xt7qv97zmz2j https://exploreuk.uky.edu/dips/xt7qv97zmz2j/data/mets.xml The Frontier Nursing Service, Inc. 1991 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. 4, Spring 1991 text Frontier Nursing Service Quarterly Bulletin, Vol. 66, No. 4, Spring 1991 1991 2014 true xt7qv97zmz2j section xt7qv97zmz2j Yi -
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 US ISSN 0016-21 16 x
Table of Contents
Prescriptive Authority - Deanna Severance 1 iv
Appalachian Spring Tour - Sheila Allen 5
Local Spotlight: Jim and Lillian Hayes - Catherine Croft 7  
Meet I ack and Leona Bowling - Catherine Craft 1 1 i
Couriers Work at Safe House - Catherine C r0ft 13  
Dr. Ruth Lubic Appointed Visiting Professor at CWRU 18 §
1
My Experiences as a Literacy Tutor - Catherine C raf? 20  
Meet the Board — Meriwether Wash 23
FNS Renovates Wendover Bam — Catherine C rcft 26
Beyond the Mountains - Deanna Severance 27
Notes from the School: A Tribute
In Memory of Alice Whitman - Dr. Judith Treistman 32
Old Staff Notes - Meriwether Wash 33
Courier News · Susie H udgins 34
Field Notes - Susie Hudgins 34
FNS Remembers Dr. Holly Petersen - Catherine Cm]? 37
InMemoriam -Mae Irvin 38
Memorial Gifts - Mae Irvin 39
Urgent Needs Inside Back Cover
COVER: Sassafras, Wendover goat-in-residence
FRONTIER NURSING SERVICE QUARTERLY BULLETIN
US ISSN 0016-2116
Published at the end of each quarter by the Frontier Nursing Service, Inc.
Wendover, Kentucky 41775 {
Subscription Price $5.00 a Year "
Editor's OlTice, Wendover, Kentucky 41775
VOLUME 66 NUMBER4 Spring 1991 ··*
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 1986, Frontier Nursing Service, Inc.  
{
I
@ w

 r
5 QUARTERLY BULLETIN 1
i Prescriptive Authority
5 Prescriptive authority is an issue affecting advanced
j nursing practice. The issue revolves around how nurse practitio-
Q ners obtain prescriptions for their patients. The following five
•l* mechanisms are used: l) by asking a physician to write a specific
,_' script for the nurse practitioner’s patient; 2) by calling in the
·* prescription under the physicians name; 3) by co—signing the
physician’ s prescription pad; 4) by using pre-signed prescriptive
pads; and/or 5) by using protocols jointly worked out with the
nurse practitioner, physician colleague and dispensing pharma-
cist. The fifth mechanism is known as prescriptive authority.
Asking a physician to write a specific script for the nurse
j practitioner’s patient is legal. This practice requires that a
l physician be on-site with the nurse practitioner at all times. The
Frontier Nursing Service has demonstrated since 1925 the effec-
tiveness of family nurse midwives and more recently family nurse
practitioners as primary care providers working solo in the hollers
of Eastern Kentucky. From the beginning and even today a phy-
sician "circuit rides" to the clinics once a week and is available by
phone every day of the week to consult with the nurse practitio-
ners. This practice provides quality, cost-effective care. It does
not allow for the physician to write a specific script for each of the
nurse practitioner’s patients.
Co-signing the physician’s prescription pad and using
pre-signed prescriptive pads are not legal in Kentucky.
The Frontier Nursing Service develops, publishes and
sells Protocols for Patient Care. These protocols are jointly
· worked out with the nurse practitioner and physician colleague.
V However, it is not legal in Kentucky to use these protocols and call
  in the prescription under the physicians name. Currently, the
§ = physician must sign each prescription before it is taken to the
  dispensing pharmacist. This is what the Service does, and you can
Q imagine the time that is taken away from patient care by using this
‘ process. Hence, the Frontier Nursing Service supports legislative
change which would allow us to retum to the process successfully
V- used in years past before prescriptive authority was denied to ad-
r
I

 2 FRONTIER NURSING SERVICE
vanced registered nurse practitioners.
Thirty six states currently have some fonn of prescriptive
authority. Kentucky has conflicting regulations regarding the
issue. Although 201 KAR 20:057, a regulation promulgated by __
the Kentucky Board of Nursing, has been determined by the wt
  < ‘rir at     ` Almmey G==¤¢f=¤’S
»  l  »   ~  ra  vista       a¤~,,,,,,,
· —· =“‘ . ,=,zq,t.j    `·?:{_-ia:‘¤ · at ‘   %,g~j*T  force of law; a con-
  -  t-.£;·`.,·>=_     ·*‘·‘ " V  , »    . .
  ·· ·-      . I, V twi g? flicting Board of
'=       Pharmacy regulation
    `  t’’: 4 ga   §»¤_· t  has prevented the im-
 - ·:-   A ·i »· _—*?=f<  w  * <~`:=¢ s’ ‘¤¥·,  . .
;;»  0     is->, ¤L,;;;,,  plementation of this
     2 -qagig-ag -  W ;  Y, regulat1on which
  ,_ ;-’_ r »-  it ~‘”%“ ,g;rgJ   would allow the ad-
        ,,,    ··>»       vanced registered
_Q     Q ` -    g     if ~§-;ti§I‘_  nurse practitioner to
  V  @ @1;;   ,, if `   M :·: ‘ >  h w?  t d t b
· ,/ t         Opera P ““ er es a ‘
M in  ` I     “ ‘ ·   lished protocol to "in-
,51};    ‘ clude those areas of
  M A :7 *  _ .  .    practice related to di-
     ¥* . ·;?;»;¥!.,-  '  _ VV tl t t d
g,i t    ;;;{;,;           agnosi tc es s, ani
 ¤  . Q ‘\ e»/*»z;»;§;i>»;;;l--· ~ 2,:; J?;..2—-if #*;-1 _     prescription of med1-
     ?*r;€/¢%~*r   at? —r-     I ¢,—. C, .
 * <._-·y-tj   =,,,,,;»·$:;q_;W,ij,   cations and treat-
,  -   ·‘,-’ ,   »»
i’I*  gi ;-Q”L~,i.,    , ka     ‘ ITICHIS.
*? i'*Lf¢    ; ,.  I: _‘,,; ;e , ,
&=»,>z;/t i  =·@~ ¤ , $`¥z,,  &~‘· ~* ?'*¢  The ISSUC IS
F:\1VBIDt;jectorléeaSna geverancemfront not Om Of quam}, Of
o en over ar en ouse. Cam. In December,
l986,theOfficeofTechnolo Assessmentofthe Con ress ofthe
SY E
United States published a paper titled "HEALTH TECHNOL-
OGY CARE STUDY 37: Nurse Practitioners, Physician Assis— _
tants, and Certified Nurse-Midwives: A Policy Analysis." This ’
paper concluded: Nurse practitioners have performed as well as
physicians with respect to patient outcomes, proper diagnosis, ·
management of specified medical conditions, and frequency of I
patient satisfaction," and "Malpractice insurance premiums and  
the incidence of malpractice claims indicate that patients are  
satisfied with NP care. Although insurance premiums for nurse  

 QUARTERLY BULLETIN 3
practitioners are increasing, successful malpractice suits against
them remain extremely rare."
The following quotes are from a pamphlet lj [ IRSE
  QRAQQTITIQ QNERS Providers ofgguality Primary Health Care-
" Documentation on Quality of Service published by the American
Academy of Nurse Practitioners.
V "In a review of l5 studies, records concluded that between 75%
and 80% of adultprimary care services and up to 90% of pediatric
primary care services could be performed by nurse practitio-
ners."1
"Productivity studies show that if a nurse practitioner is utilized
efficiently, s/he could increase the productivity of a solo practice
physician by approximately 70%."2
"Estimates of increases in the productivity of physician practices
that include nurse practitioners range from 20 to 90 percent. The
greatest increase in productivity results when the nurse practitio-
ner has primary responsibilities for a subset of patients and refer
complicated cases "up" to the physician rather than having the
physician delegate routine problems "down" to the nurse practi-
tioner."3
"The Burlington Randomized Trial Study found that nurse prac-
titioners made appropriate referrals when medical intervention
was necessary."4
The need for the maximum utilization of advanced regis-
tered nurses exists in Kentucky and across the United States.
There are approximately 230 nurse practitioners and
nurse midwives in Kentucky. 49.4% work in rural areas. 74% of
the patients they see eam under $15 ,000 a year. 85% of the
`» patients seen are women and children. I believe that nurse
I practitioners provide good care for all people. A nurse practitioner
_ is my personal primary care provider. But the fact of the matter is
Q that nurse practitioners are primarily seeing the underserved, the
  medically indigent in this country. The way needs to be paved for
  access, cost savings and quality health care. The slow progress
l being made serves only to continue to deny access to care forthose

 4 FRONTIER NURSING SERVICE
most needy, to continue to escalate health care costs, and to deny
the fact that professional teams provide a higher quality of care
than physicians alone.
It is time to build consensus in our country regarding  
health care access, cost savings, and quality. We must remove the ‘
guild-like barriers cre ated by professional groups, nursing, medi-
cine, pharmacy, et. al. We must move forward to serve the citizens ·
in our counties, states, and country. Our concem at Frontier
Nursing Service has always been to provide quality, cost-effec-
tive care for families using nurse midwives and nurse practitio-
ners. The model works today as it did yesterday.
1 Record, J.C. (ed.) Provided Requirements, Cost Savings, and
The New Health Practitioner in Primary Care: National
Estimate for 1990 Contract 231-77-0077. Washington, D.C.:
DEHEW, 1979
2 Robyn, Dorothy; Hadley, Jack, "Nationa1 Health Insurance and
the New Health Occupations: Nurse Practitioners and Physicians
Assistants" Journal of Health Politics, Policy and Law Vol. 5,
No. 3, Fall 1980. pp 451.
3 Smith, K.R., Health Practitioners: Efficient Utilization and
Cost of Health Care.
4 Sackett, D.L. et al. "The Burlington Randomized Trial of the
Nurse Practitioners: Health Outcomes of Patients. Annals of ‘
Internal Medicine. 80:137, 1974.
-by Deanna Severance I
 

 QUARTERLY BULLETIN 5
Appalachian Spring Tour
FNS ’s Development Office traditionally invites all inter-
ested friends to visit each spring and fall and see iirst hand all the
  progress taking place within our service region. During the week
* of April 22-28, we hosted a very special tour. This one was
designed to provide not only an update of FNS, but also share the
· scenic beauty and flavor of the Bluegrass with our friends "Be-
yond the Mountains." Working with Julie (Mrs. Pendleton)
White of Passages Unlimited Travel Agency, and member of our
Boston Committee, we were able to organize this wonderful seven
day tour.
The tour began in Lexington on Monday April 22nd with
Mrs. Helen Bond, co-chair of our Boston Committee, designated
as offical tourmanager. That evening Mr. and Mrs. James Kenan,
III, hosted a welcome cocktail and dinner party in their home.
Mrs. Kenan is an FNS committee member and Mr. Kenan is a
trustee. It was a lovely "Welcome to Kentucky" with a true
sampling of gracious Southem hospitality.
The next morning we enjoyed a private tour of Claiboume
Farm, home to equine greats, Secretariat, Swale and Nijinsky.
The horses were truly magnificent! Several of the group had their
photo taken standing next to Easy Goer, 1990 Derby winner, and
_ if you have never "met" horses of this caliber, it is truly an
y experience.
In the evening we relaxed at a wine and cheese reception
Q and dinner at the beautifully restored Shaker Village. On Wednes-
  day, the group traveled to Berea to visit the campus of Berea
i College. Afterlunch at the famous Boone Tavem Hotel, the group
i continued on to Wendover where they stayed for the next two days
L   touring the area, and learning about the challenges being met by
  our nurses and physicians at Mary Breckinridge Healthcare.
{~ The weather was perfect throughout the trip and
  Kentucky’s famous dogwoods were in full glorious bloom-
  which really added a special dimension to traveling through the
  Daniel Boone National Forest to Leslie County.

 I
6 FRONTIER NURSING SERVICE
Thursday evening FNS National Chairman, Miss Kate
Ireland, hosted a dinner party in her lovely home, "Willow Bend."
Tour members and past couriers, Mrs. Samuel Neel (Mary
Wilson) ’37—’4l, and Miss Helen Peterle ’75, enjoyed reliving
their Wendover days. Mrs. Neel told many wonderful stories of T,
her days with FNS when horses were the only mode of transpor-
tation. We hope to share some of her stories in future issues of the _
Quarterly Bulletin.
On Friday we left the mountains to travel to Kentucky’s
largest city, Louisville. We were greeted by our Louisville
Committee Chairman, Mrs. Edward (Shirley) Dumesnil, Jr., who
toured us through the beautifully restored "Locust Grove," the
Federalist home and plantation of George Rogers Clark. On
Saturday it was off to the races at Churchill Downs, the oldest
continually operated racetrack in the United States. Mrs. Du-
mesnil had arranged seating for our group, front row at the finish
line. It was a truly breathtaking experience to have the horses
thundering past to victory, almost within touching distance! Even
if you d0n’t enjoy horse racing this was a very invigorating
moment.
Saturday evening we gathered for a farewell dinner at Mr. l
and Mrs. Dumesnil’s home. This was a very emotional occasion
as everyone was very keyed up from the races, and feeling a little
sad that the tour was over. We had all become quite fond of each
other, and had shared some very special events. Several devoted
Louisville Committee Members joined us for dinner, Mrs. James
T. (Betty) Christee and Mr. and Mrs. T. D. Luckett.
Members of the tour were, Mr. and Mrs. Samuel Neel of
McLean, VA; Mr. and Mrs. Jolm Bloom of Millis, MA; Dr. and
Mrs. Norris Embree of Kingsport, TN; Mr. Robert Jonas of Roch- ·
ester, NY; Ms. Andrea Frost of Rochester, NY; Miss Helen
Peterle of Haddam, CT; Mrs. Joy Lee Peterle of Stonington, CT;
and Mrs. Helen Bond of Dover, MA. i `
-by Sheila Allen g
l
L

 QUARTERLY BULLETIN 7
Local Spotlight: Jim and Lillian Hayes of Camp Creek
As fri ends and supporters 0fF NS , we have
endeavored to print stories for you that reflect the
f_ work of FNS . Beginning with this issue we’d like
to introduce you to some local people who,
through their commitment and loyalty to the
l community, have made an important impact on the
area. Meet} im and Lillian Hayes of Camp Creek.
"Mrs. Breckinridge was a very close friend to my
family. I remember the time she read me Jack and
the Beanstalk for the very first time and how she
taught me a love for gardening. My parents,
Hobert and Mildred Comett, loved and respected
Mrs. Breckinridge and worked very hard for her.
My father was the maintenance foreman of all the
outpost clinics and Wendover. Although he could
have made more money working elsewhere, he
always said he wanted to bring his children up with
the kind of commitment and care for people that
Mrs. Breckinridge and FNS exemplified. My par-
ents deeply admired her initiative and drive and I
now have the same feelings toward FNS and the
incredible followers of Mary Breckinridge. Ag-
nes Lewis is one such person my family and I
deeply adore. She remains very close to our hearts
and is one of the most gracious people I have ever
met."
Lillian (Comett) Hayes recalls many stories of Mary
Breckinridge and her nurses on horseback. There is obviously a
' very special bond between Lil1ian’s family and Mrs. Breckin-
ridge. Lillian was manied in the Big House on June 30, 1956 to
y , Jim Hayes with Mrs. Breckinridge in attendance. In fact Mrs.
» Breckinridge planned the entire reception, ordered the cake and
  made sure the flowers came out of the Wendover gardens.
  The Hayes’ and Comett’s have dedicated a lot of time and
  work to FNS and Wendover. When Mrs. Breckinrid ge was dying

 8 FRONTIER NURSING SERVICE
she entrusted the Wendover gardens to Hobert Comett and as a
result, Lillian has become the official overseer. She is presently
the organizer of the Wendover Garden Club. ln the Spring she
gathers some of the local ladies and helps to plant and clean up the _
_ v_  gardens. She has
  .   ‘ “ . . hopes for restarting
 · ·‘ ` . V _     the vegetable garden .,
__   _;_   \L   " soon. "Itwas always p
  Q g, '     _ I { a treat to serve our
_ ~·-·-··\"» ps    »_       ‘ fresh Wendover- I
.,     . .   »‘‘§' _”" grown vegetables at l
  t   f_.`=    I1   g, dinners. Even if we l
  ·_V-g    ~ .  M didnt have enough  
  S   r“i`‘'`    '  ` we would mix them I
A ‘ °‘‘r5       2      with "store bought"  
    _   vegies and pretend E
_  I __    ‘j   _ `   they were all from  
 .      ifi? the garden," she  
*‘f   *       .` laughs  
'     { ‘‘‘—  ,_ I    `   l  y_,g  ,  Lillian has  
_ X     _`.__.    ·   not only been dedi-  
L   ,i t.     ..v» {_ cated to FNS, but to l
  »·a           l     Other Whhhy hh- l
   p     deavors. She {
Jim and Lillian Hayes worked as 21 V
Homefront Worker for a pilot health program initiated by the state.
Her first real challenge was to visit every home in Leslie County
and take an accurate census, so that all families in every hollow i
could be accounted for. The health program was geared to the _t
retarded children and adults in the county. Throu gh the program I,
Lillian helped to establish Hope House, a school for mentally
retarded children. She says that her most difficult challenge was
in getting the parents to admit that "special needs" children existed `I
—— no one wanted them recorded in the census. "It wasn’t that they
were neglected or loved any less. The mountain people are very S
spiritual and many thought that it was their fault that their children
were not normal. They felt that the children’s handicaps were a `

 QUARTERLY BULLETIN 9
sign of their own sins or inadequacies. Our challenge was to get
them to talk about these children and then we could mention the
school. It was a truly rewarding experience?
. Although Lillian’s husband, Jim, was bom in Arkansas
and brought up in Oklahoma, he is still able to speak of many
~ Zfiéis r?§“l.§;"’§‘§5    ,l  »`  ‘    r   ,p .    
while living here in      _   `C i g
Leslie County up { A ;;_,,»·#"i  A `Q ' ._.
{   Cf€€k   his 27;;}*) `   A i    
T family. Jim is a min-     7 * rs,       Q
r ister at the Camp         . 7 { {gi  
· Creek Church of     _ ,,__  A;,:___   
Christ. They recently  {     _ _. _,__”_.   p   V
  had to abandon the  o
, one-mom school   *`·.#     . .
i house and church be- ~ .»       ~     F —·—~ ~ F
* Cause the Lgcco CO2,] 100 yearold, one room school house on
g Company bought the Camp Creek-
g land and tore it down. But with the money from the land, Jim and
§ fellow church members designed and built a new church that is
E much more functional. Jim has spent many years as a teacher in
  the Leslie County School system and many of his church parish
T have been former students.
! Lillian also taught school for ten or eleven years and is
i presently very committed to the church. She and Jim have,
I themselves, raised and educated about twenty children, of which
T only Hve are their natural-bom children. They are a part of a foster
E parent program. Presently Jim is a fourth—grade teacher at the
~ » Hyden Elementary School and works very hard for the children of
i the community. Leslie County and FNS are very fortunate to have
such loyal and hard—working people in their midsts.
, —by Catherine Cr0ft

 10 FRONTIER NURSING SERVICE
Frontier School Receives Letter from President Bush
The following letter and certwcate of merit
was sent to the Frontier School of Mia'wh'ery
and Family Nursing from the President of the '
United States:
Word of your community service ejfort has reached ·
us and we are pleased to send you the enclosed certwcate of
merit on behah’ of President Bush.
Thank you for your commitment to community serv-  
ice. Through your generosity and hard work, you have .
shown that the tradition of neighbor helping neighbor is alive I
and well in our country. Your efforts profoundly influence j
the life of your community and they are a shining example for {
us all. Barbara joins me in saluting you and sending you our  
best wishes. God bless you. E
George Bush  
OIOOOOIOOIOIIOOOIIO  
WENDovER Q
E
O God, I thank Thee for these hills  
So richly decked in glorious hue-  
And for the rivers and the creeks {
I humbly give Thee praises due- ~
For trails that wind through mountain sides  
And finally they went their way  
To our abode so far from town , y
Where simple joys bless every day- "
And for the birds whose joyous songs .
Are wafted to Thee on the breeze- ~
And for the beauteous flowers that grow, V
I thank Thee, God, upon my knees.
-Eileen Milton, Summer 1957 Quarterly Bulletin  

 QUARTERLY BULLETIN ll
Meet Leona and Jack Bowling - Home Health Patients
Many of you have become familiar with Jack and Leona
Bowling of Saul, KY, either through previous publications or
· through the NBC segment "Sunday Today" program featuring
FNS, which aired in late November. Leona is a Home Health
patient who had a series of strokes three years ago that left her
' completely paralyzed. She also has multiple medical problems,
such as diabetes. Leona’s only form of communication is through
the use of her eyes. "She blinks once for yes, twice for no, and a
whole bunch means I love you," explains her nurse Sandy Mathis.
She is very alert, and prior to her stroke, was in the midst of raising
seven foster children. In fact the couple have raised over IOO fos-
· ll   3 ‘ ter children in
I   A past years!
`   But with the
  stroke, the
1   ” children had
~     tioflze sent to a
— ..__ , 1 ` g rg `\< i erent os-
i  ? 2 . · ‘   FE"   ter home be-
L ` ·  L .   ( ·*· i cause the
,     I     V  ‘v"‘  B owlings
  {  V { i`   -      » ii weren’t able
§   N, ~    ~* ` ' ,  to care for
I Jack Bowling cares for his wife Leona. [hem any-
  more.
  Jack Bowling has been taking care of Leona since the time
  of her stroke. For the past three years he has been checking her
i blood sugar, blood pressure and vital signs every twelve hours; he
. , tums her over every two hours, and exercises her limbs several
L times a day. Everyone recommended a nursing home, thinking
i that Jack would be unable to care for Leona, but he was deter-
€· mined. "He said he had heard of a man who had taken care of his
V wife in much the same manner after she had been paralyzed by a
stroke, so he knew it could be done," Mathis explained, "and he
has been doing it everyday." Jack took Leona home when she was
in a poor state of health after the stroke and within 2-3 weeks he

 12 FRONTIER NURSING SERVICE
developed a log system to monitor all of her health care needs.
Sandy comes by once a week to check for problems and counsel
with Jack. Early on she was needed more frequently, but now Jack
is very used to looking for problems and letting her know if Leona I
needs to be checked. Also, home health aides visit daily to help
Jack with Leona‘s personal routine care.
Within four months after the stroke Leona began blinking ‘r
as a form of communication and by the end of the first year, she
could communicate with Jack. She has only been in the hospital
once in the three years that Jack has been taking care of her. Jack .
gets her up everyday and takes her out on the porch if the weather _
is nice and she watches him plant flowers for her in the yard. In
the aftemoon he sets her up so she can watch her soap operas. .
The relationship between Jack and Leona is very spe- »
cial. J ack includes Leona in all decision-makin g and talks with her g
all the time. They are thinking of going up to Indiana to see some  
of their children soon. It broke Leona’s heart to give up her foster  
children when she became ill. Jack thinks the trip will be good for *
her. Music is another favorite of Leona's. Every once in awhile  
Jack’s sister and brother—in—law stop by to play for her. Even E
though Leona can’t move, she blinks her eyes in tune to the music.  
Before the strokes, Leona was the lead singer of the group. Leona R
also loves a good joke and will practically shake herself out of the Q
bed when someone tells her a good one. *4
Because Leona is so alert, Jack and her Home Health  _
nurses and aides would love for Leona to be able to really
communicate. Recently a physician who has become interested  ,
in her case has discovered a computer program that can be hooked Q;
up with Leona’s eye blinks that would enable her to communicate.  ;
This computer can be connected to electricity or battery operated,   "
so she can move around with it. Leona will be sixty—three years  {
old this month and we ’re excited at the possiblity of her once again  EA
being able to formally communicate.
-by Catherine Croft i

 QUARTERLY BULLETIN 13
Couriers Work at the Safe House in Hazard
The following is retold in part by two couriers,
Frances Key and Andrea Berrien,who have spent
, many days working with battered women and
children at the Safe House in Hazard, Kentucky .
"We usually arrive at the Safe House around 3:00 in
`A the afternoon, just before the children come back from
school. This allows us time to really talk to the mothers
and find out what they are going through. When the
i children arrive, we focus our attention on them. Most of
r the children are starved for attention. If it is nice outside,
we take them to the playground. These children have so
j much energy and they need to release it constructively.
. The local park is a great place to take them if it is nice
g outside. There is a swimming pool, miniature golf course,
  and a river where they can fish. The park provides
  entertainment for the entire day. I would recommend that
l future couriers ask to be driven there with the children. I
i would also recommend that male couriers spend time at
Ei the Safe House because it will show the children that not
{ all men are angry. A nurturing and caring male companion
F. for these children would be terrific. They need to know
Q that not all men are aggressive and hurtful."
L  Frances Key - courier Feb. '9l.
 . Frances Key and Andrea Berrien are FNS couriers who
_ volunteer their time a few days a week at the shelter. The couriers
if  spend much of their time with the children, teaching them to play
  constructively. Frances says, "It is a very intense experience and
 ¥_ a little unbelievable. These kids have to leave all their friends
 i from school behind when they come here and begin a new life.
 { They have also been through some pretty awful things. There
 r. seems to be two groups that the children fall into: the talkers and
the non-talkers. The talkers want to tell everything about what has
 A happened to them or what they’ve seen, while the non—talkers deal
· with their pain and fears alone. They aren’t ready to bring it out
» into the open yet. These children seem to have a harder time

 14 FRONTIER NURSING SERVICE
relating to the rest of the group."
The Safe House in Hazard, Kentucky is a shelter for
battered women and children who are fleeing domestic abuse. At
the shelter the women are counseled while the children are offered M
play therapy. Family counseling occurs on an individual family
basis. Because each family has its own set of problems that are
unique, it is most productive to work with families individually, r·
as opposed to group sessions.
  r` . = I a:—·I»  " .     I I I
 5  r.‘i` FH ·c ·<· * `   ; t H
5  A I '     .4_V_ · ___»_ .   g t
  ‘A;' H HH H H-·—,__     . ` .     ‘-.’ 1:    
  H A la..       . r li I  Y   sa·f. I i.      I ....    
  ``'H   cxx "'H HH   H H HHH    ‘H.’;HHH'HHHjHHHHHHHHHHHH  
I‘I`H   H,  H* HH ·H»»     H`  
, . ·   I   ;    -  `· Q     .*’ ·i’·  
Andrea Berrien discusses work at the safe house with an-  
other FNS courier. F
The staff members at the Safe House have a great variety  
of duties. They escort the women to the doctor, court, job  ,
interviews, school, the social service office, and help them look {
for housing. Staff also answer a crisis support line. On Sunday E
evenings they counsel the women in nutrition and meal planning   ‘
and even teach cooking classes. They also counsel the women in i
how to budget their money and in careful shopping. To work at Q
the Safe House, staff members are asked to have two years of ·

 QUARTERLY BULLETIN 15
college and an interest in helping battered women and children.
The boarders are from Leslie, Knott, Letcher, Owlsey,
Breathitt, Wolf, and Perry Counties. The women find out about
,, the shelter mainly through the social services department or law
enforcement agencies. They also fmd out by word of mouth, and
there is a hot line which is advertised on local television.
i The boarders can stay for up to thirty days. During their
time at the Safe House, they are busy looking for housing, jobs, or
places to go to school. However if they aren’t able to find housing
in that time, they are permitted to stay until they do. The housing
they find must be clean and provide a healthy enviromnent for the
children and the mother. Throughout their stay the women are
constantly working towards a goal. Each week they meet with a
staff member to review goals they’ve set and to see what stage
they’re at in accomplishing these goals.
Judy Campbell, the director of the Safe House, is very
enthusiastic about the program. "It is a much needed program in
the area and I feel very strongly about what we do." A major
‘ problem that Judy cites is the lack of space in the shelter.
; Currently the shelter can only house about twelve people. "Last
C month we had to tum away twelve mothers and sixteen children.
- If possible we transfer them to other shelters in other counties.
t Otherwise they may choose to stay with friends or relatives. We
{ do try to offer some other alternatives but we’d never send them
` back to the place of abuse.
  Nationally, the statistics of domestic abuse are stagger-
{ ing. A woman is beaten every eighteen seconds in the United
  States. Twenty percent of all murders in this country are commit-
I ted within the family, with thirteen percent committed by
f` spouses. Ninety five percent of all the spousal assaults are
g committed by men. Twenty-one percent of all women using the
I _ hospital emergency—surgical service are battered. Six million
  American women are beaten each year by their husbands or
  boyfriends and four thousand of them are killed. One in four
X female suicides were victims of family violence. Another inter-
Q_ esting statistic was printed in the Dayton Daily News. It cited "the
t

 16 FRONTIER NURSING SERVICE
most common cause of women’s injuries—abuse at home occurs
more often than auto accidents, muggings, and rapes combined,
but is largely ignored by doctors." One out of iive women are in,
or have been in, some kind of violent relationship. One out of
three women taken to the hospital are for domestic abuse. Nearly "
eighty percent of all abusers grew up in an abusive home. One out
of eight high school students is involved in some kind of a violent .
relationship and one out of four college students is involved in an
abusive relationship. This being the case, the Safe House staff
hold community awareness workshops at the high schools and
colleges in the area and circulate pamphlets and fliers in the
community