xt7sf7665f2s https://exploreuk.uky.edu/dips/xt7sf7665f2s/data/mets.xml The Frontier Nursing Service, Inc. 2002 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. 77, No. 3, Winter/March 2002 text Frontier Nursing Service, Vol. 77, No. 3, Winter/March 2002 2002 2014 true xt7sf7665f2s section xt7sf7665f2s FRONTIER NURSING SERVICE  
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 US ISSN 0016-2116
Introduction to FNS - Deanna Severance 1
Beyond the Mountains - Deanna Severance 3
New Clinic Needs - Barb Gibson 9
Wendover News - Christine Collins 10
Photography Identification Project Update - Barb Gibson 12
Dr. Anne Wasson Memorial - Barb Gibson 12
FSMFN News - Di: Susan Stone 13
Website Information 14
Courier Program News - Barb Gibson 15
Courier Experience - Christina Hawkins 16
Mary Breckinridge Healthcare News - Maile Noble 18
Miscellaneous Tidbits 21
ln Memoriam 25
Cover: Mary Breckinridge (middle) with two Couriers. Left -
Wrginia Branham and right, Jane Clark.
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 77 Number 3 Winter/March 2002 i
Periodicals postage paid at Wendover, Kentucky 41775 and at addi-
tional mailing offices. POSTMASTER: Send address changes to FNS, '
lnc. 132 FNS Drive, Wendover, Kentucky. Copyright FNS/Inc. 2000
All Rights Reserved.

Frontier Nursing Service
Kyou have never been intr0duced t0 the Frontier Nurs-
ing Service we would like t0 take this 0pp0rtunity t0 brief you 0n
the history and the 0n-going w0rk 0f the Service. Please share
, this information with a jriend.
Bom in 1881 into a prominent American family, Mary
Breckinridge spent her early years in many parts of the world -
Russia, France, Switzerland and the British Isles. After the death
of her two children, she abandoned the homebound life expected
of women of her class to devote herself to the service of others,
particularly children.
Mrs. Breckinridge established the Frontier Nursing Ser-
vice (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 modern healthcare to fami-
lies throughout an area of 700 square miles.
Until her death in 1965, Mary Breckinridge was the driv-
ing force behind the work of the Service whose influence today
extends far beyond eastern Kentucky. Through the Frontier School
of Midwifery and Family Nursing, hundreds of nurses have been
trained and this important concept of family healthcare has been
carried throughout the world.
Today, the FNS is organized as a parent holding company
for Mary Breckinridge Healthcare, Inc., (home health agency, two
out-post clinics, one primary care clinic in the hospital, Kate Ire-
land Women’s Healthcare Clinic) and for the Frontier School of
Midwifery and Family Nursing - the largest midwifery program in
, the United States.
Remarkably, the purpose and philosophy of the FNS has
remained constant since 1925. -Deanna Severance, CEO

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The Big House - Home of Mary Breckinridge  

, Beyond the Mountains
; by Deanna Severance, CEO
  “My interest is in the fixture because I am going to spend the rest
  of my life there.” Charles F. Kettering
  The FNS Board of Govemors is -
l establishing a comprehensive strategic ·
i plan to guide our future operations. In _ . pk;. ‘
  Wide Neighborhoods Mary Breckinridge »:   g _:
* wrote, "Research is a continuing thing. · if
I As one acts, one gets an insight of what rw  
J is best for the next action." (Chapter l7, _ pg
K II, paragraph l) ln the last Quarterly K 
Bulletin I wrote that we engaged the firm of Tichenor and Associ-
ates for data collection in the six eastern Kentucky counties of
l Bell, Clay, Leslie, Jackson, Owsley and Laurel. Global Business
Solutions was engaged to hold focus groups with community mem-
l bers in these same counties. I will dedicate space in these next
l issues of the Bulletin to publish the findings.
  During Mary Breckinridge’s study of the Scottish High-
  lands health care system in the Outer Hebrides, she witnessed first
l hand the high quality of care given by certified nurse-midwives,
l the advanced practice nurses of that age. Today the Frontier Nurs-
` ing Service continues to promote health care to women, children
and families in rural and underserved areas of the United States
through the graduates of our Frontier School of Midwifery and
l Family Nursing. Additionally, we continue to provide care in three
i rural clinics in Leslie County, Kentucky, and in one rural clinic in
l Clay County, Kentucky. The Board is addressing these strategic
questions: l) Do the healthcare data demonstrate need for addi-
tional healthcare in our region of Appalachia? 2) lf the population
U characteristics and healthcare trends demonstrate a need, will it be
financially possible to sustain expanded services in this area? 3)
, I Will state and federal regulatory requirements support expansion?
I 4) Do the community people perceive a need for expanded ser-
_ vice? and 5) Will advanced practice nurses be desired and wel-
. comed by the community?

The following information represents the population char-
acteristics of the counties in our immediate region. As one con-
sultant told us "Think of this as an aerial view. The focus groups _
will give us information ‘on the ground’ ".
Counties Population Age 0-I9 Age 20-34 Age 35-54 Age 55-64 Age 65+
Bell 30.060 27% 20% 29% 10% 14%
Clay 24,556 28% 23% 30% 9% 10%
Jackson 13,495 29% 21% 29% 10% 12%
Laurel 52,715 28% 21% 30% 10% 1 1% .
Leslie 12,401 27% 21% 32% 9% 11% ;
Owsley 4,858 27% 18% 28% 11% 15%
Kentucky 4,041,469 31% 21% 29% 9% 13% ,
US 281,421,903 29% 21% 29/% 9% 13%
This age data mirrors the Kentucky and United States data.
Many rural communities are experiencing aging. Only Bell and
Owsley have rates higher than the state and national average.
Counties Gender Race distribution
Bell 52% male 96% white
Clay 53% male 93% white `
Jackson 59% male 99% white
Laurel 59% male 97% white
Leslie 51% female 99% white
Owsley 52% female 99% white
Kentucky 51% female 91% white ;
US 5 1% female 77% white .
Four of the six counties have a higher percentage of males  
than the national and state averages. At this time we have no  
information to explain this data, but there are implications for plan-  
ning health programs serving a male population in these counties.  
32.3% of poor males are without health insurance. i
Counties Median Household lncorne Unempl0y@t rate % below mvegty Q
Bell $19,896 7.9% 29.5 , .,
Clay $19,231 5.4% 33.78  
Jackson $18,503 5.3% 30.8  
Laurel $27,146 4.6% 20.7 f
Leslie $20,757 4.4% 30.6 l .
Owsley $14,392 5.5% 40.9 l
Kentucky $37,186 4.1% 15.9 1
US $42,148 4.0% 13.3 ‘

Owsley County is the poorest county in the United States.
However, all the counties have a disproportionate share of resi-
_ dents living below the national poverty level.
Education levels (percent of persons 25+)
Counties 9*; Some _1;1SQ Some Associates Bachelors Graduate
High School College
Bell 33.5% 19.9% 26.1% 9,4% 2.0% 5.0% 4.3%
y Clay 53.5 17.7 22.6 7.2 1.6 3.6 3.8
· Jackson 43.6 18.1 25.2 6.5 1.7 2.9 2,0
` Laurel 27.6 19.8 30.4 11.3 2.7 4.9 3.3
I Leslie 38.0 21.6 24.6 7.9 1.4 2.8 3.8
` Owsley 49.1 15.4 18.9 6.2 0.7 4.7 5.1
Kentucky 11.5 13.7 34.6 18.0 4.6 10.3 6.8
US 6,9 11.4 29.5 20.5 6.4 16.0 8.9
These education statistics are the most conceming of all
the data. Does one question not follow the other? lf the majority
1 of the population greater than 25 years of age do not complete
high school, can it not be expected that low income, unemploy-
J ment, poverty and poor health outcome data will follow?
Of the population 25 years and older who have not com-
pleted high school the data is 53.4% in Bell county, 71.2% in Clay
county, 61.7% in Jackson county; 47.7% in Laurel county, 59.6%
: in Leslie, 64.5% in Owsley, 25.2% in Kentucky and 18.3% in the
  United States,
  Of the population 25 years and older the number who have
f some college or greater is 20.7% in Bell county, 15.4% in Clay
  county, 13.1% in Jackson county, 22.2% in Laurel county, 15.9%
{ in Leslie county, 16.7% in Owsley county, 39,7% in Kentucky,
  and 51.8% in the United States.
l Provider Data Population Enrollment Data
1 Counties Hospitals Physicians CNM/FNP Medicare Medicaid
Bell 2 25 2 21% 33%
  Clay 1 5 7 15 36
1 Jackson 0 3 9 16 28
l Laurel 1 24 6 14 22
x Leslie 1 5 13 19 33
l I Owsley 0 3 0 22 49
I Kentucky 15 14
~ US 13 12

The Medicare enrollment data is slightly higher than the
Kentucky and United States average enrollment. The Medicaid
enrollment is two to three times greater than the United States. _
This is not surprising in view ofthe household income, unemploy-
ment and poverty data.
In the United States 86% of the population have some .
insurance. In Kentucky 87% of the population have some insur- ,
ance. In these six counties an estimated 73% to 77% have insur- ;
ance with a disproportionate share of that insurance Medicaid and j
In the United States 14% of the total population is unin-  
sured. In Kentucky 13% is uninsured. Regionally, 15.8% of the  
population in the South is uninsured. In households with incomes I
less than $25,000, 22.7% are uninsured. In populations without a  
high school diploma 26.6% are uninsured, and 36.5% of poor people 1
with no high school diploma are without health insurance. Using  
the Medicare and Medicaid enrollment and estimates for the unin-
sured in these counties, the insured population appears to be be-  
tween 22% (30,3 72 people) and 26% (35,894 people). These six  
counties may represent as much as 6% of the uninsured in Ken- i
tucky. This data raises many questions relating to health care 1
access and financing care for this population. 1
Delivery and Birth Data 1995-1999  
Counties Live Binhs(2000) Prenatal care lg @1 <2500 ggams <2O yr old Unmarried  
Bell 358 86% 8% 22% 29% s
Clay 302 83% 10% 23% 25%  
Jackson 181 84% 7% 21% 22%  
Laurel 744 81% 10% 20% 25% i
Leslie 163 86% 10% 20% 25% 2
Owsley 58 77% 10% 24% 28%
Kentucky 54,403 86% 8% 16% 30% {
US 3,957,829 83.2% 8% 12.2% 33%  
I am quoting from a "KIDS COUNT" press release; "There § `
is a strong correlation between financial security and child well  
being. Oldham county and other wealthier areas in Kentucky have l
lower child poverty rates, food stamp usage, and participation in 11
free or reduced price school lunches. The reverse is true for Owsley
County and other impoverished counties. The trends for children

in these areas appear to be toward more difficult conditions. These
trends translate to higher number of high school dropouts, teen
pregnancies, and fewer supports for helping young children thrive.
‘ These children start out behind their peers in wealthier counties.
While Kentucky has improved on several child well-being indica-
tors, the report found that Kentucky’s newborns still face signifi-
` cant obstacles. Since 1990, Kentucky’s rate of low birth—weight
1 babies has increased from 7% to 8%. The rate of children born to
  umnarried mothers also increased fiom 22% to 30 % over the last
; decade, meaning that almost one in three babies is bom to an un-
married mother. We know that children of umnarried mothers are
  twice as likely to grow up in poverty as are other children. We
1 also know that child support collection, a proven strategy to re-
, duce child poverty, is made more difficult when parents were not
. married."
l Women’s Healthcare (percentage of females 18+)
Counties Pap Smears
g Bell 15%
{ Clay 4%
Q Jackson 4%
Laurel 13%
Leslie 12%
Owsley 14%
  These statistics may indicate the low numbers of women
j seeking preventive care. The 2000 nation’s health objective was
  to increase to at least 85% women over the age of 18 with an intact
{ uterine cervix who have had a Pap smear in the last two years.
i Death Data 1999 National Center for Prevention and Contml
1 Counties Heart Disease Breast Cancer Lung Cancer Cerebrovascular Disease
l Bell 36% 2% 11% 4%
  Clay 30% 0% 7% 9%
g _ Jackson 26% 2% 12% 8%
  Laurel 34% 2% 7% 6%
? Leslie 30% 2% 7% 4%
  Owsley 28% 4% 8% 10%
I. Kentucky 31% 7%
Q us 31% 7%

Diabetes Unintentional* _l»% gg Homicide
Bell 2% 4% 3% 2% 0.3%
Clay 2% 9% 6% 1% 2.4%
Jackson 3% 6% 4% 1% 0.7% _
Laurel 2% 4% 3% 1% 2.0%
Leslie 4% 7% 1% 0% 0.9%
Owsley 3% 7% 3% 3% 0.0%
Kentucky 3% 4% .
Us 3% 4% 1%
Lung cancer is the leading cause of cancer deaths in women  
today. Breast cancer is the second. The key to surviving any i
cancer is early detection and treatment. The tools are available in .
these counties. The challenge is education of the population for T
self-screening, education for stop smoking, and increased screen-
ing mammograms. p
Unintentional injury includes fires, falls, drowning, and l
firearms. The data for these counties is higher than the state and
national average. In 1999 4% of all unintentional injury deaths
occurred in the 1 -— 14 year age group. 33% occurred in the 65+ I
age group.
As a Board we recognize that the operation of a hospital j
in today’s environment requires the employment of many people
who have a high degree of knowledge about the federal and state .
rules, regulations and reimbursement policies. Unfortunately, be-  
cause our numbers are too small and our patients are underinsured  
we cannot aiford the management team necessary to compete in  
this environment. Therefore we are seeking a management part- l
nership with a larger hospital organization whose mission approxi- l
mates that of the FNS. Our strategic objective is to ensure that  
our hospital survives, supporting the healthcare and economic sta- E
bility of Leslie County, Kentucky. Q
As you read this part of the report I know you will see as  
I do the great challenges facing health care providers in these coun- A
ties. In the next Quarterly Bulletin I will share with you the com- I `
ments from the participants of the focus groups. I would love to l
receive your comments on our strategic study and planning!  

New Clinic Needs
During July 2001, we were informed by the Office of the
V Inspector General for Medicaid Services that the Kate Ireland
Women’s Clinic and the Hyden Clinic could not reside in the same
V facility. Currently, both clinics are located within the Mary Breck-
inridge Hospital. Therefore, we would have to move or close the
Kate Ireland Women’s Clinic. A decision was made to open a new
I Kate Ireland Healthcare Center in Manchester, Kentucky. Reno-
vations are well under way and we expect to open April l, 2002.
Listed below are some of the "urgent needs" for the Clinic. lf you
I wish to contribute to this project please specify on your gift that it
is restricted for the new Kate Ireland Healthcare Clinic or the new
clinic in Manchester. Thank you for your support!
Exam tables, otoscopes, ophthalmascopes, stethoscopes, blood
pressure cuffs, microcsope, centrifuge, nebulizer, oxygen equip-
ment, EKG machine, glucose testing machine, hemoglobin ma-
chine, baby scales, adult scales, 02 sat monitor, exam table lights.
I 7 Q   \\4 _   .g"   Ni ri 4 IJ-    V V     f"{`{`\\  
» / . WQQ a ` L   ;.,      T QX 
? ·.   ;_·—:»$•¤ rg; f 
T I ;*T.<"*§t'?":.‘%i..*’!.‘l’*3?¥ 
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  ’· · °£?i»€•,.§ " `   ._  
i , .   if "   »_  #4- - All .  j rtt;
,_ _  ·-  &;<    g p  it  T\ _y¢. v_   U, I .   gl _
  The site f0r the Kate Ireland Healthcare Center in Manchester;

Wendover News  
by Christine Collins
We’ve had a mild winter with l
confusing temperatures. Flowers and
bulbs were blooming in December and _  _
December 14, we had our em-      
ployee Christmas "White Elephant”   ""  
party which brought a lot of fun and     I
laughter. Also, during December, toys ‘
were distributed at the out-post clinics for all the children. Thanks 2
to the DCWs and Jerry Santini for supplying the toys.
We are looking forward to spring and have lots of work .
plamied with our flower gardens. We anxiously await the budding ‘
of the beautiful redbuds and dogwoods. As always, we extend to
you an invitation to visit our Bed and Breakfast! I
We have entertained/hosted the following guests and func- p
tions since the last report:
Dec. I Bemiie Hoppius. Petersburg, Kentucky; Pat
Rice, Florence, Kentucky; and Evelyn Mosley, I
I Hebron, Kentucky. J
Dec. 14 Annual Employee Christmas Luncheon with  
Wendover and Lexington Oiiice staff  
Dec. 22 Mr. & Mrs. Bob Joyce, Louisville, Kentucky.  
Dec. 28, 29 Carolyn and Ed Morgan and Pauletta Biscoe,  
Comiersville, Indiana.  
Jan. 3, 4 Karen Dorse, Lithonia, Georgia. FNP interview.  
Jan. 23 Dr. Robert Schiavone, Louisville, Kentucky.  

K Jan. 25, 26 Wvien Jutsum, Kenmare, North Dakota, FNP
Feb. l2 CNEP and CFNP Level Ill dimer (8 students!
Feb. 13 Heidi Froemke, FNP and FNP Coordinator;
L Dr. Julie Marfell, Chairperson of Family
L Nursing Program; and three guests for lunch.
8 Mar. l Team Management Meeting luncheon.
4 Tours
November 20 Berea College, Berea, Kentucky. 18
November 27 Carson Newman College, Jelferson City,
Tennessee. l3 students/faculty.
November 29 Hayes Lewis Elementary School,
  Yeaddiss, Kentucky. l3 students.
  November 30 Hayes Lewis Elementary School,
r Yeaddiss, Kentucky. l7 students.
  February l Clay County Extension Office, Man-
* chester, Kentucky. Two guests.
  - February l8 Rebecca Herr, Red Bird Clinic, Beverly,
¥ Kentucky.

Bed & Breakfast Comments
"My stay at the Big House was the highlight of my stay in ,,
Hyden! The history and background of this home will never be
forgotten. The breakfast was outstanding prepared by the lovely
women. I have travelled the world over and never experienced the .
kindness showed to me at the Big House". -Dr: Robert Schiavone
Photograph Identification Project Update
Thanks to former nurses, alumni, couriers and staff the
Photograph Identification Project was a great success! 95 photos
were printed in a special bulletin and we received 47 positive iden-
tifications. We received several more "partial identifications" mean-
ing one or two people were identified but not all. We hope to repeat
this project in a few months. Thanks again for all of your help!
-Barb Gibson
Dr: Anne Wasson Memorial Service
A Memorial Service will be held in Dr. Anne’s memory
Friday, May 3, 2002 at 12:00 noon. The Service will be held in the
Dr. Anne Wasson Classroom located in Aunt Hattie’s Bam upon
Hospital Hill. Refreshments will be served. If you plan to attend
please respond by April 26, 2002 to Barb Gibson or Christine
Collins, 132 FNS Drive, Wendover, Kentucky 41775, 606-672-
2317 or e-mail barbgibson2000@yahoo.com. °

Frontier School of Midwifery and Family Nursing News
Susan Stone, DNSc, CNM
FSMFN President and Dean
Our school is as busy as ever ed-
ucating the nurse—midwives and nurse- __ ;
` practitioners of the future. I am very    
proud to report that I received my Doctor j    y-  
of Nursing Science from the University f  _I`   A  - I  _
of Tennessee at Memphis on December 7, A  .     W _
200l. It was a very exciting day. I am so F .t
happy to have finished so I can again focus my full time energy
on the School.
Our major emphasis is on achieving regional accredita-
tion as a graduate degree granting institution. Many states are now
requiring the masters degree in order for our graduates to be li-
censed. We cuirently offer a masters degree in nursing through our
affiliation with Case Western Reserve University. This is a won-
derful option for many students but for our students who live far
from Cleveland, this is a barrier. We currently have students in
Germany, Alaska, Japan, Canada and across the United States.
Once we have achieved accreditation, we will be able to offer them
the masters degree without requiring two trips to Cleveland. Ac-
creditation is a long process. We must first graduate a group of
students, achieve candidacy and then complete a detailed self-study.
We expect the process to take at least three more years. Time moves
forward and we will continue to step our way through this pro-
» cess.
Our students come to Frontier and stay in the Haggin
Dormitory for a two-week session before starting their clinical
experience. During the last three years, each group has adopted a
dormitory room, repainted and decorated it. It has provided such
n an improvement in the look of our dormitory. Each room has a
I theme. In the historic room, the students actually rented horses
y and had their picture taken in a semi circle similar to the famous
j Thanksgiving photo ofthe nurses on horseback. Both pictures deco-
rate this room. We also have the Moon Bow Room, Womb Room

(which is the second floor lounge), Hand Room (which has the
students handprints as a border), Purple Room, Play Room (adomed
with hula hoops), Lady Bug Room, Baby Feet Room and many
others. I want to express our great appreciation to all of the stu- u
dents who worked hard to make our dormitory look so beautiful.
The big news this coming spring is the library relocation 5
and renovation. We needed more space for our library and com-
puter lab. We have decided to move these important student areas I
to Aunt Hattie’s Barn. We already have the Dr. Anne Wasson Class-
room located in the Barn. We now plan to renovate the rest of the
space in the Bam for student use. More on this project in coming
issues as the plans unfold.
Frontier Nursing Service - www.frontiemursing.org
Community-Based Nurse—Midwifery Education Program (CNEP)
— www.midwives.org
Community-Based Nurse-Practitioner Program
(CFNP) — www.frontierfnp.org
SME - L E-

Courier Program News
-Barb Gibson
The Courier Program has been   I 1   ··
restructured to provide better services     ,
, to the communities and to be more re-   ‘  
warding to our Couriers. The future   F ‘
~ . . . .   J *·?&•r» V  
F Couriers will be working in out—post   Fi `__, _ _ _ .·
I clinics assisting with patient follow-up; "   r~ ‘’   ' if -‘
picking up prescriptions for patients   7
who don’t have transportation; office I `~/·` A
duties; transporting mail/supplies to different clinics and assisting
with health prevention programs. Couriers will experience work-
ing in a rural healthcare environment and may be able to shadow
advanced nurse-practitioners. We are excited about the new possi-
bilities and are looking forward to new Couriers!
Former Courier News
Sonja Herbert (‘91), Albany, California, wrote, "Greet-
ings from Califomia. It’s been ten years after my Courier days and
I still dream of retuming to those Kentucky Hills"!
Kate Layman (‘95), Tampa, Florida, wrote that she is a
I traveling nurse in Colorado. She still has her sights on midwifery
with a little medical anthropology thrown in.
i Fred Jordan (‘90) called Deanna Severance to say that
° his wife is pregnant. Congratulations Mr. & Mrs. Jordan!
i, Jennyer Swisher (‘98) wrote that she is finishing up her
4th year of medical school and will graduate in June. She starts
her Family Practice Residency July I.
L   It I the

Courier Experience
Excerpts from the book entitled My False Impressions K
by Christina Ekengren Hawkins
. . . Footloose and fancy free, I was persuaded by my ,
friend, Marian Shouse, to offer as courier for the Frontier Nursing
Service in Kentucky. `
. . . I volunteered as a courier and departed in September
on a tiresome train joumey of seven hours. I was met in Lexington
by two members of the FNS staff and in the ladies’ room of the
station was told to change into riding clothes as the last part ofthe
drive over the mountains would be on horseback. We bumped over
country roads and at dusk arrived at Hyden. There we mounted
and rode the last hour in darkness to Wendover.
. . . Mrs. Breckinridge and some members of her staff
lived in the Big House where we ate our meals and, if time al-
lowed, relaxed in the lounge. Here I met the other courier, Dorothy
Caldwell, who knew the ropes and, most important, knew the coun-
. . . Breakfast at seven. Dorothy introduced me to the ten
, horses and all the tack (bridles and saddles) for which we were
responsible. Our days were filled with errands as emergencies arose.
I latched onto a young gelding with a smooth single foot gait, that
I rarely used a saddle. There were four outpost, or clinics, in the
surrounding mountains and no roads.
. . . There were always babies about to be born in the little
log cabins. The midwives visited the mothers at intervals, and, if
possible, the women would go to the hospital at Hyden for deliv-
ery. But usually the husband appeared at Wendover to give the
alarm. One night at 1:00 am, a prospective father arrived to sum-
mon help. I was roused,jumped into blue jeans, and fumbled in the ,,
dark stable to get two horses ready. The midwife and I rode off
under a full moon to the little cabin some miles distant.
. . . There in a huge wooden structure resembling a bed
lay the mother on a sheet covering a mattress of loose straw. The
midwife was laying out her implements and encouraging the

patient who hardly let out a peep in her obvious travail. I was told
to sit on the side of the bed and grasp her hand while she put her
foot on my shoulder and pushed mightily. I thought my arm would
t fly away from my body. This went on for some time. Finally, at
dawn the baby’s head appeared, then the rest of it, and the mother_
had a son. He was washed in a basin, and a solution dropped into
` each eye. We wrapped him in a blanket the mother had made and
put him in her arms. I was stumied by this miracle and thankful for
having witnessed life’s creation. I stumbled out to fetch the horses,
and we rode back to Wendover for breakfast. I haven’t been the
same since.
. . . One evening all of us from Wendover were invited to
a barn dance. It took place about a mile up the mountainside in a
cabin. We rode up, two to a horse. The music consisted of several
fiddles, well played, and a mouth organ. Having never attended a
square dance, I was pushed and pulled into various intricate fig-
ures and shown how to shuffle from one partner to another. The
pace was fast, the noise overwhelming, the com liquor flowed,
and everyone had a super time, bathed in perspiration. At last we
sagged on the horses’s backs and slithered down the mountain.
. . . My six weeks as a courier came to an end, and I was
sorry to leave that beautiful place but grateful to have taken part
in the lives of the mountain people.

Mary Breckinridge Healthcare, Inc. News
by Mollie Noble, Administrator
Mary Breckinridge Healthcare, Inc., " ` __
as well as other small rural hospitals, is ex- t f A I ~i.
periencing hard times with persistent change      » ‘
in the healthcare industry. Despite increasing  ` ’ W,     i , if
costs of drugs and pharmaceuticals, medical ,  "     V
supplies, equipment, a critical shortage of A    i
healthcare workers and constant changes in   I iini
reimbursement, we continue to operate. Change is hard. However,
the staff at MBHC, Inc. look eagerly toward the future with great
expectation. We continue to complete the dedication in the mission
of our Founder, Mary Breckinridge. I
Employee Awards Dinner V
The annual Employee Awards Dinner was held in the Big p
House at Wendover on Thursday, December 6, 2001, hosted by T
Dearma Severance, CEO, Beulah Couch, Director of Human Re- ~
sources and me. Congratulations to the following employees who
received awards for years of service: Michelle Roberts, Helen A
Begley, Kendra R. Bush, Tracie Cook, Mary Day, Tammy L. ‘
Feltner, Hargis Henson, Karen Sallee, Linda Sizemore, Christo-
pher Williams, Misty Woods, Vivian Boyer, Mary Gillmor, Marcia ,
Hanks, Robin Jordan, Amy Marowitz, Kathryn Osbome, Marianne .
L. Towler, Bettty Sue Wells, Teresa Dixon, Barb Gibson, Ethel
Mae Caldwell, Eunice K. M. Emst, Kerri Dumell Schuiling, Deloris
Sparks, Juanita Sizemore, Christine Collins, Jeanette Woods, Betty
H. Couch and Juanita B. Johnson.
Sick Time Reward Winners
Sick Time Rewards is a way for the Board of Governors ·
and the management of FNS to show their appreciation to those
employees who have good attendance during the calendar year.
This year the Sick Rewards were presented on Friday, February 8,
in the Mary Breckinridge Hospital cafeteria. Congratulations to
the following employees who received Awards:

William Caldwell, Pamela Napier, Deanna Adams and
Patrick Gentry received $500; Sherry Davis, Teresa Dixon and
_ Polly Napier received two additional vacation days; Tonya Carter,
A Juanita Johnson, Ora Kay Osbome, Opha Combs and Melissa
Joseph received $100; and Robert Phipps, Tonya Feltner, Robert
_ Howard, Vanesa Melton and Martha Bailey received one addi-
tional vacation day.
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