xt7jq23qwn6r https://exploreuk.uky.edu/dips/xt7jq23qwn6r/data/mets.xml The Frontier Nursing Service, Inc. 1983 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. 58, No. 4, Spring 1983 text Frontier Nursing Service Quarterly Bulletin, Vol. 58, No. 4, Spring 1983 1983 2014 true xt7jq23qwn6r section xt7jq23qwn6r _ FRONTIER NURSING SERVICE :2: Q
° VoIume58 Number4 Spring,I983 E Q ;
TA »I_ vc?
QUARTERLY BULLETIN °·IL,,M  
I   .
’   *»`»
Ia I ij  ,“=
· SI~S   *  u S S.
s · ·EiE~ES¥     =   I ‘°":I”°¤.¤u¤‘%
  ELI, "   .¤¤¤LT NYS S I
Reachmg mt0 — I   S R I I
I   'T  , I
  I I.;, E   L_    *- ``'`·    
   IS   A                
I   -\. ~L~\$; I   In E     ;L;— I ·~ *1-·~  
  I, N 1     A .       'Q; _? : A >· .
 .. `\   H   I   ' iv I J"
    ·,*’..   ·          ~·   -     ~ v»·` ¤
  N   IT C E~R¢RLL I in  
      I    
             
      II., ·»» .    
      ’  
    I`»I      
  ` * v s  I.,      
  S·NS            \ *
I   L, I   =   I E ISSS S
5,      I N  .   —the Commumty
E _   N `F I,I, _     ,I.II\
\ Ms WI __\I  `  ’ ··  x
_ .I E v_ ,   I :._:\;A_ . _ __;& ` ·   H
I I ·~*» ~   ·I»‘    
            S   
     ‘’·  

 1 i
I 2
I
I
g.
I;
li
US ISSN 0016-2116 li
{
_1
`l
i I
coNTENTs ?°
ii
Reaching into the Community - CHC 1  
FNS School Graduates 93rd Class 8 ‘\
FNS Student Nurses Bring Health Care
to Public Schools 12
Photo Pages 17 and 24
Beyond the Mountains 18
Joint Practice -— Care, Caring, and Trust 22
Memorial Gifts 25
In Memoriam 26
"Short-Time Couriers" Enjoy Working
Vacations at Wendover 28
Field Notes 30
Alumni News 32 `
In Brief 33
Courier and Volunteer News 34 I
FNS Announces ‘NEED’ Campaign 37
Staff Opportunities 37 ;
Urgent Needs 37 ‘
E
    ·r
FRONTIER NURSING SERVICE QUARTERLY BULLETIN I
US ISSN 0016-2116 >
Published at the end of each quarter by the Frontier Nursing Service, Inc.
Wendover, Kentucky 41775 y
Subscription Price $5.00 zi Year
Editor’s Office, Wendover, Kentucky 41775 V
 
VOLUME sa SPRING, 1983 NUMBER 4 —_
Second-class postage paid at Wendover, Ky. 41775 and at additional mailing offices  I
Send Form 3579 tu Frontier Nursing Service, Wendover, Ky. 41775  .
Copyright 1982, Frontier Nursing Service, Inc.  ‘i
 :
1
1
 1
r 
 .
 1

 QUARTERLY Bu1.1.mu~z 1
l   R
{ REACHING .
i THE COMMUNITY V _COMMUNg§NIcr
1, — CHC ,,;A\»;HN S ,`
»Q(‘
i P
·».
’T RR   r
l This is the first in a series of articles   il,   I,,'’ A ’·.   ·
on the FNS district clinics. It is expect-  Fg ,   Q_   V
ed that the articles will appear in       _» ,   _ _ 
every other issue.     ‘ A R V   - l
Z Passing through the small community of Big Creek, in
Q Kentucky’s Clay County, one may or may not notice a white
  frame building set back a hundred yards from the main road, with
  the mountains ofthe Daniel Boone National Forest rising behind
  it. It looks like many another white frame house in this part of
{ southeastern Kentucky — but it is much more than that. Where
l the driveway turns off the main road, there is a sign that reads
E "Community Health Clinic, FNS." And that is only the begin-
l ning of the story.
l
b The Community Health Center at Big Creek is, in a strictly
§ . technical sense, one of four district clinics through which the
g Frontier Nursing Service provides health care throughout the
area it serves. In that sense, CHC is orthodox enough. It sees
P é, about 24 patients a day. Sometimes there are as many as 35 or 40,
, · and the peak load has been as high as 48. Like the other clinics,
; , CHC provides primary health care, including counseling on
V xl health maintenance, and referrals to Mary Breckinridge Hospital
j for more specialized medical treatment or for nursing care at home.
'j But there is a special emphasis at CHC — an emphasis indi-
Q  cated by the first word in its name — "community." To a degree
 E unusual even for the community-oriented clinics of FNS, there
a, has grown up around CHC a network of close and cooperative
 I community relationships that make it possible, on the one hand,
 g -

 V
L FRoN·m:R Nunsmo Smnvics i`
for the community to take over health-related projects CHC could I
not manage on its own and, on the other, for CHC to reach into the
community to discover its needs and to initiate programs to meet
them.
CHC Project Director Susan Hull and her staff are dedicated to ,
the FNS belief that good health is a natural outgrowth of " general ?
well—being" in the community as a whole, and they feel that that ,
sense of well-being needs to be nourished by providing help  
beyond those services covered by medical directives.  
The approach is at once a reaffirmation of the beliefs of Mary {_
Breckinridge, who created the FNS concepts of rural health care, * 
and a reinterpretation of those principles for contemporary rural  A
society. In essence, it is a conviction that "everything is con- .
nected to everything else" — that those who wish to guide, to help,  
or to heal must deal with the whole organism, not just the indi-  
vidual parts. It is a view that underlies the teachings of ecologists, j
and of those who practice a "holistic" approach to medical care.  
This is a very modern point of view, and yet it derives from  
long—established principles. Actually, the concept is embodied in  
the much—quoted "object" of the Frontier Nursing Service: "to ¥
provide expert social service," as well as "to ameliorate economic  f
conditions inimical to health and growth," and, to that end, "to do  
any and all other things in any way incident to, or connected with  ¥
these objects."  .
The FNS "object" also speaks of fulfilling its aims in the rural  i_
districts "with the help of their own leading citizens." CHC has  
made a special point of doing just that, and it has done it with A;
great success. A "prime mover" at Big Creek has been the CHC . 
Advisory Committee, a group of dedicated and hard-working  
members of the community. Its chairman is Al Marcum, who  
retired some years ago from a career in trucking and a tour of duty 4
as traffic foreman for the State Highway Department in his ;
district. .
Mr. Marcum’s devotion to the FNS cause, like that of many of A
his fellow committee members, precedes the establishment of isi
CHC itself. In the years before CHC came into being, FNS oper-  
ated clinics at Flat Creek, Bob Fork, Red Bird, and Brutus. Mr.  
Marcum had been on the committee at Red Bird. But in the course {
of time, FNS came to realize that it could better meet its commit- 1
ments by consolidating these clinics into a new one. When word of

 Y
QUARTERLY BULLETIN 3
this decision reached the community, a number of its key people
decided to form a committee to assist FNS in its plans. Dr. W.B.
Rogers Beasley, then director of FNS, asked Mr. Marcum to start
looking for a property suitable for a new clinic. Eventually, Mr.
Marcum and his stafflocated the house that would be turned into
,  the Community Health Center.
 . From the first, the CHC Advisory Committee has supported
, the clinic in many ways, varying with need and the creativity of
  the committee members. Much of its support has been financial.
  The committee holds box dinner auctions and conducts group
f "singings" to raise money. It has given its support for keeping up
{ the property, and it has bought equipment for the center. Among
its contributions have been a new examining table and a new
, copying machine. The committee bought a metal storage shed for
* tools, and it plans to blacktop the driveway. Committee members
also seek out businesses and individuals in the community who
_ are able to contribute. Mr. Marcum expressed his appreciation of
i the generous and continuing support that has come from local
industry.
gi Al Marcum feels that the committee owes its success to its
  spirit of cooperation. "The main things that hold the committee
=  together," he said, "are getting together and studying each
‘   ‘     Y s T is  * »i#  
E  ?`"?V°?       · . ii``’  C. · ...— ;  E?   o»»»  
  i ‘’‘i .. S  C              
’ ....... -1*M ~—~»~$ ·   `S ` ` l        — §f°"> ‘~ ’   ? £i?Z
  so   ·     > `i   .   .~..     ‘·o' ~      
e T    ==g   »   ?’!‘ ?‘ §§" l { #     lE*f'    ye!}  ``_— I f  
‘   _     .     .  »   ‘i‘’    tt· T ·     ·es  b  
l         if o ·   ’
l`:   ·     l `    ls}!     l   i
The CHC staff, left to right: lunior Roberts, Alta Couch (a volunteer), lean Hoskins,
FSMFN student julie Rice (behind), Susie Farmer, Sr. joan Gripshover, and Project
Director Susan Hall. Rose Rokis was unable to be present for the picture.

 4 FRONTIER Nonsmo SERVICE l`
A     . .E»·     ·=···   ’`‘°=       Wt   `/E·      
.w '»“E`° ‘     ``    l
» ;. ,.   · · »+,` s   i` =·ri      -·»~  it?.  if
. e· 5     ’‘`‘   A‘‘,*A·   ‘-*»§ L .°.EQ?·‘;“?#’*?i°`T ; s¤ ·*  °` f
    _E_, ,   _`   4.   fg: . y »»_. i      
g . ,r   if . ,     .   ..»_» _ ,     i
.~ '~ Q ig 7 · n ,~¤ ,< `     . ·"r            . . ._’i—;»;;§·,} —;· i
K I A       - Y ig     ;» » .     ‘_-‘ gel;   Wu gi `   :_  H
 , .;. 2 %  .  r     *   —E···
4*   "     ? »  ··         ·· .a.t»·»»·»¤»  
  i » 1 .   ¤|E` Wl  
  . Q· .·    kr "»      ..,_   I ` ft _.
  · e § ·$»»l= r  ~~;»,», _I;.   . ;      . g
      .  ? — ga ` . " » "“""‘“ fi?   ~¤—  
    · ,·T; ;»   *2 E!            
      tir...»»» *‘ E»E·     ~ as   “ TT`.  
  \`> "     E   _. EEEE E ..1 * . A   .  »A ·   _
;¢   E.E          f»E
  ·*—.   #·‘?~ t`   .  . 1  . * 4  
The new firehouse at Big Creek stands on FNS property close to the Community Health
Center. Urgently needed in this wooded region where residential fires have repeatedly {
caused total destruction, it came into being a unique demonstration of community [
effort and cooperation. lt went into service early this year. V
other." And, he added, "they are all one big family, working for
the community."
Although television and modern roads came to Big Creek
some years ago, the community preserves a natural spirit of C
independence and self—sufficiency. A community that must sus- ·
tain itself without outside help tends to develop internal "net— A
works" of support. The result is very different from the "tree—like"
structure of most formal organizations, where lines of communi-
cation branch out from a main stem and each branch may branch
again, in order to reach the remotest elements of the organization.
ln a community like Big Creek, these networks seem to appear i
spontaneously, and they touch each other and interact like a kind A
of community nervous system through which all elements keep in  
touch with each other and stimulate them to action for the com-
mon good. ·
Sue Hull and her fellow family nurse practitioner, Rose Rokis, `
have enough to do in providing CHC’s basic service. In fact, they L
also need the support of a staff of five, which includes a secretary, .
a nurse’s aide, a part-time housekeeper, and a part-time volunteer _
secretary. Yet, through the networks, Sue and Rose can reach into
parts of the community they otherwise could not touch, and they .
can, in a real sense, bring the community in to CHC. j
i

 QUARTERLY BULLETIN 5
V One of these networks centers around Joy Center, which is run
by the Red Bird Missionary Conference; it is directed by a young
  couple, Tom and Chris Denman. Like the other network systems,
I Joy Center is not a part of the FNS organization, but it provides
T CHC with opportunities for reaching the community. A year and
1 a half ago, for example, Susan Hull started a series of aerobic
LI dance classes at CHC. The program was popular and soon out-
'Q grew the space available at the clinic. Sue then asked the Den-
  mans if the classes could be held at Joy Center, and classes are
\_ now given there three times a week. Joy Center has also become
, "home" to a series of CPR classes that Sue Hull started at CHC.
v_ At present, these classes are given once a year, using certified
  instructors from the larger center of Manchester, about fifteen
it miles away.
_ Susan Hull commented that one value of using Joy Center for
_ activities such as these was that area residents felt free to partici-
Y pate even ·if they were not clients of CHC. Also, she said, these
T activities seem to promote the good name of FNS and make the
community more aware of, and more appreciative of, its work. Sue
i also has plans to use Joy Center for a series of classes on preven-
tive health subjects.
1 A second "network" is a group called the Community Aware-
A ness Proj ect. This is made up of concerned citizens from Big Creek
” and from nearby Bob Fork, Elk Creek, and Flat Creek. The over-
seeing authority for this group is the United Methodist Church.
I The CAP was formed in 1981. Its membership includes,
according to its own statement, "ministers, teachers, health care
providers, community developers and local citizenry who feel
x` that needs and resources are best assessed through joint coopera-
l tion." Soon after its formation, the CAP focused on one of the
gw serious problems confronting small mountain-based communi-
1 i ties — the threat of fire. Big Creek lacked a fire department, and
‘ everyone felt it urgent to form one.
_` Fire is a particularly serious threat in a mountainous wooded
area like Big Creek. Where no fire fighting resources are available,
 Q a fire that once gets started tends to be totally consuming. Local
 f records showed that some twelve residential fires had occurred in
 ji the preceding year, and that each of them had resulted in total
j destruction. Unfortunately, most of these homes belonged to
  individuals who could not afford the high cost of insurance

 6 FRONTIER NURSING SERVICE
premiums. Thus, the occurrence of a residential fire became a
major disaster for those involved.
The CAP appointed a special committee, which concluded
after due study that the best site for a new firehouse would be on ,
land adjacent to CHC and owned by FNS. FNS was glad to
cooperate, making the land available without charge as long as it
was used by the Volunteer Fire Department as originally intended. =
Construction began last year, and the new firehouse went into  
service early in 1983. Sue Hull herself is a member of the fire  
department. Interestingly, the members of the fire department `q_
are completing CPR training set up through Joy Center —— a  
practical demonstration ofthe value of these interacting networks. ·
The Community Awareness Project was initially the creation
of Susan Hull. It now has its own organization and meets once a
month. One of its recent projects has been the compilation and
publication of a special directory of emergency telephone
numbers. This listing includes hospitals, poison control centers,
social services, churches, county extension offices, and childbirth
services. In addition, it provides numbers to call in cases of child
abuse or spouse abuse.
Talking to local leaders about the activities in which CHC has
become involved, one hears many words like "fellowship," "well-
being," and "community spirit." Hearing such words,
one finds it increasingly difficult to keep track of who is involved
in what. There is a pervading sense that "everyone’s in it
together." It seems to become increasingly irrelevant, for exam-
ple, whether a new project was started by, or is being carried on
by, CHC, or the Advisory Committee, or Joy Center, or the CAP,
or some other group. It seems to be the community as a whole that
identifies a need, and the result is that all the networks trigger =
each other to do something about it. There is, of course no end of »_
needs. One local spokesman has recently pointed out significant i
health problems in the schools, ranging from poor health habits
to lack of adequate food. Sue Hull is now working to get commun- ,,
ity backing for a program of health education in the schools.  
lf some of these many activities are not explicitly noted in the  i
FNS statement of objectives, the general intent to provide them Z
most certainly is. What CHC has done is to reexamine the pur- 1
poses for which FNS was formed and to interpret them for appli-
cation in the world of the 1980’s. In so doing, it has not lost its

 QUARTERLY BULLETIN 7
touch in its basic work. It serves the health needs of its commun-
ity. In a time when home visits tend to be replaced by visits to a
clinic or a hospital, CHC still strives to visit each prenatal home
. at least once. There still are home visits for reasons other than
pregnancy. Some visits end up dealing with problems above and
beyond the purely "medical" — Sue Hull spoke, for example, of a
{ pregnant girl who was having "coping pr0blems," and how she
  benefited from the friendly counseling of a visiting nurse.
  With the decline in home visits has come an increase in the
§·_ number of visits to the center by doctors from FNS. Yet, although
i Sue Hull said that "You don’t get people to pay for wellness,"
CHC believes firmly in the FNS tradition that an essential part of
health care is the teaching of preventive health measures. Sue
thinks that it is easier to do this in the course of home visits, and
that the decline in the number of such visits places a new burden
on CHC. This, of course, is one of the instincts behind CHC’s
community outreach. If it can promote a sense of well-being in the
community, and particularly if it can reach out through Joy
Center, or the Community Awareness Project, or the Advisory
Committee, or some other group, it can fulfill, more completely
and in a contemporary way, the objectives that Mary Breckin-
ridge defined more than half a century ago. In fact, says Susan
Hull, "I really believe that this is what Mary Breckinridge had in
mind in the first place."
   P   iii   ’ * `iif·»   —t.—“    
    ~ ii`:i`i`‘` i Q » ..     Té   
    ·»i`   I A I I .s   ¥ ` ·°f" ti?            
             
.         ...   ·      
.           _,»_ , ,         I    
        .   ' l   ‘*’      
` Tk?} ini,. }_s{;,   >>`>_>_ i . U Q Q`, g   .   __}.:.,_.f , ` l,
A              Z t   L  §>. — v=».i     `
·     ·;·`i A Y   `   T .·i.     I .    ·   .
 f    R   I A  I     .  ;     . L   i·ti T
` CHC Advisory Committee members pause for a brief chat after a meeting.
Left to right: Georgia Ledford, Glenna Davis, joe Davis, Al Marcum and Carter
Couch.

  
FNS SCHOOL GRADUATES 93rd CLASS
The Frontier School of Midwifery and Family Nursing, which
for 43 years has held a unique and prestigious position of leader-
ship in nursing education, graduated its most recent class — its
93rd — in ceremonies held at Wendover on April 30th. Eleven
nurses received diplomas, bringing to 608 the number of nurses ,.
who have graduated from the Frontier School since its estab- K
lishment in 1939.  
One graduate was awarded the school’s diploma in family _ ,_
nursing; ten received diplomas in family nurse-midwifery. At the  
time of enrollment, all eleven were already qualified as registered
nurses. They came to FSMFN for the intensive special program
that, as the school describes it, "is designed to prepare registered
nurses to function as family nurse practitioners or family nurse-
midwives in primary care agencies, with emphasis on rural
health." The family nurse program requires 12 months of study
and clinical work; the family nurse-midwifery program requires
an additional four months.
The ceremonies began with an invocation by Sister Joan
Gripshover, one of the graduates, after which Mildred Minix, of
the graduating class, introduced the faculty and students. Sister
Valerie Chaplain, District Coordinator for FNS, and Nina Sowiski,
FSMFN instructor, followed with remarks of greeting and con-
gratulations. Dean Ruth Coates Beeman then presented the
diplomas.
A Diploma in Family Nursing was awarded to:
Sr. Joan Gripshover, of Erlanger, Kentucky, who came to
FSMFN with a Diploma in Nursing from Good Samaritan  »_
Hospital, Cincinnati, and a Bachelor’s Degree in Elected V
Studies from Thomas Moore College, Covington, Ken- j
tucky. Sister Joan plans to practice family nursing in a Q
rural area. _
Diplomas in Family Nurse-Midwifery were awarded to:
Ann M. Davis - Garvin, who was born in Denver, Colorado
but is most recently from Albion, Michigan. Ann received

 QUARTERLY BULLETIN 9
 
5·;*i»*.;%§7 <é~L p "`V    
    F          
el, I : ’ c'   els    
·· il l. f?i··=·‘** .        
 ·- kr l       . —.   `i
L . , ~  I ,v   ,·»j = _] .;* 1 g ,;  {I
YY? T  één gv q V.  .  _ v   Y  fi `”€>¤
Dean Ruth Beeman presents diploma to Michele Heymann
as other class members await their turns.
her BSN from the University of Colorado in 1970 and her
MS in Parent—Child Nursing from the University of Michi-
gan in 1980. Ann is considering looking for an internship
and then returning to Michigan, where she hopes either to
work in a midwifery service or to practice with a physician.
Anita Goldman, of New York City, who attended Misericor-
dia School of Nursing and received her BS in Health Admi-
nistration from the State University of New York in 1976.
Anita says, "In July after boards I plan to join my hus-
band, an OB/ GYN, in a joint practice in Georgetown, Ken-
tucky."
Jo Ellen Hager, of Spokane, Washington, who received her
BSN from Southeastern Louisiana University in 1972 and
her MS in Perinatal Nursing from Houston Baptist Univer-
* sity in 1982. Jo Ellen says she is looking forward to teach-
 l ing maternity care to undergraduate nursing students, and
· next year she would like to begin a midwifery practice.
  Michele Heymann, from Stillwater, Oklahoma, who re-
ceived an AA in Nursing from Riverside City College in
t January 1976 and a diploma in family nursing from FSMFN
in 1982 (she returned this year for the trimester in family
nurse-midwifery). Asked about her plans for the future,
Michele said "I am currently investigating several pos-

 10 FR0N·r1ER NURSING Smzvics
sibilities in family nurse—midwifery, including an intern-
ship." She will also continue to work for her BSN through the
New York State Regents External Degree Program.
Susan Howie, of Salmon, Idaho, who obtained her ADN
from the College of Southern Idaho in 1974 and has done
further work toward a BSN in the New York State Regents »
External Degree Program. Susan’s plans include, "return-  
ing to my rural town and setting up a combined nurse-mid-  
wifery/ family nursing practitioner practice, specializing in  i
the ‘entire’ family and home deliveries, working in col-  
laboration with the one hospital and 5 MD’s in town."
Roberta Spaller Kline, of Safford, Arizona, who received an p
AS from Miami Dade Junior College in 1970 and an AAS
from Eastern Arizona College in 1978. Roberta plans to
return to a night supervisory position. She is looking for- I
ward to an internship or possibly to opening an alternative
birth center with a local physician.
Mildred P. Minix, from Salyersville, Kentucky, who grad-
uated from Prestonsburg Community College in 1975 and
has an AD. Mildred says, "I am returning to Big Sandy
Health Care, Magofiin Clinic, Salyersville, Ky. to practice as
a family nurse midwife."
Leonette Orr, of Redlands, California, who received her AA ,
in Nursing from San Bernadino Valley College in 1963. P
Leonette plans to return to California and is hoping to stay
in the San Bernadino/ Riverside/ Redlands area because p
she is getting married in July. {
Naomi Page, from Nashville, Tennessee, who obtained her  ‘
diploma in nursing from Mid State Baptist Hospital (Nash-  ,
ville) in 1964 and her BS from Belmont College in 1968.  
Naomi said, "l plan to return to Nashville after graduation.
I will be working at Baptist Hospital in Nashville." _
Stephanie Schultz, of Moline, Illinois, who received her
diploma from Lutheran Hospital School for Nurses, Moline,  »

 QUARTERLY Bux.1.1mN 11
in 1969 and from 1976 to 1981 was instructor and instructor
coordinator for the Childbirth Education Association of
Northwestern Illinois. Stephanie said of her goals, "I plan
to return to Moline and hope to find a physician in the area
to work with, doing antepartal, intrapartal and postpar-
tal care and well woman gynecology. Because my children
_ are still young, I may not work full time for a few years. I
,» also hope to begin working on my BSN on a part-time
  basis."
., After presenting the diplomas, Dean Beeman announced that
scholarship awards were to be given to the graduating class. Two
of the scholarships were for the highest combined clinical and
academic grades. The first-place grant in this category was
awarded to Stephanie Schultz, while the second-place award was
given to Anita Goldman. A second category honored graduates
who had shown the greatest improvement in combined clinical
and academic grades in the final trimester of the course. The
first-and second-place awards in this category went to Ann
Davis-Garvin and Susan Howie, respectively.
The presentations were attended by about 100 guests, who
came from all parts of the country to be with the graduates. Before
the presentations, brunch was served at the Big House.
The Frontier School was founded in 1939 by Mary Breckin-
ridge, when World War II made it impossible to continue to recruit
trained nurse-midwives from Great Britain or to send American
nurses to England for training. The family nursing program was
- added in 1970. The combination of these two programs consti-
A tuted a new and important development in nursing education. In
_ the words of FSMFN, "The joining of the long-established nurse-
midwifery program with the new family nurse practitioner pro-
* gram created a unique health care professional — the family
· nurse-midwife .... Although other programs may have both
 _ family nursing and nurse-midwifery in the same school, they are
Y not built one upon the other and do not allow nurses to focus on
  both specialties. The School is also unique in that it is located in a
rural area and most of the clinical experiences are in primary care
facilities. Other programs may offer some experience in rural
areas and/ or primary care centers; but few, if any, are perman-
. ently based in both."

 12 Faowmzn NURSING Smnviciz
·   ‘AA·       =‘»   ‘
A A.%_,‘L g. v; »    A    T2   
_ V  Y     BRING HEALTH CARE
    _   _ gal;   j TO PUBLIC soHooLs
   H   ”
            ’ `  L  v' . (K L  \  ` V
Y  ,   * A    H, · HVH’      ` ig
  H,H,H       “  
  H    r r...    
;,   ’° ‘V Y  At left, FNS student nurse Debra Buchanan
examines an eighth - grade public school
. __   student
A thirteen-year old girl, holding a book in front of her right eye,
struggles to read the letters on an eye chart. Gently, the nurse
stops her and tells her that her vision is 20/40 — and then she
goes on to explain what that means. The nurse adds that in a few
years the girl will surely want to apply for a driver’s license. She
will need to pass the eye exam, so why not see an eye doctor now?
The youngster, reassured by the nurse’s friendly manner, readily
agrees to take the nurse’s written recommendation to her parents.
The exchange is familiar enough, but the way it has come
about is a bit out ofthe ordinary. The scene is the gymnasium ofa
public school, but it is not a public school nurse who is conducting
the examination. Instead, it is one of the students from the Front- T
ier School of Midwifery and Family Nursing, who is getting clini- `
cal training in the schools of Leslie County. The fact that they are
"students," of course, does not mean that they are inexperienced. V _
They are all registered nurses with several years of practical V L
experience. They are, however, learning from these contacts with '
adolescents some of the practical aspects of dealing with health  L
problems in a rural community. A
This screening program ended its third year this April, and for L
the third year in succession, it has been applauded by students,

 QUARTERLY Burnmm is
school officials, and the FNS students and instructors. Because of
its success, it is expected to continue into the future.
The program was started to meet a combination of needs. For
several years, the Leslie County school system and the Frontier
Nursing Service had discussed ways of using FNS family nurse
practitioner students in the school health program, but it was not
until January of 1981 that a satisfactory program was worked
 . out. The present program was formally adopted at a meeting on
-2 January 13th of that year, which was attended by faculty of the
  Frontier School of Midwifery and Family Nursing and several
i members of the Leslie County Board of Education. Chief spokes-
_ man for Leslie County was Coach Floyd Hines, who took on the
. main burden of getting the program implemented in the schools,
and has carried it on effectively ever since.
Kentucky state law requires that every student who enters the
school system get a physical examination. However, when stu-
dents come in at an early age, there may be a long interval
`- between the first and subsequent check—ups. School authorities
wanted FNS to give screening examinations to detect problems
that could have arisen in those long intervals. At the same time,
FNS felt that it needed a new way to give practical clinical expe-
rience to the students in the family nursing program. Thus, the
proposed plan seemed a logical solution to two significant prob-
lems. Much, however, depended on just how the program was
carried out.
One of the first considerations was to select the right age
group. Eventually, it was agreed that the students in the eighth
grade would make ideal subjects. In the first place, these students
had gone a rather long time without check-ups. Moreover, this is
an age group that is undergoing many changes, both physical
{_ and psychosocial. It is a time of onsetting puberty, of rapid physi-
cal growth, and of many questions that agonize teen-agers as
they begin to realize that they are going to be adults.
, ,2 Another consideration was social and psychological. The
, eighth grade is the top grade in the Leslie County elementary
, school system. Arlene Day, the FNS family nurse instructor who
L coordinated the program this year, gave some of the reasons she
{ felt it was "the perfect group" for screening: As the senior grade in
* their schools, eighth graders have a certain social status. If there
 V were a higher grade in the same school, they might have to take

 14 Fnourisa Nuasmo Srzavics
some kidding from upperclassmen — for young minds can easily
imagine there is a stigma in being picked out for screening. But _
not only did they escape that problem, they ended up setting an 7
example to the lower grades that made the younger students
readier to be screened when their time came. Arlene, who as a
native of Leslie County is intimately familiar with its customs
and points of view, is quite certain that if the examinations were .
deferred until the following year, when all the students would be  A
high school freshman, they would be much less successful. l.
The examination procedure itself sets no earth-shaking prece- °
dents. It consists of standard checks of eyes, ears, nose, throat,  
teeth, blood pressure and pulse, thyroid, spinal development, A
heart, and lungs, and standard measurements of height and
weight. However, the examination leads naturally, in most cases,
to counseling sessions that the eighth-graders seem particularly
to appreciate. When they come in for their exams, they bring a
questionnaire on their health that they have completed before-
hand. (No examination is given, incidentally, without parental .
approval.) The first step in the examination is a shorter question-
naire, in which the students are asked such questions as, "Are you
satisfied with they way you are growing?" or "Are you satisfied _
with your weight?" or "Are you trying to lose weight?" (These are  T
in addition to more specific questions about allergies, diet, dental
care, and so on.)
As it turns out, the eighth-graders are very much concerned
with some of these questions. Also, they are concerned with the
last item on the questionnaire, which asks if they wish to discuss
such matters as emotions, getting along with friends, smoking,  -
work, school, and how to cope with worries. Their answers to
these questions often lead to friendly and relaxed discussions
with the nurse. Arlene Day says that the students keep asking if
they are "OK" —— if their health, their height and weight, their V. 
rate of growth are normal. The nurses soon realized that these  ;
teen-agers are unexpectedly well-info