xt7wm32n7d0v https://exploreuk.uky.edu/dips/xt7wm32n7d0v/data/mets.xml The Frontier Nursing Service, Inc. 2008 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. 84, No. 2, December 2008 text Frontier Nursing Service, Vol. 84, No. 2, December 2008 2008 2014 true xt7wm32n7d0v section xt7wm32n7d0v   FRONTIIER NURSHNG SIERVHCE Ma  , ~; we  % : Q
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 FRONTIER NURSING SERVICE
I US ISSN 0016-2116
TABLE OF CONTENTS
Introduction to FNS 1
The Joumey — Nathan Lee 2 {
Field Notes — Barb Gibson 4
Beyond the Mountains — Barb Gibson 7
Legacies - Charity Galena (Moore) Patterson 12
Former Staff & Courier News 16
Frontier School of Midwifery & Family Nursing 17
-Dr Susan Stone, President & Dean
Eighty-Third Annual Report 20
In Memoriam & In Honor Of 44
Urgent Needs 52
Cover Photo - FNS Outpost Clinic A
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Frontier Nursing Service Quarterly Bulletin is published at the end of I I
each quarter. Subscription Price $5.00 a year for Donors/$15.00 for In- p
stitutions. Periodicals postage paid at Wendover, Kentucky 41775 and 1
at additional mailing oflices. POSTMASTER: Send address changes
to FNS, Inc. 132 FNS Drive, Wendover, Kentucky. Copyright FNS/Inc.
All Rights Reserved. The Frontier Nursing Service does not share  
it’s donor mailing list.  
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Introduction to Frontier Nursing Service (FNS)
A Mary Breckinridge spent her early years in many parts of the
world — Russia, France, Switzerland and the British Isles. After
the deaths of her two children, she abandoned the homebound life
, expected of women of her class to devote herself to the seryice
of others, particularly mothers and children.
Mrs. Breckinridge established the FNS in Leslie County, Ken-
, tucky, in 1925, as a private charitable organization serving an
I area of 700 square miles. It was the first organization in America
to use nurses trained as midwives under the direction ofa single
, medical doctor/obstetrician, based at their small hospital in Hyden.
  Originally the staff was composed of nurse—midwives trained in
  England. They traveled on horseback and on foot to provide qual-
ity prenatal and childbirth care in the client’s own home.
Today, Mrs. Breckinridge’s legacy extends far beyond Eastern
Kentucky. FNS, Inc. is the parent holding company for Mary
§ Breckinridge Healthcare, Inc., Frontier Nursing Healthcare, Inc.,
l which includes five rural healthcare clinics; Mary Breckinridge
I Home Health Agency and the Frontier School of Midwifery and
l Family Nursing which offers a Master of Science in Nursing de-
gree with tracks as a Nurse-Midwife, Family Nurse Practitioner,
Women’s Healthcare Nurse Practitioner and a Doctor of Nursing
Practice (DNP) degree.
  Mary Breckinridge’s home, The Big House, located at Wendo-
` ver, is a licensed Bed & Breakfast Inn. For more information or
_ I reservations, call 606-672-2317 or e—mail: infonnation@frontier-
I nursing.org. You can also access our website:
  Frontier Nursing Seryice — www.frontiemursingorg
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r The Journey
by Nathan Lee, President & CEO
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Winter is here. Finally. We were starting to think that "Old
Man Winter" had forgotten us here in Leslie County. At our Fall
Festival in Hurricane Pasture just a few short weeks ago, staff from Q
across the Service enjoyed their barbecue and pecan pie in the  
80 plus degree warmth of a bright sun. The perennial wishes for ‘
jackets and sweaters at this annual event were replaced by hopes .
for shade or a cool sip oflemonade. But yet . . . here we are . . . in I
December. Finally, there is frost on the window panes ofthe Big
House and the Christmas greens have been hung. At last, a fire '
crackles in the fireplace below Mrs. Breckinridge’s portrait, and
hot tea and cocoa warm the hands and hearts of our visitors. How
silly it seems now to have even joked that winter wasn’t coming. jh
Of course, it always does . . . as reliably as time itself  
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Reliability seems a scarce commodity these days. We’ve all  
watched as institutions as unsinkable as the Titanic have met
the same fate. While healthcare is in many ways immune to the
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 QUARTERLY BULLETIN
negative pressures of our ailing economy, the FNS has still felt
the sting of recent financial turmoil. More and more patients
are coming to us having forgone the benefits of preventive care
U they thought would be too expensive, and more and more of
those patients are receiving free care from us as a result of their
, indigence. Increasingly, we’ve seen both private and government
insurers slow or decrease their reimbursements to us as they have
felt the pinch of their own dwindling resources. We watched this
summer and fall as institutions which had formerly made loans
to our students pull out of the market or collapse altogether. And,
like so many other non—profits, we’ve watched the value of our
endowment decline dramatically. It’s been a "perfect stom1" that’s
made for an incredibly challenging financial year at FNS; one that
will likely continue for months to come. You’ll see as much in
the most recent audit report included in these pages.
But just as winter, as steady and reliable as the sunrise, has crept
through the peaks and valleys of our Appalachian Mountains, so
too have our supporters remembered the value and importance
of our work here. At a time when most charities are seeing
significant declines in giving, the Frontier Nursing Service has
seen our recurring gifts increase by more than five percent. I think
Mrs. Breckinridge had a keen awareness of the reliability of our
supporters when she noted, ". . . we always expect the best to
happen, and often it does . . ." The FNS is responding to the current
economic situation in a cadre of fiscal and operational ways. But
just as, or perhaps even more importantly, we are responding to
' the health needs that mothers, children, and families in our area
and beyond are experiencing, very often in a more acute way, as
a result of the nation’s current economic challenges. It is, after
if all, for them that we exist at all.
The path is rocky, but the FNS has crossed rocky paths before. The
stream is swollen, but the FNS has forded rivers wide. The climb
  is steep, but the FNS has crested high mountains. The Joumey
j continues, and we are honored that you make it with us.
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- Field Notes
Leslie County School-Located Clinics _
The Kentucky School-Based Healthcare Network News recently `
featured the Frontier Nursing Service and C.O.L.L.Y (County of
Leslie Lifting Youth) and their partnership in establishing school- ,
located clinics in Leslie County. The first school-located clinic
opened during February 2007 at the Stinnett Elementary School.
Since that time, clinics have been opened at the W.B. Muncy and
Hayes Lewis Elementary Schools. The partnership has also made
it possible to provide dental services in association with the UK
Center for Rural Health.
Wendover Guests Update
From September l, 2008 - December l, 2008, Wendover hosted a
total of 850 guests. This number includes ovemight guests, tours
and special lunches/dinners/meetings and activities.
October 24, 2008, Senator Mitch McConnell and his wife, Secre-
tary of Labor, Elaine Chao, US Congressman Hal Rogers, Ken-
tucky Senator David Williams, field representatives and support
staff, had lunch at Wendover while campaigning in the area.
Rural Healthcare Centers Update
The School—Located Clinics, while challenging, have provided the
most rewarding outcomes and excitement among our providers as
we see a noticeable impact on the access to healthcare for these
children, which might not have been seen before. `
Maternity services continue to expand as a result of patient _
requests affording us the opportunity to place Certiiied Nurse -
Midwives in three ofour outlying clinics. As an offshoot ofthis
service we anticipate re—initiating, at least in principle, home visits
in the style of the nurses on horseback. Fortunately we will be
utilizing automobiles instead of horses. g
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As our eyes remain focused on our primary mission, we shift our
attentions to the coming holiday season and a special time in which
.. we give back to the community through our Children’s Christmas
Program. Each year the Clinics provide gifts to the children in
their communities, and we were fortunate last year in our ability
· to reach out to approximately 500 children. This year we continue
this service and hope to reach even more homes.
While we always look towards the future, we must remember our
past and the lessons that brought us to this point. The desire and
more importantly the dedication that we all share in accomplish-
ing Mrs. Breckinridge’s mission would definitely make her smile.
This truly is a blessed service.
Mary Breckinridge Festival Update
This year’s Mary Breckinridge Festival during October, was one
of the most successful ever held. The festivities began earlier
in the week with FNS and the Bluegrass School of Traditional
Music sponsoring a concert on Thursday night, October 2nd with
Bluegrass Performer Larry Sparks and the Lonesome Ramblers.
The fun continued with the Mary Breckinridge Festival Parade
being held on Saturday moming — the Mary Breckinridge Hospital
iioat won first place trophy. The Mary Breckinridge Hospital’s
Annual Community Picnic was held Friday, October 3rd, with
over 600 people participating. FNS bused in all fourth and fifth
grade students for the picnic and a day of activities.
C ourier Program Update
The following Couriers participated in the Courier Program over
. the summer months: Lily Burke, Four Corner, Vermont- student
at Case Westem University (CWRU), Cleveland, Ohio; Sarah
Stark, Painesville, Ohio, — student at CWRU; Lucy Chapin, Post
Mills, Vermont - student at Middlebury College; Joanna Benoit,
Lancaster, Massachusetts, - student at Hartford University and
i Elizabeth Lagan, West Simsbury, Connecticut.
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 FRONTIER NURSING SERVICE C
‘ Wendover F all Festival I
Wendover’s Annual Fall Festival was held Thursday, November
6th at The Livery and Hurricane Pasture with approximately g
75 employees attending. The smoked turkey, BBQ pulled pork j
and Hxings were prepared by Elmer Sparks, Jr., Chief of the Big I
Creek Fire Department. Games included Cake Walk, Sack Race, .
Three—legged Race, Com Hole and a Pie Eating Contest with
Wendover Maintenance Employee, Jeffery Hall, being the first
place winner and Kevin Couch, MBH Controller, second place
winner. Special thanks to FNS Board Member Rhonda Brashear
and FNH Clinics Director Ben Peak for providing singing and
music for the event.
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"To get the full value of joy you must have somebody to divide i
it with." —Mark Twain I
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 QUARTERLY BULLETIN
Beyond the Mountains
Daughters of Colonial Wars
` Ginny (Ledegang) Mucciaccio, State Treasurer ofthe Massachu-
setts Daughters of Colonial Wars, wrote that her mother, Ethel W.
_ Ledegang, passed away during August at the age of 101 years.
Mrs. Ledegang knit more than 1,000 baby caps for the FNS to
be presented to nurse—midwife1y students for the first baby they
"catch" identifying them as an FNS baby when the cap is placed
on their head. The caps are presented to students when they come
to Wendover for dinner during their Clinical Bound Classes.
Mrs. Mucciaccio wrote that her mother stopped knitting the caps
during the past year only when her skin became fragile and chafed
from the yam and needles going back and forth. Mrs. Mucciaccio
wrote that she found notes written by students to her 1no1n saying
how anxious they were to "catch" their first baby. We greatly ap-
preciate the efforts made by Mrs. Ledegang in identifying over
1,000 FNS babies in many different areas across the country.
Kitty Ernst Featured in Time Magazine
August 18, 2008, Eunice "Kitty" Emst, Mary Breckinridge Chair
at the Frontier School of Midwifery & Family Nursing, was fea-
tured in an article in Time Magazine, "Giving Birth at Home",
focusing on the fact that amid high-tech interventions, old-fash-
ioned labor is gaining appeal.
“ National Philanthropy Day - Ruth Beeman Honored
November 18, 2008 was National Philanthropy Day sponsored
by the Association of Fund-Raising Professionals - Bluegrass
Chapter, at the Hyatt Regency Hotel in Lexington, Kentucky.
The Frontier Nursing Service honored Ruth Beeman, former
. Dean of the Frontier School of Midwifery and Family Nursing.
  The purpose of National Philanthropy Day is to honor individuals
  and organizations that have made a great impact on communities
  through their philanthropic contributions.
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 FRONTIER NURSING SERVICE I
· Committee Luncheons Update Q
Fall committee luncheons began with the Louisville Committee p
held at the Louisville Country Club September 24th. Forty friends  
of the FNS attended the Luncheon and enjoyed hearing the latest
update presented by Mr. Nathan Lee, President & CEO. Special
thanks to Mrs. Betty Brown for hosting the event. .
The Bluegrass Coininittee Luncheon was held the next day,
September 25th at the Lexington Country Club with almost 100
people in attendance. We were honored to have the First Lady of
Kentucky and FNS Trustee Mrs. Jane K. Beshear, as our guest
speaker. Special thanks to Mrs. Linda Roach, Ms. Helen Rentch
and Ms. Fra Vaughan for work as committee chairs. Through their
efforts, more than 20 new people were introduced to the work of
the FNS.
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Nathan Lee, Mrs. Mary Clay Mrs. Jane K Besheur and
Stites and Mrs. Betty Brown Nathan Lee
On Wednesday, October 21st, Nathan Lee and Kate Ireland trav- 0
eled to Dedham, Massachusetts, to host the Annual Boston Com- é
mittee Luncheon. A gathering of former Couriers in the area was l
held the evening before at the Dedham Club. Special thanks to l
Mrs. Caroline Standley and Mrs. Patsy Lawrence for serving as
co—chairs and for their help in coordinating the Luncheon. Other

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  QUARTERLY BULLETIN
Q guests included Tia Andrighetti, Libby Borden, Elise R. Browne,
p Caroline Cabot, Lois Cheston, Brooks Lobkowicz, Celia Morris,
@_ Judy Sterry, Lees Breckinridge Yunits, Butch Wallace and Sally
Willis.
i, Kentucky Women K Health Summit
Nathan Lee, CEO & President and other FNS staff, attended the
Kentucky Women’s Health Summitt sponsored by the Kentucky
Commission on Women and the Kentucky Cancer Program. Mr.
Lee presented the first Mary Breckinridge Pioneer in Wo1nen’s
Health Award to Dr. Shin—je Ghim during the Mary Breckinridge
Luncheon.
A Dr. Ghim, in partnership with the Brown Cancer Center’s Dr. A.
Bennett Jenson, developed the hrst vaccine against human papil-
P lomavinis (HPV), the virus that can cause cervical cancer.
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h Tonya Nicholson, Aggie Hoegei; Allison Mattila, Renda Joy
Holladay, Heidi Froemke, Susan Stapleton, Maiy Jordan, Grace
_ Ellen Urquhart and Valerie Acosta
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 FRONTIER NURSING SERVICE
- We are deep into the preparations for our SACS reaffirmation
process. As you may all remember, the Southem Association of
Colleges and Schools (SACS) is the accreditation organization p
for FSMFN. It is hard to believe it but it has been five years since S
our first accreditation with SACS and we are due again to go
through the peer review process which is designed to assure the ,
educational excellence of our programs.
One requirement of the accreditation process is that we engage
in the development of a Quality Enhancement Plan (QEP). The
purpose ofthe QEP is to develop an effective quality improvement
process that is specifically designed to improve leaming outcomes
for our students. The initial task was to bring the faculty, students,
and staff together to identify a specific proj ect that would improve
leaming. After many meetings between faculty, staff and student
council as well as surveys of students, we have a plan. We intend
to develop a Community of Inquiry (COI) at Frontier. We have
long embraced the idea of a culture of caring as a way to enhance
the education al experience. We came across the Community of
Inquiry (COI) model in the education literature as a method of
developing more than a culture of caring; a culture where car-
ing, inquiry, and learning occurred in a carefully created online
environment. The COI model was first described by Garrison,
Anderson and Archer (2000).
Frontier has been very successful in educating students at a dis-
tance for the past 20 years. But things are changing again. The
technology is moving ahead so quickly affording us more oppor— l
tunities to interact with our students in the online environment.
For example, we can talk to our students online, show videos, do
power point slides, create simulated case studies, and offer lectures
as podcasts. The COI model will help us to create an environment
where we can systematically design our courses to improve leam-
ing while using the technology to interact effectively.
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 QUARTERLY BULLETIN
The COI model contends that effective online teaching and/or
learning is the function of three types of presences embedded
within the online curriculum. The presences include: (l) Social
l presence, the ability of learners to feel socially and emotionally
connected in the online environment; (2) Teaching presence, the
_ design, facilitation, and direction of cognitive and social processes
for the realization of personally meaningful and educationally
worthwhile leaming outcomes and (3) Cognitive presence, the
extent to which leamers are able to construct and confinn leam-
ing through sustained reflection and discourse (Garrison et al.,
2000).
We believe that adoption of the COI model at Frontier will take
the teaching methods used by our faculty to the next level. Our `
mission of providing the highest quality education that prepares
nurses to become competent, entrepreneurial and compassionate
nurse-midwives and nurse practitioners will be further fulfilled
by our being able to reach across all learning styles to provide the
best education possible using distance technologies. We will be
carefully designing the strategies and measuring the results. This
is a five year plan, the results of which will be reported annually
in the F SMFN President’s report.
Finally I want to thank all of you for your ongoing support of
our School and all of FNS as we constantly strive to improve our
programs. I want to wish all of you a wonderful holiday season
and the very best New Year as we rapidly approach 2009 mark-
I ing twenty years of distance education at the Frontier School of
Midwifery and Family Nursing.
Reference
Garrison, D. R., Anderson, T and Archer W 2000. Critical inquiijv
in a text—based environment: Computer catywencitig in higher
education. The Internet and Higher Education 2 (2-3): 87-105.
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 FRONTIER NURSING SERVICE
EIGHTY-THIRD ANNUAL REPORT
OF THE
FRONTIER NURSING SERVICE
For thc Fiscal Year
May 1, 2007 - April 30, 2008
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lndependent Acc0untants' Report on Consolidated Financial
Statements and Supplementary Information
Board of Governors
FNS. lnc. and Affiliates
Lexington, Kentucky
We have attdited the accompanying consolidated statements of financial position of FNS, lnc. and
Affiliates (Service) as of April 30, 2008 and 2007, and the related consolidated statements of
activities and changes in net assets and cash