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  • The Importance of Nurse-Midwives and Collaborative Care for Women

    By: Susan E. Stone, DNSc, CNM, FACNM, FAAN

    Those of us engaged in women’s health care know that there’s a troubling trend affecting women in the U.S. We have the most expensive healthcare system in the world, yet American women are more likely to die during childbirth than women in any other developed country. Maternal mortality rates have nearly doubled over the past 20 years, even as healthcare technology has advanced.   

    While the causes are multifactorial and not easily resolved, there is widespread agreement that we must take action to improve outcomes for women and their families. Many healthcare experts point to collaborative care models as one promising strategy.

    As an education provider, Frontier Nursing University (FNU) has an obligation to equip our students with an understanding of and appreciation for collaboration. All of our students are either becoming certified nurse-midwives and nurse practitioners or advancing their education to the doctoral level as a nurse-midwife or nurse practitioner. Our graduates will provide care to women throughout their lives.

    In recognition of National Midwifery Week in October, FNU hosted a digital summit to explore how today’s nurse-midwife plays an important role in collaborative care. The event called Today’s Nurse-Midwives: Creating a Collaborative Community of Care brought together a number of industry leaders to explore the latest and discuss changes that are needed now.  FNU partnered with the American Association of Birth Centers (AABC) to kick off the event with live streamed sessions from the AABC Birth Institute in Scottsdale, AZ.  FNU and AABC have a longstanding history with a shared mission of increasing maternity care options for women through midwifery and birth center care.

    Placing Patients at the Center of Care

    Healthcare systems should strive to implement patient-focused team care. For too long, the economics of healthcare have eroded quality leaving the industry with inflated costs and low patient satisfaction.

    When the patient is at the center of care, the patient’s needs and desires are more likely to be heard. Nurse-midwives, as part of the healthcare team, serve as excellent advocates for patients. This is particularly important as more and more women are seeking out-of-hospital care. 

    Focusing on what is best for the patient not only leads to better health care outcomes and improved patient satisfaction, but also greater efficiency and lower costs.

    Educating Physicians and Nurse-Midwives to Work Together

    Too often in healthcare settings, health care providers are operating in silos. Poor relationships can lead to a lack of appropriate consultation, and miscommunication can lead to poor outcomes. Teams improve results when they make an effort to collaborate and communicate and keep the patient at the center of their efforts.

    Adding nurse-midwives to the health care team improves quality and decreases cost. A team approach that includes physicians, nurse-midwives and other providers as necessary delivers better care to women and families. A collaborative environment allows team members to excel in using the specific skill set in which they are educated.

    At FNU, our goal is to educate nurse-midwives so that they are prepared to work in collaboration with physicians. In some cases, physicians may not understand the scope of a nurse-midwife’s capabilities particularly if they’ve had no exposure to them. Successfully working together comes down to the basics of trust, listening and relationship building.

    Making Change Happen Now

    Understanding the challenge is certainly a step in the right direction, but not enough. We must also work hard to implement solutions. The digital summit presented several practical models that are working well and could be adopted by healthcare systems across the country.

    If our goal is to improve outcomes and decrease the maternal mortality rate, we have to work together. We need more interprofessional education for health professions and more nurse-midwives joining maternity care teams. Finally, we must strive to create women’s care services in which collaborative care is the norm, not the exception.

    View Digital Summit Sessions

    FNU invites you to view all sessions from Today’s Nurse-Midwives: Creating a Collaborative Community of Care on YouTube here. Visit the digital summit website here

     

    References

    Avery M, Montgomery O, Brandl-Salutz E. Essential components of successful collaborative maternity care models: the ACOG-ACNM project.Obstetrics And Gynecology Clinics Of North America [serial online]. September 2012;39(3):423-434. Available from: MEDLINE, Ipswich, MA. Accessed November 12, 2015.

    K. Davis, K. Stremikis, C. Schoen, and D. Squires, Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally, The Commonwealth Fund, June 2014.

    Pullen, L. & Vega C. CDC Data Reveal Increased Maternal Mortality Rates.  Medscape Education Clinical Briefs, 01/26/2015

    Smith, D. C. (2015), Midwife–Physician Collaboration: A Conceptual Framework for Interprofessional Collaborative Practice. Journal of Midwifery & Women’s Health, 60: 128–139.

     

  • FNU Awards Honorary Doctorates at Commencement Ceremony

    Frontier Nursing University (FNU) graduates weren’t the only ones to be honored last month at the 2015 fall commencement ceremony in Hyden, KY, which attracted more than 2000 guests. Dr. Sandra May Perkins and award-winning author Silas House both received honorary doctorates in recognition for their alignment with the vision of FNU founder, Mary Breckinridge.  Perkins and House joined more than 550 graduates in receiving honors at the annual FNU commencement ceremony.  There were 161 graduates that traveled from a total of 41 states for the ceremony.

     

    It was Breckinridge’s devoted character, passion and dedication for delivering quality health care to underserved and rural populations that founded FNU more than 75 years ago. People like Dr. Perkins and Mr. House continue to make an impact on our world with those same convictions and passions.

     

    Perkins received an honorary doctorate in recognition of her career dedicated to the betterment of maternal and newborn care.

     

    Although her family struggled to survive poverty during her childhood due to the Second World War, Perkins received a scholarship as the first black nurse enrolled in her nursing school and graduated as class valedictorian from the Zion Bible institute. For over 25 years she dedicated her life to advancing the field of Midwifery across the country, making several trips to Africa to conduct classes along the way.

     

    House also received an honorary doctorate for serving as a voice of Appalachian heritage, culture and for his social justice efforts on behalf of the people of Eastern Kentucky and the Appalachian region.  

     

    FNU traces its roots back to Eastern Kentucky where Breckinridge worked diligently to help the underserved region. Like Breckinridge, House has dedicated his life to telling the stories of Eastern Kentucky and the Appalachian region.

    The faculty and staff of FNU couldn’t be happier to be releasing such quality nurse-midwives and nurse practitioners into the world. And thank you to Dr. Perkins and Mr. House for your service to the underserved.

  • FNU Wraps up National Nurse Practitioner Week

    It has been a great week for Frontier Nursing University (FNU) as we have celebrated National Nurse Practitioner Week (November 8-14, 2015). National Nurse Practitioner Week is held annually to celebrate exceptional health care providers and to remind lawmakers of the importance of removing outdated barriers to practice. In doing so, we hope that NPs will be allowed to practice to the full extent of their experience and education.

     

    The American Association of Nurse Practitioners (AANP) created National Nurse Practitioner Week.

     

    This is a special year to us as we are celebrating 50 years of nurse practitioners. Fifty years ago, at the University of Colorado, the first NP program was established.  Now, 50 years later, NP programs graduated approximately 17,000 students in the 2013-2014 academic year.  There are more than 205,000 NPs licensed to practice in the United States, and NPs now have full practice authority in 21 states and the District of Columbia (according to the AANP).

     

    FNU started the first Family Nurse Practitioner Program in 1970. Today, with graduate nursing specialties focused on women’s health and family health, we offer our students both a Family Nurse Practitioner and Women’s Health Nurse Practitioner track.  We currently have more than 700 nurse practitioner students enrolled in these two programs combined.

     

    FNU has celebrated the week by promoting National Nurse Practitioner Week on our social media channels. Follow us on Facebook or Twitter to see ways that NPs are making a difference. We also held several news interviews in the Lexington area that we will be posting.

     

    To check out the AANP proclamation map, go here.

     

    To learn more about FNU and the programs and degrees offered, visit us here.

  • How to Thrive while Pursuing an Advanced Practice Nursing Degree Online

    Students at Frontier Nursing University have many advantages as they pursue their advanced practice nursing degrees. In FNU’s distance education programs, a student’s home community serves as the classroom while coursework is completed online, either full-time or part-time depending on what is the best fit for the student.

    There is also a strong support system at FNU to ensure that students have the resources they need to succeed. FNU’s Associate Dean of Midwifery and Woman’s Health Tonya Nicholson likes to think of herself as a “midwife for students.” She recently offered advice for students pursuing an advanced practice nursing degree online in Advance for Nurses. Read the article here.

    So what do you think? What are some tips to help the RN as they transition to nurse practitioner or nurse-midwife? More specifically, what are some tips to help a student pursing their degree online?

  • Frontier to Host 2015 Commencement

    Frontier is excited to host our 2015 commencement ceremony this upcoming Saturday in Hyden, KY at the home of the historic FNU campus. Over the past year, more than 500 nurse-midwives and nurse practitioners from almost every state across the nation have completed an FNU distance-education program. Nearly 70 of the 2015 graduates are Kentucky natives.  

    Started by nurse-midwifery pioneer Mary Breckinridge, FNU has been educating nurses and midwives for more than 75 years and has grown into one of the country’s leading graduate schools with an enrollment exceeding 1600, and is recognized as the #1 nurse-midwifery program in the nation as well as one of the Top 30 online graduate nursing schools by U.S. News & World Report.  

    FNU offers doctoral and master’s degrees for nurse-midwives and nurse practitioners. The university utilizes innovative distance-education methods to reach nurses throughout the country and the world. FNU graduates provide primary care for women and families residing in all areas, with a focus on rural and underserved communities.

    FNU President Dr. Susan Stone will preside over the commencement ceremony and degrees will be conferred on graduates of FNU’s Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) programs. MSN graduates have completed the Nurse-Midwifery, Family Nurse Practitioner or Women’s Health Nurse Practitioner specialty tracks.  

    Award-winning author Silas House will deliver the keynote address to FNU’s 2015 graduates.  House was born and raised in Eastern Kentucky near FNU’s home town of Hyden.  House is the author of five novels and serves as the NEH Chair of Appalachian Literature at Berea College and as fiction faculty at Spalding University’s MFA in Creative Writing program.  He is a frequent contributor to The New York Times, a former commentator for NPR, and a former contributing editor for No Depression magazine. www.silashouse.org

    FNU will also be offering guided tours of the historic Wendover Bed & Breakfast Inn for all guests.  The commencement ceremony will also be available as a live-streamed event which can be accessed at https://live.frontier.edu/ at 2pm on Saturday October 24.

  • April Dobroth, FNP, MSN FNU Graduate

    April Dobroth always pictured herself as a family nurse practitioner. So, when the time came, she made the choice to return to school to pursue the Master of Science in Nursing degree. April graduated from Frontier Nursing University in 2011. As a family nurse practitioner, April provides high quality, compassionate and culturally sensitive health care to the rural community she serves. She chose FNU based on her love of the mission and of the university history. April says that, because of her close philosophical alignment with FNU, she knew she had found her academic home. Today, she is living her dream on a daily basis, providing much needed health care services to the people of the Santo Domingo Pueblo.

    Providing services to a community of approximately 5,000 of the Santo Domingo Pueblo Tribe as well as other tribes of the greater New Mexico area has made a pivotal difference to the native community. The Kewa Pueblo Health Clinic provides much needed access to a wide variety of medical services in a medical home model of care. Services include medical care, mental health services, hyperbaric treatment, dialysis, public health nursing and dental services. Transportation to and from the clinic is provided daily to those in need. Plans are in the works to expand care to an open access model which will incorporate home visits, extended hours of care and school based services.

    While April is clearly keeping Mary Breckinridge’s dream of serving “wide neighborhoods” alive in New Mexico, part of her heart has been left in Hyden. She says, “The Frontier network has always felt like more of a family to me with the home being Hyden, Ky., and stretching to some of the farthest regions of the United States.” As an alumnus she has remained in contact with many of her classmates and professors whom she looks to for support, expertise and knowledge.

    However, April is keeping up her own level of expertise and knowledge according to her many certifications and awards. She holds certifications from the AANP as a Family Nurse, Practitioner and UNM Project ECHO certification in the treatment of Hepatitis C, 12 Lead ECG certification and Sexual Assault Nurse Examiner (pediatric and adult). Additionally, April has advanced training in substance abuse, traumatic brain injury and post-traumatic treatment. She is an instructor in Basic Life Support, Advanced Cardiovascular Life Support, Neonatal Resuscitation, Trauma Nurse Core Course, and has Emergency Nursing Pediatric Certification.

    April is a member of the Sigma Theta Tau Honor Society, AANP member, AANP Legislative Committee Member, New Mexico Nurse Practitioners Council Member and American Holistic Nurses Association member. She has been Employee of the Month at the NM State Penitentiary (2012) and at the Kenwa Pueblo Health Center (2013). She has also been the recipient of the outstanding clinical preceptor award for the year at Colorado Health Science Center (2001). 

  • Linda Jacobsen, CNM, CFNP, MPH, FNU Graduate

    From serving as a Peace Corps nurse in Africa to teaching nursing and midwifery in Tanzania to serving as Deputy Chief Nursing Officer for Seed Global Health, Linda Jacobsen, CNM, CFNP, MPH is a true example of taking the passion of caring for women and families to communities around the globe.

    Linda Jacobsen recently returned to the U.S. after serving for a year teaching nursing and midwifery in Tanzania as part of the inaugural class of the Global Health Service Partnership (GHSP) volunteers. The GHSP program, a unique public-private partnership between the U.S. Peace Corps, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and Seed Global Health, places U.S. physicians and nurses on faculties at medical and nursing schools in Malawi, Tanzania and Uganda, to support educational capacity development aimed at long-term health system strengthening. Since ending her service, Linda has become a Deputy Chief Nursing Officer for Seed Global Health in which she helps to recruit and train new nursing volunteers for service.

    While Linda was a Peace Corps nurse in Africa in the late 1970s, she experienced a crisis when delivering pre-term twins, which motivated her to study midwifery. She then sought out other midwives who worked abroad, and found that many studied and served with Frontier Nursing Service (FNS) and were trained to provide comprehensive care. So Linda returned to the US and continued her education in a cohort of ten nurse-midwives who trained and served with FNS in 1983-1984. Three graduates from her class were involved in international nursing and continue to support each other in their leadership roles. Leaders like Kitty Ernst and FNS Dean, Ruth Stevens, fostered professionalism and trained the students to meet challenges successfully, which became a life-long habit of Linda’s.

    Linda and her classmates forged leadership roles wherever they served in their careers. After training at FNS and earning her masters at University of Washington School of Public Health, Linda served in U.S. public health programs, primarily in rural and underserved areas in the state of Washington, while she raised a family. She has been a clinician, family planning consultant, public health program manager, clinical preceptor and implemented a project that integrated HIV screening in Title X family planning clinics.

    When their children left for college, Linda and her husband searched for an opportunity to serve together in Africa and discovered the GHSP program. As Seed Global Health’s Deputy Chief Nursing Officer, she returned to Tanzania in November 2014 to mentor current GHSP volunteers serving in the field. In Tanzania, nurses train at the diploma or bachelors level and learn midwifery in their standard nursing program.

    Remembering her years at Frontier, Linda recalled working from district centers, visiting families in log cabins, and escorting sick patients from remote areas as part of ambulance transport teams. She remembers the hospitality and warm manners of the people in the Kentucky mountain communities and found that similarly, people in Tanzania are also very gracious and reach out to form relationships with each other. Due to a lack of resources, Tanzanian patients tend to come for care more acutely ill than rural U.S. patients. Women are especially vulnerable; only about half those who are pregnant actually make the targeted four prenatal visits, and many are not tested for HIV because they don’t have access to testing facilities.

    Trained healthcare workers in Tanzania are in short supply, and even medical centers must ration resources. However, Linda was encouraged to see, when observing student presentations in a village, that the students engaged with the villagers and leaders about how their needs might be addressed and that the villagers responded by bringing the nurses food. There, as in Kentucky, addressing patient and rural community needs at the local level is vital to promote overall health. Linda is proud to be a FNU graduate with international experience, and pointed out that FNU graduates are willing to make difference where there are huge needs for health care. 

  • Student Spotlight: Laura Giles, BSN, RN

    At the heart of Frontier Nursing University is a talented and diverse community of faculty, students, alumni and preceptors. Spotlight blogs feature members of our FNU community that are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality health care to underserved and rural populations.

    While some may assume the term “distance education” implies a gap between educators and students, FNU student Laura Giles disagrees. Laura was recently interviewed by The Alaska Nurse, which surveyed her distance education experience with FNU.

    In the article, “A 21st Century Approach to Nursing Education” by Taylor DiBiasco, B.Ed., Laura explains that she actually feels more connected to her instructors at FNU than in her traditional undergrad degree.

    According to Laura, the online aspect of education makes it easier for instructors to check-in on students with an individualized approach via email than that of the traditional classroom format, which has a short amount of allotted time.

    FNU has allowed Laura to continue working full-time while pursuing her masters and becoming a certified nurse-midwife. 

    Her dream to help in women’s health began as a teenager after a bad experience with a healthcare provider. According to Laura, the nurse didn’t take a second to explain anything about her visit and as a terrified teenager, she decided that if she were ever in that position she would make sure to be more caring.

    “I strive to educate and inform the women I care for to make sure they understand exactly what they are going through and what their options are,” said Laura.

    Laura obtained her Bachelors of Science in Psychology from Portland State University and her Bachelors of Science in Nursing from Oregon Health Science University. She has more than five years of experience as an RN. She is currently a nurse in the ER at Providence Alaska Medical Center pursing an MSN degree at FNU to become a certified nurse-midwife.

    To read the full article in The Alaska Nurse, go here and scroll to page 18.

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