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Even though its administrative staff and leadership have called Lexington home for 16 years, officials for Frontier Nursing University make sure you know one thing up front: The school’s headquarters isn’t in Lexington, nor even central Kentucky. The space of commercial real estate it occupies at 170 Prosperous Place — just a few hundred yards from where Man O’ War intersects with Richmond Road — is merely an outpost from which a workforce of about 30 performs its day-to-day jobs.
“This is just a place for some of us to do our work,” said Dr. Susan Stone, the school’s president and dean. “If we were at our Hyden office, it would be a different story.”
The tale to which Stone, a native of upstate New York who has been involved with the school since 1989, alluded began more than 70 years ago, and it’s still being written as we move deeper into the 21st century.
Frontier Nursing University (FNU) is a graduate school of nursing offering community-based distance education programs in three tracks: nurse-midwifery, family nurse practitioner and women’s health-care nurse practitioner specialties. It was founded 73 years ago in Leslie County by Mary Breckinridge, the daughter of Arkansas congressman Clifton Rodes Breckinridge and granddaughter of John C. Breckinridge, a former senator from Kentucky and the vice president of the United States under James Buchanan. Motivated by the death of two of her young children as well as by experiences she had while working in post-World War I Europe, Mary Breckinridge dedicated her life to creating the first midwifery school in the United States with the specific aim of improving and providing health care in rural areas.
That mission remains today, though the business model Breckinridge created has evolved significantly, thanks to natural growth as well as advances in technology.
Faculty members are scattered across the country and each makes six trips to Hyden a year to teach. Students attend a four-day orientation focused on the history of the school to develop a better understanding for its mission. They then return to their respective communities for a year of coursework before going back to Hyden for an eight-day intensive that includes simulations with actors trained in how to portray patients. Clinicals at home follow that for six to nine months.
“It draws student from all over the country to here,” said Jimmy Sizemore, judge executive of Leslie County. “It’s been here for so many years, you might say we’re on the map for it. It also provides jobs for the county. Maybe when someone graduates, they’ll stay here and work here. It’s really one of the staples of this community.”
The average age of FNU students is fairly advanced at 35 years old, and being a graduate school, all are already registered nurses when they enroll. The students have the option of enrolling in a two- or three-year program operating on quarterly terms. The dropout rate is an estimated 20 percent, as most of the students continue to work and raise families while pursuing their studies. According to school officials, however, most students who have to resign from the program can usually pick up where they left off, as most courses will transfer or carry over.
“Whenever I go [to the Hyden campus] and I have lunch with the students or something, you start learning she’s got two kids, she’s got three kids, she’s got two kids,” said FNU marketing coordinator Brittney Edwards. “I’m like, ‘You guys are amazing.’ And they’re all working. We tell them the program is difficult; it requires a full-time commitment. And yet they still work and raise those families. It’s incredible.”
FNU has seen tremendous growth since the initial class of two students. More than 3,000 nurses and midwives have graduated from the school, and it pioneered the first midwifery community-based distance education program in the United States in 1989, with Stone being a student in that first class. The distance education program was initiated by Kitty Ernst, a 1951 graduate of the program who studied directly under Mary Breckinridge. Ernst remained full time with FNU for 48 years and was responsible for getting the school accredited before she passed her duties to Stone in 1998.
The school created a Lexington office in 1996 — first downtown and then moving to its present location — as a way to not only expand its footprint, but to accommodate its staffing needs as the school continued to grow.
“We were getting bigger and you have to be able to recruit people, such as accountants and marketing staff,” Stone said. “But the number we needed we couldn’t find in Hyden. [Being in Lexington] allows you to recruit from a wider pool. It’s the same as with our faculty; we’re able to recruit highly qualified faculty because we don’t make them relocate. We have some people who would not have relocated to Hyden, Ky., that are able to still live in Chicago and all over the country.”
Under Stone’s watch, FNU has expanded from 200 students in 2004 to the current enrollment of more than 1,300. Other recent milestones include:
• The start of the school’s Promoting Recruitment and Retention to Increase Diversity in Nurse-Midwifery and Nurse Practitioner (PRIDE) education program in 2011, which has led to an increase in recruitment of minority students; and
• The creation of a new curriculum for nurses who wish to become nurse-midwives and nurse practitioners that will culminate in a doctorate of nursing practice degree, a clinical doctorate program that will provide students the option to exit with a master of science in nursing degree midway through the program or to achieve a doctoral degree after its completion.
This year also marks the graduation of the 100th distance education class — or 99 such classes since Stone completed the program 21 years ago. Now, more than two decades later, she sits in the same chair the school’s founder occupied with her mentor, Ernst, serving as a direct link.
“She laid down this huge agenda for us,” Stone said, “and we still feel compelled to follow that agenda today. That’s to improve the care and health of families, particularly the ones in rural areas, because they often seem to be the last to receive adequate health care. It’s interesting because our mission, of course, is to educate nurse-midwives and nurse-practitioners. But the more important mission is to provide health-care providers to rural and underserved areas to families that would generally not be able to get that health care.”