The CommonHealth of Kentucky

A 13-part KET production aimed at improving the health of all Kentuckians by sharing health and wellness projects from across the state that are succeeding in making their communities healthier.

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a project of KET’s Be Well Kentucky initiative

Foundation for a Healthy Kentucky
The CommonHealth of Kentucky is a 2005 KET production. Produced in partnership with the Foundation for a Healthy Kentucky with funding from the Robert Wood Johnson Foundation.

Frontier Nursing Service

Leslie County

Frontier Nursing Healthcare Rural Health Clinics
200 W. Vine St., Suite 415, Lexington, KY 40507, (859) 253-3637
(Clinics located in Clay and Leslie counties.)
Bed & Breakfast Inn at Wendover: (606) 672-2317

One of the most important criteria for selecting the “Models That Work” to be featured in The CommonHealth of Kentucky was that they be able to be replicated in other communities. Perhaps none of our examples meets that requirement better than the Frontier Nursing Service, which was founded more than 80 years ago with exactly that idea in mind.

Mary Carson Breckinridge, who founded the FNS, was conditioned to a life of public service by family background. Her father was a congressman and ambassador, and her grandfather was a U.S. vice president. After one marriage that left her widowed at 25, another that ended in divorce, and the deaths of her two young children, Mary decided to devote the rest of her life to the causes of maternal and child health. She served with the Red Cross in World War I France, studied midwifery in England, and traveled the U.S. as a spokesperson for the National Children’s Bureau.

Those travels had brought Breckinridge to Eastern Kentucky at one point, and in 1925 she decided to return there to establish a midwife service. She later explained that she was drawn to the area by its scenic beauty, by the “integrity and decency of the mountain people,” and by the challenge: If a successful health care service could be established in this remote area with few roads and almost no electricity or phone service, then the same could be done anywhere.

Breckinridge set up a home and headquarters at Wendover, a small community outside Hyden in Leslie County, and began recruiting and training nurse-midwives—a new concept to America. She and her colleagues covered a 700-square-mile area on horseback, carrying their medical supplies in saddlebags. Their primary purpose was to deliver babies. (Mountain children who asked where babies came from were sometimes told that “the nurses bring them in saddlebags.”) But word that a nurse was on her way would inevitably draw a crowd of neighbors, and the FNS nurses ended up treating all sorts of ailments. Payment might be produce from the garden, labor to help build a clinic, or even a puppy, since the nurses traveled with dogs along to help fend off snakes and feral pigs.

The effectiveness of Mary Breckinridge’s idea became evident almost immediately. The infant mortality rate in the region, among the nation’s highest at the time the FNS was founded, began dropping steadily until it was one of the lowest in the country.

Family health is still the focus of Frontier Nursing Service Healthcare, which today operates clinics in Manchester, Big Creek, Hyden, and Asher. Family nurse practitioners and nurse-midwives work alongside physicians to provide low-cost health care to this medically underserved region. In addition to primary care, the clinics offer various programs to deal with such long-term health issues as diabetes, smoking, and cancer.

The FNS also continues its founder’s emphasis on training. The school she started for nurse-midwives has evolved into the Frontier School of Midwifery and Family Nursing, a sister corporation of FNS Healthcare that provides both on-site and distance-learning education for advance-practice nursing students. In the true spirit of Mary Breckinridge, one FSMFN alumna serves rural Alaska, traveling between far-flung settlements in a small airplane.

Breckinridge was also a skillful and creative fund-raiser, and that spirit lives on, too. Her historic home at Wendover has been converted to a bed-and-breakfast inn, with the proceeds supporting the work of the FNS clinics.

600 Cooper Drive, Lexington, KY 40502 (859) 258-7000 (800) 432-0951