xt7kkw57fm6c https://exploreuk.uky.edu/dips/xt7kkw57fm6c/data/mets.xml The Frontier Nursing Service, Inc. 2004 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. 80, No. 2, Fall/December 2004 text Frontier Nursing Service, Vol. 80, No. 2, Fall/December 2004 2004 2014 true xt7kkw57fm6c section xt7kkw57fm6c FRONTIER NURSING SERVICE { gl
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 US ISSN 0016-2116
The J oumey - WW Hall, Jr 2
Wendover News - Barb Gibson 3 i
Impressions of Wendover - Noel Smith F ernaalez 8
Mary Breckinridge I-Iealthcare News - Mallie Noble 9
Mary Breckinridge Festival- Barb Gibson I2
Frontier Nursing Clinics update - Dr Julie Maq’ell 16
FSMFN News — Dr Susan Stone 18
Courier Program News - Michael Clausserz 24
In Memoriam 25
Websites 31
Urgent Needs 33
Cover: Molly Lee, former FNS Nurse-Midwife. Grand Marshall in Mary
Breckinridge Festival Parade October 2004. Photo by Mary Ethel
Frontier Nursing Service Quarterly Bulletin
Published at the end of each quarter by the Frontier Nursing Service
Subscription Price $5.00 a year for Donors/$15.00 for Institutions
Volume 80 Number 2 Fall/December 2004
Periodicals postage paid at Wendover, Kentucky 41775 and at addi-
tional mailing offices. POSTMASTER: Send address changes to FNS,
Inc. 132 FNS Drive, Wendover, Kentucky. Copyright FNS/Inc. 2000 All .
Rights Reserved.

Frontier Nursing Service
Bom in 1881 into a prominent American family, Mary Breckinridge
spent her early years in many parts ofthe world - Russia, France,
» Switzerland and the British Isles. After the death of her two chil-
dren, she abandoned the homebound life expected of women of
her class to devote herself to the service of others, particularly
Mrs. Breckinridge established the Frontier Nursing Service (FNS)
in Leslie County, Kentucky in 1925, then one of the poorest and
most inaccessible areas in the United States. Mrs. Breckinridge
introduced the first nurse-midwives in this country. Riding their
horses up mountains and across streams in blizzard, fog or flood,
the FNS nurses brought modem healthcare to families throughout
an area of 700 square miles.
Until her death in 1965, Mary Breckinridge was the driving force
behind the work ofthe Service whose influence today extends far
beyond eastem Kentucky. Through the Frontier School of Mid-
wifery and Family Nursing, hundreds of nurses have been trained
and this important concept of family healthcare has been carried
throughout the world.
Today, FNS, Inc., is organized as a parent holding company for
Mary Breckinridge Healthcare, Inc., Frontier Nursing Healthcare,
Inc., which includes four rural healthcare clinics (Community
Health Center, Beech Fork Clinic, Kate Ireland Healthcare Cen-
ter and Dr. Anne Wasson Healthcare Center), Mary Breckinridge
Home Health Agency and for the Frontier School of Midwifery
and Family Nursing — the largest midwifery program in the United
States. The Frontier School of Midwifery & Family Nursing also
` trains family nurse practitioners.
Remarkably, the purpose and philosophy ofthe FNS has remained
` constant since 1925

The Journey
by WW Hall, Jr, President & CEO ~
The spirit of Mary Breckinridge is alive and
well nearly 80 years after the birth of FNS.  _   ‘
We have many fine individuals who contribute  if    {
to honor her ongoing legacy and for that, we   E
are eternally grateful. We have been visited   j
by many old friends who continue to share    
their experiences and vision for the future.     ·
This has been a year of tremendous success throughout the orga- g
nization led by the hard work and dedication of Dr. Susan Stone  
and her staffat the Frontier School of Midwifery & Family Nurs-  
ing (FSMFN). Our school moves steadily forward with national  
and international recognition. Most importantly, we continue to i
provide bright, optimistic and highly trained professionals who are  
truly fighting the obstacles and challenges Mary Breckinridge met l
and conquered nearly a century ago. Our heritage and her l
healthcare model works. It is the answer we seek.
Our hospital and clinics aggressively reach out to our community  
and our staffconstantly find new opportunities to enrich the lives  
and health of those we serve. These successes open greater op-  
portunities to push this positive momentum forward with a single .
focus. Our focus will always address the mothers and children ;
who benefit from the care we gladly give.  
Financial decisions, new opportunities in healthcare, provider re-  
cruitment and capital needs will remain consistent with the for-  
mula Mrs. Breckinridge left with us through her tireless devotion l
to detail. We enjoy her work. _
Pleasejoin us in celebrating 80 years ofservice to our friends and j
neighbors at home in Leslie County, across this great nation and to  
the world. We look ahead to 2005 with high ambitions tempered ‘
only with care and good judgment, a legacy we cherish.

Wendover News
. by Barb Gibson, Assistant t0 CEO
- Guests numbers at the Bed & Breakfast Inn have continued to
increase during the fall season. The Bed & Breakfast Inn is now
a partner with LKLP (Leslie, Knott, Letcher, Perry counties) for
. their Elk Viewing in Leslie County. The Elk population in Leslie
l County has reached 4,500 and is becoming a big attraction. Dur-
ing the months of September, October and November, Wendover
accommodated 704 visitors. This number includes ovemight guests,
luncheons, dinners, tours, and functions at The Livery.
i Maintenance Projects
The renovation project at The Livery is almost completed. Fenc-
ing has been built around most ofthe pasture with plans to finish it
  in the spring. Walkways and flower beds still have to be built. The
l rustic cabin is a perfect get away place for meetings, etc. Mainte-
nance projects this fall included roof leak repairs, cleaning and
screening gutters on all the Wendover buildings, drain replace-
ment and many other general maintenance tasks in preparation
l for the winter.
A Bluegrass Committee Luncheon
The annual Bluegrass Committee Luncheon was held this year on
September 21 at the Lexington Country Club. Thanks to Board
I member John Foley for making it possible for the luncheon to be
i held there. The luncheon was sponsored by Merrill Lynch Private
  Client Group and Merrill Lynch Investment Managers Fred M.
I Keller, Jr. and Travis Musgrave.
The following people from FNS gave updates about FNS: Mr. Bill
’ Hall, CEO & President of FNS, Inc; Dr. Susan Stone, President
& Dean of the Frontier School ofMidwifery & Family Nursing;
Dr. Julie Marfell, Chair ofFamily Practice; Mallie Noble, MBHC
j' Administrator; Michael Claussen, Tour Guide and Assistant Cou-
  rier Coordinator and Nathan Lee, CFO.

We were honored to have 49 friends and supporters of FNS from  
Lexington, Louisville and surrounding areas. Everyone enjoyed '
wonderful food and lots of door prizes including tickets to Keeneland ,
Race Track rovided b friends of Mr. Hall.
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Michael Claussen spoke about Wendover and the Courier Pro-
Employee Fall Harvest Festival
On Friday, October 29, Wendover hosted an employee Fall Har-
vest Festival with about 7l in attendance. We gave our Wendover I
cooks a day off from cooking and had the food for this event
catered by some friends of mine. Music was provided by the Trough
Sloppers, a local bluegrass group. Games included a Pie Eating
Contest, Cake Walk, Three Legged Race and Horseshoes. Frank {
Baker won the Pie Eating Contest, Brent Swafford and Norman i.
Ray Hoskins won the Three Legged Race and Michael Claussen l
won a Walmart gift certificate door prize. We plan to make this an .
annual employee celebration event. »

l We were honored to have Monica Luke Mana er of The Th-
p ompson Foundation in Knoxville, Tennessee, attend our Festival.
| The Thompson Foundation helped fund renovations of The Liv-
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Pie Eating Contest - le]? to right: Kevin Couch, Nathan Lee,
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Impressions of Wendover
by Noel Smith Fernadez '
We are deep in the Cumberland Plateau, a table land carved down _.
by water. It is so close and steep that here at Wendover, you
should be able to reach out and touch the mountain across the
river. But, as in all respectable land, you can’t. You can only be l
tantalized knowing that there is virgin timber over there, and you
can’t see it.
We are suspended in a hanging garden above the Middle Fork of
the Kentucky River. It reminds me ofBali in its opulent lushness. 1
The river is the spine ofWendover. We can hear it sliding past in l
whatever mood it is in. One moment the Middle Fork murmurs
gently its pebbly syllables, the next, it rages through the land like a
giant serpent of rolling mud. The song of the Redbird ricochets
from the green canyon walls - cheri, cheri, cheri, cheri, cheri . . . Z
It is a land ofwater. Wherever you are, you hear a running brook;
water that carved these steep valleys in the first place. The June I
nights are thick with the other worldly croaking of toads, calling 1
from the river,joined by an occasional bullfrog. I think I am in a I
foreign country. p
In August, the song ofthe katydids press in upon us, lulling us to y
sleep, thick as a blanket. I
In the early mornings a ghost mountain rises in a luminous mist. A l
few frazzled outlines of trees emerge high in the grey. The day’s  
weather will not be revealed to usjust yet. Spirals of mist rise like .
a hundred campfires.
The path toward the Big House is lined with a riot of impatiens,
gladioli, exotic lilies, unusual daisies, rose of sharon, all blooming I
at once .... j ·

i Mary Breckinridge Healthcare, Inc. News
i· by Mallie Noble, Administrator
Mary Breckinridge Festival
·‘ This year’s Grand Marshall ofthe Parade W  
q at the Mary Breckinridge Festival was Miss _  
{ Molly Lee, Certified Nurse Midwife. I was .- V `   _i;_     —
i very fortunate to have had the pleasure of “   , V      
1 working with Miss Lee in the early l970’s   Q. H I
Q at the Hyden Hospital. AsI reflect back, I   ti,y . li i
  owe a lot to Miss Lee. She always told me
i I was worth my weight in gold. This is one ofthe best compli-
  ments I have ever had. The week prior to the Mary Breckinridge
i Festival I had the pleasure of having tea and dinner at the Big
Q House at Wendover with the F SMFN students, Dr. Stone, Dr.
  Marfell, Molly Lee, faculty, MBHC Advisory Committee mem-
; bers Mrs. Rhonda Brashear, Ms. Mary Ethel Wooton, Mr. Ray
i Wilson and Mrs. Ruby Campbell. It was special reminiscing about
  the earlier times with staff, community members and Miss Lee.
  This year, on Friday, October ls', 2004, in conjunction with the
i Festival, a community appreciation picnic was held at the Hospi-
  tal. There was a huge crowd for barbeque and the fixings and
  Bluegrass music by Uncle Dave and the Trough Sloppers.
  Barbeque was done by Jeff Holmes, Pharmacist "Hawg Wild".
I Many thanks to staff at the School, Clinics, MBHC and Wendover
  for the hard work to make this event all come together. Approxi-
  mately four hundred people attended this event.
i Christmas Gws for Children
  Each year at Christmas, the employees of Mary Breckinridge Hos-
i pital work with the Commission for Children with Special Disabili-
" ties as Christmas Angels. Each department or employee chooses
  a child to purchase gifts for Christmas consisting of clothing and
E toys.These are children who otherwise would not receive any gifts
  i on Christmas Day.

On November l2'*‘, 2004 the employees of Mary Breckinridge
Hospital were presented a Community Star Award for their good `
work and charity toward these children.
Bioterrorism Preparedness Planning Grant J
Mary Breckinridge Hospital Emergency Room Department has
received funding from the Health Resources and Services Ad-
ministration (HRSA) Kentucky Hospital Association Bioterrorism
Preparedness Planning Grant 2003/2004 Cycle which was ap— .
proved in August of this year. Mary Breckinridge Hospital will
receive equipment to meet required benchmarks prepared by .
HRSA. Funding totaled $41,000. Equipment must be utilized for I
overflow of patients during a disaster and to reach Hospital Bed
Capac cities for the State of Kentucky.
Mary Breckinridge Hospital Laboratory Department received a V
Biological Safety Cabinet from the Cabinet for Health and Family ,
Services in the amount of $4,47 I .00. The Cabinet was approved I
and purchased through the HRSA (Health Resources and Ser-
vices Administration) Bioterriosm Federal Funding. The Cabinet
provides a safe laboratory environment for microbiologists work- I
ing with bioterrorism agents and is also needed to manipulate pos- A
sible bioterrorism agents that are transmissible by the aerosol route _
to decrease the risk of personnel exposure. l
Breast Cancer Awareness  
October was Breast Cancer Awareness Month. MBHC offered y
promotional mammograms during the entire month of October with I
extended hours of operation. The Radiology Department performed  
24 regular mammograms and 69 promotional mammograms for a  
total of 93 exams.  
Critical Access Meeting  
Mr. Nathan Lee, Vice President of Finance, and I traveled to  
Louisville, Kentucky, to attend a Critical Access Meeting spon— ·
sored by the Kentucky Hospital Association. Speakers included  

Robert W. Brandenburg from Louisville and John J. Sheehan from
— St. Louis, Missouri. Topics included critical access bed limits of
twenty-five and outpatient laboratory procedures. Centers for
Medicare and Medicaid Services (CMS) stopped reimbursing
“ CAHs (Critical Access Hospitals) for outpatient laboratory ser-
vices at cost in October of 2003. CMS opted for a fee—based
reimbursement system. This change in reimbursement has made
it financially impossible for some CAHs to continue to provide
off-site lab testing and has forced some Medicare beneficiaries to
travel to the Critical Access Hospitals, often at great distances, to
p receive lab services formerly provided at accessible outpatient
sites such as rural health clinics, home health agencies and nurs-
ing homes. The American Hospital Association (AHA) and Ken-
tucky Hospital Association (KHA) continue to work with key con-
gressional staffto gain additional cosponsors to ensure a legisla-
tive remedy to this policy made by CMS.
i KHA Leadership Conference
Mr. W.W. Hall, President and CEO of FNS, Inc., Mr. Nathan
Lee, Vice President of Finance, and l attended the Kentucky Hos-
pital Association (KHA) Annual Leadership Conference in Lex-
ington on October 27"‘ and 28‘*‘. The Conference focused on up-
coming state and federal legislative issues that will affect hospi-
A tals. Richard J. Davidson, President of the American Hospital
Association was the keynote speaker.
l Maintenance Work
l During the latter part ofthe fall, the maintenance department re-
i modeled the fence surrounding the hospital property. Metal screens
l were cut out and quarter inch steel bars were welded in place.
l Thanks to the Ladies Auxiliary Committee for funding this proj ect.

Mary Breckinridge Festival ,
by Barb Gibson
The Mary Breckinridge Festival this year was held September 27 .
— October 2 with lots of activites including a Community Picnic
held in the parking lot ofthe Hospital. Members ofthe community  
and FNS employees enjoyed wonderful food together. The high-  
light of this year’s Festival was the return of Molly Lee from  
England, to act as Grand Marshall ofthe parade. Miss Lee, former  
FNS Nurse-Midwife, made her visit to Hyden a long one, seeing  
old friends and familiar places. Miss Lee worked in Hyden at  
different intervals from I955 - 1982 and is well known throughout 5
FNS. I am an FNS baby delivered by Miss Lee in l957!  
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f Dr. Roy Varghese - 5K Run and Fun Walk

In an eyfort to make elementary school children more aware
of Mary Breckinridge and the Frontier Nursing Service, chil- ‘
dren were asked to write a story about Mrs. Breckinridge.
The following are excerpts from stories written by two sixth
grade students: E
A Young Woman with a Big Heart
by Anthony Bryan Burns
Long ago, people only had horses to travel. They lived in houses
that most ofthem built themselves. Most ofthe houses were built
with logs or stones. They would build fireplaces in their homes in
order to have heat because there was no electricity.
There was a man by the name of Asher. Asher lived in a house
built with logs. Asher’s house did not have windows but it did
have a fireplace. Also, Asher had a horse, "Jack". Asher used
Jack to travel and to pull a wagon. Asher kept Jack in a little place
like a shed. The shed was built out of logs and tin.
The weather was changing and Asher decided that it was time to
gather firewood for the winter. Asher hooked the wagon to Jack
and got his axe. On his way he met a young lady riding a horse.
She said her name was Mary Breckinridge. She said "l am a
nurse. I use my horse to go to homes and deliver babies and take
care of their mothers".
Asher went on up the hill. He started cutting firewood. His axe
slipped and went into his foot. Asher was frightened because he
was losing a lot ofblood. So, hejust sat down beside ofa big tree.
As Mary came back up the hill she saw Asher. Mary got off her
horse and got her black bag that she carried her stuff in. Many ,7
then cleaned the cut and stitched it up. Asher offered to pay Mary
for the care that she gave him. Mary would not accept the money.
Mary said that she wasjust glad to help him. Mary Breckinridge ,
was known as a good loving person. Not only did she deliver ba-
bies. she also helped others that she saw were in need.

The Fallen Citizen
. by Ethan Jacob Estep
Joe and Little John were brothers and lived side by side. Their
e homes were in the head of a holler, in the Appalachian Mountains.
One day after breakfast Little John was reading a book when Joe
came up and said, "What are you doing reading you are supposed
to be helping me work". In a loud voice Little John replied, "All
we do is work. I want to readjust a little". "No"! Joe said loudly,
You’rejust lazy and stupid”. Little John was so mad he took off
on his horse and rode into the hills. Joe said to himself, "He is too
chicken to stay out long".
ln six more hours, to Joe’s surprise, Little John had not returned.
Joe was worried sick. He went to the barn as fast as he could to
saddle his horse to go looking for Little John. About two miles into
the mountains Joe found Little Jolm’s horse. lt had been bitten by
many rattlesnakes and died! Joe was now so worried he almost
passed out. I-le found Little Joe halfburied under some leaves and
dirt. Little John had ridden into a large snake den, the horse went
crazy then Little Jolm fell off and had also been bitten and lay
passed out under the leaves. Little John said in a quiet voice, "Go
get the nurse".
Joe came back with Mrs. Breckinridge. She said there were two
bites on the leg and ankle and he had a broken arm and finger
from the fall. Mary Breckinridge asked Joe if he had an axe. She
cut down two small trees and laid them down side by side. She
then tied her coat and jacket to the trees and made a travois and
hitched it to the horses. When Mrs. Breckinridge and Joe got to
the hospital Mrs. Breckinridge gave Little John an antidote. She
" thought she would have to amputate the leg. John said, “You have
my permission to amputate the leg". Joe and Little John will never
forget the time that tragic thing happened. Sometimes Joe and
° Little John go visit Mrs. Breckinridge at the hospital. They were
friends after that.

Frontier Nursing Clinics Update
by Dr Julie Marfell, Executive Director l
Campaign for Safe and Healthy Kids l
and Reach Out and Read Program
As the year draws to a close, the district  
clinics have been busy seeing patients and    
providing outreach to the community for   V  
health promotion and disease prevention.   _  
Our FNS campaign for Safe and Healthy      
Kids is continuing. Items needed for each     I  
age group are being given to the families   if liyv
with the anticipatory guidance needed to  
promote safety and healthy child development at each well child
visit. Our Reach Out and Read Program has also been very well
received and we are in the process of ordering more books.
. Patient Education
In an effort to help educate our diabetic patients, Barb Baird, RD,
a diabetic educator from the Leslie County Health Department is
teaching a class monthly at Beech Fork Clinic. The staffprovides
breakfast for the attendees and their appointments with the FNP
are scheduled around the class. This has been very well received
and some positive health outcomes have developed from this.
Blood Borne Pathogens and Aids Presentation
Linda Ahrens gave a presentation October 20th on Blood Borne
Pathogens and AIDS to Forestry Service employees at the Peabody
Ranger Station in Big Creek, KY. The employees consider Mary
Breckinridge to be their hero. During the years of I933
through 1935 Mrs. Breckinridge visited forest service officials in
Washington, D.C. and corresponded with the Chief of the For-
estry Service, the Eastern regional Forrester, the Forest Supervi— I
sor, the Secretary of War and the Head of the National Forest
Preservation Commission in an effort to have a purchase unit es- Q
tablished in the headwaters ofthe Cumberland and Kentucky Riv-
ers. Mrs. Breckinridge did not accomplish this in the l930’s, but

the Redbird Purchase Unit was authorized in the mid-l960’s. Af-
t ter Linda Ahren’s presentation, Biologist Kim Tartar gave Linda
a tour ofthe Redbird area ofwhich the highlight was seeing three
elk eating in a field within tive yards ofthe vehicle. The employ-
‘ ees also had a cookout to mark the occasion.
Line Dancing
Katherine Lauderdale, FNP, and Linda Cress, LPN, from Beech
Fork Clinic are holding line dancing classes every Thursday evening
at the Stinnett Elementary School. This was done in an effort to
help our clients increase their physical activity and promote exer-
cise to increase health. Linda Cress is teaching the class. The
attendance is increasing every week and all that attend have a
good time.
National Midwyery Week
To celebrate National Midwifery Week, October 3-9"‘, the Fron-
tier Nursing Healthcare nurse-midwives donated a new rocking
chair to the labor and delivery unit at Manchester Memorial Hos-
pital. An article with a photograph about the donation and its
purpose (for the comfort of birthing women during labor and for
breastfeeding), and about nurse-midwifery services available
through FNH, Inc., appeared in the local newspapers.
Renovations in Anne Wasson Rural Healthcare Center
The CNM practice has recently redecorated the old pediatric area
ofthe Anne Wasson Rural Healthcare Center and has begun see-
ing patients in that area. Advantages ofthe new setup include a
more private waiting area for clients and a "women’s clinic" at-
J March of Dimes Walk
On October 23"’, Laura Manns-James, CNM, joined Angela
Mitchell, FNP, for the annual Clay County March of Dimes Walk
, America to help raise both money and awareness for the problem
of pre-maturity and birth defects. The event was well attended
and set a new record for the Clay County walk in terms of funds
raised for the March of Dimes.

Frontier School of Midwifery and Family Nursing News
by Dr: Susan Stone, President & Dean f
What a busy Fall! We were honored to have
Molly Lee come to visit us from England. E ` W
She was the Grand Marshall of the Mary Q I ,,_ g
Breckinridge Festival and proudly led the ; 1‘ F" 3  
parade through town on October 2. Most      
Hyden residents fondly remember Molly as   ` li ’ - I  
she served the county as a nurse—midwife  ~   ‘ l
for 28 years before returning to her home in England in 1983. She l
was kind enough to come to the School a few times during her  
visit. She regaled faculty and students with stories ofthe old days. l
We all learned from her stories. l
Kitty Ernst (Alumni 1951) and the Mary Breckinridge Chair of I
Midwifery was also here in Hyden for the Mary Breckinridge 1
Festival. Under the guidance of faculty member, Debi Karsnitz, {
we all decorated a float for the parade. Special thanks to Micheal  
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Feltner from maintenance who not only lent us his trailer to deco-
I rate as a float, but then pulled it in the parade with his truck. Kitty
and all the current Level III students rode on the float. I led the
riderless horse representing Mary Breckinridge’s horse and the
I faculty practice members walked right behind us. It was a slightly
damp but overall fun day for everyone.
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