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Frontier Nursing School is U.S. Birthplace of Midwifery and Family Nursing

by John Gregory | 08/26/14 10:24 AM

This October, alumni and friends of Frontier Nursing University (FNU) will gather to mark the 75th anniversary of the Hyden, Kentucky-based school and its commitment to training nurses and midwives to serve in rural and impoverished areas.

This weekend on KET's Connections, Dr. Susan Stone, president of Frontier Nursing University, and Dr. Julie Marfell, Frontier's Dean of Nursing, joined Renee Shaw to talk about the history and current work of the institution.

Created by Frontier Nursing Service founder Mary Breckinridge, the school is the longest continually operating and largest midwifery program in the nation. Dr. Stone explains that in the 1920s and ’30s, Hyden, deep in the mountains of southeastern Kentucky, was an isolated community. There were no roads to the town, so visitors had to endure a 15-mile horseback ride just to reach Hyden. Stone says Breckinridge chose Leslie County for her nursing service and school because she wanted to prove that community health efforts could be successful even in the most remote locales.

A Commitment to Rural Health Care
Today, FNU is fully accredited to offer masters and doctoral degree programs for nurse-midwives and women's health nurse practitioners. U.S. News and World Reports has listed FNU among the top 50 graduate schools of nursing in the nation.

Marfell says FNU has an annual enrollment of about 600 students, coming from all 50 states and multiple foreign countries. While most of the students are female, Stone says they are seeing a slow increase in the number of men who apply. Their two-year program combines visits to the Hyden campus, along with online instruction, and clinical work near where the students live.

Marfell says the majority of their students come from rural communities, or regions that are medically underserved.

"Most of them talk about how they see health care being administered in their communities, [about] how maternal/child care is there," Marfell says, "and they really want to make their community a better place."

Types of Services Provided
Stone and Marfell say a general shortage of doctors and nurses in rural areas, combined with newly-insured people seeking health care under the Affordable Care Act are both driving up demand for nurse-practitioners and midwives.

Nurse-practitioners provide a range of primary care services; they can conduct routine checkups, order and interpret tests, make diagnoses, and prescribe medications. While some Kentucky counties still lack medical doctors, Marfell says every county at least has a nurse-practitioner. She expects to see more practices opening in the future thanks to recent legislation that's enabled nurse-practitioners and advanced registered nurses to operate more independently of doctors.

Meanwhile midwives are qualified to provide pre-natal, birthing, and post-partum care to women and their children. Marfell explains that midwives work in collaboration with a team of health care providers, so if a mother needs more intensive medical attention, the midwife can call in those resources.

The Home of American Midwifery
With such a limited enrollment, Marfell says competition to enter the school is highly competitive. Prospective students must have high GPAs, three references, good writing skills, and demonstrate a passion for the work. She says tuition is comparable to other state schools.

Once through the program, Stone estimates starting salaries for midwives and nurse-practitioners to range $78,000 – $95,000 a year. She expects demand for FNU's graduates to increase as current nurses retire, and as community-based health care services become more popular.

Stone, who came to Hyden from upstate New York in 1989 to study at the school, is pleased to see the school continuing to thrive after 75 years.

"It's the birthplace of midwifery and family nursing in the United States," Stone says. "That is really big in our circles to be able to say that and to have this lasting legacy that really means so much."

Watch the full Connections conversation.