s. Hopefully, we will be able to return with another group sometime. -Susan M00dy I I E 6 FRONTIER NURSH~IG SERVICE m_ News from the Courier Program ` The Couriers would like to thank whichever donor it was . who sent Spring our way. It was very thoughtful since we had completely given up on Mother Nature. Mae, our development office secretary, is admittedly a little confused about how to make l out the receipt. . Now that Spring has arrived, life at Wendover has re- ’ tumed to normal. The trees are budding and the migratory Mid- t wifery classes have been flying through on their pilgrimages to Wendover. More importantly, the Couriers have finally been able to run around Leslie County on a routine basis. The Past Couriers have sent their thoughtful letters back to Wendover. Kate Ireland ('5l) andjane Leigh Powell ('S4) have tied with each other in the unofficial nationwide Courier Turkey Shoot. ‘ Both have managed to "collect" three large birds. This means that ¤ next season we will have to have a shoot off to determine the l winner of the yet to be determined prize. Christina Jachman ('87 & '89) sent along a note to say she { is planning to get married in June, with Cari Michaels ('88 l Coordinator '90) as one of her bridesmaids. Our warmest wishes go out to her. l Carrie Williams ('90) passed along to us that she is presently working in Massachusetts at the Cambridge Hospital psychiatry ward. She is also busy applying to medical school. Emily Davis, RN (aka. Big City Nurse) ('93) continues to l live with us here at Wendover. She keeps herself very busy helping deliver babies all night long and then seems to have enough energy to mn around with the Couriers. She is presently nursing into the F; world a whole family of tomato plants. V Jen Galvin ('95) sent us a nice postcard of the Newfound ’ _ Harbor Marine Institute in Big Pine Key, Florida. She is spending V a few months there teaching marine biology and running around g exploring the Keys. t . l QUARTERLY BULLETIN 7 — Mitch McClure ('95) was very thoughtful and dropped us a very nice card from the "Yard" at Harvard. He claims that it took him a full six months to get over Kentucky and all of its charm. E Mitch is planning to run home to Kansas with his "friend" Elizabeth (who he met here) and then is planning to settle down on the East Coast while further exploring the world of health care. We l wish him luck. { Bhavin Mehta ('96) has also kept in touch with us. He is presently back home in North Carolina taking some required courses that he needs for Podiatry School. He has kept us amused by a barage of amusing postcards and letters. We miss all of his _ stories and wish him luck in the admission process. The Current Clutch J3; · ’ A 4 ` I _ ` I V it ..¤...{, · ii `:. ..i.. ( . · ° ‘ . ‘*».. { · { — - = I ’ B ` . :. ` Y tf `° ·»[% . 2 l i _ ¤ ’ J 4 . fil i Karen Thamissee, 21, came to us in February from North ~ Carolina and has continued to run around the community with her ~ unabated enthusiasm. She has spent a great deal of much appreci- ated time at the Stinnett Elementary School and has been of great I help around the Kate Ireland Women‘s Center. In addition to this, " she has been an active member of the traditional Alabam Quilting 8 FRONTIER NURSING SERVICE _ Club and has even co—hosted the Acoustic Attitude radio show . with Susan Ziegler (FNP) out of the Appalshop in Whitesburg, Kentucky. , Tarah Somers, 22, fled to Wendover as an exile from the ` cruel Boston winter. While the weather might not be everything that she had hoped for, we hope that she has made up for it with all _ her experiences. Tarah has spent a great deal of time with Marina (CNM) at the KIWC and has even been able to witness some births. She has also spent a great deal of time zipping around the countryside with the home health nurses. In her spare time, Tarah has been visiting the various/numerous cemeteries in the area l which she developed an interest in while writing her thesis at i Hampshire College. Daniel Boss, 19, was a little late in migrating south from Michigan but he seems to have made up for lost time. Other than 1 confusing almost everyone with his name (remarkably similar to { the Courier Coordinator's) he has been spending his time going on i rounds with the doctors, observing surgery, trundling around the countryside with the home health nurses, and has even joined the exclusive Alabam Quilting Club. Kate Gamble, 21, arrived at Wendover only in the last part {_ of March but has proceeded to astonish some of us with her productivity. Not only has she kept a full schedule with the { doctors, midwives, and nurses, but she has also been able to complete a number of small baby quilts with Alabam, and both a } stool and paddle with the help of Sherman. Luckily, Katie drives A a station wagon since at this rate it will be filled with Kentucky i memories and mementoes when she returns home to Maryland. i Elizabeth Tartell, 21, just arrived at Wendover from Ithaca, New York where she recently graduated from Cornell. i Elizabeth will be spending the summer with us and hopes to get Z some first hand exposure to the world of medicine. She is currently applying to medical schools and has a great interest in public » health. -Dan Eldridge I QUARTERLY BULLETIN 9 » Beyond the Mountains 1 "Give aman a fish and you feed him for a day. Teach a man i` to fish and you feed him for a lifetime." Chinese Proverb. 1 This Proverb encapsulates the activities ofthe FNS during I these past many months. The Board of Govemors has been meeting since Decem- 1 ber 1993 to develop strategic planning for the FNS. This has been 1 a very arduous process. The process was led by The Preston Group é of Lexington, Kentucky and was initiated with a thorough and } exhaustive research process. Experts from within and beyond the · mountains contributed information to the Strategic Planning Com- i mittee regarding current conditions and future trends in health care 1 and education. After eighteen months of research and assessment, 1 in July 1995, the Board adopted a strategic plan for the FNS, * appointed strategic planning committees for the subsidiary Boards ofthe Frontier School of Midwifery and Family Nursing and Mary 1 Breckinridge Healthcare, and charged these committees to carry 1 out strategic planning within the principles set forth by the Board { of Govemors. i Mary Breckinridge Healthcare, Inc. i The Strategic Planning Committee for Mary Breckinridge { Healthcare, Inc. (MBHC) was chaired by Mr. Kenneth Tuggle, 1 senior partner with the law firm of Brown, Todd & Heybum in i Louisville, Kentucky. Strategic Planning for MBHC was accom- 1 plished, concurrent with FNS strategic planning and recommen- i dations, were presented to the Board and adopted in July 1995. I A review of our health care service history only pointed ‘ out to us what we already knew. In the late 1970's and throughout . the l980's, Mary Breckinridge Hospital, the clinics and the home { health agency were in deep financial trouble, as were many small 1* hospitals in the United States. Over 1,000 small hospitals closed " during this time, but thanks to our donors, we kept our doors open. = In 1993, we approached the Appalachian Regional Healthcare p A (ARH) system, and opened discussions with them regarding the 10 FRONTIER NURSING SERVICE hospital. We were just coming out of our financial quagmire, and _ after reviewing our audits, ARH offered to manage the hospital for 25 to 99 years with a payment to FNS of $ 10.00 per year. We would retain many of the financial liabilities. The Board did not feel this . agreement supported the Board's fiduciary responsibility to our community, our employees or our donors. We decided to continue ” efforts to improve the physical and fiscal condition of the hospital 1 in order to make it more attractive to strong, committed systems. As the Strategic Planning Committee reviewed health ; l care delivery and financing trends, it became clear that it was only a matter of time until Mary Breckinridge Healthcare would have to join a larger system to survive. To our knowledge, Mary Breckinridge Healthcare is the only sole proprietary hospital system left in the region. The planning culminated in July 1995 with a recommendation to seek requests for proposals from health care systems within Kentucky and outside. Philosophical compat- ibility was the number one priority for FNS. The most enthusiastic Q and prompt proposal received was from Community Care of America (CCA). In January 1996, FNS signed a Letter of Intent g with CCA, and for more than three months we shared information with each other. At the end of that time the Board was convinced that if Mary Breckinridge Healthcare was sold to CCA, the hospital, clinics and home health agency would continue to be operated and that care for indigent patients would continue to be provided. Furthermore, CCA and FNS wished to establish liaisons which 1) ensure that midwives and family nurse practitioners E continue to use the hospital, clinics and home health agency as a training site; 2) explore joint development of birthing centers g regionally and nationally in rural areas; and 3) continue the Courier Program. These are serious negotiations, not taken lightly by either side, and they continue. Regardless of whether an agreement is li reached between the FNS and CCA, the Board believes the j hospital, clinics and home health agency have a better opportunity i to flourish in today's environment because of the Board's actions. ‘ Any proceeds from a sale will be used to expand philan- » · thropic work. Mrs. Breckinridge knew there were needs she was _ QUARTERLY BULLETIN 11 . unable to address. She writes in Wide Neighborhoods, chapter 36, II, "The thing that we most want - - more than all our plans — - is to better the work we do now in the years to come. Which of you ‘ has not felt, as we so often do, the bafflement that comes from having really tried to do better and failed? . . . Since the first aim l of the Frontier Nursing Service is to help children, we struggle J continually to improve our techniques in their behalf. In common ‘ with all who study the loss of infants at birth, we know that some of these deaths need not be, and perhaps one field in which we can l make real progress in the years to come lies in the prevention of l _ some of this waste of human life." On a small scale, the FNS has offered nursing scholarships to Eastem Kentuckians; however, [ there are many opportunities for augmenting our work in the E mountains and beyond. I Frontier School of Midw#ery and Family Nursing l The Strategic Planning Committee for the Frontier School of Midwifery and Family Nursing, Inc. was co-chaired by Mr. Bill § Hall, Vice—President Trust Manager, Fifth Third Central Ken- tucky Trust, Lexington, Kentucky and Mr. Robert Johnson, former Vice—Chancell0r at the University of California at Berkeley and immediate past CEO and President of Appalachian Regional Healthcare, Lexington, Kentucky. In July 1995, the Board of Govemors charged the Strategic Planning Committee for FSMFN to pursue the broad recommendations of the Board. The following is the Strategic Plan adopted for the FSMFN by the Board of Govemors in July 1995. · I a l Strategic Plan l 1) Strategic Planning to continue with respect to the l Frontier School of Midwifery and Family Nursing by the estab- < lishment of a FSMFN Strategic Planning Committee (SPC) to l. . make recommendations concerning FSMFN to the Board of Govemors by June 1995. The FSMFN SPC will work in conjunc- B tion with any other ongoing planning considering a permanent or · ‘ semi-permanent location for FNS corporate headquarters to inves- » tigate and make recommendations conceming the permanent, or 12 FRONTIER NURSING SERVICE semi—permanent location of the FSMFN. Also, the FSMFN SPC . shall make recommendations conceming at least the following: A midwifery program (MP), including the existing Community — Based Nurse—Midwifery Education Program (CNEP), a Family ‘ Nurse Practitioner Program (FNPP), an Intemational Midwifery! Nurse Practitioner Program (IMNPP) and a possible fourth educa- tion program involving_an allied health program such as public health. With respect to each program, the FSMFN SPC shall investigate, and make recommendations conceming whether the Program will permit direct entry by prospective students holding V one or more college degrees from areas unrelated to health care; j provided, however, that the national and state credentiating bodies . for such a program permit direct entry. Finally, the FSMFN SPC F shall investigate and recommend whether FSMFN should/must become an institution granting academic degrees to program I graduates. 5 2) Each FSMFN program shall operate as a separate I division under a common FNS, or perhaps FSMFN, administra- I tive umbrella for operational oversight, even if program adminis— j tration and instruction occur in diverse geographical locations, but , that academic control of each program remain with its faculty, subject to the review and approval of the FNS and FSMFN Board. Additionally, subject to the approval of the FNS and FSMFN i Boards: a) each program detemiines its prospective student group(s) f the student minimum qualifications; and b) each program estab- f lishes pemianent or semi—permanent location(s) for administra- f tion and instruction. j MP/CNEP l) CNEP to continue as a certificate program for prospec- i tive midwifery students holding ADN or BSN degrees, provided that: a) MP/CNEP midwifery strategic planning continues with the establishment of a midwifery strategic subcommittee, operat- l — ing under the auspices of, and subject to the review and approval of, the FSMFN SPC, to make recommendations to the FSMFN SPC by June 1995. b) CNEP stabilizes its operation by taking at T ' least the following steps: establishing CNEP as a self—sustaining i QUARTERLY BULLETIN 13 tuition-driven program with sufficient excess of revenues over V expenses to maintain necessary research and development; deter- mine optimum enrollment needed to sustain its operation; deter- . mine the qualification of the CNEP faculty it needs and number of FI`E's with various qualifications it needs to continue operations; stabilize CNEP curriculum content and presentation technology; and establish a CNEP recruiting program for replacement faculty members and new students. FNPP 1) An FNP programbe established as a program for I appropriately qualified prospective students, provided that: a) J FNPP establishes itself, within a twelve month period following ` conclusion of FSMFN Strategic Planning, as a self-sustaining, p tuition-driven program with sufficient excess of revenues over E expenses to maintain necessary research and development; b) I FNPP determines the optimum enrollment it needs to sustain its . operation; c) FNPP develops its curriculum content with great J stress placed on state of the art multimedia education technology. i IMNPP l) The strategic planning process shall continue with the r establishment of an IMNPP study group within the FSMFN Board I charged with assessing needs, determining requirements and Q identifying opportunities for FSMFN in the intemational arena consistent with the member comments developed during the I December 18, 1993 Board meeting: "Potential worldwide training in midwifery—family prac- titioner—birth control/family planning." Q "FNS will be defined as a model for primary healthcare education in delivery, with matemal child health as the core 1 component; a model that will be recognized globally for its § _ innovation and success." [ "The School expands intemationally and is not limited to [ midwifery. The national program is not limited to midwifery. The L · healthcare consists of consulting intemationally regarding rural systems. The Courier Program is intemational. . ." 14 FRONTIER NURSING SERVICE "FNS should become involved in midwifery care for the U. S. andthe world as its major mission." "A leader in developing altemative health care delivery systems that can be utilized locally, nationally and globally. 2) Establishment of an IMNP program is a long—range project which will require several months to a year of foundation study in a number of areas in order to permit the FNS and FSMFN strategic plans to come into focus and commence operation and in order to develop background data necessary to evaluate possible program alternatives, educational versus practice components, potential intemational service areas, etc. The IMNPP study com- mittee shall make its report to the FNS and FSMFN Boards at quarterly meetings and a final report on or before the December 1995 meetings. In December 1995 the Board recommended the Committee's recommendations to: 1) continue with planning to implement a FNP Program; 2) continue the investigation regard- ing the feasibility of implementing a Physician's Assistant/Mid- wifery Program; and 3) to locate the FSMFN administration headquarters in Lexington. The decision conceming the location ofthe CNEP admin- istrative offices has caused the greatest intemal discussion. Actu- . ally, there have been requests to locate the FSMFN at various places over the years. In 1990, the FSMFN planted a seed program in Albuquerque, New Mexico by transferring the traditional program and providing the University of New Mexico with the third year of DON Grant funding. At the same time the Board felt j CNEP was exciting and adopted the CNEP as the official mid- i wifery program of the FSMFN. CNEP was then moved from Perkiomenville, Pennsylvania to Hyden in May 1991. There was a great deal of Board reluctance to open the » office in Conshohocken. The Board acquiesced to help with individual concems: Ms. McHugh was the Academic Director at the time and needed office space; the other three staff members in 1 ' the area needed a meeting place (they had been meeting in a chapel QUARTERLY BULLETIN - 15 at the mall); and the staff were working out of their homes. There- fore, the Board agreed to open a small office in Conshohocken which would accommodate personal considerations and give space for people to meet. When Ms. McHugh took the job as Program Director for CNEP the Board discussed again the history of FNS and emphasized that FSMFN would be Kentucky-based and that included CNEP.The Program, Clinical and Academic Directors were asked to locate in Lexington. The Clinical Director position was vacant at the time. Unfortunately, Kate McHugh and Jerri Hobdy notified me in February that they would be unable to locate in Lexington. Thanks to Ms. McHugh, Ms. Hobdy and Ms. Carr, interim directors have agreed to serve while we recruit for these three key positions. These Interim Directors are Ms. Phyllis Long, Ms. Kerri Schuiling and Ms. Cindy Farley. Mrs. Kitty Emst has agreed to serve as my Executive Assistant during this transition time. The Board and I are very appreicative of the commitment shown by our faculty and staff during this transition period. In 1939 in a historical perspective written by Peggy Elmore, she quotes Mrs. Breckinridge, "I wanted the Sc