xt7mw6694f4p https://exploreuk.uky.edu/dips/xt7mw6694f4p/data/mets.xml The Frontier Nursing Service, Inc. 1990 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 Quarterly Bulletin, Vol. 66, No. 2, Autumn 1990 text Frontier Nursing Service Quarterly Bulletin, Vol. 66, No. 2, Autumn 1990 1990 2014 true xt7mw6694f4p section xt7mw6694f4p FRONTIER NURSING SERVICE   ”“`‘  
Volumc 66 Numbcr2 Autumn 1990 5    
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Old Hamblin Place, Campbell Creek, Kentucky, 1990
drawn cart. When roads were impassable the mail came by muleback. i
Typo, also on the North Fork was another route taken by those i
early frontier nurses. Typo, a name coming from the logging days when ,
"poles" were "tied" was another L&N way station. Mary Breckinridge L
in her book Wide N eighborltoods says that by horseback it was 32 miles I
round trip from Wendover to Typo. The real disadvantage, she goes on
to say was that Typo was on the wrong side of the river. This required a
flat boat to cross.
Thus it was in the early days that Krypton served as the main
transportation and trading center. Even before the coming of the railroad .
in l9l2 the north fork of the river was counted on as navigable for
supplies needed for the interior Leslie County. The Middle Fork of the .
Kentucky River passing through Hyden had many rapids, low places and = I
the fall in the river was too great for navigation. _
Mr. Feltner reports that goods were purchased and collected at   ,
Krypton by Leslie County country store keepers—anything from baking   ,
soda, sugar, to bolts of cloth and shoes. Many fami implements were g  
purchased. Perhaps the most amazing development was the buying of   ,
wagons. From early days mountaineers had fashioned home made El

I flodder and com sleighs for hauling. Mr. Feltner relates that in one year
T* he sold thirty three wagons.
  Speaking further about the products for sell, Mr. Feltner men-
V tioned that he sold Mary Breekinridge hay brought in by rail from the
'  Grain and Hay Company in Cincinnati. One rail car would hold 216 bales _
t or 30,000 pounds of hay. A wagon drawn by two or four mules would L
 ? haul twelve bales in each wagon to be carried over the difficult trail to
{3 Wendover.
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I   The Old Eversole Hotel, Krypton, Kentucky, 1990
r l
I r Just to contrast the economics of that day and this, Mr. Feltner
I), said he was considered the most prosperous man in town; he made $80
  r a month.
  I Where did Krypton get its name? I have not found a person to
    inform me about this. However Krypton is a known rare chemical in the
I  atmosphere and it means "hidden" in Greek. But our Krypton on the
I . . . .
sl North Fork of the Kentucky was at one time the busiest L&N station in
E Eastem Kentucky.
[ Therefore it was that Mary Breckinridge and her nurses used all
I three gates into their neighborhood of Leslie County. The illusion is one

of daring romance. Itis easy to visualize riding horseback into the rugged  
forested mountains, along rolling rivers, twisting creeks and picturesque  
rock castles. But in reality, the trans-  
portation task required great energy, E;
      time and devotion to their cause. Q 
  1 i — r'   Bringing medical service to a very P
‘ .       ,     i V,_,   rural people was their calling, In our  
  "·       ' i mind’s eye we see shadowed fern-
  ..._   . i    carpeted paths along the sides of ~
» »t     . t,. mountains to reach some remote l,
_ g   »» (_  F_ cabin where a family waited for the ' ,
. = I     angels of mercy. The purplemantled ?
  . mountains are crowned with memo-  
y , A ries that whisper the names of those  
  who marched across the landscape of Q
  y `  · the early 20th century. Such are  
. ‘’ ‘     Mary Breckinridge and her nurses; §,’
Nan Hagan Gorman they belong to the most significant.  
At the end of this century it behooves E
us to remember their tremendous contribution to a medically deprived i
area. As we look over our shoulder let us appreciate the dem ands of the Q
past and reason with our new challenges.  
—by Nan Hagan Gorman it
I rl

, Daughters of Colonial Wars visit
it Frontier Nursing Service
E, On October5 , 1990 The National Society, Daughters of Colonial
” Wars, as part of their Semi-Annual Council Meeting held a memorial A
A service and laid flowers on Mrs. Mary Breckinridge's grave, in the
" Lexington Cemetery in Lexington, Kentucky. While at the Lexington
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‘ FNS Director Deanna Severance boards DCW float.
Ccmctary they also marked the grave of Mrs. Benjamin F. Buckley, 5th
  National President and had a memorial service and laid flowers at the
  grave of Mrs. Robert L. Keaven, past National oflicer.
  p The group then continued on to Hyden, Kentucky for the 7th
" Annual Frontier Nursing Tour. The annual Mary Breckinridge Festival
1 t had all of Leslie County active that weekend with craft and food booths,
  contests, a parade and more!
  Upon arrival at the Appalachian Motel in Hyden the group was
M transported to the Frontier Nursing Service headquarters at Wendover. A
g, tour of the Wendover grounds and afternoon tea was highlighted by a
lr L

 I if
viewing of the lilm "Forgotten Frontier".
A banquet was held at the motel that evening and was followed
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DCW Members aboard their 3rd place winning float.
by an executive DCW meeting at the Richard M. Nixon Conference
Saturday began with a buffet breakfast at the motel and was
followed by a tour of the Frontier School of Midwifery and Family
Nursing and St. Christoplier's Chapel, on the hill above Hyden, and the
Mary Breckinridge Hospital.
After the tour some group members prepared to ride the DCW V
float through the parade, while the remaining members were transported \
to bleachers downtown to watch the parade.
It was a beautiful fall day; perfect weather for a parade. The ‘
DCW float, assembled by couriers and other FNS employees, won 3rd
place in the theme category.
Following the parade all group members enjoyed the displays,
delicious food and festivities at the Mary Breckinridge Festival and at f ,
Wendover before returning to the motel. i ,

Another banquet was held at the motel Saturday evening, and
  Sunday the group departed after a buffet breakfast.
I The FrontierNursing Service enjoyedhostingthistourand hopes
il that all group members had an interesting and delightful time while in
Leslie County. The National Society, Daughters of Colonial Wars, are
, faithful friends and supporters of the Frontier Nursing Service.
·, -by M criwct/ter Wash
DQ QW Members gnjgtgincling thg 199QQ FNS Tgggnr
Mrs. Sranleigh Swan, VA Mrs. Donelson Bridges, TN
National President Mrs. Whitney Dunlap, II, KY
Mrs. David Hickey, TN Mrs. French Maggard, KY
Mrs. William L. Hudgins, VA Ms. Ella Erskin, IA
Mrs. A.W. J urgeleit, AK Ms. Marion Samo, IA
Mrs. Alva Gregg, LA Ms. Eva Bedford, IA
Mrs. Alexander J. Smith, Jr., MA Mrs. GH. Bryan, VA
Mr. & Mrs. Raymond McAuliffe, FL Mrs. Thomas P. Callier, OK
l Mrs. Francis H. Huron, MA Mrs. Kenneth Wickett, TX
Ms. Jane Eppes, TN Mrs. George T. Lockwood, IA
Mr. & Mrs. Robert Hendry, VA Miss Alice Underwood, IA
I Mr. and Mrs. Joseph R. Riden, Jr., KS Mrs. Al Acker, TN
Mr. & Mrs. Joseph P. Roysdon, NC Mrs. Robert E. Stevens, SC
Mrs. Charles Stagner, KY Mrs. E. Murphy Shaw, FL
  Mrs. David Watts, KY Mrs. John Duvall, FL
I Ms. Stacia Kaufman, KY Mrs. Stewart Huddleston, VA
Mrs. W. T. Buckner, KY

Health Care Is Not Enough
When asked to discuss how the provision of health care strength- =
ens the young family, I kept turning over in my mind the thought that ¥
health care is one part of the equation, a microcosm in the Cosmos of t
solutions. Health care is important for children and adults to be healthy, -
happy and fully able to realize their potential. But alone, without the  
integration of child care, economic security, education, and the myriad of "
elements of a well-rounded life, health care cannot realize its potential to  
improve and uplift and save lives. ,'
Mary Breckinridge wrote that during her work in France she felt
as she was to feel later in the Kentucky mountains. She said: "Work for
children should begin before they are born, should carry them through
their greatest hazard, which is childbirth, and should be most intensive _
during their first six years of life. These are the formative years—whether ,
for their bodies, their minds or their loving hearts." Mary Breckinridge “
founded the Frontier Nursing Service in 1925. She died May 16, 1965, f
a visionary...a woman who saw clearly that our leaders of tomorrow are ‘
our children today. I
How did the family nurse midwives of yesteryear integrate into
the mountain community? They lived in the community, at the clinics.
Locally, the family nurse midwives were backed by physicians in Hazard.
Louisville, Lexington and Children’s Hospital in Cincinnati were the i
linkages for tertiary care and referral. The focus was care for the entire 1
family with midwifery at the heart.  
Today four clinics operate in the "hollers" of Leslie and parts of J
Clay and Harlan Counties, and one clinic operates at the Mary Breckin- 2
ridge Hospital. The first outpost nursing center to be built after Wendover T
was the Jessie Preston Draper Memorial Nursing Center known as
"Beech Fork". Sr. Sonia Miley, FNP, lives in the original clinic which i
was builtin 1926. This clinic, Sr. Sonia’s home, is on the ledge above the ‘
new clinic which was built in the 1970s. The Clara Ford Nursing Center,
known as "Red Bird", was built in 1928. This is the home for Bill Powell, p
FNP, his wife Amy and their two year old daughter Ida. Bill works at the E
Community Health Clinic in Big Creek. His area was once served by the r Y
Caroline Butler Atwood Memorial Nursing Center at Flat Creek, the .

i Belle B arrett Hu ghitt Memorial Nursing Center at Brutus and the Marga-
ret Durbin Harper Memorial Nursing Center at Bowlingtown. Trudy
· Morgan, FNP at Pine Mountain, recently moved from above the Pine
Mountain Clinic across the street to a log house. Sr. Joan Gripshover,
FNP, and Sr. Katharine Donohue, FNP, rent their own house in the
¤ Wooton area. Susan Davis, FNP, who serves with Sr. Sonia Miley at
‘ Beech Fork, lives at Wendover’s lower pasture with her husband Chris-
Y tian and their two year old son, Nathaniel.
Why, you may be asking, have I told you the residences of our
xr. family nurse practitioners who serve in the "hollers"? Allow me to
answer that question with another question: lf I pass through your life
casually, examine you child’s vision, suture your cut, give your family
medicine, will I have as great an impact on your life as I do when I also
live in your neighborhood, celebrate your births, offer solace at your
, wakes, and share your meals? Then, and only then, am I part of your
family, a unit of caring. To encourage positive lifestyle and even value
` changes, the practitioner must be a part of the community, the community
f that cares.
i The mountains of Leslie County envelope a people with a rich
culture. Mary Breckinrid ge was a part of the mountains and their people.
Today Frontier Nursing Service remains one of the important threads
which support the mountain people.
, The following statistics from the October 8, l990 issue of Time
j Magazine are not new to many of us. I hope they have not ceased to be
L shocking.
‘ Every day in the developing world more than 40,000 children
. under the age of five die of diarrhea, measles, malnutrition
g and other preventable causes.
Nearly l in 4 American children under age six lives in pov-
{ erty.
Every eight seconds of the school day, a child drops out.
° Every 26 seconds, a child runs away from home.
, Every 47 seconds, a child is abused or neglected.

Every 67 seconds, a teenager has a baby. }
Every seven minutes, a child is arrested for a drug offense.
Every 36 minutes, a child is killed or injured by a gun. V
Every day 135,000 children bring their guns to school. F
The Time Magazine article goes on to state: "A nation can spend  
money either for better schools or forlarger jails. It can feed babies or pay ’
forever for the consequences of starying a child’s brain when it is trying t
to grow. One dollar spent on prenatal care for pregnant women can save A
more than $3 on medical care during an infant’s first year. A year of Q
preschool costs an average $3,000 per child; a year in prison amounts to
$16,500." r
Is the answer more money? The people of the United States, `
through our private insurance systems and our govemrnent programs,
spend more money on health care than our Western neighbors. Yet,
programs for families remain underhrnded, and the U.S. infant mortality
rate remains worse than 17 other developed countries. Therefore, the
solution is more complex than funding, per se. I
Part of the solution has to do with having accessible, available
providers of health care. There are inadequate numbers of nurse mid-
wives and obstetricians practicing in rural America. FNS has part of the ,
answer in the Community—Based Nurse Midwifery Education Program I
(CNEP). The success of this program, success being measured in terms 3
of educating thousands of competent, crcdentialed nurse midwives  
during this decade, is partially dependent on the use of technology. -,1
Mature RN learners can complete didactic education in their homes, j
throughout the country. Faculty can communicate with the students via _
, im
computer, FAX, video, and telephone. Students do not have to be _g
physically present, within the walls of institutions, to learn. I believe this Q
use of technology can increase the numbers of nurse-midwives practic- i
f ing inthe U.S. significantly. The technology can also improve access to 1
continuing education. _“
Financing through Medicaid has improved, but not enough.  

Approximately 60% of the people we serve through Mary Breckinridge
» Healthcare, Inc. are dependent 0n Medicaid and Medicare, Individual
ii states set the reimbursement rates. Prenatal care alone costs FNS
approximately $600 for a healthy pregnant woman for nine months.
I FN S cannot pay salaries, utilities, etc., at the current reimbursement rate.
Reimbursement rates *‘
Q are, of course, so much E V g E i
  better than they were. , , _  
  However, small rural       V,  "-Q?. E   
IV hospitals and health care           i_   g V _  
r services, those without '  X   V Q  _  2 i s ` A  
I the great philanthropic f' (  {   >  ` ~ ` ’ gf.   i\
f support such as that of   A "_'_'f___,_,, '  I »  V  ,1 » O
Q the FNS, cannot survive     f _I»,VV. Q V V_V~ »..
F without a further shift in   " ' " ‘ ° u  W. S 4
I funding towards preven— .-r    »   ~,~ 
I tion and primary care. `.   
During these , _,.  
Hm lg months I have FNS Director Deanna Severance
A been a part of the FNS
family, people have stated to me their support of our nurse practitioner
  demonstration model. Some go on to say, it is a good model, given the
Y fact that our community cannot afford the cost of physician care. It is true
that our model is cost effective. Our model, however, is good care for all
people, regardless of insurance or financial status. In Wide Neighbor-
  hoods Mrs. Breckinridge wrote, "It is possible, under this system, for a
I hardy physician to be responsible for the medical needs of some nine
T thousand people annually, many of whom he does not meet, whereas he
  could serve little more than a five-mile radius withouthis nurse—midwife.
j Although our current "hardy" physicians——Dr. Anita Comett, Dr. Ken
* Peasley, and Dr. Al Nunez- can serve more than a five mile radius, they
It remain like the palm of a hand from which fingers radiate in several
  Even with our wonderful history, and with the current exciting
programs at the FNS, I feel a sense of urgency about our health care
ir system in Leslie County and in America. I have a sense that priorities
lg must be set now, that funding must be adequate for our children, and that
  our providers must be imbued with the commitment to healthcare,

education, child care, and all the threads which mean real progress for our
I end with two quotes. The first from the Time Magazine article
and the second from Wide Neighborhoods: I
"...children are an honest conscience, the perfect mirror of a l
society’s priorities and principles. A society whose values are entirely ,
material is not likely to breed a generation of poets; anti-intellectualism  
and indifference to education do not inspire rocket scientists. With each r
passing day these arguments become more apparent, the needs more  
pressing. Where is the leader who will seize the opportunity to do what  
is both smart and worthy, and begin retuning policy to focus on children p
and intercept trouble before it breeds?" I
"The thing we want more—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? We have never done enough for children, even though I
the emphasis of all our years of work has lain with them. We must fmd I
a way in which we can help bring about a normal emotional life for more
of them, during their tender years when wounds are made which leave x
scars forever." [
-by Deanna Severance i

British Midwife Visits FNS After 22 Years
The Frontier Nursing Service was thrilled to have Betty Pale-
i thorpe, an original "nurse on horseback," visit during the last week in
i September. Miss Palethorope worked as a nurse—midwife for FN S
j between 1956-1967. Originally from Dorsett, England, she leamed
j about the Service through an article written by FNS nurse—midwife Eve
g Chetwynd. Miss Helen Browne who was second in command to Mrs.
  Breckinridge at the time hired her and so she and Ann Cundle, another
  British nurse—midwife arrived together.
i In those days half of the midwives were from England and the
r other half were from America. The service covered about seven hundred
E miles reaching a population close to ten thousand.
  Miss Palethorpe was a trained midwife and registered nurse. She
{ committed to staying the expected two years, but actually stayed eleven
I years. She remembered her life here as "a happy, family life." She
1 worked at the Beech Fork Clinic closest to Mozelle. The clinic had a cow,
two horses, one jeep per nurse-midwife, and a maid who cooked, cleaned,
and most importantly, milked the cow.
` When Miss Palethorpe first anived she had to wait one year for
a vacancy at one of the clinics. So in the meantime, she worked at the
hospital in Hyden and did a little bit of everything. After a spot opened
at Beech Fork she moved out there.
She found her work on the districts to be very self—satisfying. For
an annual fee of two dollars an entire family would be guaranteed
complete medical care. The patients were expected to pay for their
medicines and other supplies. Generally the people did pay for the
. medicines, although sometimes they paid it through an installment plan.
{ Or they would pay in kind by providing the nurses with eggs, milk, cows,
labor, produce, etc. The women might even make bonnets, jackets,
f booties, or diapers to pay for medicine.
It cost about thirty dollars for a birth and about fifty dollars for
* a Caesarean Section. A layette or a bundle cost five dollars. ln these
bundles were all the clothes a newbom would need, from diapers to
‘ booties. There was one doctor who did Caesarean Sections under a local
 . anesthetic but he never performed any deliveries. He worked seven days

a week and had clinics everyday of the week at a different outpost clinic.  
Most patients were referred to Lexington if the doctor was unable to treat I
them, and children were sent to Cincinnati for medical or surgical  
problems. The Frontier Nursing Service had an arrangement at Cardinal `
Hill in Cincimrati and all service was free. Only medicines were paid for I
by the families or the patients. §
Another agreementwas setup with the blood banks in Louisville. I
Every two weeks, FNS would get two pints of blood from Louisville. In I
retum when the Mobile Van arrived from Louisville every six months, i
people from all around the area donated a pint of blood. Even if FNS S
wasn’t able to meet the blood quota, Louisville would still give them the I
two pints of blood bi—monthly. Those who had received blood, often gave I
when they had the chance. Aside from blood coming in via Louisville, _
there were walking blood donors. The clinics kept a list of the people in  
the area, their type of blood, and the date of their last blood donation. E
When there was a need for a certain type of blood, Norma Mattingly, the I
telephone operator, was contacted and she got in touch with the donors. I
The midwives cross—matched the blood to be sure it was sufficient and I
then they would draw it. |
Miss Palethorpe would make housecalls out in her district eve- I
ryday except Wednesday mornings when clinics were held. If a patient
was expected to be at the clinic and wasn’t there, she would do a follow I
up on them and find out why they had not attended. If a patient couldn’t
find a way to a clinic or to the hospital, she and the other nurses would go
pick them up and take them. Twice a year, in the spring and fall, there
would be a surgical clinic held for two days. A surgical team would come
down from Lexington and about nine or ten surgeries would be per-
forined in a day. Two of the nurses from the clinics would serve as
runners, doing odd jobs.
Medicaid had just began before Miss Palethorpe left Kentucky.
Prior to Medicaid, most deliveries were done at home and not in the  
hospital. But Medicaid wouldn’t pay for home-deliveries, so people had
to come in for their prenatal care. If families couldn’t get the mother-to- ,
be into town, the nurses would.
While working district nurses wore riding uniforms which con- T
sisted of a white shirt, riding britches, leather boots, and a black tie which _ 
could be used as a tourniquet in case of a snake bite. The nurses all carried

 ] .
[ snake anti—venom. Miss Palethorpe recalled the story of a dog that was
f bitten by a snake and the nurses were able to save it with around the clock
g attention and care. In a sense the nurses also served as veterinarians for
l many of the animals. They used the knowledge they had of people
I medicine and applied it to the animals.
  Betty Palethorpe recalls her days of nurse-midwifery with great
i fondness. She was committed to improving the quality of life for the
,i Kentucky mountain people through adequate health care. ln 1963 Betty
§ became the Superintendent at the Hyden Hospital and continued in that
r— role until she left in 1967. Although times have changed at the Frontier
{ Nursing Service since the days of horses, the goal is still the same. The
service and the people who work for FNS place significant importance
i on rural health care and do all that is in their power to provide it. Miss
  Palethorpe was glad to see FNS still thriving and working eohesively as
{ a family unit. She could see that even today people still live "a happy,
} famlly MCS, -by Catherine Croft
i Meet the Board of Governors
The FNS Board of Governors is responsible for
establishing the policies by which FNS is governed, as
I well as approving the annual budget and overseeing ex-
penditures. Each member ofthe board brings unique gms
and apersonal history ofinvolvement with FNS to his or
her postion of leadership; and each has a key role to play
in the governance ofthe Service. This is another in our
series of proyiles on the members of the Board of G over-
Mary G. Hodge
‘ Mary G. Hodge, Chairman of the Philadelphia Committee of
Frontier Nursing Service and member ofthe Board of Govemors, was in-
i troduced to FNS through her marriage to John Hodge, a cousin of Mary
2 Breckinridge. John’s family was involved in supporting FNS. As Mary
  joined in these activities, she saw the pressing need for nurse—midwifery
 ` and other health care services in Appalachia. Her energy and enthusiasm
led her eventually to ehairrn anship of the Philadelphia Committee, one of

the several city committees or- ‘° ‘    *` I SI      
ganized in support of FNS. p _`p» , -      
MBYY Hodge (née Gmd' S if S if    ‘
hart) grew up in Washington’s >  N -      __r _  
Crossing, Pennsylvania. She     »-»<  ` ·         .
obtained her B.A. from Rider ~ -·_` J g     ;s_ » .  ,  
College in Trenton, and is now S I   _ ,_      I Q` . I
involved in the real estate busi- _     _..»··»* Y
ness. She andherhusband have up    5,     z .. ·
two children——Cortlandt, I3, `   .i   V  _ gi _ p   3
and Cabell, 6. In addition to her   ` RFE;  f if   _ Q   " i
activities on behalf of FNS, she    , .  . "       I
is a Regent in the Daughters of __p_ ,         P    ' I r   §
the American Revolution of   S -   at       I {
Trenton, and is active in the  
Episcopal Academy Parents’  
Association and annual giving campaign. ;
Mary sees the challenges FNS must face in the context of health l
care problems nationwide. "The medical situation in this country is alot  
worse than people realize," she say