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Frontier Nursing University All-Access Podcast, Episode 3 Transcript
What is the PMHNP and why is it important?

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: 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 Frontier Nursing University’s 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. Jess Calohan to the lounge. Hey Jess, how are you doing?

Jess: Good, Angie, thanks for having me.

Angela: Oh, it’s my pleasure. Listen, do you want to tell people who you are and what you do here at Frontier?

Jess: Sure. I’m Jess Calohan. I am the chair for the psychiatric mental health nurse practitioner department at Frontier Nursing University, the newest program at Frontier. We have grown significantly since we had our first students in 2018. We’re really excited about the growth that we have in our program and the direction that it’s headed.

Angela: It is very exciting, but before we get into that, I have to ask you a question. How’s your golf game?

Jess: It’s stable right now. I can’t quite seem to move the needle. Right now, I’m taking care of my kids and letting them have some lessons. One of my sons is good enough to beat me consistently now.

Angela: Right. Well, you will be tickled to know, I’m sure, that I took up golf a couple of years ago before the pandemic started. Do you know what my favorite part of the game is?

Jess: What’s that?

Angela: The outfits and riding around in the golf cart. [laughs]

Jess: We have our own golf cart too. Last year, I got it right during the pandemic because our home course wouldn’t allow us to use the carts that they had. You either had an opportunity to walk or you could ride your own cart. Well, after 20 years of military service, and three combat deployments to Iraq, this body is a little beat up, needless to say. Walking 18 holes is not exactly what I want to do, especially in the Texas heat. We picked up a used golf cart so we could get out and have some fun and play.

Angela: It is really a fun game. I’m pleased at this point in my golf career that I’m making contact with the ball and that I can get out of the sand pit. Yes, it’s a fun game. I’m definitely enjoying it. Now, you mentioned you were in Texas. How did an ex-military Texas guy end up at Frontier Nursing University?

Jess: Interesting story. I had learned about Frontier when I was the chair of the psych mental health nurse practitioner program at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. That was my last duty assignment. We trained about 98% of all the psych mental health nurse practitioners for the department of defense. I had a colleague who happened to be a nurse-midwife who was coming to Frontier, and she was working on her DNP and eventually earned her DNP. That’s when I first heard about Frontier. I started to do some of my own research and found what a really cool place and the opportunity just so happened to come about. It was about two years after I retired. When the opportunity came up, I jumped on it and was selected for the position, and really loved it ever since.

Angela: We are so glad that you’re here. This is a great program. I know that it’s still relatively new and it’s growing very rapidly. Can you talk to us about why did FNU start this program?

Jess: Well, I think the main reason that FNU started this program is, one, with the mission of Frontier in terms of serving rural and underserved communities. The psych mental health profession in terms of the prescribing aspect of it, the role that the psych NP has in the mental health system is incredibly important. Unfortunately, there’s a significant nationwide shortage of psychiatric mental health nurse practitioners, and really other mental health nurse practitioners. Frontier was committed to meeting that need and again, it fit really well with the mission of the university in terms of how psych mental health issues have been stigmatized in this country for a long time. I think that’s certainly getting better. I think one can argue that folks that have mental health conditions were sometimes marginalized, and again, similar to some of the rural areas that we work with at Frontier, as far as resources and not always having those resources. I think that’s the primary reason why the university started our program.

Angela: When I look back on the origins of Frontier and we say that those original nurses on horseback were nurse-midwives, but they were so much more than that. They were public health nurses, they were midwives. They always went beyond really the scope of what you’d think of when you think of a nurse-midwife today. You’re right, the mission has always been to provide the services and the care needed in these rural and underserved communities.

I remember when you and I were working on a grant not so long ago, and we’ll talk about that in a little bit, the amazing statistics that we found regarding the lack of mental health care providers in this country, and that people are waiting sometimes months to even get an appointment and having to drive hours away. I love that you guys are doing this and that we have this wonderful program and that we are making a difference in the lives of people all over the country, through your students and graduates.

Jess: Yes. We’re really proud of our graduates. One of the other things too, that we’re very proud of is we’re one of the most diverse programs, one of the program tracks in the university. I heard a story last summer that was just heartbreaking on the national news. Obviously, all of the things that we have going on in our country right now with the social justice issues, the racism and all of the things that have happened over this past year. I was listening to a news story and there was an African-American couple who were a middle-class family in a very suburban area or urban area. Both of them had experienced some pretty significant depression. The wife had experienced postpartum depression, and the husband had a family history of some depression. One of the things that they said in this interview was, there’s no providers available that looked like them in their areas.

Certainly, from a cultural standpoint, that was huge. That just resonated with me. I was like, “What are we doing to help improve and facilitate diversity, equity, inclusion and cultural considerations?” It was at that point that I said, okay, we’re going to look at our curriculum and we’re going to engage our faculty who is also very diverse. We’re going to be a program that’s going to do more than just say we talk about cultural competence and that we address diversity. We are actually going to put that out there and have work in our courses that addresses those things specifically in hopes of improving the ability of our students to be able to work with a broad population of folks from different ethnicities, races, and cultures. That’s something that is incredibly important as we look at some of the health inequities for example.

Like I said, I want us to be committed to that work and not be a school that just says it, but actually does it. I think a lot of us have lamented and struggled with, how can we make an impact? What can we do different? We have an opportunity as a university to make a difference through education, because if we educate our providers and we work on changing approaches and we work on changing how we interact with each other– I know Frontier is doing a ton with diversity, equity, and inclusion. We’re very proud of that, but I just think it really does start with education and that’s where we have an opportunity to make an impact. We don’t always have to go protest and we don’t always have to do these other things, which those things are effective and those things can facilitate change, but where we are facilitating change, I think, is through education. That’s one of the things in a lot of things that I’ve read about a lot of these issues that we’re dealing with. It really does start with education and so we have that opportunity to do that.

Angela: 100%. This has been a hot button issue as you said for the last year, but one of the things that I find very interesting is that Frontier really started a focus on making sure that we were providing diverse practitioners over 10 years ago. When we first started this work, our diversity population was like 9%.

Today, I just looked at our dashboard, our diverse student body population is over 27%. It’s just an amazing place to be, to see that we are doing what’s necessary. I love that your program is also specifically focusing on that. Now, Jess, are you part of the President’s Task Force on Diversity Equity and Inclusion?

Jess: I am, in more from a leadership standpoint, but I have multiple faculty members that are active on the different subcommittees.

Angela: I am actually co-chairing one of those subcommittees and I’m so excited that we are not saying, “Okay, we’ve done enough.” But what else do we need to do? What else can we do? What else should we do?”

My particular subcommittee is actually focused on making sure that we’re raising the money and that we have the financial infrastructure to be able to continue this work in a real and meaningful way. Thank you for bringing that up, Jess. I really hadn’t thought about the DEI avenue when I was thinking about talking to you about this program, but I’m so thrilled that you have brought that up and that we are maintaining that focus throughout all of our programs. I know why you love it, but why do you think this program has been so popular with our students?

Jess: I think just the opportunity to work in the virtual environments, or online environment, distance education. Frontier has been a pioneer in distance education and it’s interesting, when COVID hit and all of our our family members or kids and even peers that were going to other universities that hadn’t had experience with distance education, I just remember telling my wife and my kids, “Hey, we’re ready for this. It sucks that this pandemic is happening, but we are totally ready for this.” I saw the distance education platforms and things like that that were being implemented at the high school level and also the collegiate level and certainly graduate and doctoral. Hands down, Frontier has been a leader in distance education and virtual education. I think that’s part of why our program is successful.

I think the other part of our program, or the reason why we’re successful is our mission and the type of students that we attract. We do have students from rural and underserved communities. I think our university’s affordable compared to other programs.

Frontier built a reputation of being a quality institution with the midwifery graduates and other nurse practitioner graduates. The psych mental health nurse practitioner graduates have followed along that same vein. We are doing very well in terms of job placement after graduation. We’re doing very well on national board certification pass rates. To put that into context, the average national board certification pass rate is about 76% overall, and our overall board certification pass rate is 94%.

Angela: Wow. Now that’s something to really be proud of Jess.

Jess: Yes. We’re very excited about that. The psych mental health certification exam is not easy. Not saying that the other course certification exams are easy, but like I said, 76% pass rate, overall pass rate nationally speaks to the difficulty of the exam.

The other thing is, is there’s three specific domains on the exam. We routinely, the last two years since I’ve been here, have scored on average 10 percentage points above the national benchmark in each one of those domains.

Angela: Fantastic.

Jess: We are really doing well on our board certification exams. I think the other thing too that’s important is that there’s other programs out there, and I can’t really speak to the quality of the programs because I don’t know them very well. I know three programs that I’ve been a part of, Frontier being one of them. This is by far one of the best programs in my opinion in the country. I know that I’m a little bit biased, but we are teaching students to become specialists.

I look at other programs that may be a shorter program of study length and that kind of stuff. It baffles me that these schools train psych nurse practitioners, whether they’re already nurse practitioners getting a postgraduate certificate or master’s degree students in the amount of time that they are. I don’t understand how you can train somebody to be a specialist, which this is a specialty field of advanced practice nursing that fits into the mental health system.

The expectation is that we are ready for independent practice. I think that philosophy along with I think the American Nurses Credentialing Center talks about entry level practice. I don’t believe in entry level practice. We are preparing students for practice because there’s such a need and many of our students are going to be on their own. We need them to be competent and safe psych mental health nurse practitioners. That’s what emphasis is on this program. Our faculty have bought into that in the remarkable work that they have done. Our students have bought into that. When you look at our attrition rate, I think it’s less than 6%. We are doing some really cool things and our students are being successful.

I also think that our approach at Frontier, we talked with the students in our Frontier Bound, which is our new students’ welcome to the Frontier community. I don’t want to use orientation, because it’s not really an orientation.

Angela: [laughs] It’s a community building, almost week-long event, right?

Jess: Absolutely. Where we are hopefully building connections, we’re inspiring students and we’re making them ready for starting their academic journey. I think the other thing is our approach. We have such robust support systems in place to support students. We don’t focus on, “Oh, we have this many people that don’t graduate,” we focus on, “How can we help students be successful?” I think the way the infrastructure that we have in place, allows students to be successful. That’s our focus and that’s the faculty’s focus, that’s the staff’s focus, and certainly that’s the administration and leadership’s focus.

Angela: We talked in our last episode about what the heck is an RCF. I think that that is something that is pretty unique to Frontier, to have faculty all over the country that are not just supporting the students, but also supporting the preceptors who are training these students in their clinical environments.

We also talked about Stephanie Boyd’s team, of course, that helps our students understand what they’re going to need for their clinical practicums and helps them search for those placements and supports them. I would have to agree, we have a wonderful system in addition to our faculty. I’m really proud of the work that our staff does with our students. We wrap them in our arms and help them fly. [laughs]

Jess: One of the other things too that I think makes us unique is that many other institutions’ faculty are academic advisors, and that’s not how it is here at Frontier. We have the academic advising session and their team has been very, very helpful. Not only to the students, but also as thought partners, if you will, for faculty in helping them navigate maybe some challenging student issues or things that come up. The focus is always on, how can we best support the student?

Angela: Absolutely. You know, something that I’ve not talked to our listeners about is our library staff. A lot of people may think, “You’re an online institution. Why do you need librarians?” They work with students every single day because — I’m not sure that people understand that the research is changing every single day and that our students are constantly reading best practices, learning about the newest, the latest, the greatest. One of the things that I hear from our preceptors is they love our students because our students are bringing them new ideas, new ways to solve problems, new strategies. I think a lot of that has to do with how we train our students to be evidence-based and find the evidence through the support of our library staff.

Jess: Absolutely. They’ve been instrumental, certainly also supporting faculty as well, as they are looking to maybe improve or identify new resources that are valuable for students, and then also as faculty have their own scholarship endeavors and aid faculty with scholarship endeavors. One thing that I found interesting the other day, talking about scholarship endeavors is that — My alma mater is University of Washington. I was looking at some grant funding and Frontier’s right there with them in terms of the School of Nursing and grant funding for the different types of programs that we have. I thought that was pretty impressive.

Angela: It’s very interesting when you look at our history with particularly federal grant funding. I don’t think that we have been without some kind of federal grant funding for the last 10 years. That is just a testament of the faculty, the students, the staff, because anybody who’s worked in federal grants will tell you that you don’t get that money for nothing. You have to be able to show some outcomes, and you have to be able to back up what you’re doing in those outcomes with lots and lots of data. That is one of the things that I love about Frontier is that everything we do is data-driven.

Jess: Absolutely. I think on the scholarship aspect of things, again, it just speaks to the quality of the faculty that we have and the types of projects that are really making an impact. The thing that I also like about our university is that faculty are free to do different types of scholarship and I just think that that is awesome. It’s not mandated. It’s encouraged and I think when you take that approach, you empower faculty to be more creative and learn what is going on in their communities and identify what’s going on in their communities so that they can have some research interests that are going to impact their communities.

Angela: Absolutely. I’m glad you brought up communities, because we’ve talked about the fact that we have regional clinical faculty all over the country, but our faculty are actually all over the country as well. One of the beautiful things about that is that when we are looking for highly qualified faculty, just like with you, Jess, we are not confined to those who live in our community. The entire nation is our community and therefore, we are able to pick from the most talented and brightest all over the country. Which is how a Texas military fella ended up here at Frontier Nursing in Versailles, Kentucky, right?

Jess: Exactly. I tell people, “What do you do for a living?” “I work for Frontier Nursing University.” “Where is that?” “Kentucky.” “Oh.” That’s the response that I get. It’s like, “We’re one of the oldest nurse practitioner schools in the country and we’ve been doing distance education for a long time.” It’s an opportunity to explain to people who we are and what we’re about.

The other thing that I think is really incredible about Frontier is that almost all of our faculty are in some form of clinical practice. You don’t see that in many other places, to include me. I actually saw patients today through telehealth. Just an awesome opportunity to be able to share our experience with our students, and we know what our students are going to be going through when they graduate. I think that gives us a lot of credibility. I think that’s another reason too, why Frontier is where it’s at in terms of quality and people being excited.

Angela: We could talk about why we love Frontier all day, but I know that one of the big challenges for you in the past year was, of course, the COVID pandemic, and what that meant for our students. Can you talk about how we overcame some of that and some of the great things that you guys are doing with telehealth?

Jess: Yes. First of all, we again, as I said earlier, we were well-positioned to move everything to an online environment or virtual environments. Our faculty did an excellent job of putting together a clinical balance, which are typically on-site activities before students go out to their clinical rotations or faculty supervise. It’s essentially clinical intensive to prepare students and make sure students are ready to go to their clinical rotations. We were able to pivot fairly quickly and transition what was an on-campus experience to the virtual environment. I will tell you, our faculty did such a great job. That very first iteration of student evaluations were phenomenal. We were able to leverage our technology, we were able to leverage simulation and standardized patients and clinical scenarios that really prepared students for their clinical rotations. That’s one thing that we’ve done.

My program specifically, we were able to shift to the telehealth environment. While the other program specialties had maybe a few more students out of clinical because of COVID and organizations not allowing students in, we didn’t have that level of impact on our students because psychiatry has been doing telehealth for a very long time. It’s not a foreign thing to us. I have my own telehealth company. Started it for the army in 2005 and so I’ve been doing it for quite some time. We had already integrated those telehealth principles into our curriculum and so when students had the opportunity to do telehealth with their clinical rotations, it allowed them to stay in clinical rotations, and continue their educational journey so that they could graduate and get out and take care of the people that they needed to take care of. Quite frankly, there’s a mental health crisis in America right now and a lot of it has to do with the pandemic.

Angela: Right. My kids are grown, but if my children had been out of school in the house with me for a year, I think I would be in a mental health crisis. [laughs] Did your kids have to be homeschooled during the pandemic?

Jess: Yes. They’ve actually been in virtual school for the last two years. We were transitioning to Texas from Virginia in the fall of 2019. It’s just easier for us to keep them in the virtual environments and so they did two years of school virtually. I think just like many families across the country, it takes a toll. You’re having to help them with homework and again, I talked about the educational piece of it. There was such a variance in terms of the quality of education they were getting, and there was variance within classes and different teachers and those sorts of things. Very challenging time, that’s for sure. We are ready for them to start school here in about two weeks and go back. We have two seniors going into their senior year of high school in a couple weeks.

Angela: Wow, a senior. I just had my second grandbaby. I look back on those and can’t believe that I made it through those high school years [laughs] but now I’m enjoying the grandbabies. It’s worth it eventually, Jess. [laughs]

Jess: Teenagers are definitely very, very difficult.

Angela: Right. You know what? Let’s talk about this grant, because the federal government is a lot of fun. They have these amazing due dates for their grants and they’re usually right around the holidays. Jess and I, and a whole team of individuals spent Christmas and New Year’s [laughs] writing an enormous grant application for a behavioral health grant through HRSA, that not only supports students in rural areas but also has a focus on underserved populations and students of color. We’re really excited about this application and the fact that it was funded. Jess, do you want to tell us a little bit about what we call lovingly the BHWET grant?

Jess: Yes. It’s the behavioral health workforce education and training grant. The focus of the grant is to provide education on rural and underserved communities and how to work in those communities with different clinical scenarios and things like that. It’s also to have clinical partnerships with organizations in the healthcare provider shortage areas, where there’s just not a lot of resources. We are very excited that we have partnered with an organization in Eastern Kentucky. In fact, just found out this morning from HRSA that they are totally okay with us pursuing another clinical partnership in northwestern, Colorado.

Angela: Fantastic.

Jess: We’re really excited about that. Big shout out to Dr. April Dobroth, my wonderful clinical director who facilitated that and is working on establishing that partnership.

The grant provides stipends to students in their last portion of their clinical rotations, to help them cover costs related to either travel, to not working as much, and anything that the student needs it for besides tuition. They can’t use it for tuition, but to really support the students in clinical. The purpose of the grant is really to not only provide education, but also to partner with these organizations, to help improve their behavioral healthcare delivery systems and also a recruiting pool to get folks with this specialty in their community.

We’re really excited about this. We’re going to have the opportunity over the grant life, which is four years, to provide $10,000 stipends to about 110 of our students. Also, some travel opportunities to go to some conferences, to come to our diversity, equity, and inclusion conference, Diversity Impact Weekend, that Frontier hosts every June.

Also, our other focus is on building our simulation capability, telehealth capability within the university. Some of the grant funds are going to go to some technology that’s going to allow us to improve students’ ability to apply information they’re learning in the classroom through controlled simulated events that are faculty supervised, so that when they get out to clinical, a lot of times they’ll have already had an opportunity to maybe make some mistakes and get what I call a controlled burn.

They can learn from that, so that when they get out to clinical, that they’re ready to go. I will tell you, we have surveyed some preceptors over the last year and with some of our simulation efforts and the things that we have done, not only with our virtual clinical bound, but we also have a hybrid course. That’s one of the first clinical courses that our MSN students take that’s a hybrid between faculty-supervised hours and simulation and also in the clinical space, seeing patients. Preceptors had noted a difference, a positive and significant difference in the students’ preparation for clinical rotation since we’ve implemented these changes.

In fact, I talked to a preceptor last week who has taken four of our students and has had three students from other unnamed universities and he said, hands down, our four students were way more prepared than those students from the other unnamed universities.

Angela: You know, Jess, I hear that all the time. I talk to people all over the country about Frontier in my role and one of the things that I consistently hear is that our preceptors and the organizations that they work for are so impressed because our students in all of our programs are very well prepared. One of the reasons I think that is, is, of course, we’re great and all of our faculty is wonderful, but at some universities, students don’t do all of their didactic work before they go into clinical. They’ll learn a certain skill and then they go into clinical for practice of that skill. We are different because students get all of their coursework out of the way and then go into clinicals after a very intensive check off from their professors during their clinical intensive or clinical bound as we call it. It’s a different model than a lot of universities use, but it produces great providers.

Jess: I think along that vein, it allows us to get preceptors a little easier as well because our students can see a patient from beginning to end and make recommendations for treatment plans. Whereas I’ve been part of four universities and three universities front-loaded everything and then went to clinical and one didn’t. I will tell you that the one that didn’t, the students struggled in clinical. They struggled finding preceptors because our preceptors are such a valuable commodity. We love our preceptors. They’re taking their time, they’re volunteering tons of hours, and I think we need to respect that and have a commitment to them that when we send them students, that our students are going to be ready to go and be able to see patients.

Angela: Absolutely. The fundraiser in me can’t let this go until I mention, you talked about these stipends for students in their clinical rotations. That was one of the most exciting parts of this grant for me, because what we know is that even though we’re one of the most affordable programs in the country, our students still live with debt and our students are primarily working nurses with families, children. What happens is they can go through their didactic work pretty well while practicing, but when it gets to their clinical rotations, it’s nearly impossible for them to hold a full-time job, which sometimes provides the insurance for their family and do their clinical rotations.

There is an enormous need for support for students during their clinical rotations beyond just tuition. I’m just so excited that HRSA recognized this and is providing the funds for that. That’s what these folks need to get through that portion of this program. If you’re listening and you want to help a practitioner get through their clinicals, you can contact me or you can visit our website at frontier.edu and click on that Give Now button. Enough of the fundraising. [laughs] You know I had to get that out there, Jess. Jess, it is always such a pleasure to talk to you. I’m so thankful that you joined us today. Is there any advice that you would like to give a prospective student or a closing message you would like to give us?

Jess: Yes. I get the question all the time from perspectives with students about psych experience. What I will say to nurses out there everywhere is psych is everywhere. You don’t necessarily need to be a psych nurse to come to our program. You just have to have a passion for nursing and an interest in caring for this population. If you have those two things, we will teach you to do the rest. We’re super excited about the direction that our program is headed. The quality of students and applicants that we’re getting is phenomenal. Again, can’t underscore the diversity component enough. If you’re interested in this profession, Frontier is the place for you.

Angela: Oh, thank you, Jess. Thanks for joining us, thank you for taking your time and thank you for the wonderful work that you do with our students. We really appreciate you.

Jess: Thanks, Angie. Appreciate the opportunity to come join you today.

Angela: You are welcome. My pleasure. To our listeners, thank you for joining Frontier Nursing University all access. We hope that you have enjoyed our conversation. 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, or reach out to me your all-access host at angela.bailey@frontier.edu.

Always, 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.

END

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Frontier Nursing University All-Access Podcast, Episode 2 Transcript
What the Heck is an RCF

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.

[music]

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 health care across the country. Today, it is my pleasure to welcome Dr. Mary Jones and Stephanie Boyd to the On-Call Lounge. Thank you both so much for joining us today.

Mary Jones: Hi, Angela.

Stephanie Boyd: Hi, Angela. Thanks for having us.

Angela: Thank you for being here. It’s so great to be with you ladies. I don’t know that everyone is aware, but Frontier Nursing University has had everybody working from home. Any chance I get to hang out with these two very cool ladies, I am excited to do so. Before we dig in, I just want to again, thank you both for being here today. I know that both of you have very busy lives outside of Frontier. If we have time, I’d like to get into that just a little bit. First, let’s talk about the title of this episode. What the heck is an RCF?

Mary, would you like to talk a little bit about that?

Mary: Sure. RCF is known as the Regional Clinical Faculty at Frontier Nursing University. Our real work begins with the students once they attend Clinical Bound.

Angela: Tell me, Mary, what is Clinical Bound for our listeners that don’t know?

Mary: Frontier is a little bit different. They do the didactic work upfront, and then the students go to their clinical settings once they’ve completed all their didactic work, so they can focus on their clinical practice and getting used to functioning as a nurse practitioner or a nurse-midwife. Clinical Bound is a week-long session where the students come to campus in Versailles and they learn skills and techniques that will help them become providers. They come from all across the country, and they meet with other classmates. Once they finish Clinical Bound, then they work with their RCF to start their clinical sessions actually.

Angela: Now, Clinical Bound is really a lot of fun. Were you at the Clinical Bound that I was able to attend with students, Mary?

Mary: I have been at so many Clinical Bounds because I’ve been a team leader. I feel like I’ve been to many where you were present.

Angela: Well, I actually went through some of the sessions at one Clinical Bound, and the session where you use that very realistic model to deliver babies was absolutely my favorite. I actually talked about this with Dr. Stone in a previous episode and there’s actually a video of my knees shaking as the students made me practice delivering or catching a baby as well. Again, now that video has never seen the light of day. We’re clear that the RCF, their real work with students begins after Clinical Bound, which is a week-long skills-intensive. What does a Regional Clinical Faculty do? Is this a position that all universities have?

Mary: The Regional Clinical Faculty is unique to Frontier Nursing University. We have a panel of students that we work with closely, we spend time with them, we meet with them every two weeks once they start their clinical practicum. As the RCF, we grade your reflections and your case logs, and your paperwork. Everything that you have to submit for your clinical practicum your RCF takes care of doing that. They also are the ones that can tell you whether or not you can start clinicals.

If you don’t hear from your RCF, you can’t start clinicals. It’s a pretty important role. As far as other universities, I have worked at other universities prior to Frontier and they do have what they call Adjunct Faculty, and those faculty do work with the students and grade their assignments. In my experience, it’s different because they don’t help the students find clinical placement like the RCFs at Frontier.

Angela: I think there are a few other things that make you guys pretty unique and different from other universities. For instance, I know you also provide a lot of support to the actual preceptor. Would you like to talk about that a little bit?

Mary: Yes. Prior to the students going to clinicals, we do meet with the preceptors and we offer them support, we offer them some CEUs that they can earn while they’re having our students precepting our students. We have a large network of preceptors, around 16,000 preceptors that we have an affiliation with across the country.

Angela: That’s amazing. Correct me if I’m wrong. Stephanie, you may know a little bit more about this, but 16,000 preceptors, over 4,000 clinical sites spanning all 50 states, is that correct?

Stephanie: Actually, we use about 4,000 clinical sites every couple of terms, but we have over 13,000 that we’ve utilized either in the past or currently, and it’s growing.

Angela: Wow. I think that’s remarkable because as our student body has continued to grow over the last decade, I know that there’s been a lot of work that went into also credentialing and certifying all of these different preceptors and clinical sites. I know that Mary, the RCFs, you really develop relationships, not just with the students who you support during this process, but with the sites and the preceptors. I remember doing some preceptor site visits with you on a very rainy day in New York City.

Mary: It seems like eons ago that we did that. For a small-town girl, less than 500 population, it was an interesting time to run through the streets of New York City and just pretend like I’ve done this my whole entire life.

Angela: I was so impressed when we went into the site that people knew exactly who you were, that they welcomed you, that you even brought a little gift for the site. It was very meaningful to me to know that our RCFs really do have that supportive relationship not just with our students, but also with our clinical preceptors at the clinical sites. I know that your work with the students really begins, as you said, with Clinical Bound. Stephanie, I think you have a lot to say about some support for students before Clinical Bound. Mary alluded to the fact that sometimes there’s difficulty in finding clinical sites. Do you want to talk a little bit about your team?

Stephanie: I would love to. Just to clear everything up for anyone listening, I am not a practitioner. I’m not a clinician. I don’t catch babies. I don’t pretend to catch babies or any of that. I’m actually the Director of Clinical Outreach and Placement. I’ve been here for about 13 years. I am so lucky to be able to work with this particular Clinical Outreach and Placement team, which consists of a clinical services coordinator, and three clinical advisors currently.

Really the goal for our unit, our services, are to meet with the student as soon as they come to orientation and start walking them and talking them through the clinical site identification process, because it can be rigorous, depending on the program that the student is in, geographically where they’re located. We always want to make sure that students know well in advance what the expectations are, and also what resources are available to them. Some of our students will come in right away and know exactly where they want their clinical experience to be and what they want that to look like. Then we do have some students who come in and they’re not really sure.

They may have an idea, but perhaps they’re new to that area, or they haven’t been a practitioner long, and they haven’t created a lot of relationships. They’re still trying to figure out what that clinical experience is going to look like. The goal for us is to really help walk them through. There’s so much in terms of what to do and what not to do when you’re looking as a student for clinical sites. We give them some advice, help them use our resources at Frontier, and really try to get their plan in line so when they’re ready for their RCF to look at their clinical plan and approve it, all their ducks are in a row so to speak.

RCFs can check, check, check and approve everything and the student can get ready to move into Clinical Bound and then their clinical experience. The flip side of that is we have our clinical services coordinator. She’s more on the customer service preceptor side of things. Her name is Brittany and she will really work closely with our new preceptors and then also our more seasoned preceptors to help them with anything they may have questions about, using our online system. We call her the preceptor whisperer because she answers all these questions because the RCFs are busy out at the sites. They’re out there, meeting with students and meeting with preceptors. They’re not always right there at their phone to answer a quick question. Brittany’s able to back up the RCF, sometimes either with a technical issue or something, when they’re out on doing that work on the ground.

Angela: Yes. Honestly, it sounds like in between your team, Stephanie, and the RCFs, Mary, that both the preceptors and the students are really supported from day one throughout their entire experience. Mary, do you know how many RCFs there are at FNU right now?

Mary: Off the top of my head, let me just add quickly. I want to say there are probably close to 40 RCFs between all three programs and I know that we’re increasing our student population. We’re also trying to increase our RCF population because it is a time-intensive position and we really want to give the support to the students that they deserve and that they do need.

Angela: Right. I think it’s important for our listeners to understand that, while Stephanie’s team is holding down the fort here in Versailles and providing that excellent support, our RCFs actually live all over the country and they are spread out that way intentionally so that they can provide support to our students where they are and the preceptors where they are. It’d be really hard to do that from our campus in Versailles, right, Mary?

Mary: Oh, absolutely, yes. It’s nice to have someone out in the field supporting the students in the preceptors while having that support back home.

Angela: Absolutely. Now, Stephanie, I know that your team is a bit new. Can you talk a little bit about why the team was created and when?

Stephanie: Yes, our team was created essentially — the middle of 2019 is when I came on board and then we hired all of our clinical advisors. That came from our administrative really looking at all of the data that we collect at Frontier, whether it’s quantitative or qualitative data, we’re a very data-rich environment. They were able to really pinpoint some areas where students were indicating they would need more support.

One of the places that they did or one area they thought, well, this might be a good idea to have some more support was right when the student comes into the program. The students have a rich — It’s just a vast network of support already in terms of academic advising, their didactic faculty, financial aid. The one piece they said was perhaps missing, was that focus on how to identify clinical sites, where do I start and how do I make sure I’m finding appropriate clinical sites?

That was really where the discussion started with the administration on how do we develop support service for students in that area. The RCFs, quite frankly, they have an assigned caseload and that’s done on purpose. They may have 20 to 40 students, sometimes max. That’s a lot of students, to really be able to focus on out in their region, but you may have two or 300 students up the pipeline that haven’t even reached clinical bound yet. The RCFs really want to be able to spend all that one-on-one time with students and they just couldn’t. That’s what we were hearing from students is we want someone that can sit down with us and just really make sure– that can really reassure us that what we’re doing is right because the last thing we want students to do is get to clinical bound and not have all those things in place. That’s really why our team was formed to help with that caseload upfront. And really the RCFs could really focus on being in the moment at the site, doing the site visits to make sure the site’s ready for the students, making sure the preceptors are appropriate and then, being there for the student in the moment once they’re there at clinical.

Angela: Love it.

Stephanie: Yes, it was pretty exciting. I don’t know another university that has the type of office that we do and the type of services that we provide. We actually have other students from other universities that will contact us and ask us for help. We’re like, well, we can’t really do that but good luck. I think it’s really unique. The relationship that our team has with the RCFs, we work really closely together to be able to provide support to that student when they need it.

Angela: It’s amazing. Not only is the support and the relationships and the network amazing, but it is amazing to me. You mentioned it, that even this was evidence-based, and it’s also amazing to me that the students spoke and Frontier listened. It’s just a true example of the service that is at the core of Frontier’s mission and our attitude towards all of our students and alumni.

Stephanie: Absolutely.

Angela: All right. Is there anything that either one of you would like to share about your team’s accomplishments that you’re most proud of, particularly you, Stephanie, because you guys have only been around for two years?

Stephanie: Yes, it’s been a whirlwind two years because I don’t need to tell anybody if you’ve been awake, what’s been going on in the world and especially we were not even into this a year when COVID happened and we have had to pivot as an institution in how we delivered services and provided all of our coursework to our students from a clinical perspective. In turn, a lot of hospital systems and things were really having to put things on hold. It was a stressful first year.

I’m really proud of our team still being able to provide one-on-one service to students, even during a pandemic. I can’t say enough about all the time and the hard work that the staff has put into supporting the students and quite frankly just being able to really develop new services for students. That’s the great part about working at Frontier. If we have a really great idea, and especially if it’s something the students have because we make this assumption, we know what the students need, but sometimes they’re not correct and we have to listen to the students and what they say they need.

For Frontier to be able to develop this service and allow us to say, what do you need and then create the service as it’s needed and create the resource as it’s needed, we’ve developed lots of systems, processes that are new to our students and then just creating those relationships with the students and RCFs. I’m really proud of that because I feel like there was a little bit of a hole there that we’re helping to help fill and meet a need.

Angela: Right. Great. Wonderful. What about you, Mary? Can you talk about how this new team has helped you and the other RCFs in your role with working with students?

Mary: Well, that’s a really good question because I’ve been doing this RCF role for nearly 10 years now. I remember getting students, they contact you immediately after they attend what we call Frontier bound at Frontier Nursing University. That’s their initial orientation to the university. They start asking all these questions and how do I contact these sites?

As Stephanie, mentioned, as an RCF, we’re out on the road running through an airport, trying to text someone as we’re jumping on the shuttle bus in the Atlanta airport, trying to get our messages across. It’s just been really great having someone there that can say. “We need to work on your resume. We need to look at what sites you need because it’s different for each program.” Everyone needs something different and they have now the specialists in the clinical outreach and placement that can help individualize each student’s plan.

Angela: Oh, love it.

Mary: I definitely can’t answer my phone every time it rings. I might be in the air and COVID has decreased some of the travel but we’re still networking with preceptors and students.

Angela: What I love most is that I can absolutely hear the passion for our students in both of your voices, and because I know you, I know that both of you are very passionate about that. Mary, we talked to about you and I spending some time together in New York City. One of the things that we did while I was there with you at a beautiful Airbnb in Soho that we got for a song, we should do a whole podcast about Airbnb discoveries, right, Mary? One of the things that I remember most about that trip besides us running around in the rain is the Case Day. Can you tell our listeners what a Case Day is?

Mary: All of the students, as they near the end of their clinical practicum have to present a case study — a difficult patient that they cared for as a student or a memorable patient that they cared for as a student. It’s all evidence-based. All the information they collect and care for the patient is based on their evidence, the most recent evidence for that patient population. We do them either virtually or in person. The in-person ones are great because obviously, you get that face-to-face contact, and then you share the knowledge. You share the information that you learned about caring for that patient. The beauty of that is that somebody else might be having a patient with that same problem and they’re like, what am I doing? What is my next step? And the senior students can share their cases and give them some support as they move up to become the senior student.

Angela: Like Stephanie, of course, I’m not medical. I’m a fundraiser by trade and so attending those case days just blew me away. I was so impressed with the level of knowledge and information that these students were able to present and articulate. They clearly understood how all of this affected their patient so when the other students started asking what I thought were some really tough questions and the RCFs asking them some really tough questions, the answers were just peppered back. I was just so impressed with the level of knowledge of our students, but I understand I’m biased, but wow. It gave me chills every time but now going back to New York because that was a fun trip, Mary.

Stephanie: I’m really mad that I missed that trip now that I hear you all talk about it.

Angela: We were even on The Today Show, we went to The Today Show with one of our faculty in an old Frontier Nursing Service uniform and the rest of us carried baby dolls. We had all these signs and they showed us on TV and we were so happy but let me tell you, there’s nothing like traveling through New York City at 4:30 in the morning. We got some great pictures and good memories, but now Stephanie, you’re no stranger to New York City ether. I seem to remember you running a little race in New York. Would you like to talk about that and why you did it?

Stephanie: Yes. I have traveled to New York City at 4:30 in the morning, but I had supreme service because all the rail system, everything is shut down just for the race because I ran the New York City marathon. It’s a ghost town because all the local residents there know what’s going on that morning so they’re not out and about, but it was eerie actually. I ran the New York City marathon there in 2018 for a team — Every Mother Counts — so one of my passions besides helping students at Frontier is birth advocacy and the other is endurance sports, endurance running. I don’t know how much you all know about Every Mother Counts, but it’s a nonprofit agency that really works to help improve birth outcomes for women and babies across the globe.

I actually met their founder when she came to Kentucky. Christy Turlington Burns is their founder and she actually came to Frontier and was working on a project and came and spoke to the students at Frontier. That’s where I met her and learned more about Every Mother Counts. It inspired me to sign up to raise money for that team and run with them in New York City. That was my first New York City marathon experience and it was amazing. It was amazing to be a part of that team and to be able to really have a different platform outside of my work, to be able to promote healthy birth experiences and healthy birth outcomes. I learned a lot just through that experience and it’s great, it’s an awesome race too.

Angela: Listen. I was so excited. You guys know me, if I am running, you better run too, because something’s chasing me. I am not into endurance. I am the world’s best couch potato but I was so excited that you were running the marathon in New York and for Every Mother Counts. Mary, you might not know this, but I was like tracking her. There was an app and I could track her on my cell phone and I was sending her all these crazy selfies that they showed on these big boards, and it was such a special moment because you’re right, Every Mother Counts and Frontier have such similar missions and I think it’s more important today than it ever was because our birth outcomes are continuing to decline. We’re getting higher and higher maternal mortality rights and infant mortality rates and we know that mothers of color — particularly Black mothers — are four to six times more likely to die in birth than that of their white counterparts. I just really love that you supported that cause and glad that they are connected in some way to Frontier and us to them.

Stephanie: It’s really amazing. I learned a lot about it and its birth advocacy. I had nurse-midwives with both of my children and one of them was a Frontier grad and it was one of the most transformational experiences that I’ve ever had as a human being. I told her having a midwife was my gateway to being an endurance athlete because if I could do that, if I could have a child the way that I did, it empowered me to be like, I can do anything and that’s what I’ve heard at Frontier over and over again about the strength of mothers and the midwives really help you as someone who’s given birth, understand your power and the power that you hold.

When I couldn’t have children anymore — I would have children all day long if my husband would let me, but he won’t let me do that anymore; we’ve retired from that sport and we’ve gone on out to other things — but I started running and learned that I could use what my midwife and my doula had helped me learn, just techniques, pain management techniques, and things like that. I apply those now when I’m running and racing. To do an ultra race over 30 miles, 30 to 60 miles, I pull out all those tricks out of my bag that my midwife taught me and it’s what gets me through really not just physically, but it’s the mental aspect. I’m still using all of those things today so just a midwifery model of care to be able to support it through the work I do at Frontier or through any of the hobbies that I have, it’s a little way that I can give back in some way and help improve those outcomes, hopefully for all women, but especially women of color and underrepresented groups that maybe don’t have the same care that some of us are afforded.

Angela: You’re amazing, Stephanie, I get worn out driving 60 miles much else running it.

Stephanie: Swimming and biking like, Mary though, I have done like small triathlons, but Mary’s doing like these very long races.

Angela: I was going to say, Mary’s into all this endurance stuff too. Mary, tell us about the triathlons.

Mary: Well, I started doing triathlons in my early 50s, so it’s never too late to start something new. I had finished my doctoral degree and I was like, I have been a couch potato for far too long so I started just by riding a bike and one of my RCF students, we were down in the basement in Haggin, remember the gym in Haggin?.

Angela: For our listeners. That’s a Haggin dorm that was on our campus when we were still in Hyden, Kentucky but go ahead, Mary.

Mary: She was on the treadmill because she’s like, “Well, I’m training for a triathlon,” and I was on the bike because I’m like, “I’m just starting to get back into cycling,” and stuff and I’m like, “Do tell.” She started talking to me and I had to go do her site visit and lo and behold, she had an extra bike so when I was there, we went out with a ladies group cycling, and then she’s like, “You really have all this endurance, you should really think about doing triathlons,” and I’m like, “Well, she’s right. I’m going to try it.” A year later I had trained for a year and then I did my very first triathlon and I was like, “Oh my gosh, this is so cool,” because it’s not like just running forever because I am not a runner.

I am a quick walker/jogger until I had my knee replaced and now it’s really just fast walking, but you get the swimming, the biking, the running and actually now I am really enjoying the biking because like I said, I had a knee replacement. The stress of the pounding on the pavement, even just walking can make it uncomfortable, but I never have that feeling in my knee when I cycle so actually in about four weeks, I’m getting ready to do a 300-mile bicycle ride across Michigan if COVID doesn’t get us, the plan is to do that. It’s a five-day bike ride.

Angela: Wow. Guys, I’m telling you, you almost make me feel guilty. Almost. [chuckles] I am very attached to my couch.

[laughter]

Stephanie: I like my couch too.

Angela: Okay. I don’t know when you have time to be on the couch, but I’ll take your word for it. Okay ladies, before we leave, you guys are both so inspirational. Would you like to share a piece of advice or words of wisdom to prospective students who may be listening to this podcast?

Stephanie: Mary, I’ll let you go first.

Mary: Well, I guess, I’ve been around Frontier for 20 years now. I came from my first degree in 2001, so I’m officially at my 20-year affiliation with Frontier.

Angela: Wonderful.

Mary: I had such a good experience that I came back and I got my FNP, and then I returned again for my doctorate. What I got out of Frontier was the support that the faculty truly — and staff — they truly care about your success. I have gone to another university and didn’t have quite the same experience. I’m maybe a little bit biased, but my best advice is to trust the process. Even when you feel like it’s just not going to work out. I’ve had RCF students that lose their clinical sites, especially during the COVID. They’re like, “I’m never going to graduate.” I’m like, “It’s going to work out, I promise, it’s going to work out.” Lo and behold, they’ve all graduated, so trust the process.

If you’re feeling like you need a little bit more, just reach out to your faculty, your advisors, the clinical outreach placement, everybody is here to help you be successful.

Angela: Wonderful. What about you, Stephanie?

Stephanie: I think Mary’s summed it up really well. I would just piggyback on what she’s talking about in terms of the support. Do not be afraid to ask for help and don’t be afraid of the process. It’s kind of like when we’re training for a race or triathlon, you have a 12- or 16-week plan in front of you and you follow that plan. It’s all laid out there for you, it’s the same thing at Frontier. There is a plan laid out for you and all the resources are right there. If you’re able to follow that plan and if there’s a bump in the road, just reach out to someone and we’ll just wrap a whole support network around you to be able to come up with a way to tackle that part of the plan.

There’s highs and lows to every graduate program that you might go through, but I really do feel like Frontier is so unique in that support that we give our students in a distance education program. It’s pretty amazing. I hear our graduates say the same thing Mary said, like I am more invested. They don’t use the word invested, they’re more tied to their classmates in this program than even some of the brick and mortar programs that they went to, and I really do think it’s about those relationships they build at orientation and having that one-on-one time with their faculty and the staff to support them.

I just think it’s hard to find that at a lot of universities. Don’t be afraid to reach out and ask for help when you need it. That’s what we’re here for.

Angela: Yes. I will echo that. I attend a lot of professional conferences, where our alumni are there to host receptions and that kind of thing. I just love it when I am at one of these big exhibit halls and I see all these people running down the aisle to go, “There she is, I’ve not seen her.” They normally actually have the reception to see the alumni who are so connected and are just so thrilled to be together again and sing the school song and circle up, which we’ll have to do a whole episode about at some point.

Anyway, ladies, I love it and I think that you guys really make some great points. I think we can wrap it up by your advice by saying it’s not a sprint, it’s a marathon or triathlon. Train and prepare well and trust the process, right?

Stephanie: Absolutely.

Angela: Ladies, again, thank you so much for joining me today. It has absolutely been my pleasure and I’m so glad to know and work with both of you.

Stephanie: Thank you, Angie, it was great. It was great being here with you guys.

Angela: We’ll do it again sometime, okay?

Mary: All right. Take care.

Angela: Thanks you. To our listeners, thank you for joining Frontier Nursing University All-Access. We hope that you have enjoyed our conversation as much as we have. 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 @Frontier.edu or reach out to me your all access host, @angela.bailey@Frontier.edu. If you have enjoyed this podcast, and we hope that you have, please remember to rate, review and subscribe. Until next time, thank you for listening.

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