xt7dfn10q97t https://exploreuk.uky.edu/dips/xt7dfn10q97t/data/mets.xml The Frontier Nursing Service, Inc. 1987 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. 62, No. 3, Winter 1987 text Frontier Nursing Service Quarterly Bulletin, Vol. 62, No. 3, Winter 1987 1987 2014 true xt7dfn10q97t section xt7dfn10q97t v~\JRS1~
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In Memomam
Miss HELEN E. BROWNE, C.B.E.

 US ISSN 0016-2116
TABLE OF CONTENTS
A Life of Service: Miss Helen E. Browne, C.B.E. 1
Ode To The Faded Blue — by Edward A. Mattingly 4 ._
A Traditional Navajo Medicine Woman Ll
A Modern Nurse—Midwife  
Healing in Harmony — by Debra Goldstein, CNM 6  
The Kate Ireland Women’s HealthCare Center Ai
Quality Care for Women, by Women 14  
School Notes — by Ruth Beeman 17  
Introducing Heidi Sulis and Nancy Clark 18  
An Urban Physician Finds Rural Medicine  
a Rewarding and Personal Experience — lt
by Paul Diamond, M.D. 23 [_
Frontier School Welcomes 98th Class 26 l'
In Memoriam 29 j
Memorial Gifts 30 l;
Beyond the Mountians — by Ron Hallman 32 4
Courier News - Edited by Elizabeth Wilcox 33 ;`
Alumni News — Edited by Alice Whitman 33 l
Field Notes — by Elizabeth Wilcox 36 y
Form of Bequest 37 l
Urgent Needs Inside Back Cover
Staff Opportunities Inside Back Cover
Cover: Miss Helen E. Browne, C.B.E., former Director and Honorary Member of the  
Frontier Nursing Service Board of Governors. We dedicate this issue to her memory and y
exemplary life of service.
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After receiving the insignia of an Officer of the Most Excellent Order of the British ,
Empire (OBE) in 1964, Helen E. Browne is greeted by the Queen Mother on the grounds
of Buckingham Palace. ln 1976, Browne received the CBE, a higher honor.  

 1
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i
Y QUARTERLY BULLETIN 3
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I Helen E. Browne receiving an Honorary Doctorate Degree in Nursing from Eastern
[ Kentucky University (1976).
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ji Browne and two couriers by the cabin at Wendover (1966),
 \

 L 
4 FRONTIER NURSING SERVICE  
Ed Mattingly says his association with the Frontier Nursing Service
began at his birth since he was delivered by an FNS nurse—midwife. He {
has been actively involved with the organization — "helping out in one I I
way or another" — for 34 years. He presently serves as a member of the il
FNS Board of Governors. Mr. Mattingly is the Executive Vice President fi
and General Manager of the Leslie County Telephone Company, Inc. ~
The poem that follows was written many years ago and recently
rediscovered by Mr. Mattingly among some old papers. It is with a great Q,
deal of pleasure that we share it here with you.
* * * * *  
A number of years ago I visited the tiny FNS Cemetery, at R
Wendover, Ky. As I looked at the names on the headstones and Q
read of the far-off places from which they had come I was deeply Q
touched.  
They not only chose to work in the Mountains, while they lived, ij
but to remain in the Mountains, when they died. And, just  
perhaps, that is the most sincere expression of love.
The following was written a short time after the visit and I ¢
share it with you not from any sense of vanity, but simply because ,
it was and is the way I feel, and because the kinship of thought is [
universal.  
* * * * *  
I
Ode to the Faded Blue L
"She considereth a field, and buyeth it; with the fruit of her
hands she planteth a vineyard." _
Proverbs 31-16 .
The fence has long ago given up being new ;..
and the aged gate hangs unevenly on rusty hinges.  
The giant trees stand i A
eternal against an azure sky.
Upon the earth fallen leaves  ,
form a blanket over those who lie in _
endless sleep. I
This place is most quiet, as if sheltered ‘
by the very hand of God. _;

 L 
 i QUARTERLY BULLETIN 5
At the bottom of the hill,
; where the ancient Elms grow.
gi The mighty river runs and bubbles
ll and slides, on its way to the
il Great Grey Waste.
= But here only a soft murmur is heard.
" As if the river in all of it’s power
was mindful
lvl of this tiny plot of hallowed earth.
¤.
Q All is still — and over all
ll like a giant watchdog, sits
Q` Solitude.
1
l It is strange, but there is no sadness here.
  The people who in this place
  Chose to sleep the Long Deep Sleep
  Were not the breed to wear
Sorrow as a garment
; Nor to use pity as a
Handmaid.
l Gentle they were, and plain.
L But borne above the masses
‘ by a strength and goodness
in known only to those whose heart
l is at one
~i with all mankind.
They gave their strength, with generosity.
Their goodness, with modesty.
‘ Their lives, with humility.
If you should, by chance,
  walk the winding path
l up this far—away hill.
l Take with you
il, Love —— Humility — and
Compassion.
 . But leave
» Sorrow V
· On the other side of the gate that hangs unevenly
. on rusty hinges.
V Edward A. Mattingly
 li 1964

 6 FRONTIER NURSING SERVICE
A traditional Navajo Medicine Woman .... ,
A modern Nurse-Midwife . . .  _
Healing in Harmony ,
Editor’s Note: The success of Mary Breckinridge’s goal- to bring good  S
health care to the isolated mountain people of southeastern Kentucky __
—is well known. Not so well known is her second goal — to use the  
successful Kentucky effort as a model to demonstrate that good, afford- E
able health care, through the use ofhighly trained nurse-midwives, could ,`
be delivered to people in rural, hard—to-serve areas in other parts of this ,j,
country and throughout the world. At present count, there are FNS
graduates at work in 48 states and in 42 foreign countries and provinces.
Debbie Goldstein, CNM, (class of 1984), is one ofthose who is very much a
part ofthat second goal. In the following article, Debbie tells us ofher life, V
friends and work on the Navajo Reservation in Chinle, Arizona. Her I
narrative demonstrates how truly flexible the FNS concept and nurse
can be. Debbie puts it very well when she says, "The spirit and
philosophy . . . [of] . . . the Frontier Nursing Service has enabled count-
less nurse practitioners to provide culturally sensitive health care, no
matter what the setting."
IN BEAUTY (HAPPILY) I WALK
WITH BEAUTY BEFORE ME I WALK
WITH BEAUTY BEHIND ME I WALK
WITH BEAUTY ABOVE ME I WALK
WITH BEAUTY ALL AROUND ME I WALK  
IT IS FINISHED IN BEAUTY _
(Portion of Navajo Blessingway Ceremony)  
The Navajo Reservation lies in N.E. Arizona and N.W. New V,
Mexico. The beauty of this land and the Navajo people is evident ‘
everywhere. As the rays of the early morning sun silhouette the  *1
surrounding Mesas, the presence of the Holy People can be felt. 2
This presence prepares the human spirit for the day to come. The ·
Navajo sheepherder, in the daily routine of tending his flock,
demonstrates a commitment to his traditional way of life. The
smoke rises from the roof of his hogan as his wife and daughters '
prepare the morning meal. Across the wash, another family

 QUARTERLY BULLETIN 7
  prepares for the day to come. They leave their contemporary,
‘ Western-style home to share their knowledge of the Western world
  with their people. They may be teachers, medical practitioners, or
a businessmen. In part, the beauty ofthe Navajo people lies in their
  blend of traditional, transitional, and modern cultural values and
_ practices.
  I have had the privilege of working as a nurse-midwife with the
‘ Navajo people for the last two and one-half years. The current
.. OB-GYN service in Chinle, Az. began at that time. Presently, the
service employs two obstetricians, one family practice physician,
and five full-time midwives. We average 60-70 deliveries per
· month. Despite the fact that approximately 50% of our patients
have high risk factors complicating their pregnancies, the care
they receive is given by midwives, as well as physicians. One of
our consistent goals has been to provide culturally sensitive
health care to the Navajo people.
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  Debbie Goldstein and a Navajo medicine woman work with a patient in labor. The
f medicine woman, (in this case, the woman’s mother), performs a ceremony using a
  feather which she waves over the laboring woman’s abdomen. Debbie wears a juniper
I seed and bead "birthing necklace" to assist in bringing about a safe birth.

 8 FRONTIER NURSING SERVICE
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Debbie makes a ho an house call to a mother and her new baby. The infant sleeps l
S
peacefully, secure in a traditional Navajo cradleboard. .
ii
As I mentioned earlier, Navajo beliefs and practices run the
gamut from traditional to transitional to modern, with most y
people demonstrating a blend of all three. It has been our
challenge to gain an understanding of traditional Navajo beliefs
and their impact on current health practices. We have had much
help in this pursuit.

 QUARTERLY BULLETIN 9
When our service began, we were invited to visit the summer
sheep camp of a Navajo medicine woman and her family. From
these people, we learned of the Navajo belief that being in good
? health means being in harmonious balance with the total physical,
` social and spiritual forces in one’s life. Illness results when there
is an upset in this balance. We were shown the practices of
Y` traditional Navajo healers as they attempt to restore balance and
T harmony to their patients. We witnessed hand-trembling (a
l. means of diagnosing illness), head-sweating, and the preparation
of a sandpainting, all therapeutic practices used by traditional
healers today. We took sweat baths, both physically and spirit-
ually cleansing. We arose at 5:00 a.m., with our hosts, to offer
prayers using corn pollen, and to jog into the direction of the
rising sun. We came away from this experience refreshed and
eager to use our new-found knowledge in our work with child-
bearing families.
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i A laboring woman and her two daughters get a lesson from Debbie on the mechanisms
of labor and delivery.

 10 FRONTIER NURSING SERVICE
We have been assisted in our understanding of traditional
beliefs about pregnancy, birth, and family life by our patients, by Y
traditional medicine people, and in particular, by one family who  N
has been very much involved in our service since its conception.
Ursula Knoki-Wilson, a Navajo CNM, and her parents have E
taught us much. Ursula has worked part-time on staff in Chinle,
and her parents are both traditional healers. From them, and  
others, we have learned that traditional Navajo women view .
childbearing as a natural process. The pregnant woman becomes {
one with Mother Earth, Father Sky, and the Universe of Holy F
People. She is believed to physically relive the creation plan of
humankind. It is, therefore, very important for her to attune
herself to the divine events of conception, fetal development, and
* birth. She attempts to meet behavioral requirements regarding
diet, activity and customs. The pregnant couple must observe
dictates that govern their thoughts and actions. For example,
they must not view things that are non-living-i.e. dead animals, V
or sandpaintings. They may not attend funerals. They are taught
to keep their thoughts and actions pure and positive. During labor
and delivery, positive thoughts are also encouraged. The use of
juniper seeds, worn as a necklace, assist in the safe passage of the
fetus into life outside the womb. After birth, the use of herbs to
encourage lactation and involution are recommended. The ex-
tended family is looked to for assistance with household tasks and _
newborn care. Should something go wrong at any point along the
childbearing continuum, there is a traditional ceremony that can
be performed to attempt to restore harmony and health.
We have attempted to use this wealth of knowledge in designing K
the type of obstetrical care offered in Chinle, First and foremost, Q
we encourage families to seek the assistance of traditional healers  
when they feel the need. We welcome medicine people into the  .
hospital, and it is not uncommon to see Western technology (IVs _
and fetal monitors), in side-by-side use with traditional chanting _§»
and native medicine. We encourage Western practitioners to be m
positive in their speech and actions. The midwives, and many of  E
the nursing staff, wear "birthing necklaces", made of juniper  
seeds and beads, which are given to women during labor to assist  
with a safe birth. In all of our birthing rooms, traditional woven  —
belts are suspended from the ceiling for use by women during the  

 QUARTERLY BULLETIN 11
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Debbie teaches a woman how to use the sash belt for pushing during the second stage of
labor. The sash belt is woven in a traditional Navajo pattern and may be worn as a belt
, during the prenatal period. `
  second stage of labor. They are encouraged to squat and push
p holding onto these sash belts — a practice of traditional Navajo
midwives. Extended family members of all ages are welcomed
¢= into the prenatal clinics, labor and delivery area, and the post-
i partum rooms. Family support systems are identified and utilized
 1 as much as possible in planning for patient care. Patient teaching,
  in particular, has benefited from an understanding of traditional
. practices. We must modify our instructions to incorporate dietary
 . preferences, beliefs regarding contraception, and a knowledge of
· the home to which people will be returning. Many traditional
Q

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 ;
I
iz FRONTIER NURSING SERVICE {
families live in one—room hogans with no electricity or indoor {
plumbing. Our postpartum instructions regarding personal care, I
hygiene, and newborn care must take this into consideration.  
There are many times when a Navajo-speaking interpreter helps {
. . . . . . . I
us clarify our teaching. The challenge with each individual family j
is to discover their unique blend of beliefs, and to tailor their care ij_
accordingly. I
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Debbie makes a home visit to a postpartum mother and her newborn. Home visits by iT
CNMS are not routine; on this call Debbie accompanied a Community Health Nurse on 7
her rounds. QQ,
In writing this article I feel compelled to share some partic- .
ularly personal and meaningful experiences with you. I share  ~
them to illustrate that healing does not flow in one direction only.  I
Many Anglos (as Caucasians are called by the Navajo) seek  
healing ceremonies from Navajo practitioners as well.  
i

 l QUARTERLY BULLETIN is
  The births of both of our children were attended by Ursula
“ Wilson, who, as mentioned before, is knowledgeable in both
Navajo and Western healing practices. After the birth of our son,
we were invited by her family to participate in a traditional
Navajo naming ceremony for the newborn. Our entire family was
I blessed, and our son, Joshua, now has a Navajo name which may
f be spoken by him only on holidays and his birthday. It is an
inspiring name that depicts a quality which will characterize his
V life.
,7 During pregnancy with our second child, we lost my husband’s
  father. As we were particularly close to him, and involved to a
  large extent with his physical care and the arrangements for his
{ burial, we felt the need for a ceremony prior to the birth to restore
  our inner balance. Again, this was performed by the Knoki
Q family. I am sure that the healing which resulted contributed to
  the beautiful birth of our daughter, Megan.
i Those of us who live and work on the Navajo Reservation are,
l indeed, fortunate. We are given the opportunity to expand our
l world view, and to be creative in using our healing skills. I often
l think of Mary Breckinridge and the early Frontier Nursing
  Service midwives who had this same opportunity. The spirit and
Q philosophy with which they endowed the Frontier Nursing
  Service has enabled countless nurse-practitioners to provide
l culturally sensitive health care, no matter what the setting. This
  sensitivity lays a portion of the foundation upon which families
' build as they help to shape their children into the adults they will
I become.
s
 
,j· CHANGING WOMAN, SHE HAS PREPARED HER CHILD,
Q NOW THE POLLEN OF ALL KINDS OF JEWELS HAS
BEEN PLACED IN HER CHILD’S MOUTH FOR
t HER SPEECH,
NOW THE CHILD OF LONG LIFE AND EVERLASTING
  BEAUTY, WITH THESE THINGS, SHE HAS
i PREPARED HER CHILD
‘l (Navajo Chant/Prayer, from the
 c Blessingway Ceremony)

 14 FRONTIER NURSING SERVICE  
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Kate Ireland, FNS National Chairman I
THE KATE IRELAND WOMEN’S HEALTHCARE CENTER
QUALITY CARE FOR WOMEN, B Y WOMEN
Enthusiasm ran high as the staff of the soon to be opened Kate Y
Ireland Women’s HealthCare Center gathered in Berea to develop p
the philosophy and goals that will guide their work. I had been
invited to join the group as their official recorder. Dean Ruth ;
Beeman set the stage for the discussion. "When people walk in the I
door," she said, "we want them to get a feeling for the Center
through an environment that is homelike, warm and welcoming
and a staff that is unified in presenting what we’re all about. In  
order to do that, we need a common understanding of our  
philosophy and goals. That is what we are here to develop."
I
1

 f QUARTERLY BULLETIN 15
E The expectation that a roomful of such individualistic,
if independent women could reach consensus marked Ruth Beeman
I as either a total optimist or a chief with complete confidence in her
l staff. She was proved justified on both counts, for after 9 hours of
\ open, frank and often intense discussion, six major goals were
, agreed upon which evolved from and reflected the group’s basic
' philosophical stance.
  In edited and capsule form . . . the philosophy follows:
`Z As Family Nurse Practitioners and Nurse-Midwives, we seek to be
sensitive to the needs and desires of individuals and their families.
We need to meet our client’s needs on biological, psychological,
‘ social and spiritual levels. We see ourselves as nurturers, dedicated
to preventive health care and the restoration of health through
assessment and management of the human response to illness. We
have a responsibility to educate and provide maximum access to
` information regarding health and illness care.
We believe a Health Care Delivery System should be available to
and provide one standard of excellence for all; should involve the
Q client in decisions regarding their care and should provide choices.
The client’s needs are primary, therefore, services offered should
I reflect the needs of the citizens in our service area and then be
· balanced with the needs of the institution, providers and learners.
In the Kate Ireland Women’s HealthCare Center, we are special-
izing in the care of adolescent and adult women in all areas and
· development of their lives. In order to best accomplish this we
‘ establish the following goals:
I. Achieve financial stability
° 2. Increase the client caseload
3. Expand services available to clients
4. Develop an outreach program aimed at the teen population
 . 5. Increase community involvement, support, networking and
education
§¤ 6. Review and develop indicators for measuring the health
` outcomes of our clients (research)
 `( The sense of satisfaction that followed goal development was
; short lived, for next came the "nitty-gritty" task of identifying
I concrete ways to make those goals a living reality. Creative ideas
 4 flowed energetically and produced an abundance of possibilities
  for future consideration. As a small sample . . .
i . . . redeemable coupons for free paps smears or blood pressure
  checks

 16 FRONTIER NURSING SERVICE  
. . . speaker’s bureau—focusing attention on schools, senior citizen’s ‘
groups, churches, women’s organizations and teachers
. . . lots of good PR — utilizing radio and TV public service spots
. . . group sessions dealing with diet counseling, exercise, stress i
management, smoking cessation l
. . . add a mental health nurse clinician  
. . . special clinic hours and "rap" sessions for teens  
. . . develop support groups for people dealing with infertility, =
rape/ abuse, troubled teens, breast feeding, grief counseling and `
support g
When the retreat ended and each went on her way, I, as
recorder, was left with the formidable task of collecting and
organizing the wealth of material the group had generated. Large
sheets of chart paper covered the walls and as I removed them I
smiled to see the lofty, idealistic philosophy side by side with the
pragmatic goals and realistic ideas for accomplishing them. I .
knew they would make it happen — that these weren’t just words
on paper — just an exercise to be forgotten — because I had
experien