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  • Alumni Spotlight: Ingrid Andersson, CNM, brings compassionate care to her community while advocating for reproductive justice 

    Alumni Spotlight: Ingrid Andersson, CNM, brings compassionate care to her community while advocating for reproductive justice 

    At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, Couriers 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.

    For Madison, Wisconsin-based Certified Nurse-Midwife (CNM) and Frontier Nursing University alumni Ingrid Andersson, the fundamental rights of pregnant people has always been at the forefront. Andersson believes that reproductive justice should be actively defended and that these rights, as defined by  Loretta Ross of the Sister Song Reproductive Justice Collective, include the right to have children, the right to not have children and the right to parent children in safe and healthy environments.

    “Throughout my career, I have worked to ensure pregnant people’s access to a full spectrum of pregnancy options, at the same time working for safe and healthy environments,” she said.

    Andersson earned her post-graduate certificate (PGC) in Nurse-Midwifery from FNU in 2000. She has worked as a CNM through a private home birth practice for 21 years.

    As a CNM in a private practice, Andersson said her model of care is not based on “provider/patient,” but on a healthcare partnership.

    “I learn as much or more from my families as they do from me,” she said. “It is also very prevention-oriented, so much of our hour-long visits are spent in discussing things like work stress, relationships, nutrition and COVID management.”

    Andersson said though many people  are aware of the effect stress and anxiety can have on a pregnancy, these factors also can have an effect on breastfeeding. To address this, Andersson founded Mothers’ Milk Alliance, Inc. (MMA) in 2007. The organization is designed to provide mothers who cannot produce enough breast milk (in the short-term or long-term) access to breastmilk from donors. Today, MMA has five community freezers, and about 6,000 ounces of breast milk is moved in and out of their facilities each month. Those who donate breast milk to the organization are tested by volunteer midwives and the organization also receives support from local physicians and lactation consultants.

    In addition, Andersson was included on the founding steering committee of the Wisconsin Environmental Health Network (WEHN). A group of healthcare professionals who collaborate with local environmental advocates, WEHN works to inform healthcare professionals, the public, and policy makers about the effects of environmental toxins and climate change on public health. This year’s virtual conference, which began in February and will continue through March, focuses on various topics including the health and financial burdens of extreme heat and what health professionals should know about protecting vulnerable populations from environmental and occupational harm.

    Andersson also is the co-founder of Pregnancy Options Wisconsin: Education, Resources & Support, Inc. (POWERS). The organization is made up of volunteer doctors, midwives, doulas, educators, and activists who are committed to pregnant people’s informed choice and access to all pregnancy options.

    “I believe that a career of connecting dots and walking bridges between practitioner and activist, individual and community, health and environment, has helped build the strong relationships that my community enjoys between home and hospital,” she said.

    Just as Andersson’s career influences her advocacy, it also influences another one of her passions: poetry. She recently released her first published book of poetry, entitled “Jordemoder: Poems of a Midwife.” Published by Holy Cow! Press, the book draws upon Andersson’s experience as a Certified Nurse-Midwife with an academic background in medical sciences, anthropology, and European literature and languages. “Jordemoder” is the Swedish and Danish word for “midwife.” “Jord” translates to “earth/ soil/land/world,” while “moder” translates to “mother.”

    “The word, for me, captures midwifery as a metaphor for an ecology or a reciprocity of world relationships, as much as the literal processes of pregnancy, birth and early parenting,” Andersson said.

    Since earning her certificate from FNU, Andersson has precepted several Frontier students and continues to enjoy meaningful relationships with them.

    “I loved – still love – [FNU’s] legacy of turning around abysmal, shameful local health statistics and its benchmark history in serving families at home,” she said. “I continue to work with Frontier colleagues and students and love the ongoing connection and support as a preceptor.”

    FNU is incredibly proud of Andersson’s work as a healthcare professional and passionate advocate. She is an exceptional example of FNU’s Culture of Caring.

    To read more alumni stories, visit the FNU Alumni stories page.

  • FNU Celebrates Women’s History Month with FNU History Faculty Expert, Dr. Anne Cockerham

    FNU Celebrates Women’s History Month with FNU History Faculty Expert, Dr. Anne Cockerham

    March is Women’s History Month. During this time, we aim to celebrate and recognize women’s achievements in history, raise awareness against bias, and take action for equality. 

    Dr. Anne Cockerham

    This month Frontier Nursing University (FNU) will highlight a few female leaders at FNU in Q&A style blogs. The first person we want to spotlight is Dr. Anne Cockerham, PhD, CNM, WHNP-BC, CNE, FACNM, FNU Professor and Course Coordinator, whose scholarly focus is on nursing history.

    Jump to Q&A

     

    Both midwifery and nursing are professions in which women have been at the forefront, including many women who are associated with the history of FNU.

    FNU’s rich history begins with the Frontier Nursing Service (FNS) which resulted in remarkable outcomes as these nurse-midwives served the people of eastern Kentucky. This work drastically reduced maternal and infant mortality, included widespread implementation of extensive public health interventions such as sanitation and vaccinations, and the provision of primary and inpatient health care to thousands of people who previously had little access to care.

    While we want to celebrate the achievements and perseverance of those who pioneered midwifery in the United States, we should also acknowledge and be aware of any wrongdoing and harmful thinking and actions by them.

    “Now, I think the time is right for us to reexamine our history with a careful eye toward identifying any harms that have been done, inequities that have been perpetuated, privilege that has been afforded to some but not all, and opportunities that have been lost,” Dr. Cockerham said. “In other words, I’m glad that historians and those interested in history are moving beyond unquestioning celebration of accomplishments and toward a more nuanced examination of the past.”

    Dr. Cockerham believes the most enduring legacy of the FNS is the school that began in 1939 and continues to be in operation today as FNU.

    “The large number of well-prepared midwives who come from the FNU program, particularly since the beginning of the distance learning program in 1989, has dramatically increased the nurse-midwifery workforce in the United States,” Dr. Cockerham said. “I’m so proud to be a graduate of the program and now a long-time faculty member!”

    To celebrate Women’s History Month, we asked Dr. Cockerham a series of questions in hopes of inspiring and empowering all people to continue to work towards equality and raising awareness of the bias women face or have faced.

    Women’s History Month Q&A with Dr. Cockerham:

    1. What advice would you give to women in your field (midwifery/nursing/healthcare)?

    Midwifery and nursing are dominated by women so I think it’s particularly important to seek out, respect, and celebrate differences. Diversity of all kinds enriches us and can make midwifery and nursing even stronger.

    1. Tell us about a woman you look up to and why.

    There are so many folks who are so inspiring that it’s difficult to choose just one. But one woman who comes immediately to mind is Angela Smith, the Executive Director of the Accreditation Commission for Midwifery Education (ACME). I serve as the ACME chairperson, so I have the great privilege of watching Angela’s work up close. She started in the ACME Executive Director role in the early days of the COVID-19 pandemic, and she has gracefully and skillfully navigated the many challenges ACME has faced (along with the rest of the world). Angela is the epitome of equanimity. She is unfailingly professional and utterly unflappable. She is kind, caring, and optimistic, yet realistic. She builds collegial relationships and always keeps her eye on the long-term plan. I learn from her every day and I’m so grateful to work with her.

    1. Do you have a favorite quote about female empowerment or from a female influencer?

    In my role as a teacher, I find Dr. Cate Denial’s work to be powerful. Although I have always gravitated toward a certain approach to teaching, Dr. Denial’s description of the Pedagogy of Kindness has helped me put words to what is in my heart as a teacher. Here’s a quote from Dr. Denial:

    Kindness as pedagogical practice is not about sacrificing myself, or about taking on more emotional labor. It has simplified my teaching, not complicated it…I’ve found that kindness as pedagogical practice distills down to two simple things: believing people, and believing in people…A pedagogy of kindness asks us to apply compassion in every situation we can, and not to default to suspicion or anger. When suspicion or anger is our first response, a pedagogy of kindness asks us to step back and do the reflective work of asking why we’re reacting in that manner.

    1. Is there anything else you would like to share to empower women or encourage people to create change that positively impacts women?

    In our work as midwives, WHNPs, and educators, I think one of our most important goals should be to work to make pregnancy, birth, and the postpartum period safe for ALL birthing people. This work includes being humble and listening to members of communities that have been historically marginalized. It includes welcoming folks into the profession who represent the communities they serve, and then humbly asking how we can support their success. It includes acknowledging and mitigating the harms that we have perpetuated on individuals and communities. It includes learning and learning some more, until all birthing folks are safe and satisfied with their care.

    We thank Dr. Cockerham for her work in midwifery, education and nursing history. Dr. Cockerham is an FNU alumni (CNEP class 27, graduated in 2001) and has been a faculty member since 2009. She has cared for patients in private midwifery and midwifery and physician practices, a military hospital, Planned Parenthood, and a Free Clinic.

    Dr. Cockerham is the author of two award-winning books that celebrate the history of the Frontier Nursing Service: Rooted in the Mountains, Reaching to the World: Stories of Nursing and Midwifery at Kentucky’s Frontier School, 1939-1989, published in 2012, and Unbridled Service: Growing Up and Giving Back as a Frontier Nursing Service Courier, 1928-2010, published in 2014.

    Subscribe to our blog to be the first to know when our other blogs in our Women’s History Month series are released! Follow us on social media as we highlight women in history all month long.

  • Staff Spotlight: Sarah Juett receives fall Circle of Caring award

    Staff Spotlight: Sarah Juett receives fall Circle of Caring award

    At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, Couriers 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.

    Frontier Nursing University (FNU) is proud to recognize staff member Sarah Juett as one of the recipients of the 2021 Fall Term Circle of Caring Award!

    Juett has been with FNU for nearly seven years working as an academic advisor. As an academic advisor, she provides direct support to students during their entire academic journey, beginning at Frontier Bound until graduation.

    “The personal approach that Frontier provides with academic advising sets us apart,” Juett said.

    Juett gets to know each student she works with personally and serves as an encouraging guide while they are at FNU. Being an academic advisor, she works directly with the students, but also with other faculty and staff members. She approaches each of these interactions with our Culture of Caring in mind.

    Juett exemplifies the Culture of Caring perfectly as she is passionate about helping others, especially in higher education.

    “What I love most about my work is building relationships with students and the reward of seeing them achieve their educational goals,” Juett said. “They inspire me daily!”

    Juett, a first generation college graduate with a Bachelor’s degree in Social Work from Eastern Kentucky University and Master of Science in Social Work from University of Louisville, resides in Richmond, Ky. with her husband and 4-year-old niece. In her free time, she enjoys a good book or podcast, board games and cooking or baking.

    In response to being awarded the Circle of Caring award, Juett says, “It is such a great surprise and honor to be recognized by my colleagues with this award. I’d like to share it with my entire team. They are some of the most caring and compassionate people I know and I’m so fortunate to know and work alongside them.”

    Thank you, Sarah, for demonstrating FNU’s Culture of Caring! Circle of Caring winners selflessly go above and beyond to help others at FNU. We are proud to have you as a member of the FNU community.

  • FNU All-Access Podcast Episode 7: Why Advocacy Matters in Nursing and How to Be an Advocate  

    FNU All-Access Podcast Episode 7: Why Advocacy Matters in Nursing and How to Be an Advocate  

    Episode 7 of the Frontier Nursing University (FNU) All-Access Podcast introduces a fascinating discussion about the importance of advocacy and what it means to be an advocate for nursing care and autonomy. FNU faculty member Dr. Vicky Stone-Gale, DNP, APRN, FNP-BC, FAANP, details her experiences as an advocate for nurse practitioners in Florida, where she lives and practices.

    Dr. Stone-Gale details how she was first introduced to the idea of advocacy and how that led her to begin speaking out publicly about the healthcare gaps in Florida and the role that nurse practitioners could play in resolving those issues. She details her meetings with legislators, public speaking engagements, and collaboration with physicians to ultimately bring about new legislation and essential change.

    Dr. Stone-Gale also explains her motivation for becoming an advocate, the importance of finding allies, and the role that other faculty, practitioners, students, and supporters can play in their own communities.

    What You’ll Learn From This Episode: 

    • What it means to be an advocate and how to become one.
    • Why advocating for legislation to increase nursing autonomy matters and how it impacts the overall health of the community.
    • How advocacy led to new legislation in Florida allowing for autonomous practice for nurses.
    • Why Dr. Stone-Gale won the American Association of Nurse Practitioners (AANP) State Advocacy Award for 2022.

    Listen to the Full Episode:

    Full Episode Transcript

    Enjoy the show?
    Be sure to follow the Frontier Nursing University All-Access Podcast on Google Play, Apple Podcast, Spotify, or wherever you find your podcasts. Visit the FNU All-Access Podcast page here.

  • FNU All-Access Podcast Transcripts: Why Advocacy Matters in Nursing and How to Be an Advocate (Ep #7)

    Frontier Nursing University All-Access Podcast, Episode 7 Transcript
    Why Advocacy Matters in Nursing and How to Be an Advocate

    Please enjoy this transcript of the Frontier Nursing University All-Access Podcast! This podcast provides a closer look at Frontier Nursing University through lively and entertaining discussions with a wide variety of guests and topics.

    Angela Bailey: Hello and welcome to The Frontier Nursing University All-Access podcast. I’m Angela Bailey, Chief Advancement Officer, and your host for this adventure. I’d like to welcome you all to the on-call lounge here on the Frontier Nursing University campus in beautiful Versailles, Kentucky. Within this inaugural season, we give you an all-access pass to delve deeper into Frontier Nursing University and the individuals who are making a daily difference in advanced practice nursing, midwifery, education, and healthcare across the country. Today, it is my pleasure to welcome Dr. Vicky Stone-Gale to the on-call lounge. Now should I call you Dr. Stone-Gale or Vicky?

    Vicky Stone-Gale: You can call me Vicky. That would be fine, Angie.

    Angela: All right. Thank you, Vicky. Welcome to the on-call lounge.

    Vicky: Thank you. This is great to be here.

    Angela: It’s a fun project and we’re so glad to be able to offer this to our listeners. Vicky, for our listeners’ information, tell us a little bit about who you are and what you do at Frontier Nursing.

    Vicky: Well, I’m an associate professor at Frontier Nursing University. I came to Frontier in 2014 from a previous university that I was at in Fort Lauderdale, Florida, where I live. I have been in the university for almost eight years now. I teach in the primary care one course, which is the management course for the family nurse practitioner track at Frontier. Prior to doing that when I first came to Frontier I was in an epidemiology and biostatistics course, and then I had the opportunity to take over the primary care course. I’ve been in that course now for probably around six years. I just love the course because it’s a course where I can watch the students really grow and develop and start to see them just blossom.

    Angela: Wow. Do you remember what month you came in 2014?

    Vicky: I did. It was March. It was March 30th, as a matter of fact.

    Angela: Isn’t that fine, because I started at Frontier in February of 2014. I started on February the 3rd and we both remember those dates exactly, right?

    Vicky: Yes, we do. It was a wonderful day in my life to come to Frontier.

    Angela: Oh, mine too. I don’t think that I have ever looked back. You have talked about what courses you teach and our listeners do know, hopefully, at this point that we are a distance learning institution. How have you found that to be different from previous positions? Is the distance dynamic easier or how are your relationships with students? Are they the same?

    Vicky: Well, I came from a brick-and-mortar school so I had not taught online prior to coming. I had done some online work at that university because we had some hybrid courses, but to be in an all fully online program I had not done that before. I find that I connect so much better with my students. I think a lot of that has to do with the fact that you really forced to do that. You want to connect, you want to make sure that they feel your presence in the course that you are including them in the course, and making sure that they are getting all of the information that they need.

    In my primary care one course, we do a lot of face-to-face sessions and that’s enabling the student to be fully engaged in the actual course. I find that the students really learn so much differently in an online program. I think that they really put a lot more into it than when they’re coming into class, and that’s just my perception having done both, but I find that they put a lot more effort into it. I see that they study more there. I see the times that they’re online because I can track that in my course.

    They put a lot of time into coming into that course and really doing what they need to do. I have found it was a much easier thing for me to teach. Not only do I have more time to prepare and do a lot of things for the course, but I also have a lot of time to spend if students need assistance and we can do it on the computer at any single time. We’re not limited to — I’m in the university at 8:00 AM and I’m home at 5:00 o’clock and then I don’t have any connection with you.

    I connect with my students in the evening and the weekends if I need to do that. That’s part of what we need to do as online faculty. We can’t just say it’s five o’clock Friday and we’re done, because students might need help over the weekend, especially if that’s the only time they’re doing their work because they’re working Monday through Friday and they’re working 12-hour shifts.

    Angela: Yes, Vicky, that was beautiful. That is exactly what we continually hear from our alumni. My office also works with our alumni to keep them engaged with the institution, and all of the things that you have just said, I have heard echoed by them over and over again, that they didn’t realize how much more they would actually be connected with their classmates and with their professors in an online environment. I think that is a true testament to you and the rest of the faculty and also to our commitment of having this community of inquiry and this community that involves all students. I know that students hate the group projects, but I know that there are lots of those that our alumni say, “at the time, but now I’m so glad”, and we spend a lot of time helping our students build those connections. Right?

    Vicky: We do. In my course, I make sure that the students are connecting because they’re paired up in either groups of three or groups of five to do some of these live sessions and they get to talk to each other and they get to know each other. They don’t even know what their assignment’s really going to be when they come into that session. They develop in that session and they develop amongst each other. It ends up where I’ve had a few of the students tell me that when they end up leaving the course they’ve made relationships with those students that they’ve connected with in the course.

    I think they work better together when they’re really being challenged and they can talk things out. We talk so much about critical thinking skills that nurse practitioners need and we’re able as faculty to listen to them while they’re working through these scenarios and really pick up on those critical-thinking skills that we want to hear them doing because that’s what we need to know that they can do to go out and practice safely.

    Angela: Oh, yes. Absolutely.

    Vicky: We’re preparing them to practice safely and that’s what they have to do. We just don’t know if we don’t hear and so it’s really a great thing for them.

    Angela: You guys do a wonderful job, and I’m not sure that you’re aware but our number one source of referral for new students has been for years and continues to be referral from our alumni. I think that is such a testament to the work that you as faculty do and the relationships that you’re able to build. So, thank you for that.

    Vicky: I do think that our faculty are probably one of the best faculty that I’ve ever worked with. We have so many years of knowledge in this university. So many hundreds of years of teaching experience and practice experience in this university and the students know that when they come in. They do their research and they’ve talked to people and they’ve read about Frontier before they come here. They know that we’re top in the nation on many levels.

    They don’t come in blinded. They come in knowing exactly how rigorous the program is and which, sometimes you hear all these online nursing programs are just not rigorous enough. They’re not what they need to be as like in a brick-and-mortar school. I find it more rigorous for the online program. It’s very interesting because I was on a call the other day with a hundred nurse practitioners, and they were talking about online programs and the concern that some people in the community are saying, well, there are so many online programs and they’re just throwing these students out and they’re just putting them out in the field and they’re not really getting a good education.

    I was just ready to say something when one of the members said well, I’m going to tell you that the only nursing university that I really know puts out quality nurse practitioners in an online school is Frontier Nursing University. I was so proud to hear that. It was an awesome thing to hear.

    Angela: Well, and a lot of people don’t know that we created the Family Nurse Practitioner program many years ago and we have always been pioneers in distance education. I think that one of the things that people forget is that because we are distance, it allows us to pull from a very talented group of faculty all over the country. They don’t have to live in Kentucky. They don’t have to be here and so we get to pick the cream of the crop, like you, Vicky, from Florida, right?

    Vicky: Thank you.

    Angela: You’re welcome, and speaking of Florida, I hear you just won a really great award in Florida. Can you tell our listeners about that?

    Vicky: I did. I was just notified a few weeks ago that I was honored to receive the American Association of Nurse Practitioners (AANP) State Advocacy Award for 2022. That is really for doing the work that I’ve done in Florida for nurse practitioners to get autonomous practice, to get a controlled substances bill approved, and I didn’t do that by myself trust me. I did that with many, many, many of my wonderful colleagues in Florida over the years. It was a real honor to be told that I have that award and I’ll be accepting that in June, at the AANP National Conference in, I believe it’s in New Orleans this year.

    Angela: Yes, and I hope to be there and be in the audience clapping for you, as you receive that award.

    Vicky: Thank you. Thank you so much.

    Angela: You are welcome but I’m sure that our listeners don’t know – because I don’t think that I understood before I got to Frontier – that the laws governing nurse practitioners are really state-dependent. Can you talk about that a little bit and what your thought has been in Florida and why it’s important?

    Vicky: Yes, it’s been a big struggle in Florida and every state has their own laws and it depends on the legislation that says this is what the nurse practitioners in that specific state can do. I remember when I graduated in 1992, I met a lady named Barbara Lumpkin. Barbara Lumpkin was a registered nurse and she worked for the Florida Nurses Association. She was probably kind of a lobbyist for them, but she did many, many other things. She was a big advocate for nursing in general. I was introduced to her about a year when I got out of school and she said to me, “I really want you to come with me to Tallahassee, and listen to what the legislators do and testify in front of the legislators in regards to nurse practitioners and what you’re doing in the community.”

    At that time in my area of Broward County, Florida, we didn’t have any nurse practitioners. There were five of us that graduated from their university, from their family nurse practitioner program. We were the first five in the area. In this area, there were a few down in Miami that went to the University in Miami, and they didn’t even have a master’s program. They were bachelor’s prepared nurse practitioners.

    We were one of the first master’s prepared nurse practitioners in the community and the physician that hired three of us had a big vision. He saw what we could do and he had a vision and he hired two of us and his friend hired one of us. 

    We started out with an organization that one of the drug reps said one day, “You need to start a nurse practitioner organization, a local nurse practitioner organization.” We went to Red Lobster and at that time now we’ve got about 10 nurse practitioners and we formed this group and that’s how I met Barbara Lumpkin. We invited her to come and speak to our group. She asked me to go to Tallahassee and I was like, “Oh, no, I’m not doing that. I’m not talking in front of those people I don’t know.” She said, “No, book your airfare. You’ll be on a plane next Wednesday or Thursday,” whatever day it was and away I went.

    I listened to this testimony in the legislature and I was able to speak and I was hooked and that was it. I never looked back. That fight for our autonomous practice, for our controlled substances, that was all still brewing back then and it hasn’t been until recently that we were able to get legislation through. I’ve been practicing since ’92 and it’s that many years that we have been fighting this battle. We went from physicians not even talking to us about our patients to now most physicians have nurse practitioners in their practice. But I remember when I graduated and I would send a patient to a specialist and I would call that specialist to ask him about what he saw with a patient, he wouldn’t talk to me.

    I remember this specific cardiologist saying, “I’m not talking to you because you’re just a nurse and I need to speak to the physician.” My physician that I worked with got on the phone and said, “This is my nurse practitioner, and she is educated and qualified to treat patients. She referred a patient to you and it’s her patient and you need to discuss the patient’s care with her, not me. If you choose not to do that then we won’t be referring to your practice anymore.”

    Angela: Good for him.

    Vicky: Yes, he really stood up for us and was an advocate for us and he’s the one that saw that vision. He even took so much flak from the hospital because he was only one of two physicians in the area that put nurse practitioners in the practice. They were just all against it and he really took a lot of hits at the hospital for that. Then as we transitioned within a couple of years, I had physicians calling me asking me to get them a nurse practitioner because they knew what myself and the others were doing in the practices and they saw that we were making a difference and really helping the practice.

    It wasn’t that we were just taking care of patients, we were educating patients, we were providing more care to the patients and they could give because we took a little bit more time with the patients. Now, they were transitioning, they were like, “Oh, you can do pap smears. As males, we don’t want to do that anymore.” Then we saw ourselves being able to transition into a lot of women’s health in the practice.

    It took many, many years for us to transition into that. It’s interesting we had a webinar last night, that Kim Curry, who’s with AANP – she lives in Florida – and she just did a webinar on a complete video on the history of nursing and nurse practitioners in Florida. It was very interesting to hear some of the people that have been involved way back in the 70s and how we’ve progressed since then. I have to say that it takes a village to try to get things passed and the Florida Medical Association has not been friendly to us over the years and they’re still not friendly to us.

    Angela: But let’s go back just a second because I think that our listeners may not understand how a nurse practitioner, or nurse-midwife for that matter, is an integral part of the care team that also includes doctors and why autonomous practice is even an issue?

    Vicky: Well, I think that a lot of the old school physicians, they don’t want to let go. They don’t want to have change in their practice. They still want to have their thumb on people. Some of the newer physicians, I think they get it and I think they understand it because they were trained with nurse practitioners. The whole part of this is the team. You’re a team, you’re taking care of patients. What with the physicians getting so upset that we want to do what they want to do and we want to do it by ourselves, it just doesn’t make sense when you’ve got patients that live in underserved areas and rural areas of the state that don’t have access to care. They have to go maybe 50 or 60 miles to see somebody, that’s just not feasible for people. They don’t have the money to travel, they don’t have the means to travel, not even just financially but maybe they don’t have a good car. We really are an integral part of the health care team in Florida, and some people just don’t see that. The whole thing has been, we need to work together. We need to work together as a team, the nurse practitioners, the midwives, the CRNAs. Every aspect of the nurse practitioner team has to work with medicine, with radiology, with oncology.

    It’s not just primary care, it’s all different settings and we have nurse practitioners practicing in every single setting. They’re all over in specialty areas. Psych mental health is a huge thing right now. We have to partner with our physicians to give the best care that we can give. That’s the key right there and by becoming autonomous in Florida, it can open so many doors because people don’t think of Florida’s have underserved rural areas. Up the panhandle, we don’t have a lot of nurse practitioners and healthcare providers up there. There was a scenario we gave to the governor about seven years ago. I remember this very clearly when we told him that these children that have ADD have to travel 60 to 70 miles to get their medication filled when the nurse practitioner could do that. I think there’s a lot of tension that doesn’t need to be there amongst medicine. Some people see it, and some people just don’t, Angie.

    Angela: Yes, I think that’s one of the beautiful things about Frontier. Even from the very beginning, it was about creating relationships, helping and educating people about how advanced practice nurses are a part of the team. I think that once people start to understand that they’re not replacing, they are a part of a team where everybody has a role and is needed. I love that you mentioned the healthcare shortage areas because we have several areas in this country, as you well know, that are called healthcare deserts. Where people are having to wait weeks and months and travel great distances to be able to get the care that you and I may take for granted, that we can go down the road two miles and get.

    As our country continues the migration from rural areas to urban areas, those who are in rural areas are continually and increasingly underserved. I think that your point about nurse practitioners and nurse-midwives filling those gaps is just such an integral role and, of course, it’s always been Frontier’s mission to serve those who are rural and underserved.

    Vicky: Angie in 2020, Health Bill 607 was passed and that bill left out some significant healthcare providers such as psych mental health nurse practitioners and all the specialty groups and the CRNAs. It was really geared towards primary care. As long as you practiced in primary care practices, in family, in general internal medicine, or in primary pediatrics, and you met the guidelines as far as meeting the CEU requirements and making sure that you did not have anything on your license, you had an unencumbered license and you had malpractice insurance, that type of thing, then you could get your autonomous nurse practitioner license. In that bill, there were some provisions for nurse practitioners for underserved areas, if you worked in underserved areas. They put in the bill, that there was a $5 million budget for the nurse practitioner that worked in an underserved area to apply for $15,000 a year to go towards paying down their student loans. Some of our nurse practitioners in primary care looked at that and said, “Not only do I want to become autonomous in this underserved area because my community needs it, but I also would love to get some of my student loans removed.” A lot of us have a lot of student loan debt. 

    One of my colleagues up in the panhandle, she opened a practice and was really supported by a legislator to open her own practice in an underserved area. She went last week to find out — we were trying to find out where we could get this money for her to start paying down her student loans – and the money was pulled from the budget. Out of our bill. That money was pulled from our budget out of our bill last year, well, this session because they hadn’t used it yet. They pulled it to use it in something else in the budget in the state, but yet autonomous practice couldn’t even be applied for until October of 2020. A lot of nurse practitioners were just starting to start the application process and everything and then they pulled it in March. They didn’t even give any nurse practitioners time to even be autonomous, get everything up and going, get their practices running or anything before they pulled that money.

    Now, I’m trying to see if we can get that money back somehow because that was a recurring budget. That could dissuade some nurse practitioners in the state from saying, “Okay, I’m working in an underserved area and I can’t even get what I wanted to get out of this bill.” There’s so many things that we have to do still to take care of – we need to get psyche nurse practitioners in all the specialty groups and every nurse practitioner in the state, we need to get them autonomous. When autonomous practice was approved in 2020, I was able to be the first nurse practitioner in the state of Florida to get my autonomous license. My daughter, who’s also an FNP, she was the second nurse practitioner to get her autonomous license.

    Angela: Fantastic. You must be a very proud mama.

    Vicky: I am. I probably won’t practice for more than four years. I’m at that age. I’m on the downside, but we did this bill for these people who are coming behind us. My daughter’s still got 25 years to practice. The autonomous practice we want to try to get for every single nurse practitioner in this state. We still have our struggles. I can’t stress enough, Angie, the need for all nurse practitioners in every single state to be working with their legislators, working with students to let them know that this is something that, you get out of school and you just don’t start practicing. We want you to also become involved in your legislative groups and stuff and your state, your local, and your national organizations. You have to be aware of what’s going on in your practice because it can be taken away from you in one line in a bill.

    Angela: What I really hear you saying, and correct me if I’m wrong, is it is important for all nurse practitioners to be involved in the professional organizations and in advocacy for themselves, for the nurses that come after them, and for the patients that they serve. If you do not have the support of those state governments, it really ties your hands about where you can practice, how you can practice, and how you serve the communities that you’re in.

    Vicky: Absolutely. That’s the way you connect. I’ve got students that I know are coming to, we have a nurse practitioner meeting next week. Some of my students that were in my course are coming because they live in the area. In those meetings, we talk a lot about advocacy. We talk a lot about getting involved in your local. and also doing your state, and also doing your national, and going to those conferences. Hooking up with somebody who really knows advocacy and knows how to talk to senators and the house of representatives. Those people who really can connect you and help you and be mentoring for you.

    I didn’t know how to do it. I was mentored by Barbara Lumpkin to do it and I didn’t know how to do it. Those things are really important. The mentoring process is important because we’ve got so many people who are going to retire and we really need all these people to come behind us and still do the work. There’s so much work to be done. We can’t give up. We need voices and unfortunately, we need dollars because dollars talks and we know medicine has the money to pay legislators. Nursing doesn’t have that kind of money. Our packs are a lot smaller, which is your political action committee funds are smaller than physicians.

    You get out there, you get the legislators to know you. You get them to understand what you do in the community for them, and for the patients. You get them to understand in your district, this is how many nurse practitioners we have in your district. This is what they’re doing in the community. This is the amount of patients that are seen by those nurse practitioners. You have to educate these legislative representatives because some of them are coming in brand new and they don’t even know who you are unless they see you in practice.

    Angela: It all comes around full circle for me because one of the first things that had to happen again when Frontier first started was to get the support of the state and of the doctors in the state in order for a nurse-midwifery program to even happen because it was a new idea. From the get-go, this has been an issue for advanced practice nurses to break into that realm and say, “Hey, this is what we can provide. We’re here to be a team member.”

    What I also love, is that I know that every Frontier student gets classes on leadership. and on how to be a leader in their community because we know from the get-go that our students may be practicing in rural and/or underserved areas and they’re going to have to be their own advocate and be leaders in their community. I think that having mentors like you, who are saying, “This is an important part of your leadership to advocate for yourself and your brother and sister practitioners,” is just so incredibly important.

    Vicky: It really is. You hit on a key word, advocating for yourself. That’s a real important thing. I was very blessed to have a physician that I worked with and I’ve been with him for 21 years. He’s so pro-nurse practitioner and has been so supportive of me over the years in my advocacy efforts, but it’s important to be able to also educate the physician if you’re working with one and making sure that they understand because they share that with their physician colleagues too.

    I know that the physician that I work with has talked to his own colleagues about the importance of autonomous practice for nurse practitioners. When I got autonomous practice, he was so excited. Now, I won’t leave there because I don’t need at this stage in my life to open my own practice. My daughter does, she will and she’s in the process of working with that, but they need to understand the physicians also need to educate their colleagues on what you can do. If you’ve got a really strong physician you work with who supports you and who understands the need for that advocacy, they can also advocate for you and help you too.

    You have to just not reach out to your colleagues. You have to reach out to everybody around you, put op-eds in the paper, do articles in the paper, speak at conferences, speak at local meetings, speak at state meetings, and just get the word out there. It all pays off in the end, that hard work. We saw that with our controlled substance bill which was passed in 2017, I think it was. We saw that with our autonomous practice bill but we need to continue that advocacy effort and to be letting our students know that we need them to be leaders in our community too

    Angela: Absolutely. Now, for our listeners who may not be nurses or nurse practitioners at all, who are just interested in Frontier in the work that we do in improving rural and underserved health, what would you say to those non-practitioners, how can they help make sure that our best practice nurses have the resources and the support that they need in their own states?

    Vicky: Well, I think we need to educate them about what we can do and we need to be working with the community. The best thing I think that we can do – we do this down here in south Florida – Dr. Diane John and Dr. Sally Weiss, who are also Frontier faculty live right by me. They’re part of our local organization. Diane John is very, very entrenched in the community. She does a lot of community work. I do it with her.

    We’re out there where people are meeting us. These are not physicians. These are not nurses. These are people in the community at the YMCA, at the schools that know that educating that know what resources we can bring to them. They see the things that we do in the community. We work with kids in distress. We work with women in distress. We work with very low-income schools to do food drives and clothing drives and school drives. They remember us and they tell other people in the community. 

    It’s not just about the legislatures. It’s about other people in the community, learning about you, learning about what you do for them, and sharing that with other people because they will – 

    Angela: Beautiful.

    Vicky: -share it with everybody. We get calls all the time too. “Can you come and speak to our group, can you come and talk to our elders at the church about nurse practitioners and what you do in the community?” That’s a beautiful thing. It doesn’t have to just be our elected officials.

    Angela: Yes, there’s been lots of grassroots movements across this country that have had a huge impact. I totally agree. Educate yourself and share the knowledge, right?

    Vicky: Share the knowledge, share the love.

    Angela: Share the love. Vicky, this has been so wonderful. Is there anything that you would like to share that we haven’t talked about?

    Vicky: One of the things that I just want to say is that Frontier Nursing is just a phenomenal university. I’m not just saying that because I work there. I love working there, but just to hear the community say positive things about our university. There was a physician here that another university who was trying to get him to take students for women’s health. He said, “I only take Frontier students.” The faculty member came and told me, “He won’t take anybody unless it’s from Frontier.” I’m like, “Well that’s because they’re good.”

    Angela: That’s right.

    Vicky: For those out there who are thinking of maybe being students that are wondering what we do we. We’re a very rigorous university. We have excellent faculty. We have strong faculty. We put out really good students. Our graduates get jobs and the people who hire them have the utmost respect for them. The other thing we do too, that is so good is we publish on all kinds of different diagnoses and conditions. Our faculty do book chapters and we do presentations internationally, nationally. We’ve got a lot of good things going on at Frontier.

    Angela: We’re going to be highlighting many of those as we move forward with this podcast, because sometimes I like to say that Frontier is the best-kept secret in the country because there is much going on here that folks just don’t know about. 

    Well, Vicky, I certainly thank you. You are not only a wonderful advocate for nurse practitioners but you are also a wonderful advocate for Frontier. I really appreciate you taking the time to talk with us today and help our listeners understand a little bit more about advocacy and why it’s important.

    Vicky: Well, I thank you so much for inviting me, Angie, it’s been a pleasure.

    Angela: Oh, thank you so much. 

    To our listeners, as always, again, thank you for joining Frontier Nursing University, all-access. We hope that you have enjoyed our conversation and that you will share what you have learned today. If you would like to learn more about Frontier and how you can make a difference for mothers, babies, and families across the country, please visit our website at frontier.edu. If you have enjoyed this podcast and we certainly hope that you have, please remember to rate, review, and subscribe until next time. Thank you for listening.

    [music]

    END

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  • Faculty Spotlight: FNU faculty member Victoria Burslem recognized with the Circle of Caring Award

    Faculty Spotlight: FNU faculty member Victoria Burslem recognized with the Circle of Caring Award

    At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, Couriers 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.

    Vicki Burslem, MSN, CNM, APRN, CNE(cl), FACNM

    Frontier Nursing University (FNU) is proud to recognize faculty member Vicki Burslem, MSN, CNM, APRN, CNE(cl), FACNM, who is one of the recipients of the 2021 Fall Term Circle of Caring Award.

    Burslem’s ties to FNU go back to the late 1980’s, when she served as a member of Frontier’s initial Community-Based Nurse-Midwifery Education Program (CNEP). Serving on the faculty from 1989 to 1996, Victoria helped develop curricula and taught early nurse-midwifery classes during her initial time at FNU.

    “I was thankful to be a part of something that revolutionized midwifery education and have been delighted to see its growth through the years, expanding into the development of other strong programs for family nursing, women’s health, and psychiatric-mental health nurse practitioner APRN tracks,” she said.

    In fact, Burslem’s initial inspiration to pursue a career as a nurse-midwife came from Elsie Meier Wilson, a nurse-midwife with the Frontier Nursing Service. Wilson spoke at one of Burslem’s classes while she was earning her bachelor’s degree at Vanderbilt University in Nashville.

    “I was initially interested in pursuing a career in psychiatric nursing but when I heard her speak, it resonated with my desire to care for the physical as well as the emotional and psychological needs of those I would be caring for as a nurse,” she said. “The ability to provide physical and emotional support for patients during a major life transition appealed to me, and I saw it as a time when people are more open to healing, growth, and change.”

    Burslem has worked as a Certified Nurse-Midwife (CNM) for 45 years, working in clinical practice for over 35 years, providing midwifery care in a variety of roles and settings. Early in her career, she owned a private midwifery practice with a CNM partner. Later, she was the clinical practice manager for many years at a large Obstetrics & Gynecology practice in Atlanta, Georgia, which employed 10 CNMs and provided care in both clinic and private settings.

    Over the years, Burslem has enjoyed the opportunity to practice in two university teaching hospitals, a freestanding birth center, and a community hospital with an ongoing commitment to providing evidence-based care for underserved individuals whatever the setting. Teaching nurse-midwifery and midwifery students has also been threaded throughout her career. In addition to her work at FNU, she taught at the Midwifery Institute at Philadelphia University (now known as Thomas Jefferson University) part-time for four years and has served as a clinical preceptor for nurse-midwifery students from eight different midwifery programs. Coming full circle, Burslem was delighted when the opportunity opened up for a return to FNU in 2015 where she now serves as a Clinical Bound faculty member. 

    “I am passionate about working at FNU, helping to instruct the next generation of nurse-midwives so they are well-prepared to provide evidence-based care upon graduation with the knowledge, clinical competency, and wisdom to care for patients holistically, enabled as vigilant guardians of the physiologic while confident in their ability to identify and manage emergent situations when they arise,” she said.

    Burslem has been recognized through several awards and distinctions over the years. She became an American College of Nurse-Midwives Fellow and inducted as a member of the Sigma Theta Tau International Honor Society of Nursing in 2014; received the Dorothea M. Lang Pioneer Award from the the American College of Nurse-Midwives Foundation in 2013; won Frontier’s CNEP Pioneer Award in 1992 and won the Tennessee Nurse in Action Award from the Tennessee Nurses Association in 1982. Burslem is active in her professional community, currently serving as chair of ACNM’s Continuing Education Committee and president of ACNM’s Kentucky Affiliate.

    As a recipient of the Circle of Caring Award, Burslem said she believes FNU’s Culture of Caring is more than just a slogan, and values the university’s goal of fostering a positive, anti-racist environment of diversity, equity, and inclusion.

    “It is a philosophy that is threaded throughout the inner workings of the university community and its approach to decision-making,” she said. “I see evidence of the school’s commitment to this culture in written and verbal communication, and to the honor and value I see expressed in interactions with members in every part of the organization. This commitment makes me proud every day to play a small role in achieving Frontier’s goal of educating outstanding nurse-midwives and nurse practitioners who share the vision in particular of caring for rural and underserved populations.”

    Burslem lives outside of Lexington, Ky., with her husband, Rick, who she has been married to for 40 years. They have three children and three grandchildren.

    Thank you, Vicki, for the years of dedication you’ve put into the nurse-midwifery profession and for setting an exceptional example for the FNU community!

    If you know an FNU staff or faculty member that goes above and beyond, nominate them now for the Circle of Caring Award!

  • FNU’s Innovative Faculty Adjust to Students’ Needs during the Crisis

    FNU’s Innovative Faculty Adjust to Students’ Needs during the Crisis

    Dean of Nursing
    Joan Slager, CNM, DNP, FACNM, FAAN

    This article was written by Frontier Nursing University (FNU) Dean of Nursing, Dr. Joan Slager, DNP, CNM, FACNM, FAAN and was originally published by ACEN

    Just as Frontier Nursing University (FNU) teaches its students to understand and address the needs of the communities they serve across the country, the FNU faculty and staff are keenly aware of the needs of our student community. Those needs are ever-changing, never more so than during the COVID-19 pandemic. I am incredibly proud of how our faculty and staff acted with tremendous efficiency, professionalism, and care to ensure the best possible outcomes for our students.

    As the first wave of COVID-19 grew and spread, FNU began receiving notices from many of our clinical partners that they were either limiting or eliminating clinical rotations for students. By April 24, 2020, 140 clinical organizations had suspended all student rotations and 13 clinical organizations had implemented restrictions but had not suspended all student rotations. Thus, 289 students had rotations impacted by COVID-19 restrictions or cancellations between March and July. Some of our students were about to travel to campus for a skills-intensive session to prepare for clinical rotations.

    Some students were abruptly without clinical sites in the middle of their clinical experience, and some could see the finish line, but no longer had the opportunity to complete their final clinical hours. In the DNP program, carefully planned quality improvement projects imploded as patient visits decreased or priorities shifted in the sites.

    Faced with these urgent issues, the FNU team rapidly went into problem-solving mode. As President Stone reminded us, with our expanding use of technology to develop and refine a quality education program for students all over the country, while maintaining a sense of community, we have prepared for this for years.

    Within a few short weeks, the following programming and policies had been developed:

    • Regional clinical faculty and didactic faculty developed simulated and web-based activities that could be counted as clinical hours, thus allowing progress in clinical courses. Students who had met a minimum of 500 face-to-face clinical hours used these experiences to complete their clinical hours and graduate.
    • Policies allowing telehealth visits in the family nurse practitioner, women’s health nurse practitioner, and midwifery programs were approved.
    • The number of telehealth hours permissible in the psychiatric mental health nurse practitioner program was increased.
    • Virtual clinical preparation courses were developed for all programs. Students joined faculty via telecommunication sessions and practiced skills in preparation for clinical.
    • The DNP faculty developed four virtual quality improvement projects, allowing students to continue progress toward their Doctor of Nursing Practice degrees.

    The efficient and well-planned development and implementation of these measures were vital to our students, many of whom would have had to go on hiatus or even withdraw from the university if these options were not available to them.

    As the year continued to be challenged by the pandemic, the adjustments that were developed to enable students to continue to progress in their clinical education provided some valuable insight and lessons for the faculty and students. The faculty discovered that some of the skills taught during on-campus clinical sessions could be improved using the technology employed during the virtual clinical bounds. For example, demonstrating suturing techniques on a large display screen was more beneficial than when a single instructor circulated around a room of students practicing this skill. The simulated clinical scenarios that were taught in a virtual environment demonstrated the value of incorporating simulations into the clinical courses to enhance students’ exposure to infrequent clinical presentations or to facilitate evaluation or remediation.

    In all tracks, the initial clinical courses were converted to a virtual format taught by a combination of didactic and clinical faculty. Students practiced foundational clinical skills such as taking a patient’s history, critical thinking, and clinical reasoning guided by expert faculty. The feedback from students and their preceptors revealed that students demonstrated more confidence and were better prepared for clinical experiences after completion of the virtual courses. As clinical sites began reopening to students, the tangible evidence that some clinical preparation beyond the one-week intensive clinical-bound week was beneficial led to the development of a hybrid approach to the clinical courses. Currently, all students receive an initial 30‒60 hours of virtual clinical instruction led by faculty in a simulated environment, and the remainder of the hours are fulfilled in the clinical sites.

    Prior to the pandemic, the psychiatric-mental health nurse practitioner (PMHNP) students spent about 10% of their clinical time providing care via telehealth. Although discussions about including telehealth in the other program tracks had occurred, no provisions for this had been developed. Many clinical practices rapidly converted to providing some visits via telehealth, which accelerated the development of policies and procedures that allowed students in all tracks to participate in telehealth visits with their preceptors. In the PMHNP program, the utilization of telehealth increased to 70%.

    While telehealth as a care delivery modality preceded the pandemic, its utilization has expanded exponentially, especially in rural communities. Recognizing the need to prepare our graduates to deliver care via telehealth, software was purchased that will facilitate the incorporation of simulations into our programs across the curriculum as well as enable us to teach students how to provide healthcare via telehealth.

    While many universities struggled with the challenges associated with the COVID-19 pandemic, FNU seized the opportunity to adapt, learn, and improve our programs. These examples of flexibility, creativity, and resilience are part of our heritage.

    In-person Frontier Bound orientation sessions and Clinical Bound sessions are returning at FNU, and the innovative teaching methods that were seen throughout the pandemic will continue to be used in our distance education programs. The pandemic has taught our faculty and staff ways to enhance the in-person experience at Clinical Bound and to improve the didactic portion of our programs.

    Are you interested in learning more about what programs FNU has to offer? Fill out this form to start the conversation today!

  • FNU All-Access Podcast Episode 6: What’s So Special About Birth Centers?

    FNU All-Access Podcast Episode 6: What’s So Special About Birth Centers?

    Episode 6 of the Frontier Nursing University (FNU) All-Access Podcast features an in-depth look at birth centers and their place in the healthcare system. Frontier faculty Drs. Jill Alliman, DNP, CNM, and Diana Jolles, Ph.D., CNM, are joined by Kate Bauer, MBA, from the American Association of Birth Centers (AABC) in a discussion about a research project in which they were all involved. They share the findings of the project and what the data reveals about birth centers, including overall health outcomes and disparities, and the need for more midwives of color leading birth centers.

    The conversation also includes an explanation of the differences between hospital-based birth experiences and birth center-based birth experiences. Additionally, the differences between midwifery-based maternity care and physician/hospital-based maternity care are discussed.

    The trio also talks about the deep connection between FNU and the AABC, the role of the AABC, and their own roles and experiences at FNU and AABC, respectively.

    What You’ll Learn From This Episode: 

    • The difference between maternity care in birth centers and hospitals
    • The study that Kate Bauer and Drs. Jill Alliman and Diana Jolles participated in, its purpose and findings
    • What the data reveals about the impact of birth centers in overall health outcomes
    • The need for more birth centers led by midwives of color
    • The role of the American Association of Birth Centers and how to join the organization

    Listen to the Full Episode:

    Full Episode Transcript

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