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FNU Celebrates National Rural Health Day

On November 21, 2019, healthcare providers and organizations across the country came together to celebrate National Rural Health Day (NRHD). Organized by the National Organization of State Offices of Rural Health, NRHD is an opportunity to celebrate the “Power of Rural” by bringing to light the unique challenges that rural communities face and the efforts of rural healthcare providers to address these challenges.

Frontier Nursing University (FNU) participated in the NRHD festivities by offering free online sessions led by FNU faculty and alumni as they discussed how they address unique healthcare challenges faced by people in rural communities.

NRHD kicked off with FNU alumna and preceptor Estella Wetzel, MSN, APRN, FNP-C, in her session, “Improving Care through Drug Testing Education.” Studies show that misinterpretations of drug test results are quite common and can lead to many negative outcomes. Estella addressed commonly prescribed controlled medications by metabolites to simplify drug test interpretation.

FNU Dean Dr. Joan Slager CNM, DNP, FACNM went live to present a free Continuing Education Course, “Billing and Coding Tips and Tools: Is There a Hole in Your Bucket?” The workshop focused on how to select correct CPT and ICD-10-CM codes, especially for complex patient encounters, in order to accurately reflect services provided and enhance revenue.

Course faculty member Stacie Olson, DNP, PMHNP-BC gave a presentation entitled “Rural Health Opioid Overdose Prevention.” She spoke to viewers about general opioid overdose, public health prevention strategies, and identification of FDA approved medication for treatment of opioid use disorder.

Our last session, “Midwifery and Women’s Health in the Last Frontier,” was presented by FNU alumna and preceptor Ana Verzone, DNP, APRN, CNM, FNP-BC. Ana drew from her experience as a healthcare provider and educator in Alaska to discuss the unique challenges midwives face providing care for rural Alaskans and the Alaska Native Population.

Since its foundation more than 80 years ago, FNU has been committed to serving rural communities and meeting their unique healthcare needs. Thank you to everyone who joined us to celebrate NRHD and the Power of Rural!

December 9, 2019
Highlights from the 2019 FL ACNM Meeting

Representatives of Frontier Nursing University (FNU) recently attended the 2019 Florida State Affiliate ACNM Meeting on Friday, October 12, in Haines City, Fla.

Dr. Jane Houston and Dr. Noelle Jacobsen generously hosted an FNU table at the annual event. FNU was the only educational institution with a booth amidst a sea of pharmaceutical companies. Dr. Houston, who serves as FNU’s Doctor of Nursing Practice (DNP) clinical director, was able to advise many interested CNM attendees on the advantages of pursuing their DNP. Dr. Jacobsen, a Florida regional clinical faculty (RCF), met with several CNM students to offer support on finding and securing clinical sites and preceptors.

In addition to selling space, Florida ACNM also raised money by holding a silent auction. FNU pre-clinical Certified Nurse-Midwife (CNM) student Crystal Norman from Miami won a beautiful midwifery quilt.

FNU faculty Meghan Garland, CNM was one of the five presenters at the conference. She traveled from Chicago to give a riveting talk on Physical Activity During Pregnancy: Barriers and Opportunities to Change Behavior. Other conference topics included nitrous oxide, egg preservation, fetal surgery, and breaking the bad news to families.

FNU DNP student Minyon Outlaw, CNM, WHNP sold earrings donated by attendees. She was able to raise $200 for Harbor House of Central Florida whose mission is to prevent and eliminate domestic abuse in Central Florida by providing critical life-saving services to survivors. Minyon also earned the newest Florida ACNM honor, the Rising New Star Award, for her work in creating and chairing the ACNM Nominating Committee.

The absence of Florida ACNM staple and FNU RCF Dr. Mary Kay Miller was felt as she stayed home with an illness, but many spoke of her recent accomplishment of completing her DNP as well as her decades of work in supporting ACNM.

Thank you to everyone who represented FNU at the 2019 Florida ACNM State Meeting! Next year, the chapter will celebrate its 50th birthday in Jacksonville, Fla. on October 20, 2020. Hope to see you there!

December 3, 2019
Alaska Spotlight: Holly Fisk

Since its foundation in 1939, Frontier Nursing University (FNU) has adopted a mission of reaching rural, diverse and underserved populations. This mission is still being lived out today, where more than 80 FNU alumni are answering the call in Alaska. In the coming months, we will be highlighting several of these alumni who serve in our country’s most remote and unforgiving state.

Holly Fisk, MSN, FNP, ONC, Class 142 is a family nurse practitioner in Anchorage, Alaska where she was born and raised. On November 30, 2018, when a magnitude 7.1 earthquake hit south-central Alaska, her center’s lobby became a triage center.

“That’s the Alaskan way,” Holly said of the center’s care for the earthquake victims. “The emphasis FNU places on rural and underserved communities has been helpful for me in this role. We really take care of one another. In rural areas, you have to pull together and have teamwork.”

Holly and her team at Southcentral Foundation’s Anchorage Native Primary Care Center helped care for the earthquake victims, but additional challenges came in the form of extensive damage to Glenn Highway, one of only two roads out of Anchorage. While Anchorage itself isn’t rural, with a metro population of approximately 300,000, Holly’s clinic serves patients from extremely remote areas, some of which are only accessible by plane. Community health aides in those areas help treat basic conditions and triage those who need to be transported to larger healthcare facilities.

Southcentral Foundation is part of the Alaska Native Tribal Health System, which works in conjunction with Alaska Native Tribes and Tribal organizations to provide comprehensive health services to more than 160,000 Alaska Native people. The health care provided at Holly’s clinic is prepaid via this system.

“We call our patients ‘customer-owners’,” Holly said, noting that essentially all of the patients seen at the clinic are Alaska Native or American Indian people. The clinic serves a population of about 65,000 customer-owners in the Anchorage area.

To meet the needs of those patients, the Anchorage Native Primary Care Center is divided into seven distinct smaller clinics. Each clinic has an integrated care team. Holly serves as her clinic’s only nurse practitioner and is joined by two medical doctors, three physician’s assistants, a doctor of osteopathic medicine, an internal medicine physician, pain management, behavioral health consultants and a nurse-midwife.

Holly, whose preceptor Christopher Haupt-Chronister, MSN, FNP, Class 71, also works at the clinic, says that while the clinic offers every kind of specialty, the access is limited.

“There is not enough access to specialized care,” Holly said. “We have every specialty, but they might come in from another city once a month.”

The lack of access to specialty care often results in exorbitant costs of care, which acts as a barrier for many. Some patients go to Seattle instead, finding it more affordable even with flight and hotel costs.

According to Holly, her time studying at FNU helped prepare her for the challenges of working with a rural and remote population. FNU’s curriculum includes instruction on dealing with complex patients in rural communities where access to specialists may be sparse.

“Our graduates are well-prepared clinicians who are improving healthcare around the country and the world,” said FNU Associate Dean for Family Nursing Lisa Chappell, Ph.D., FNP-BC. “As a Frontier student, you will get to know the needs of your community.”

One of those needs for Anchorage patients is mental healthcare.

“The biggest need is behavioral health services,” Holly said. “It’s a three-month wait right now for intake. We have behavioral health consultants who bridge the gap until the patient can be seen by a psychiatrist.”

Holly notes that the clinic has seen a significant uptick in the number of patients coming in with anxiety, depression and PTSD since the earthquake. The clinic’s behavioral health consultants assist with that, and they have started offering extended appointment times.

“Alaskan Native people emphasize relationships, so we provide very relationship-based care,” Holly said. “Most appointment times are 30 minutes. I love that about this place.”

Holly’s experience with FNU played a significant role in preparing her for her current career. “FNU did a great job in preparing me for the more holistic and relationship-based kind of care that we do here,” she said.

Holly enjoys preventative care and educating her patients while she takes the time to talk to them and to understand their particular needs. Still, when the time comes for more urgent care, the clinic responds quickly to those in need.

“We have excellent same-day access,” Holly said. “We keep appointment times open for those types of urgent situations. That’s what we do. It’s the Alaskan spirit.”

November 25, 2019
Recapping A Successful NP Week Virtual Event

Frontier Nursing University (FNU) celebrated National Nurse Practitioner (NP) Week by hosting a free virtual event from Nov. 11-15. Four sessions presented by FNU leaders educated viewers on various topics affecting NPs everywhere. Viewers were also able to receive continuing education (CE) credits from two sessions, which are still available for those who have not yet participated! Here is a recap of each of our NP Week Virtual Event sessions.

FREE CE: Reflective Practice: A Leadership Enhancement Tool

Katheryn Arterberry, DNP, APRN, FNP-BC

Dr. Arterberry was taught the importance of reflection by her mother at a very young age, and she has certainly seen it ring true in her work in health care. In this session, Dr. Arterberry tells us that reflective practice is the foundation of professional development. It makes meaning from experience and transforms insights into practical strategies for personal growth and organizational impact. She emphasized that reflective practice is an active endeavor, not simply thinking about the past. Effective reflection allows leaders to challenge assumptions, review current practices, recognize harmful behaviors, and develop new ways of working. She gives us practical ways to implement critical reflection in our own lives, starting with structured journaling and through dialogue in a group setting.

FREE CE: Evidence-Based Prescribing of Practices in Treating Post-Traumatic Stress Disorder

Jess Calohan, DNP, PMHNP-BC

In this informative session on post-traumatic stress disorder, Dr. Calohan outlined the new DSM 5 diagnostic criteria implemented in 2014 that categorized PTSD separately from anxiety disorders. He reviewed the physical and psychological symptoms of different forms of PTSD. He told us about emerging neurobiological theories that are influencing new treatment methods, including targeting the endocannaboid system and GABA-B receptors associated with fear extinction. Dr. Calohan reviewed potential evidence-based treatment courses, going into the different options (or lack thereof) in the categories of anti-depressants, antipsychotics, mood stabilizers, benzodiazepines, and hypnotics. He also talked about the importance of sleep for PTSD patients and dove into evidence found in a recent study of the efficacy of Prazosin for trauma nightmares, giving advice on prescribing Prazosin. At the conclusion, Dr. Calohan provides a wealth of tools, external resources, and care models for PTSD patient care.

A Team-Based Approach to Improving Timely Sepsis Care

Carla Bray, DNP, FNP-C

Sepsis is deadly with delayed treatment and constitutes the number one hospital cost in America. In this session, Dr. Bray describes a project she instituted in response to concerning results on a survey of sepsis charts in the Tippah County Hospital Emergency Department. The project focused on four main areas: team engagement, patient engagement, sepsis screening, and the sepsis checklist. Dr. Bray reviewed the one-hour bundle for sepsis best practice that was implemented in the project. She discussed the adjustments they made as the project went on to continue to improve sepsis patient care, including simplifying tools, nurse initiated orders, and more effective interventions. The project results exceeded goals in each of the four categories, and Dr. Bray is now working on expanding the project to the Tippah County EMTs.

Nurse Practitioners in Action Serving Their Communities

In the final session of the week, FNU NP faculty shared with us how each are serving the rural, diverse and underserved in their own communities. Led by Associate Dean of Family Nursing Lisa Chappell, PhD, FNP-BC, the session kicked off with Nena Harris, PhD, FNP-BC, CNM, CNE who talked about integrating a comprehensive case management model of health care to homeless women and children in Charlotte, N.C. Nikita Duke, DNP, PMHNP-BC discussed the need for integrating behavioral access care into the urgent care environment in her Muscle Shoals, Ala. community. Diane John, PhD, APRN, FNP-BC, CNE told us about her work in Miramar, Fla., fostering relationships with community partners and community dwellers, and providing leadership opportunities for nurse practitioners. Vicky Stone-Gale, DNP, APRN, FNP-C, FAANP shared about the expansion of a Ft. Lauderdale, Fla. NP organization, who has helped Kids in Distress for many years and has now added a community outreach committee to help other underserved community members. Finally, Mary Biggerstaff, MSN, FNP talked about her impactful work at a low barrier Medication Assisted Therapy/suboxone clinic for opiate dependence in Olympia, Wash.

Thank you to all who participated in our virtual event! You can view each of the sessions (and earn CE credit for two!) by visiting Frontier.edu/NPWeek.

November 21, 2019
Summer Term Circle of Caring Winners

Frontier Nursing University (FNU) is pleased to announce the 2019 Summer Term Circle of Caring Award Winners: staff member Jamie Wheeler and faculty member Lisa Chappell.

The Circle of Caring Award is given each term as a recognition for faculty and staff who go above and beyond their job duties and strive to uphold FNU’s mission and Culture of Caring every day.

Award winners are anonymously nominated by fellow FNU faculty and staff. Nominations are voted upon by a committee based on the following Culture of Caring characteristics: professionalism, mutual support, respect, positive communication and inclusivity.

Jamie Wheeler, MA, Clinical Advisor

Jamie is one of two clinical advisors at FNU who support students with their clinical site and preceptor search. She meets one-on-one with students, leads clinical search webinars, and attends Frontier Bound orientation sessions to meet with new students.

“My typical day involves a lot of brainstorming with students to come up with creative solutions for their clinical plan,” she said. “I’m here to make this process easier for students to navigate and answer any questions that come up during their preparation for clinicals.”

Jamie’s anonymous nominations lauded her helpfulness and willingness to go above and beyond for her students. One said, “Jamie shows professionalism by how excellent, responsible, transparent and consistent she is. Anyone you ask will tell you that she always gives 110% in all she does.”

Jamie’s favorite part of her job is working with students and learning what brought them to FNU. “I am always amazed at the hats our students wear as they juggle multiple roles and work through our programs to reach lifelong goals!” She also enjoys working at the new Versailles campus and watching it take shape.

Lisa Chappell PhD, FNP-BC, Associate Dean of Family Nursing

Lisa is an associate professor and the associate dean of family nursing at FNU. She works with fellow faculty and staff to problem-solve and offer support.

Nominations praised Lisa as a great leader and role model. One said, “She does her job professionally, but has a special touch where we get to know her as a person too. I feel like she truly cares about me as a person and my professional growth. I see that she does the same for each member of the faculty. Amazing. Even her ‘tough calls’ are made with compassion and kindness. Every day I work under her supervision, I feel supported, protected, and encouraged to do my best.”

Another nomination echoed the sentiment: “Lisa’s leadership style makes me feel like I am her only employee. She truly cares and this shows when she takes the time to meet with me and ensure that I continue to grow as a professional. She deserves recognition because she never demands it herself!”

Lisa’s favorite part of her role is working with students at Frontier Bound and Clinical Bound, as well as spending time on campus with the faculty. She said, “I enjoy working with such highly motivated and well-prepared faculty and staff. The focus remains on the students and their success and preparation as advanced practice nurses.”

Congratulations to our winners and thank you for contributing to the culture of caring at FNU.

Thank you to everyone who submitted nominations. To submit your nomination for the fall term Circle of Caring Award, click here!

November 18, 2019
Alumni Spotlight: Marli Parobek

Frontier Nursing University (FNU) alumna Marli Parobek, MS, APRN, FNP-C, PMHNP-C, noticed a growing need for better mental healthcare in her community and rose to meet the challenge.

Marli graduated from FNU in June 2018 as part of the first class of the Psychiatric-Mental Health NP post-graduate certificate.

A resident of her hometown, Yakima, Wa., Marli has been a nurse practitioner for 14 years. She is currently head of the inpatient psychiatric unit at Astria Toppenish Hospital, where her focus is mainly on voluntary and involuntary inpatient psychiatry, medical withdrawal and detox.

Yakima is a town in rural eastern Washington, a largely agricultural community. Much of the population is made up of minority races and, as is common in rural, blue-collar communities, struggles with poverty and substance abuse are prevalent.

Marli and the Astria psychiatric unit received federal and state grants to implement their psychiatric and detox programs, allowing them to offer a service that had previously not existed in eastern Washington.

The voluntary detox program for alcohol and opiate addicts is 3-5 days of 24/7 nursing care in the hospital. Marli prescribes detox medications and performs psychiatric evaluations for these patients until they are discharged to outpatient detox programs.

Marli’s unit also offers an involuntary inpatient suboxone program for psychiatric conditions such as schizophrenia and severe bipolar disorder. The program offers secure, lock-down units and is staffed with chemical dependency therapists and social workers who offer individual and group therapy.

On Thursdays, Marli also does outpatient work with teens and other patients on the nearby Yakama Indian Reservation.

Marli chose to pursue the PMHNP degree to take her career to the next level. “I was a family nurse-practitioner for twelve years and I enjoyed it, but I started to feel too comfortable and wasn’t being challenged,” she said. “I also saw a lot of mental illness and felt ill-prepared to address the issue correctly with only an FNP degree.”

One of Marli’s biggest takeaways from her time in the PMHNP program was the importance of evidence-based practice as really the only way to offer proper care. “Now I know what I didn’t know!” she said.

The personalized support she received at FNU really impressed Marli, and now she is enrolled in the Doctor of Nursing Practice (DNP) program. “I love how FNU really wants their students to succeed,” she said. “Now the addition of a doctorate degree will set me apart personally and professionally.”

We are proud of Marli for continuing to challenge herself to increase the quality and scope of care she offers. Thank you for representing FNU well!

November 14, 2019
Alaska Spotlight: David Moore

Since its foundation in 1939, Frontier Nursing University (FNU) has adopted a mission of reaching rural, diverse and underserved populations. This mission is still being lived out today, where more than 80 FNU alumni are answering the call in Alaska. In the coming months, we will be highlighting several of these alumni who serve in our country’s most remote and unforgiving state.

David Moore, FNP, Class 75, chose to work in Alaska so he could serve some of the most vulnerable people in the country’s harshest environment: the homeless.

David serves as the only nurse practitioner at the Front Street Clinic in downtown Juneau, Alaska, where he is joined by a registered nurse, two behavioral health specialists, and two case managers. Most of his patients are homeless and medically underserved, and many are battling chronic illnesses.

“Most people who come in are present with chronic illnesses,” David said. “They aren’t usually coming in to be treated for a cold. A lot of our patients are transient, and we only see them when some crisis arises.”

The complexity of his patients’ cases prevents David from seeing more than five to seven patients per day. In addition to medical care, the clinic hands out free socks, gloves, hats and hygiene kits to the area’s homeless population.

A native of eastern Tennessee, David was inspired when he read Wide Neighborhoods, the story of Mary Breckinridge and the founding of the Frontier Nursing Service in southeastern Kentucky.

“I’m never shy to say that Mary Breckinridge is my nursing hero,” David said. “I read Wide Neighborhoods even before I went to FNU. I bought my own copy and I fell in love with the mission. That’s why I went there.”

After graduating, David was drawn to the stunning beauty of the pacific northwest and the opportunities it held to serve vulnerable populations. He knew Alaska had a great shortage of medical specialists, requiring patients who need specialized care to either wait for months to see one of the few practicing in Alaska, or fly to Portland or Seattle to receive care.

David has one such patient who was sent for a routine colonoscopy and was diagnosed with rectal cancer. She would have to be treated in Seattle.

“She was a naturalized citizen but didn’t have her paperwork in order to be able to travel,” he said. “We got her to Seattle for surgery and got her in touch with a lawyer to help get her proper identification so she could travel back and forth between here and Seattle. They wouldn’t let her on the plane otherwise. That’s an example of the challenging situations we face in this region.”

David is diligent about looking for ways to increase access to healthcare for his patients. Flying to see a specialist is impossible for many of his patients, so he began utilizing e-consultants via AristaMD, allowing him to send a patient’s chart a specialist online who responds within 24 hours with recommended treatment and instructions.

He also learned how to treat hepatitis C so those patients would no longer need to travel to Anchorage for treatment. Many of his patients suffer from psychiatric illnesses and co-occurring conditions such as substance abuse combined with psychiatric illness, so he learned to treat substance abuse patients.

David credits FNU for helping to cultivate his desire to serve in rural and underserved areas and to look for solutions beyond what would be considered his normal scope of practice.

“The way the FNU program is designed, I had to be independent and dig for resources,” David says. “I had to find my own preceptors. It taught me independence and perseverance. It taught me to go above and beyond to get the job done.”

We are proud of David and all of our FNU graduates, including Kristina Amundson, who go the extra mile to serve in Alaska.

November 7, 2019
Free Virtual Event for Upcoming NP Week

National Nurse Practitioner Week is November 10-16, and Frontier Nursing University (FNU) is celebrating by hosting a virtual event for nurse practitioners (NPs) and those considering a career as an advanced practice nurse. Featured topics include improving sepsis care, treating post-traumatic stress disorder and using reflective practices as a leadership enhancement tool. Nurse practitioners and others can participate in this free event online at Frontier.edu/NPWeek.

The Empower 2019 FNU Virtual Event: Nurse Practitioners Improving Patient Care Through Teamwork will bring together leaders in health care to present the following sessions:

Nurse Practitioners in Action Serving Their Communities: Lisa Chappell, PhD, FNP-BC, FNU’s associate dean of family nursing, will be joined by FNU nurse practitioner faculty as they share how they are impacting their communities and carrying out the mission of serving rural, diverse and underserved populations. This session will take place on Nov. 11 at 6 p.m. ET.

A Team-Based Approach to Improving Timely Sepsis Care: Presented by Carla Bray, DNP, FNP-C, the presentation will cover a rapid cycle quality improvement project. Each cycle tested changes related to team and patient engagement, screening, and the use of timely sepsis orders. Participants will learn strategies to implement best practices for timely sepsis care. Tune in on Nov. 12 at 6 p.m. ET.

FREE CE: Evidence-Based Prescribing of Practices in Treating Post-Traumatic Stress Disorder (PTSD): Presented by Jess Calohan, DNP, PMHNP-BC, this session will cover the neurobiological underpinnings of PTSD and review evidence-based prescribing practices. The presentation will also discuss collaborative care and patient engagement strategies to assist in the management of PTSD symptoms. This session will take place on Nov. 13 at 6 p.m. ET.

FREE CE: Reflective Practice: A Leadership Enhancement Tool: Katheryn Arterberry, DNP, APRN, FNP-BC, CNE, will focus on the use of reflective practice to enhance leadership skills, improve interpersonal relationships, and heighten personal self-awareness in nurses. The presentation will provide practical reflective practice tools for nurses in various settings. Tune in on Nov. 14 at 6 p.m. ET.

We encourage you to take advantage of the opportunity to earn free CE credits!

National Nurse Practitioner Week is held annually to celebrate health care providers and to remind lawmakers of the importance of removing outdated barriers to practice so that nurse practitioners will be allowed to practice to the full extent of their experience and education. According to AANP.org, there are approximately 270,000 NPs currently licensed in the U.S.

Frontier Nursing University is the birthplace of nurse-midwifery and family nursing in the United States and has 80 years of experience in delivering graduate nursing and midwifery programs. This is the fourth consecutive year FNU has hosted a virtual event in recognition of National Nurse Practitioner Week.

Register for the virtual event and learn more at Frontier.edu/NPWeek.

November 4, 2019

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