xt7rfj29b80g https://exploreuk.uky.edu/dips/xt7rfj29b80g/data/mets.xml The Frontier Nursing Service, Inc. 1985 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. 60, No. 4, Spring 1985 text Frontier Nursing Service Quarterly Bulletin, Vol. 60, No. 4, Spring 1985 1985 2014 true xt7rfj29b80g section xt7rfj29b80g ` - . . I 5**  
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 US ISSN 0016-2116    
Frontier School and Case Western Reserve l
University Join in Affiliation to Advance  
Nursing Education 1 l,
Frontier School Graduates 95th Class 6 (
Class Pictures 8 ‘
Diony Young Exhorts Graduates to Stress "High-Touch" L"
and Caring in Nursing Practice 11  
by Diony Young I
Baby Wins Race With Car 19 i
The FNS Medical Directives — The Historical .
Innovation That Has Assured the Best in Rural
Health Care 20
by Deirdre Poe
Beyond the Mountains 25
by Ron Hallman
An Inside Look at the Nurse-Midwifery Program
at John D. Archbold Memorial Hospital, Thomasville,
Georgia 26
by Ron Hallman
Notes from the School 29
Alumni News 30
Field Notes 30
Courier News 33
In Brief 34
Do You Know These Nurses? 35
In Memoriam 36
Memorial Gifts 36
Urgent Needs Inside Back Cover W
Front Cover: The Frontier School of Midwifery and Family Nursing, which
occupies the old Hyden Hospital on Thousandsticks Mountain, overlooking
Hyden. i
Comments and questions regarding the editorial content of the FNS Quarter/y Bulletin
may bc addressed to its Managing Editor, Robert Beeman, at the Frontier Nursing Service, A
Hyden. Kentucky 41749.  
Us ISSN 0010-211b
Published at the end of each quarter by the Frontier Nursing Service, Inc.
Wentlovcr, Kentucky 41775
Subscription Price $5.00 a Year
Edit0r’s Office, Wendover, Kentucky 41775
Secondclass postage paid at Wendover, Ky. 41775 and at additional mailing offices
Send Form 3579 to Frontier Nursing Service, Wendover, Ky. 41775 ‘
Copyright 1985, Frontier Nursing Service, Inc.  

 I    F   The deans of the two schools K  W ,_ I     
i  g —.r; °”’¥ that have joined in an innova- z ·'     .
J V   I . ,     tive academic programto bring  V  ; ,
A l .t. , ,~ A       significantadvancesin nursing _-§,_ it     
j    _j¢_,f       ~»` education. Left: Dr. loyce 1. ‘-  ‘ 49* ,    
l ’ ., "i      '`;   '`,i,»_ f   Fitzpatrick,dean ofthe Frances V. <     ”
l   {  ,_V_  by i    Payne Bolton School of Nurs- Y     q , , __ z
'   , ,,—,   .,l4   ”V'   ing, Case Western Reserve { ,
   _,_, l**;y University. Right: Ruth Coates ,     _' _ 
_ V,    _ Beeman, dean and director,    _  ` ,.5 
‘ l       Frontier School of Midwifery _A j  .< , {    ,   "  
l   .V`_ I and Family Nursing.   “  ,_ 
by V . :;.;., I `
A significant advance in nursing education was achieved during
May by the signing of documents that establish a new linkage
between FNS’ Frontier School of Midwifery and Family Nursing
and the Frances Payne Bolton School of Nursing at Case Western
Reserve University in Cleveland. Case Western Reserve, in a recent
statement, said that the goal of this cooperative program "is to
advance health care for mothers and infants during pregnancy,
childbirth, and afterward."
The new affiliation will make it possible for students at the
Frontier School to receive academic credit toward advanced degrees
at Case Western Reserve. Reciprocally, clinical and educational
facilities at the Frontier School will be available to CWRU nursing
students. Although some of the details remain to be developed,
i students at FNS will be able, beginning in January 1986, to apply
course credits earned at FSMFN toward a master’s degree at Case
Western Reserve. CWRU students will be able to take courses at the
' Frontier School that will apply toward a master’s degree at Case
Western Reserve. As part of this plan, the faculty of the Frontier
School have been appointed adjunct professors at the Frances
Payne Bolton School. It is expected that the schools will not only
share faculty but will also work together on joint research projects.
; The two schools each have lengthy records of distinguished
  accomplishment. The Frontier School was established in 1939 at
{ Hyden to meet an urgent need at FNS. Until that time, FNS nurse-
; midwives had been trained in England, but that source of supply
  was abruptly cut off by the outbreak of World War H. FNS founder

Mary Breckinridge responded to the emergency by establishing her  
own educational program, the Frontier Graduate School of Mid- ]g
wifery. Its initial purpose was to prepare professional nurse-  
midwives for the Frontier Nursing Service, but over the years, its {
graduates have carried their expertise and care to all parts of the ?
world. Family nursing and preventive care have been integral in J;
FNS services since their beginning.  {
The Frontier School was the second school of nurse-midwifery in  
the United States, having been preceded a few years earlier by the    
midwifery school of the Maternity Center Association in New York Q,
City. The latter closed several years ago, and the Frontier School is A
now the oldest of its kind in the country. In 1970, thirty-one years  
after its founding, the Frontier School added a certificate program E
to prepare family nurse practitioners. With these two programs it E
became uniquely qualified to prepare both family nurse practi-  
tioners and family nurse-midwives. It has always placed special I
emphasis on developing Mary Breckinridge’s concept of the profes- j
sional midwife who is also a professional nurse, fully qualified and —
motivated to bring lifetime care to entire families. gi
Last year, the Frontier School became the first school in this  
country to have an endowed chair of nurse-midwifery, as a result of  
generous gifts from Miss Kate Ireland, FNS’ National Chairman,  
and Mrs. Jefferson Patterson, former FNS National Chairman, a  
second cousin of Mary Breckinridge’s and a long-time benefactor of  
FNS. Ruth Coates Beeman, dean and director ofthe Frontier School .
since January 1983, was named to the new chair. Mrs. Beeman has
devoted much of her substantial energy and experience to help p
bring about the new affiliation with Case Western Reserve. ‘°
The Frances Payne Bolton School of Nursing, which evolved
from a small training school, was established in Cleveland in 1923. A
It came into being as a result of a generous endowment from
Frances Payne Bolton. Mrs. Bolton was a friend of Mary Breckin- j
ridge’s and was an early benefactor ofthe Frontier Nursing Service.  
The FNS district clinic at Possum Bend was made possible by a gift Qi
from Mrs. Bolton, and when the clinic had to be closed because of g
the construction ofthe Buckhorn Dam, she generously consented to ,
the use of the condemnation proceeds for purchasing a house on `
Hospital Hill, Hyden. This building, known since then as the
Bolton House, is used as a residence for FNS staff. .

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l The Frontier School o  Midwifery and Family Nursing J
  Case Western Reserve University, of which the Bolton School is
  a part, was established in 1967 through the federation of Case
  Institute of Technology, which dates from 1880, and Western
  Reserve University, which was founded in 1926. The university has
an enrollment of about 8,500 students, about 5,000 of whom pursue
courses leading to graduate or professional degrees. The Frances
l Payne Bolton School is one of seven professional schools within the
’ University. Its dean is Dr. Joyce J. Fitzpatrick. Last fall, Nursing
Outlook published the results of a 1982 survey in which the deans of
i all accredited nursing schools in the United States, together with a
.' random sample of members of the Council of Nurse Researchers of
{ the American Nurses’ Association, were asked to rank the ten top
  baccalaureate nursing programs in this country. The 140 deans
lj who responded (out of 353 polled) ranked Case Western Reserve’s
Q school second in the United States. The Frontier School offers a
non-degree graduate program only and was not considered in the
survey. Both schools are widely esteemed for their high standards
» and their innovative approach to nursing education.
5 The linkage between the two schools is a result of two and a half
years of negotiation and hard work. Dean Beeman of the Frontier

School says that the first discussion of the concept took place at a ,
meeting in December 1982 attended by Eunice K. ("Kitty") Ernst, EF
Dr. Ruth Lubic, Dr. Anne Wasson, Christine Schenk, and herself.  
Dean Fitzpatrick of the Bolton School had previously discussed the  
idea with Christine Schenk (a member of both the CWRU faculty l
and the FNS National Nursing Council), and asked her to present it _
at that meeting. The proposal had immediate appeal, and the
committee turned enthusiastically to making plans to explore it in `i
depth. Mrs. Beeman discussed it with Kate Ireland at the first
opportunity, and it was not long until "wheels were beginning to J
spin." Mrs. Beeman, who had attended the December meeting as `
the prospective dean and director of the Frontier School, assumed
her new duties at FNS on January 3, 1983, and in February, she and
Kate Ireland met in Cleveland with Dr. Fitzpatrick and other ,
members of the Bolton faculty. From that time onward, plans for  
affiliation moved forward steadily to the goal that has now been  
A plan of this kind requires the working out of many details,   l
having to do with such matters as curricula, academic credits, l
course content, admission requirements, location and nature of ~
clinical experience, fees, administration, faculty credentials and .
responsibilities, and so on. Recruitment of qualified faculty was a
critical aspect of the affiliation. During these intervening two il
years, representatives of both schools maintained constant contact,  
at meetings, by phone, and by mail, to work out all of these issues. I
The entire plan, of course, required legal approval and the blessing  
of the two administrations. Ultimately, this led to the contractual i
arrangements that have now been formalized.   ·l
This important new development is symbolic of significant
changes that are taking place in education today. In the nursing
field, ever greater emphasis is being placed on raising the profes- °‘
sional standards required of nurses and on nurses’ need to continue l
to educate themselves over their working careers. The American |
Nurses’ Association now requires that any candidate wishing to sit   (
for its certification examination as a family nurse practitioner must §
have at least a BSN degree. The Frontier School has also made the
BSN a basic requirement for admission, in addition to very
substantial nursing experience. The class that entered FSMFN last
January was the first for which the BSN was a formal prerequisite.
. A

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l The Frances Payne Bolton School of Nursing,
F Case Western Reserve University, Cleveland
ly At the same time, there have been a number of changes in the
I; educational philosophy of nursing educators. It is increasingly
l recognized that candidates for graduate degrees bring to their
I educational programs very individual needs, aptitudes, and exper-
l ience, both in education and practice. They are assumed to be
{ motivated, responsible, and self—directed. Increasingly, educational
l authorities are creating programs that permit students to obtain
l their needed expertise "off-campus," especially through studies and
,, clinical experience at programs offered by other institutions. Such
y programs require a careful definition of objectives, together with
{ the establishment of controls and evaluation techniques designed
I ( to ensure that the objectives are being met. In addition to using FNS
l facilities, the Frontier School has for some time sent students to
? hospitals and birthing centers in various parts ofthe United States
in order to provide still richer and more varied clinical experience
for its nurse—midwifery students. The new affiliation develops this
concept further, to the advantage of the Frontier School and the
_ Bolton School, and of the many mothers and infants its graduates
; will serve.
or A

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The graduating class awaits the beginning of ceremonies  
The Frontier School of Midwifery and Family Nursing graduated I
its 95th class on Saturday morning, April 27. Traditionally, gradua— I
tion ceremonies take place on the Grassy Spot at Wendover, just
below Mary Breckinridge’s home, the Big House. However, heavy
rains fell on Leslie County during the morning, and it became
necessary to move the exercises to the Presbyterian Church in I
Hyden. I
The Frontier ·School is the oldest school of nurse-midwifery in I ;
continuous operation in this country. It prepares graduate-level I
nurses as family nurse—midwives, family nurse practitioners, or I
both. Graduates are qualified to sit for the certifying examinations I ,
given by the American College of Nurse-Midwives and the Ameri- I
can Nurses’ Association.
This year’s graduating class consisted of sixteen nurses, all of I
whom came to the school as registered nurses with several years of ·
nursing experience. Twelve of the graduates began the program in ‘
January 1984, while the other four entered with advanced standing
in September to complete the nurse-midwifery portion of the
curriculum. Of the sixteen graduates, fifteen completed all four of ;
the four-month trimesters that cover family nursing and nurse- 1
midwifery. The sixteenth chose the other basic option, which f

concentrates on the preparation of family nurse practitioners; this
option requires completing the first three trimesters.
The commencement address was given by Mrs. Diony Young,
well—known writer and consumer advocate on issues of childbirth
and maternity care. Mrs. Young, in a forceful speech that was
  greatly appreciated by her audience, concentrated on some of the
Q serious challenges facing today’s graduates, including the sweeping
advances of medical technology and the ominous problem of out-of-
control malpractice litigation. She drew from the writings and
  practice of Mary Breckinridge several principles that can provide
{ guidance in meeting these challenges. The first of four, all expressed
t in Mary Breckinridge’s words, was what she called Mrs. Breckin-
} ridge’s magic key: "Do it yourself." The other three were:
', First, "I also formed a habit, indispensable in new undertakings,
it oflearning all that I could about native customs so that new things I
I could be grafted onto the old." l
Q Second, "I gained a respect for facts — old and new — with the
knowledge that change is not brought about by theories."
And third: "It is wise to begin small, take root, and then grow."
From these principles, and from her own experience, Mrs. Young
offered two groups of specific points for guidance. In one series, she
defined areas in which nurses can provide support and care for
I women and families, through emotional support, teaching, and the
, establishment of trust. In the other group, she offered guidelines for
  solving the problems the graduates are likely to find as they move
{ , into their careers. She mentioned, among other things, the need to
I start slowly and solidly, to understand local problems before trying
i to deal with them, to enlist the support of key persons in the
, community, and to persevere in the face of difficulties. A fuller
account of these issues may be found in the complete text of Mrs.
-; Young’s address, which follows on page 11.
Following Mrs. Young’s address, Dean Ruth Coates Beeman of
_` the Frontier School presented the diplomas to the class. She also
Y made a number of scholarship awards to the graduates. These
awards were made possible by the generosity of the Daughters of
Colonial Wars, who have been faithful supporters ofFNS for many
p years. The recipients were Stephanie Stauber, Mary Mays, Sharon
Machan, Gere Perona, Ivy Kotovsky-Stearman (two awards), Holly
p Powell, Nancy Ritenour, and Janet Scoggin.

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5**  »   ;   .     .  
T Rosalinda Campbell, T Mary Dent,RN, Lux- ‘
RN, lmmokalee, Florida; emburg,Wisconsin; BSN,
ASN,Florida Keys Com- University 0f Michigan
munity College (1973); Schoolof Nursing (1979). ·
OB/GYN nurse practi- FNS diploma: family
ti0ner,University Hospi— Q nurse—midwife.
tal, jacksonville (1980).
FNS diploma: nurse-
l Sandra Founds, RN, i
Somerville, Massachu- —
setts; BA (Psychology),
State University of New {   S S
York at Genesco (1976);
BSN,Cornel| University, l Lucy Hosmer, RN,
New York Hospital Tempe, Arizona; BSN,
Schoolof Nursing (1979). Arizona State University ·
FNS diploma: family (1983). FNS diploma:
nurse—midwife. nurse-midwife.
·2*"°» T'? V   .·  
. is       " ~   ‘
lily   ‘   _ A , ;·;;   ( A
~     ( ,    Y. . A- ‘i’`      I- i L

· l Sharon Machan,RN,
5+.  V in , Detroit, Michigan; BSN, . B
ag'.,   ,  ; Wayne State University  
A C0llegeofNursing(197‘l). ’
, `     FNS diploma: family if ’: —
    Y`   nurse-midwife. .1  
}· ,,_t   r,r4     »··‘i   4 ‘
l . V 1   _.,.  
l     ‘ I _ ...v‘   `ii~i I .
I  lv   ,»v* '  1      `   ”   ·:;~   ,1;;  
    V.     It A -<3=L:-  ·=·s€¢!·'}-6—` ·=¥4. 
l l Ivy Kotovsl’ * I I . "I ;:$'~ 3_
  _, \   l janet P. Scoggin,RN, __    
  "°# ‘ · I_ "¥{» Tempe, Arizona; BSN, A
  I A .¢¢» » If    University of Portland 1 A A ' I, `i»_
  A I   ’'  ,   ¢;  · (Oregon) (1963); MS I;1   w F3;
~’i` (  ' ‘ ‘  W  g,  ·; (Maternal/Child Nurs-   4   (
;       ,, ing), Arizona State Uni-  I ·w;;   II -   I
it   versity(`l97'l).FNS(fl[)lO—   I i l
      ..,_ A ma: nurse-midwife. =  ;IA}§2 g (
  I J I I   , ) _,
l Holly Powell, RN,   l NancyRitenour,RN, l
Providence, Rhode Is-     if Pittsburgh,Pennsylvania;
land; diploma, Miami .     , __I Ip BSN, University of Pitts- _
Valley Hospital School g   ‘ `·· burgh(1976).FNSdipIo-
ofNursing(1972);Bach— I II   ·.   ma: family nurse—mid-
elor of General Studies, {QI; Q €$·=   wife.
Chaminade University of  (    
Honolulu, Hawaii (1975);   ·;·° I  
MSN and FNP, Medical          
College of Georgia I _ A
(1978). FNS diploma: —
II I l Coleen Wold, RN,
3.; A,  BSN, University of Min-
_ __,,i i " ._ nesota School of Nursing
l Stephanie Stauber,   (1979); MPH, University
RN,Bozeman,Montana; ·   of Minnesota School of `
BSN,MontanaStateIUni-       I Public Health Nursing
versity(1979).FN5drpI0-  ~-• ~; (1982). FNS diploma: '
ma: family nurse—mid· , i   family nurse practi-
wife.     ‘·~ tioner.
, ' . · { Yu ri,`,, i? iiii wi '’’>»\—i »     A
  ii I l Carla Stange, RN,     ZVV I  
    A A Berkeley, California:  Siii    
      , » . ADN, Merritt College V A  
. (1981). FNS diploma:    
,, ,A A V · __ I _ . family nurse—midwife. "
  ,` i` I   r·.·={’*‘.;`·,-_*
_ *  n    M I  _AI     , .4.   ,,

by Diony Young
[ Diony Young is a well-known consumer advocate and writer who has long
i been concerned with issues relating to childbirth and maternity care. She
` i is widely respected for her work with the International Childbirth
, Education Association. In recent years, she has been particularly active
i and forceful in organizing efforts to cope with problems arising from the
7 l explosive growth in malpractice litigation.
  M Following is the text of Mrs. Young’s address to the 95th graduating
g class of the Frontier School of Midwifery and Family Nursing, on April 27,
| 1985:
F I feel greatly honored to be here today — at this historic place where
midwifery has its roots in this country. I am especially happy to be
able to speak at your graduation and to congratulate you as 1
graduates of the Frontier School of Midwifery and Family Nursing.
You are leaving here to carry on the dream and work of Mary
Breckinridge, who with her "angels on horseback" achieved mira-
cles in bringing health to the mothers and babies of these hills.
As you know, this year is special — it is the 45th anniversary of
; this school, and the 60th anniversary of the founding of the
Kentucky Committee for Mothers and Babies, which became the
. Frontier Nursing Service. At its first organizational meeting on
. May 28, 1925, in Frankfort, Kentucky, Judge Edward O’Rear, in
opening the meeting, talked of the "sublime audacity" of creating
this new rural public health program} He felt sure of its success,
, and he was right.
But the frontiers of maternal and child health in 1925 were very
I different from the frontiers of maternal and child health today in
` ' 1985. And, as you leave here and spread out into the "wide
¤ neighborhoods" of the United States and beyond, you will probably
V find that you too will need a good measure of "sublime audacity" in
 A your new jobs and undertakings.
In 1952, Mary Breckinridge wrote her autobiography, and she
Q gave it the name Wide Neighborhoods} I read it a few weeks ago
because I wanted to feel what she felt and to understand her
V purpose and mission in establishing the Frontier Nursing Service. I
` thought perhaps I could find some insights and inspiration to pass
1 on to you as you leave here.

I came upon one guiding principle which I believe helped her [
carry out her dream and work. When she was a child, she had a l
favorite old book, written in the l880’s, which was called From  
Do—Nothing Hall to Happy—Day House.? The story told about a  
magic key called "Do it yourself." It was with this magic key that '
she created what has now become a strong and vital school and I
program of family—centered primary health care. 3
She followed a second important principle as well when she
started out in this community: "I also formed a habit, indispensable
in new undertakings, of learning all that I could about native ,»
customs so that new things could be grafted onto the old.""
And there was a third principle which she firmly believed in and
followed. Again I quote from her autobiography: "I gained a respect Q
for facts —— old and new — with the knowledge that change is not  
brought about by theories."1  
These principles are as valuable and valid today as they were in ’
the 1920’s. We all need to remember and follow them as we work on  
new ventures and progressive change in public health. i
But the major message throughout her book was her overwhelm-
ing commitment to bring compassionate and skilled care to
children, women, and families. And although many of the health
care problems of the 1920’s were very different from the health care }
problems that face you in the 1980’s, one thing has not changed
—that is what childbearing women want and need from the health
professionals who look after them during pregnancy, birth, and in F
the months afterwards. Women want basically to receive com-
passionate and personalized care and to be treated with respect and l ,
dignity. Parents want the same care for their children. In fact, these  
are fundamental human needs that we all want and should expect l
from our health care providers. From the very beginning, these M
elements have been an essential part of the philosophy and care
given by the midwives and nurses of the Frontier Nursing Service.
The challenges and hardships that Mary Breckinridge and her .
midwives faced and overcame were "awesome" indeed — the
physical barriers of a rugged and roadless country; the constant ·
specter of suffering, disease, and death; the frustrating problems
with water, sewage, landslides, and no electricity; the threat of
natural disasters; and even a troublesome local rumor that the new
midwives were witches who turned boy babies into little bears!]

I The challenges and hardships you face in your practices today
i will be very different from these. You will find that most of them
I come from within the health care system itself — a health care
, which is changing so rapidly that it’s almost impossible to keep up
I with it. You will, like Mary Breckinridge, need every ounce of
determination, stamina, and commitment that you have. And in
_ addition to giving women the skilled care that you have learned
° here, you will especially need to find out the many ways to turn the
magic key, "Do it yourself." You will also need to be aware in your
A undertakings that there are always those who stand ready, waiting,
and hoping for new ventures to fail and for newcomers to make a
I Over the past 60 years, maternal and newborn health care has
3 progressed to an extraordinary degree, and the woman- and family-
  centered care of today can trace its foundations to the Frontier [
  Nursing Service, the Maternity Center Association in New York
l City, and the pioneer midwives and nurses of the day.
  Paralleling the development of family-centered care, especially
l in the past 15 years, have been the tremendous advances of medical
l technology, which have contributed so much to reduce disease and
l death among mothers and children today. But as you leave here
* and go into practice around the country, you will find that
l increasingly the essential human elements of family-centered care
I are coming into conflict with the brave new world of technology.3
Maternity care is becoming more and more specialized at the
l expense of primary health care. Childbirth as a normal physiologi-
  cal process is being turned into a complicated medical and surgical
l ° event. Already, one woman in five gives birth by cesarean section in
  the United States, over 60 percent of women receive one or more
  A ultrasound scans during pregnancy, and the majority of women are
‘ i now attached to an electronic fetal monitor during labor, to mention
only a few of the many procedures which have become a major part
of clinical practice. Indeed, if you think about it, more and more
people enter the world hooked up to tubes and machines, and they
leave the world hooked up to tubes and machines.
I One of the great concerns of parents and consumer advocates is
that scientific evidence has not demonstrated the benefits of many
of these procedures on healthy women and babies!

   at lj          _
»,AV   I    V g
  ..  I     VV . ;  I Diony Young speaks to the
*       .4 »-··   _      , A _ _ graduatesandtheirfamilies, V
 W,   » . K V   as the Frontier School of
    y V . ` Midwifery and Family Nurs-
  va   ;  ,_V`` _ M   _ V ing graduates its 95th class
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