Dr. Susan Stone
Frontier Nursing University was founded in 1939 by Mary Breckinridge, a nurse midwife who traveled remote regions of eastern Kentucky by horseback providing medical care for Appalachian families. Originally called the Frontier School of Midwifery and Family Nursing, the school, established in Hyden, Kentucky, helped set standards of care for nursing and midwifery.
While the university’s mission remains the same, its scope has grown. Under the leadership of Dr. Susan Stone, president of Frontier Nursing University (FNU) since 2001, the school has developed accredited graduate programs that lead students to careers as nurse-midwives, family nurse practitioners, women’s health care nurse practitioners and psychiatric-mental health nurse practitioners. The school primarily offers distance learning programs, with students living in all 50 states who travel to Kentucky for orientation as well as for educational clinics.
We spoke with Dr. Stone about FNU’s programs, as well as the school’s recent move to a new 67-acre campus in Versailles, Kentucky. While the first in-person orientation at the new campus has been delayed, instruction continues apace.
Having such a robust Distance Education program in place has had to have helped during the pandemic.
Certainly, it has. We were of course worried about whether students will continue to come and whether they would be ready for graduate education during a pandemic, but apparently they are and our admissions have not dropped at all. And [students] are eager to serve. They’re eager to take that next step in nursing to achieve either a nurse practitioner degree or a nurse-midwifery degree. We continue to roll along and are feeling very blessed.
If the pandemic has shown us anything, it’s how critical frontline health care workers are. How has nursing been impacted?
So many things changed in health care immediately, like, suddenly [providers] were able to receive healthcare system payments for telehealth visits for things like prenatal care and primary care visits, which hadn’t been done in the past. And also advanced practice nurses were given full scope [in primary care services]. These are practices we’ve been fighting for. In Kentucky, we’ve been pretty lucky that we had almost full scope practice, except some restrictions on prescriptions, and that was lifted for the time of the pandemic.
For midwives what you’re seeing now is they are doing maybe the first prenatal visit in person, and then the second, third and fourth visits will be done by telehealth, and then [the patient] might come in for an ultrasound. Women are checking their own weight and their blood pressure, and then checking in with their nurse-midwife. We’re talking about for completely healthy pregnancies, of course.
The same thing is happening with the mental health profession, which has done this largely in the past. They’re probably the leader in the profession in terms of telehealth. And with family nurse practitioners.
"It’s not that everything can be done through telehealth, but I do look at this happening and see the effectiveness of it and wonder, even after the pandemic is over, what we’re going to learn from this?"
It’s not that everything can be done through telehealth, but I do look at this happening and see the effectiveness of it and wonder, even after the pandemic is over, what we’re going to learn from this? When you live in a rural area, think about trying to drive from Hyden, Kentucky, to UK HealthCare for prenatal visits and ultrasounds. A lot of women are just not going to do it, and [telehealth] makes it much more convenient for them.
At the school, we’re doing some fundraising to develop a telehealth clinic for our students to practice. Helping people stay healthy is our biggest focus.
FNU was the first nursing school to offer a distance learning program, correct?
Yes, we had some visionary leaders who put that process in place, and we started distance education in 1989. Think of it — there was no internet yet, and we were sending out big boxes of books and articles and faxing things and calling people back. I happen to have been in that first class as a young nurse. I lived in upstate New York at that time, about six hours from the city. It was a very rural area.
Many students still go on to work in rural areas after graduation, right?
A lot of them are already committed to their own communities, and they will stay and serve those communities. And we know that’s really beneficial. For example, in Native American communities or in black communities, we see that if you have race concordant care, you actually get better outcomes. If you educate the people who live in these communities to be the healthcare providers in those communities, there’s just this connection that happens. They understand the culture and they understand the people.
How will the new campus in Versailles help further FNU’s mission? What prompted the move?
We have over 2,000 students now, and every quarter we do five different orientation sessions. Students come in, they stay for four days, and then they go home. We also host students for six week-long clinical sessions each term. In Hyden, where our primary residence was, we were using buildings that were 100 years old. They are really historic, beautiful buildings and we’re hoping that there will be a new use for those. We were also sitting up at the top of a mountain and would have problems with retaining walls and other things. For years, we would bring this big bus — we called it the purple bus — and transport students in from the Bluegrass Airport in Lexington. It was different when we did it three times a year 20 years ago, but now we’re doing it almost every week. The logistics were just getting harder and harder.
So, we started looking around and found the Versailles campus, which was the United Methodist Children’s Home previously. It’s a beautiful environment, it’s close to the airport and it’s close to the major highways. We renovated the existing buildings, and they’re much better suited for the numbers and the needs that we have now. The location will also allow us to better interact with organizations in Frankfort and other health care organizations, for example at the University of Kentucky.
The biggest thing is that we are very clear in our mission and we stay focused on our mission, and that’s what helps us to be successful. It’s about the students and their passion — that allows us to do what we do.