xt7v416t0373 https://exploreuk.uky.edu/dips/xt7v416t0373/data/mets.xml The Frontier Nursing Service, Inc. 1940 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 The Quarterly Bulletin of The Frontier Nursing Service, Inc., Vol. XVI, No. 1, Summer 1940 text The Quarterly Bulletin of The Frontier Nursing Service, Inc., Vol. XVI, No. 1, Summer 1940 1940 2014 true xt7v416t0373 section xt7v416t0373 x
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FIFTEENTH ANNUAL REPORT
VOLUME XVI SUMMER, 1940 NUMBER 1
British (Sybil Holmes) and American (Hannah Mitchell) Nurse-Nlidwives
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AN INDEX IS ON PAGE 2
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MADGE TAIT VVITH NURSES AND PATIENTS
(See "O1d Staff News")
THE QUARTERLY BULLETIN OE —
THE FRONTIER NURSING SERVICE, Inc. I 
Published Quarterly by the Frontier Nursing Service, Lexington, Ky.
SUBSCRIPTION PRICE $1.00 PER YEAR
VOLUME XVI SUMMER, 1940 NUMBER 1
"Entcred as second class inatter June 30, 1926, at the Post Oflice at Lexington, Ky.,
under Act of March 3, 1879."
Copyright 1940 F1·ontim· Nursing Service, Inc.

 "CHILDE ROLAND TO THE
DARK TOVVER CAME"
(See Edgar’s song in "Lear")
Burningly it came on me all at once,
°* ?§ This was the place! those two hills on the right,
Crouched like two bulls locked horn in horn in iight;
While to the left, a tall scalped mountain . . . Dunce,
Fool, to be dozing at the very nonce,
After a life spent training for the sight!
What in the midst lay but the Tower itself?
The round squat turret, blind as the fool’s heart,
l Built of brown stone, without a counterpart
In the whole world. The tempest’s mocking elf
Points to the shipman thus the unseen shelf
He strikes on, only when the timbers start.
Not see? because of night perhaps ‘?—Why, day
Came back again for that! before it left,
The dying sunset kindled through a cleft:
I The hills, like giants at a hunting, lay,
Chin upon hand, to see the game at bay,-—
"Now stab and end the creature—to the heft!"
I Not hear? when noise was everywhere! it tolled
” Increasing like a bell. Names in my ears,
Of all the lost adventurers my peers,——
V How such a one was strong, and such was bold,
And such was fortunate, yet each of old
~ Lost, lost! one moment knelled the woe of years.
ll! There they stood, ranged along the hillsides, met
` To view the last of me, a living frame
For one more picture! in a sheet of flame
I saw them and I knew them all. And yet
Dauntless the slug-horn to my lips I set,
And blew. "Childe Roland to the Dark Tower Came. "
—Robert Browning.

 INDEX i
l ARTICLE AUTHOR PAGE  
Annual Report 3 i 
Beyond the Mountains 59 M
Childe Roland to the Dark Tower Came ]§)'}‘O'l.L’/I't7I.g 1 %`
Detroit Comes Again to the I
Kentucky Hills Mrs. Ja./mes T. Slzazv 18 I
Field Notes 67 Y
In Memoriam 28 {
Letters From One of the Small Q
Invaded Democracies Contvrvbuted 38
Old Courier News 21  
Old Staff News 39
Rattlesnake Bites Cause Death 57  
Third Courier Conclave Nlrs. PcmljN[agn¤us similar work in other outpost areas. This part of our program
i had been deferred only for lack of larger hospital facilities and
’ for lack of special funds to cover costs. The war left us no
j choice but to start the nurse-training plan at once with such
3, scholarship funds as we could raise, and with our all too meager
  ,
Vi
3

 6 THE QUARTERLY BULLETIN ~
accommodations. On November 1st we opened our iirst post- i
graduate course for American nurses in midwifery and frontier
technique, with two pupil nurse-midwives and with our Assistant
· Director, Miss Nora Kelly, in charge of the course. Two of the Q
three Hyden districts were consolidated into one, and all the {
maternity work on these two districts was given over to the ,
training school, while to a non-midwife nurse was given the Y 
sick nursing and public health on these two districts. Such of V
the maternity cases transferred to the Hospital as were normal  
were used for teaching purposes under the direction of the Hos-   -
pital nurse-midwife, Miss Betty Lester, while the pupil nurse- J
midwives were allowed to give nursing care under Dr. Kooser -
to the abnormal cases. When Miss Lester sailed for England,
Miss Louise Mowbray took over the Hospital teaching for the  
second class. Dr. Kooser gave the medical lectures and our first i
Assistant Director, Miss Dorothy Buck, the quizzes. The Ken-
tucky State Board of Health agreed to certificate the young
graduates of the course upon the satisfactory completion of an i
examination conducted by the Board. In the number of cases 1
given the pupil midwives, divided between the districts and the i
Hospital; in the course of lectures; in the classroom instruction; yp
the course corresponded to the four months’ course endorsed  
for nearly twenty years by the Central Midwives Board of Eng- J
land until it was lengthened in recent years. The Frontier Nurs- E
ing Service expects to be able to lengthen its course this au- L,
tumn; and will train at least six nurse-midwives at a time in- jg
stead of two, whenever we receive the funds to build a nursing Q;
home and release needed Hospital space for a maternity wing.  
Although this course is set up primarily to meet our own  
acute emergency caused by the war, it is also a part of our ,
permanent program. When our emergency has been met, we _
will be able at last to respond to the calls so frequently made  
upon us to provide frontier nurses for American outposts from A
the Caribbean to Alaska and including the Indian reservations. - `
We want to make special mention of the courtesy of the ,
Lobenstine Clinic in New York in taking two nurses to train  
for midwifery for us in their January class. These nurses come   j
to us in the late summer and will be ready for duty when our  
couriers have taught them to ride well enough to cope with a  

 · Fnoiwriicn Nunsimo smzvicn 7 o
i rough mountain country and when our older nurse-midwives
r have broken them in to our frontier technique.
Here follows a summary of the past fiscal year which closed
.  April 30, 1940. The fiscal statements are taken from the ex-
{ hibits and schedules of the audit, and the figures in the report
4  of operations are supplied by the statistical department of the
Y  Frontier Nursing Service.
_ FISCAL REPORT
i . We received this year from all sources, including donations
J and subscriptions, nursing, medical and hospital fees, investment
. income, the Alpha Omicron Pi Social Service fund, sales of books,
revenue from the Wendover Post Office, benefits, and fees for
i speaking engagements, a total for running expenses, new con-
; struction, new land and cottages, and retirement of debt, of
$104,702.26. .
, The total number of subscribers to the Frontier Nursing
‘ Service during the year was 2,635, the largest number we have
ever had. This figure includes 2,239 old donors and 396 new
,4 donors. Total gifts and contributions were $82,015.71. Our
3 grateful thanks are due the chairmen of several Frontier Nurs-
’} ing Service city committees for benefits and special appeals,
Q by means of which they raised funds during the past year. The
V total sum received from benefits and the Director’s speaking
  engagements was $4,823.11.
Y. Other sources of revenue during the past year have been -
  as follows:
*1 Income from Nursing Centers .............................................. $ 3,227.16
  Medical Fees ............................,............................................... 1,497.12
` Hospital Fees .......................................................................... 810.82
Wendover Post Oflice .............................................................. 825.10
Investment Income ................................................................ 11,293.45
§ Sundry small receipts, from the sale of F. N. S. books, the Leslie
` County Infantile Paralysis Fund ($26.01), and rent from cot-
.· tages on the Hyden property, bring the total receipts up to
$104,702.26.
  ENDOWMENT
Q g The Frontier Nursing Service received no new endowments
  during the past fiscal year. We have endowment gifts be-
  queathed in estates which have not yet been settled, and an

 n
1
8 THE QUARTERLY BULLETIN z
' Q
endowment for the Bettie Starks Rodes Memorial Baby Bed {
just after our fiscal year closed, and these do not therefore
come into this fiscal year’s accountability. The endowment
- funds of the Service to date are: j
Joan Glancy Memorial Baby Bed ..,..........................»,......, $ 5,000.00
Mary Ballard Morton Memorial ........................................ 53,024.53  
Belle Barrett Hughitt Memorial ........................................ 15,000.00 f,
Jessie Preston Draper Memorial Fund N o. 1 .................. 15,000.00 Q
Jessie Preston Draper Memorial Fund No. 2 .................. 50,000.00 '
Isabelle George Jeffcott Memorial ........................ _ ........,... 2 ,500.00   f
General Endowment (Marion E. Taylor Memorial) ...... 10,000.00 ;
General Endowments (Anonymous) ................................ 102,400.00  
Total ................................................................................ $252,924.53  
REAL ESTATE, BUILDINGS, AND EQUIPMENT l
(From Exhibit C of the Audit) y
The Frontier Nursing Service owns realty, equipment, and  
livestock conservatively estimated by our auditors, after adjust- I
ments in values have been written down or up, at $216,7 79.58,  
all without lien. __  
INDEBTEDNESS .  
The Frontier Nursing Service owes $10,000.00 to its trus-  
tees, left from a total of $50,000.00 loaned during 1930-1932, to  
enable us to tide over that difficult period. The Service is also  
indebted to the older members of its staff for the sum of Q 
$17,655.55, representing the amount, on a 2/3 basis, of unpaid  
salaries during the same years of adjustment and reduction.  l
Current bills unpaid at the close of our fiscal year amounted  Q
to $2,740.09. Cash on hand in banks was $2,171.55. Therefore,  
the Service was in arrears on last year’s budget to the extent _, 
of $568.54. This overdraft is allowed for in this year’s budget,  {
which is set at $98,000.00. j 
BUDGET FOR FISCAL YEAR 1940-1941 i
The budget for this year represents an increase of $6,000.00 ,4
over the budgets for the past several years but an increase of  
only $1,542.45 over the exact sum expended during the past  
fiscal year (other than special gifts for land and new construe-  
tion), which was $96,457.65 (Exhibit B of the Audit).  j
There are two reasons why the Frontier Nursing Service  ;
had to raise and expend more money during the past fiscal year  §
than was allowed for when its budget was fixed, and the same  
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  W
  FRoN·r1ER NURSING smavicm 9
` reasons apply to the new Hscal year in setting a larger budget.
The first reason is, of course, the new training school for grad-
p uate nurses in midwifery and frontier technique forced upon the
. Service by the war. This adds $3,000.00 to the budget. The
second reason is the rising cost of living. In comparing in-
3 voices this year with those of last year we End that the increase
g in costs of food, drugs, horse blankets, hay, and so forth, raised
. . the price at which we get all such supplies, and will make an
g increase of from $2,000.00 to $3,000.00 on the current fiscal
Q year. Therefore, we have allowed for this increase in price in
it I fixing this year’s budget.
gp ` There is nothing that can be taken out of our budget to
ji offset the increase in prices. We have learned from long experi-
ix ence in running a remotely rural piece of work, under circum-
{E stances of the most careful accounting, to evaluate the purchas-
  ing power of each dollar and keep costs at a minimum. An
  analysis of the budget will show that $53,000.00 of the $98,000.00
  is allocated to salaries; and yet no one in the Frontier Nursing
{2 Service, except the Medical Director, receives a salary of more
 , than $125.00 a month, out of which each member of the staff
'  pays her living expenses.
rj We give here an analysis of this budget, accepted by the
  trustees of the Frontier Nursing Service at the sixteenth annual
 fg meeting, at the Louisville Country Club, on May 28, 1940.
 I Field Salaries .......................................................................... $53,000.00
 E Field Expenses (General)
jj I (Bulletins, stationery, stamps, printing and ap-
  peals, auditing, advertising, telephone and tele-
  graph, etc.) .................................................................... 8,000.00
 g' II (Dispensary and Hospital supplies, freight, haul-
 g; ing, car expenses and gasoline, laundry, etc.) ........ 12,500.00
 .  Feed, Care, and Purchase of Horses .................................... 6,500.00
,  Social Service Department .................................................... 3,000.00
 i Interest on Borrowed Money ................................................ 300.00
. Repayment of Money Borrowed .......................................... 1,000.00
·. , Insurance
( (Fire, employer’s liability, car insurance on 3
, V cars) .................................................................................. 1,000.00
 2  Repairs, Upkeep, and Replacements .................................. 7,700.00
  Training School for Frontier Nurse-Midwives ................ 3,000.00
 {i Miscellaneous Promotional Expenses
 , (Invitations, stamps, petty cash sent outside city
 g committees for annual meetings and benefits) ........ 500.00
5 Contingencies ............................................... . .......................... 1,500.00
rl  ‘* 
 , $08,000.00
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10 THE QUARTERLY BULLETIN  
REPORT OF OPERATIONS  
Field and Hospital {
The field nurses carried during the year a total of 8,517  
` people in 1,712 families. Of these, 4,960 were children, including y 
2,279 babies and toddlers. Bedside nursing care was given to
278 very sick people, of whom 19 died. The district nurses  
paid 19,559 visits and received 19,188 visits at nursing centers.  
In addition, 4,242 visits were received at the doctor’s clinic in 1
Hyden. The Frontier Nursing Service Hospital at Hyden was ‘
occupied 4,383 days by 507 patients. There were sent to hospi- l 
tals and other institutions outside the mountains 51 patients 3,
who, with their attendants, were transported on passes given .
by the Louisville and Nashville Railroad Company. F
Under the direction of the State Board of Health, the  
Service gave 5,115 inoculations and vaccines against typhoid,  
diphtheria, smallpox, etc., made 11 tuberculosis skin tests and  gi
5 Schick tests, and sent off 1,560 specimens for analysis.  
During the year 187 iield clinics were held with an attend-  
ance of 5,835 people.  il
lv[3.l3Bl'l1ll7y  
Registered Cases `
The maternity work was unusually heavy this year. 443  
new antepartum patients were admitted into the regular ma-  
ternity service. The Frontier Nursing Service delivered 413 pa-  
tients during the year. This is the largest number in the his-  
tory of the Service, eight above the seventh iiscal year (the year {
before the curtailment of work necessitated by the depression)  
and twenty above any year since. There were 427 patients dis-  
charged from the maternity service at the close of their puer- ’ 
perium.  E
Of the 413 women delivered, 354 were delivered in their . 
own homes--2 by the medical director, 26 by pupil midwives `‘‘\
under graduate midwife supervision, 326 by the nurse-midwives. i,
The remaining 59 women were delivered in the Hyden Hospital-  
3 by the medical director, 1 by the visiting surgeon, 22 by the !
pupil midwives under supervision, 33 by the Hospital nurse-  l,
midwife. There were 5 women who miscarried. The other 408  
were delivered of 412 babies including 4 sets of twins. There  li
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it

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§ FRoN·1·1E12 NURSING smizvicm 11
i were 18 babies born prematurely, 394 at full term; 13 were
1 stillborn. There were no maternal deaths.
Q Emergency Cases
y  In addition to regular registered cases, the Frontier Nurs-
p ing Service answered emergency maternity calls of 18 women
  not previously registered—14 in their own homes, 4 admitted
  to the Hospital. Of these 18 women, 12 miscarried and 6 were
delivered of full term babies. There were no maternal deaths.
i Outside-area Cases
  The Frontier Nursing Service delivered 27 mothers who had
I come from outside its territory in order to obtain this service.
V; Of these 18 were delivered in the Hyden Hospital, 9 in homes
  within the districts. There were 1 miscarriage, 1 stillbirth, and
`*  25 full term, live babies in this group. There was one maternal
 i death. The patient who died came to the Hospital from her
  home outside our territory. She then showed very severe anemia
  (hemoglobin only 20%), cardiac disease and pellagra. After two
  days in the Hospital she insisted on going home and we saw no
` more of her until she was brought back a week later in labor,
  and collapsed. She died four hours after admission, undelivered.
· Medical and Surgical
  Dr. R. L. Collins and Dr. J. E. Hagen of Hazard, Kentucky,
E performed numerous operations during the year, those on indi-
§ gent people as a courtesy to, the Service. None of the doctors
j in the various cities to whom the Service sent patients made any
I charges for their services. The regular medical work was car-
 ? ried by the Frontier Nursing Service Medical Director, Dr. John
,  H. Kooser, and, during his absence, by Dr. Samuel Kirkwood of
Q Boston and Dr. Isadore Dyer of Oklahoma. The Service is par-
  ticularly grateful to Dr. F. W. Urton of Louisville and Dr. Fran-
  cis M. Massie of Lexington for again giving their services for
rl tonsillectomy and surgical clinics at the Hospital at Hyden.
 , The Service is also deeply grateful to Dr. Josephine Hunt,
  Dr. Scott Breckinridge, and their associate members on the Medi-
 i cal Advisory Committee in Lexington, Kentucky, for the atten-
Q tion they have given, gratuitously and so graciously, to both
if patients and members of the staff sent down to them on various
 Bi
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12 THE QUARTERLY BULLETIN g
occasions; to the Children’s Free Hospitals in Cincinnati and  
Louisville for gratuitous care given the children sent them; to  
the Louisville and Nashville Railroad for free passes; to the  
. Kentucky Crippled Children’s Commission, the Kentucky School  
for the Blind and the School for the Deaf for care of our pa- Y
tients; and to Miss Florence Johnson and her associates in the ;
Nursing Service of the New York Chapter of the Red Cross for {
their kindness in meeting at the dock new nurses coming to us K
from overseas before war was declared. “
Pellagra Clinic i
Dr. Kooser’s Pellagra Clinic, held in cooperation with the 2
Perry County Health Department, at Hazard, treated sixty-four L
pellagrins with nicotinic acid during the past year. In addition ‘~
to the cases treated, others were examined and were found to _
be free of pellagra. The patients made 493 visits to the Clinic. J
In collaboration with Dr. M. A. Blankenhorn of the Uni- l
versity of Cincinnati, Dr. Kooser has written a full report of his  
work in pellagra for the Journal of the American Medical Asso-  
ciation, June 24, 1939. We will be glad to send a reprint of this  
report to anyone who wants it.  
SOCIAL SERVICE DEPARTMENT Q 
(Alpha Omicron Pi Fund)  
Service and aid have been given in connection with the fol-  5
lowing numbers and types of cases:  .
Dependent and neglected children: 13 cases  
Handicapped children: 11 cases  
Medical-social cases: . 56 cases: Of these  {
40 were sent to hospitals else-  Y
where ,5
16 were given service of other `
kinds  Z
Assistance to families, usually to  .
meet an acute need: 26 cases  
Miscellaneous services: 17 cases ; 
Total 123 cases  
Service also has been given in connection with the following I
group or community activities: e 
Knitting classes: beginning and advanced  
Circulating libraries  
Christmas celebrations QT
Tuberculosis and Crippled Children’s clinics  

   -
I FRONTIER NURSING SERVICE 13
I
I
' Crippled Children’s Seal Sale Campaign
t Red Cross Drive
, County Red Cross Chapter—Leslie County and Clay County, Kentucky
I Girls Sewing Pr0ject—National Youth Administration, Clay County, Ky.
  GUESTS
  The Frontier Nursing Service entertained at Wendover 127
I, overnight guests who stayed 360 days. Wendover also enter-
  tained for meals 245 guests for 319 meals. Included among
these guests are both outside and mountain friends. No exact
record has been kept of the guests at the Hyden Hospital and
outpost centers.
. VOLUNTEER WORKERS
_ Twenty-two couriers and other volunteer workers (Christ- ,
mas Secretary, volunteer clerical assistants) worked for the
Frontier Nursing Service a total of 1169 days. They lived at
f Wendover, the Hospital and the outpost centers.
I
1
f FIFTEEN-YEAR TOTALS
  Now that the Frontier Nursing Service has just passed its
  sixteenth birthday, it may be of interest to our members to read
  a few totals covering the whole fifteen-year period of our work.
I Patients registered from the beginning——Total ....,............... 20,678
II Babies and toddlers .............................................. 8,361
p' School children ...................................................... 4,813
Ig Adults ....................................,................................. 7,504
ii Midwifery cases (reg.) delivered ...........................................   4,153
I. Inoculations—Total .................................................................... 109,001
' · Typhoid ,....... . ......................................................... 74,499
  T.A.T. or Toxoid .................................................. 20,646
». Other ...................................................................... 13,856
` Nursing visits paid in homes .................................................... 270,592
g  Visits received at doctors’ and nurses’ regular clinics ........ 254,662
· Visits received at doctors’ and nurses’ special clinics ...,.... 78,000 plus
, These include clinics held by visiting physicians in gyne-
3 cology; neurology; eye, ear, nose and throat; tracoma; or-
_ thopedics; pediatrics; helminthology (worms, including
. hookworm) pellagra.
g Patients admitted into the Hyden Hospital .......................... 4,122
3 Number of days of occupation .................................................. 43,094*
*'1`he F. N. S. Hospital at Hyden was not opened until the
{ fiscal year 1928-1929 and was operated only six months in
lj that year.
  CONCLUSION
N During all of the past diflicult months, we have had the
3Y support of our city and mountain com