Merlene Davis: Nursing school's name changed; vision remains the same

The Frontier School of Midwifery and Family Nursing in Hyden is now Frontier Nursing University.

No need to worry, though.

The name of the historic graduate school for nursing officially changed July 1, but the institution's mission remains the same.

"Our focus is educating nurses to serve the under-served," said Susan E. Stone, president and dean of the university. "That is our mission."

More than 1,100 nurses from throughout the country are enrolled in the school's nurse-midwifery, nurse practitioner, and doctorate of nursing practitioner graduate programs while living and working in their home communities. Most of those communities are designated as rural, which is in keeping with the vision of Mary Breckinridge, who founded the Frontier Nursing Service in Eastern Kentucky in 1925 and the school in 1939.

The school's name change "connects our past with the future," said Stone, herself a graduate of Frontier.

Stone said that in 2004, the school began offering master's degrees in nursing, so students didn't have to pursue them elsewhere. And it offers a doctorate in nursing practice.

"Because the school is offering all those options, we all thought it was good to change the name," she said.

"By combining the Frontier Nursing heritage with the academic prestige of the 'university' title, we will be able to more appropriately describe our unique institution," Stone said.

All 50 states are represented by students enrolled at FNU, which is a private, non-profit, non-residential graduate school of nursing. The students attend through the distance-learning program, which allows them to remain a vital part of their own communities while completing coursework and clinicals. Two sessions on the Leslie County campus are required: orientation and intensive workshops before clinicals.

Unfortunately, midwifery is accepted more widely in other states than it is in Kentucky, Stone said.

"Ninety-three percent of our nurse midwifery graduates work as midwives," she said. "If they are willing to relocate, they can find a job."

That's mystifying considering that 70 percent to 80 percent of most births are low-risk and can be easily handled by a midwife.

Stone said Florida and New York use a "tremendous number" of midwives, as do Pennsylvania and California.

Kentucky has 98 licensed nurse-midwives, she said, compared with 2,804 nurse practitioners who practice in medical offices, clinics and other facilities, managing common illnesses and injuries and providing information for healthy living.

Of the 1,100 students at Frontier, 176 are working and studying in Kentucky. Nurse practitioner students account for 147 of them, 20 are nurse-midwives, and the remaining nine are in other programs.

Stone said nurse-midwives, who are nurses with master's degrees, do more than attend births. They take care of the patient before and after birth and conduct annual physicals.

Most areas with a large number of hospitals tend not to use nurse midwives, Stone said. But Lexington has shown some movement toward changing that in recent years.

Plus, the new federal health care law makes it more practical for midwives and nurse practitioners to set up shop because it allows 100 percent reimbursement from Medicare for their services. Before, they were reimbursed only 65 percent.

Stone is a nurse-midwife herself, graduating from the first distance-learning class held at the school in 1989. Since then, she has risen through the ranks, dedicated to continuing Breckinridge's vision.

Because of that dedication and the fact that under her leadership, the school's enrollment has more than tripled since 2004, a group of her peers at the National Rural Health Association named her the distinguished educator of the year for 2011 at the association's annual conference in May.

"I was given the award because our mission is to educate nurse practitioners in rural and underserved areas," said Stone, who was named president and dean of the school in 2000. "Seventy-five percent of our current enrollment is in rural and medically underserved areas."

That is what Breckinridge hoped for when she chose Eastern Kentucky as her service area in the 1920s.

Breckinridge, who dedicated her life to the welfare of women and children, traveled the mountains of Eastern Kentucky on horseback with others to provide health care in remote areas. After discovering the benefits of nurse midwifery during visits to Europe, she recruited nurse-midwives from Great Britain, who joined Frontier Nursing Service and became the first nurse-midwives in the United States.

When World War II unfolded in Europe, the British nurse-midwives returned to their homeland. Breckinridge then started the Frontier Graduate School of Midwifery, as it was then named, with two students.

The school has been in continuous operation since. It created the country's first family nurse practitioner program in 1970, adding the doctorate in nursing practice over the years. Nearly 3,000 nurses have graduated from the school, which is now exploding in popularity.

"I hope we can keep educating nurses," Stone said. "Our health care system needs help.

"Until it becomes about people instead of economics, people will continue getting caught up in the health care system," she said. "We have a focus on health. We are trying to teach people to take care of themselves."