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US ISSN 0016-2116 V
Introduction to FNS 1
The Journey - Nathan Lee 2 —
Field Notes - Barb Gibson 4
"Footprints” - Excerpts from Wide Neighborhoods 7
Beyond the Mountains - Barb Gibson 11 I
Courier Program News — AnnDraia Bales 13
I Old Staff and Courier News 15
Frontier School of Midwifery p
& Family Nursing News - Aggie Hoeger 16 I
"Legacies" — Nat/ian Lee 18
In Memoriam 20 l
Urgent Needs 32 .
Cover: "Rooted in the Past" (see page 3, The Journey) — FNS nurses  
(photographer unknown) I
Frontier Nursing Service Quarterly Bulletin is published at the end of
each quarter. Subscription Price $5.00 a year for Donors/$15.00 for A
Institutions. Periodicalspostage paid at Wendover, Kentucky 41775 and
at additional mailing offices. POSTMASTER: Send address changes to
FNS, Inc. 132 FNS Drive, Wendover, Kentucky. Copyright FNS/Inc.
All Rights Reserved. The Frontier Nursing Service does not share
it’s donor mailing list.

_,  Introduction to Frontier Nursing Service (FNS)
ll  Mary Breckinridge spent her early years in many parts of the
  world - Russia, France, Switzerland and the British Isles. After
 li the death of her two children, she abandoned the homebound life
  expected of women of her class to devote herself to the service
  of others, particularly mothers and children.
 J Mrs. Breckinridge established the FNS in Leslie County, Ken-
  tucky, in 1925, as a private charitable organization serving an area
 B of 700 square miles. It was the first organization in America to use
T3 nurses trained as midwives under the direction of a single medi-
,.  cal doctor/obstetrician, based at their small hospital in Hyden.
  Originally the staff was composed of nurse—midwives trained in
  England. They traveled on horseback and on foot to provide qual-
gl ity prenatal and childbirth care in the client’s own home.
  Today, Mrs. Breckinridge’s legacy extends far beyond Eastem
  Kentucky. FNS, Inc. is the parent holding company for Mary
  Breckinridge Healthcare, Inc., Frontier Nursing Healthcare, Inc.,
f  which includes six rural healthcare clinics; Mary Breckinridge
  Home Health Agency and the Frontier School of Midwifery and
 ik Family Nursing which offers a Master of Science in Nursing de-
 ll  gree with tracks as a Nurse-Midwife, Family Nurse Practitioner
 if and Women’s Healthcare Nurse Practitioner.
  Mary Breckinridge’s home, The Big House, located at Wendo-
  ver, is a licensed Bed & Breakfast Inn. For more information or
  reservations, call 606-672-2317 or e-mail fnstours@yahoo.com.
  You can also access our website:
  Frontier Nursing Service — www.frontiernursing.org

The Journey I
by Nathan Lee, President & CEO
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"R00ted in the Past" j
There are many times I find myself sitting in my Wendover office j
gazing at the historical photographs from FNS days gone by. I find
these pictures to be terrifically moving, not just in their graphic
beauty (Marvin Breckinridge Patterson, who shot many of these p
scenes, was quite a photographer), but also in the history they  
represent. As many of you who have worked with me know, and as I
others of you will surely come to find out, I love history. Indeed,  
I began my undergraduate studies at Transylvania University l
majoring in it, before the romance of the past gave way to the  
practicality of accounting, finance and business. I realize each I
day that the FNS is not a historical society; our work is very .
much alive, thriving, and as necessary as ever in the twenty-first
century. At the same time, however, I also fully realize that we E
can never truly know where our joumey will take us if we don’t , '
understand from where we have come. As my pastor reminded 5
me on a recent Sunday moming, "We are rooted in the past. We  
forget it at our peril." E

V lt is in this vein that I tell you about some changes you’ll note
beginning in this Bulletin. You’ll continue to see the same updates
that you’ve come to expect for the past eighty—two years. You’ll
· also find some new features as well. Some are less significant, like
the re-introduction ofthe quotes and sayings that filled the margins
of Bulletin pages years ago. Others are more important. You’ll
‘ find beginning in this Bulletin, a passage called "Footprints.” Few
organizations are so blessed as to have an "instruction manual"
in how they were intended to be run. The FNS has this in Mrs.
Breckinridge’s autobiography, Vldde Neighborhoods. Each quarter,
a short excerpt from this wonderful book will be included as a
reminder of from where we have come and, hopefully, as direction
for where we will go. You’ll also find a passage called "Legacies."
Each quarter, this shoit column will profile a supporter on whose
shoulders we stand. This support could well be financial, but could
just as or even more easily be a nurse, a courier, or a committee
chair who has helped to blaze the trail of the FNS.
Absent from this issue will be the Annual Report ofthe F NS. Fear
not, however. The Annual Report is simply being shifted to the
winter issue. Many of you have noticed what has, in some cases,
been a sizeable delay in your receipt of this issue of the Bulletin
each year. As the FNS has grown in size and complexity, so has
the nature of our annual audit. We felt that delaying the publication
of our Annual Report by one issue the most acceptable solution
to publishing delays we’ve experienced the past several years. We
‘ hope you will agree.
The work of the FNS is alive and well. We hope that is reflected
. in the changes in the Bulletin. To borrow Mrs. Breckinridge’s own
words in her dedication of Vldde Neighborhoods, this Bulletin
". . . is dedicated to you who read it and like parts of it. To you
‘ who read and like it all — it is dedicated with fewor."
l 3

Field Notes .
Wendover Guests
From April 20, 2007 - July 20, 2007, Wendover hosted a total of ·
518 guests. This number includes special dinners, meetings, tours
_ and overnight guests.
3 Travel Writers Visit
I During a Press Tour of Southern & Eastern Kentucky the week
of July 31st, a group of five Freelance Travel Writers visited
Wendover to experience and possibly write about the food. The
Writers, Betty Winslow, Shirley F ong-Torres, Jim Duncan, Betty
Terry and Kelly Sliwa had the opportunity to taste several special
dishes prepared by our Wendover cooks during dinner. They were
all very impressed with the food and we’re hoping to be featured
in at least one magazine.
  National Hospital Week
I The Hospital celebrated National Hospital Week by providing to-
1 kens of appreciation to the staff. Also, as part of National Hospital
x Week, Reader’s Digest conducted a Book Fair featuring quality
i books and unique gifts. The event "Books are Fun" earned $300.00
i for the Hospital Room Renovation Fund.
} Community Health Fair
, The 12th Annual Community Wide Health Fair was held June
22nd at the Hyden Community and Development Center. Thirty-
nine exhibitors participated with over two hundred community
1 members attending.
Hospital Renovations
The second floor roof of the Hospital has been repaired and patio
stones have been added to the balconies allowing patients to enjoy
• the outdoors during their stay.
I .
` `
. 4  

Stinnett School -Bused Clinic Update
Board Member Mary Ethel Wooton wrote the following update
l about the Stinnett Elementary School Clinic:
_ While Stinnett Elementary students were on summer vacation,
local artists, under the direction of Laura Ann Osbome and Linda
Adams, painted murals on the walls ofthe in-school clinic room.
The artists donated their time and talents to improve the envi-
ronment for childen visiting the Clinic. Paintings of aquariums,
children in tire swings over the river, dolphins leaping from the
water, a spider named Charlotte, a dragon with his reading book
and ocean scenes now greet the children as they enter for well-
child checks, dental screenings or routine bumps, bruises and sore
throats. The painting below was done by twelve—year old Robyn
Brock, a local middle-school student. The Clinic is a collaboration
between C.O.L.L.Y (County of Leslie Lifting Youth) and FNS.
l »\~`s The
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"Smarty the Squid " and "Crazy Cat”
i s

Employee Wellness Program at Hospital
An Employee Wellness Program was put into place at the Mary
Breckinridge Hospital several months ago. The total employee (
weight loss to date is 1,776.6 lbs.
Electronic Medical Records Conversion I
The Mary Breckinridge Hospital is progressing toward the elec-
_ tronic chart. Installation ofthe Clinical Information System is un-
I derway. Order Entry and Nursing Documentation are operational
and the "Carts on Wheels" are available for providers to chart
while performing rounds. Additional functions will be available
in November including Providers’ Access and Online Medication
Administration Record.
Kate Ireland Healthcare Center
I An expansion project is underway at the Kate Ireland Healthcare
j Center in Manchester. The patient numbers have outgrown the
  existing space. A modular section will be added within the next
I two months allowing more exam rooms.
I Early years of the Quarterly Bulletin featured “Sayings ofthe
I Children " — cute sayings of the children in the community. The
I following was takenfrom one ofthe early issues:
I .
"A three-year—old girl, poking her head in the cabin where the
Frontier Nurse is dressing a dirty wound with a lysol solution, ‘I
· smell a nurse." ·.
I “Six-year-old girl, asked what she had been eating all winter, shyly
I replied, "beans and ole taters."
I 6  

_ "F00tprints"
Excerpts from Hide Neighborhoods
by Mary Breckirzridge, Founder
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Chapter 1 7, Part I
"Early in 1925 I came back to Kentucky. The years spent in getting
I ready to work for children had ended. It was time to begin. If I had
known all that lay ahead of me in the next quarter-century, I wonder
if I would have had the courage to launch the small movement
destined to grow into the Frontier Nursing Service. One day, when
I was overwhelmed by the responsibility we had assumed, I sought
out Scott Breckinridge to ask him how we could have taken on
» so much and if we could not carry less. He replied that we would
have to carry more, not less. He said, ‘And had we failed to do it
we would have been untrue to everything that has come down to
* us from the past.’ Noblesse oblige'? For him, yes, but not for me.
Scott and I had been raised by the same family code - one which
did not admit the shirking of responsibility. But, insofar as I am
concerned, the steps I had taken since Breckie’s death had not so

much been chosen by me as thrust upon me, by something inside _
of me that came from beyond me. Although I seemed to make my
own plans, I doubt if I did. But I was free to bungle them.
Elsewhere in this book I have given the reasons why my work for
children placed its emphasis on the little ones and, among these,
I the country dwellers. If my readers have accepted these reasons, ·
then there are two questions which may occur to them - in fact,
have occurred to many people - and these are: ‘Why did you begin
in Kentucky‘?’ ‘Why did you not extend the work to other areas,
such as Puerto Rico and Alaska‘?’ I shall answer the second ques-
tion first. Administrative costs of a demonstration are much higher
if the demonstration is located in several areas, and in scattering
I you do not reach more people.
I There are several answers to the Hrst question. Not only was there
= no reason why the Kentucky mountains should not be chosen, but
we had the best of all reasons for choosing them, namely, their
¥ inaccessibility. I felt that if the work I had in mind could be done
I there, it could be duplicated anywhere else in the United States
` with less effort.
From the beginning I had the wish to do the work so well, and
to keep such accurate records of it, that others would study it, be
trained in its techniques, and then, in other remotely mral parts of
, our own and other countries, repeat the system we used. It would
be possible for us to reach only a few thousand children directly,
but hundreds of thousands of children could be reached by oth-
i ers because of us. Our inaccessibility was a priceless asset. None
1 who wanted to copy our work could plead that it would be more .
difficult for them than it had been for us.
i A second advantage to me in setting up the demonstration in Ken- ‘
{ tucky was that I would be working in a part ofthe world where my
I family name was known and I would be accepted without explana-
{ tion, because I belonged. As an example of this, I recall speaking

. at a rally of mountaineers at a place some twenty-odd horseback
miles from a railroad. The rally had been called by local leading
citizens who had asked us to place one of our nursing centers in
· their section. They indicated what they were prepared to do in the
way of gifts of lumber, use of mule teams, a site for the nursing
center, several days of free labor from men before they took pay
‘ at the prevailing rate of fifteen cents an hour. Then the chairman
of the rally introduced me, so that I could explain what we had
in mind. He said that he didn’t know me but that my people had
held "high office" in Kentucky, and none of them had betrayed a
public trust. Therefore, he was willing to guarantee that the local
citizens could trust me too.
A third reason for the choice of Kentucky, a vital one, was Dr.
Arthur T. McCormack, Health Commissioner for the Common-
wealth, an imaginative man of rare ability. Many were the confer-
ences I had with him that spring of 1925. He not only approved
of what I wanted to do but he, almost alone, understood it. It was
his suggestion that we establish our first nursing center on the
Middle Fork ofthe Kentucky River, in Leslie County, in the heart
of a thousand-square mile area covering parts of several counties,
where some fifteen thousand people lived without benefit of one
resident state-licensed physician. He gave me a certificate licens-
ing me to practice midwifery in Kentucky.
A final reason for locating the demonstration in Kentucky lay in
the fact that I had hundreds of kindred and family friends in that
state, who were willing to back me up. A few of the physicians
who were my cousins - among them Scott Breckinridge, Joephine
· Hunt, John Scott, Julian Estill, Waller Bullock — knew what l was
setting out to do. Waller said to me, ‘There isn’t one of us, Mary,
that won’t stand by you.’ All of that helped - God! (and I say it
` reverently) how it helped!
Among Kentuckians there is a strong sense of family solidarity not
unlike that in the old Scottish clan. We stand by our own people

unto the fourth and fifth generations. In my family there is as _
much English as Scottish blood, but the clanship probably comes
through the Scottish strains. As I went about my work of forming
a committee to back me up, I stayed with members of the clan. I
Before the spring was over I had completed the organization of
a group of nearly seventy people. We call ourselves just what we
were — a Kentucky Committee for Mothers and Babies. *
Our members came from highlands and lowlands, from town and
country. Five of them did not live in Kentucky at all. They included
prominent ministers of various denominations, well-known poli-
ticians of both parties, physicians of many specialties, and men
high in the educational, business, legal and newspaper worlds.
Represented also were those who had been active in establishing
the mountain settlement schools. Early mountain workers on a
heroic scale were Miss Linda Neville and Dr. J.A. Stucky. They
. had started the cleanup of trachoma, and were more instrumental
than all others in getting the U.S. Public Health Service to take
i it on.
` Of the members of that first committee I wrote Breckie’s god-
~ mother: ‘They are our nucleus- - first fruits of public sentiment
A - and they have been gamered ‘one of each’ - not in a bunch. It
l couldn’t have been done without the Spirit."
{ "lf you would not be forgotten, as soon as you
I are dead and rotten, either write things worth the
l reading, or do things worth the writing." .
{ -Benjamin Franklin

_ Beyond the Mountains
i May 22, 2007, Nathan Lee, CEO & President, and Barb Gibson,
é Assistant to CEO, traveled to Washington, D.C., to re-connect with
l former Washington Committee Members. Several city committees
i are no longer active and Mr. Lee plans to visit different groups
i in an effort to re—connect them with the FNS. A special thanks
l to Beth Hadley for hosting a luncheon at her home for the group.
ln attendance were Trudie Musson, Ann Becker, Jenny Urguhart,
Kate Sedgwick and Katherine Wilkins. While there, Nathan and
Barb had dinner with former Courier Susie Quinlan Hill and new
friends Jackie and Darrel Musselman. We look forward to visiting
1 with our friends in Washington again next year!
1 . ....  .7- .
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Back raw lep to right: Nathan Lee, Beth Hadley, Jenny Ur-
guhart, Kathernine Wilkins. Front mw - Ann Beckeig Trudie
_’ Musson and Kate Sedgwick

As we mentioned earlier, we were thrilled to have the opportunity _
to have dinner with 1994 Courier Susie Quinlan Hill. Susie lives
in Maryland, is married and has a full-time job taking care of her
three beautiful children. ,p,
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F0rmer Courier Susie Quinlan Hill and Nathan Lee
Healthcare Security aml Safety Meeting
During June, staff attended the International Association for
Healthcare Security and Safety Annual Meeting in Boston.
The goal is to train FNS security personnel as certified security _
Cmferences »
During May, Mallie Noble, Mary Breckinridge Hospital Admin-
’ istrator, attended conferences sponsored by the Kentucky and
American Hospital Associations.

_ Courier Program News
by AnnDraia Bales, Courier C00rdinaI0r
.. During May, I was given the responsibility of overseeing the
Courier Program. I assisted with the Progam several years ago
and am very excited to have this opportunity to work with our
¢ young volunteers.
This summer we had three Couriers participate in the Program:
Jenna Wenger from Iowa City, Iowa; Amy Woodbury, White Bear
Lake, Minnosota; and Sally Krikorian, Tampa, Florida. All three
Couriers reported having a wonderiial Courier experience. Since
May, we were able to accomplish the following:
The re-introduction of the Courier Program to Community Min-
istries in Hazard which offered a new volunteer opportunity with
their New Beginnings Day Care.
The Couriers attended staff meetings at the FNS, Inc. Lexington
Ofiice, Frontier School of Midwifery & Family Nursing and
Wendover, to update everyone on the role of the Courier. These
staif meetings will continue as we feel necessary.
New contacts were made in Manchester through the Commu-
nity Christian Church and Manchester Baptist Church. The two
churches offered opportunities through their clothing ministry,
"God’s Closet", a 12 step support group called Life-Line, their
free clinic, food pantry, dmg rehab center and Vacation Bible
School. A member of the Baptist Church also made it possible
, for Couriers to sit in on a Drug Court Session.
Other activities included a Luau to show their appreciation to
» providers and other people who made their stay enjoyable and a
visit to Laurel Mission and Gabe Falls, Pine Mountain Settlement
School, Red Bird Mission and Red River Gorge. See photos on
next page.

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