Nurse-Midwives | Page 7 | Frontier Nursing University

Faculty Spotlight: Kim Baraona DNP, CNM

January 25, 2018 By frontieredu

Dedicated to actively pursuing her goal of mentoring students in their journey to becoming advance practice nurses, Frontier Nursing University (FNU) Course Coordinator Kim Baraona, DNP, CNM, works closely with nurse-midwifery students. Kim instructs one of their final didactic courses, helping them understand antepartum, intrapartum, postpartum and newborn complications and how to collaborate with other healthcare professionals.

Kim began working at FNU over three years ago, bringing with her 23 years of midwifery experience. Her motivation for coming to FNU was simple: to share her expertise with those who would be carrying the torch into the future.

“Throughout my midwifery career I have felt it to be an honor to work with women and families during one of the most important days of their lives – I feel the same honor working with passionate, dedicated, midwifery students who will soon be embarking upon one of the most rewarding professions,” said Kim.

Kim has garnered many accolades during her tenure. Most recently, Kim and three colleagues were published in a 2017 issue of Journal of Midwifery and Women’s Health with an article entitled, Tobacco Harms, Nicotine Pharmacology, and Pharmacologic Tobacco Cessation Interventions for Women.

In May 2017, she gave a presentation at the 62nd American College of Nurse-Midwives convention, speaking on the topic, “Smoking Cessation During Pregnancy: Brief Intervention for a Busy Practice.” Her article, Tobacco Cessation Interventions During Pregnancy, was also featured in ADVANCE (read about it on our blog by clicking here).

Kim plans to continue educating future nurse-midwives alongside the rest of the Frontier team.

“FNU is an inspiring institution, where each day I am in contact with exceptional faculty and staff members who are dedicated to FNU’s mission,” she said.

When she is not working with the midwives of tomorrow, Kim enjoys spending time with her family, spoiling her grandchildren, gardening, running, sewing, and trying out new recipes.

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 who are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality health care to underserved and rural populations.

Women and Families Face Consequences of Maternity Workforce Shortage

December 1, 2017 By frontieredu

By: Dr. Susan Stone, Frontier Nursing University President

Frontier Nursing University celebrated National Midwifery Week in October with our third annual virtual event recognizing nurse-midwifery practice and the outcomes of midwifery-led care. We spent the week exploring the experiences of certified nurse-midwives who are improving care for rural, diverse and underserved populations around the world.

Frontier hosts the virtual event to celebrate the roleof nurse-midwives and to reach others who may be thinking about a career in nurse-midwifery. As a leading educator, we strongly advocate for integrating midwifery into the health care system to improve access to care. The nurse-midwife plays an important role in maternity and primary care for women, as well as the health of the family.

Rising Maternal Mortality in the U.S.

Frontier educates nurse-midwives to seek opportunities to lead positive change. One of the biggest concerns facing our society is the rising maternal mortality rate in the U.S. We have the most expensive health care system in the world, yet American women are more likely to die during childbirth than women in any other developed country (1). The U.S. has experienced a continued increase in the maternal mortality ratio, which was 7.8 per 100,000 live births in 1987 and climbed to 22 per 100,000 live births in 2014 (2).

Rising maternal mortality is a complex issue, and contributing factors extend beyond medical complications. There are financial, bureaucratic, transportation and language barriers, as well as social concerns and a shortage of maternity care facilities and providers. The obstetrician to patient ratio is much less than it was 20 years ago, and the number of family physicians providing maternity care has decreased from 25 percent in 2000 to 10 percent as of 2010 (3) .

Health Disparities and Inequality

Rural areas are some of the most affected as community hospitals shut their doors. According to the American College of Obstetricians and Gynecologists, 49 percent of all U.S. counties do not have an ob-gyn. And while 23 percent of women live in rural areas, only seven percent of ob-gyns practice in rural areas. Additionally, health care insurance coverage is not a guarantee in the U.S. which leads to difficulties accessing care and worsening health outcomes (4).

Health equity is another priority for nurse-midwives. A 2007 National Center for Health Statistics study showed that non-Hispanic black women are three times more likely to die than non-Hispanic white women during childbirth. While that study is 10 years old, we are not seeing any improvement. Racial disparity is highly evident in Washington, D.C., where the maternal mortality ratio is the highest in the country. If you separate white women living in Washington D.C., however, they have the lowest maternal mortality ratio in the country (2).

Improving Access to Quality Care

Accessibility to quality health care should be a social goal and a human right. Effective access includes convenient locations and hours; an adequate number and choice of providers; economic and informational resources; and appropriateness of services provided. Social determinants, such as confidentiality, perceptions of quality and cultural sensitivity, are also key to patients seeking care (1).

Frontier Nursing University is working to increase not only the number of certified nurse-midwives, but also diversity among those who provide maternity care in rural and underserved areas. Through our distance education model, we educate nurse-midwives in their home communities. We were delighted when the American Midwifery Certification Board recently reported a record number 11,600 certified nurse-midwives. But there’s more work to be done as we need to dramatically increase the number of nurse-midwives needed in the U.S. in order to meet the health care needs of women and families.

According to a recent Cochrane Review, midwifery-led care can result in better outcomes. For example, there is more continuity of care, fewer pre-term and instrumental births, higher maternal satisfaction and a cost-savings compared to medical-led care (6).

As educators and providers, we must have a larger focus on primary and preventative care and collaborative health care environments. We need to continue to collect more data to better understand the factors that lead to maternal mortality and poor health outcomes, and then develop programs to address those issues. And finally, we must diversify the health provider workforce so that patients are more likely and willing to participate in care.

We invite you to learn more about nurse-midwifery led care at Frontier.edu/midwiferyweek.

Dr. Susan Stone
President, Frontier Nursing University

Frontier Nursing University is the birthplace of nurse-midwifery and family nursing in America.

View Dr. Stone’s presentation on maternity workforce shortages here.

Maternal Mortality in the United States: A Human Rights Failure; Contraception 83 (2011) 189–193
Amirhossein Moaddab, MD, Gary A. Dildy, MD, Haywood L. Brown, MD, Zhoobin H. Bateni, MD, Health Care Disparity and State-Specific Pregnancy-Related Mortality in the United States, 2005–2014; OBSTETRICS & GYNECOLOGY; VOL. 128, NO. 4, OCTOBER 2016
Sebastian T. Tong, Laura A. Makaroff , Imam M. Xierali, James C. Puffer , Warren P. Newton & Andrew W. Bazemore Family Physicians in the Maternity Care Workforce: Factors Influencing Declining Trends ; Matern Child Health J (2013) 17:1576–1581
The Obstetrician–Gynecologist Workforce in the United States: Facts, Figures, and Implications, 2017 The American Congress of Obstetricians and Gynecologists.
The U.S. Is The Only Developed Nation With A Rising Maternal Mortality Rate; Huffington Post 5/19/14
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.: CD004667. DOI: 10.1002/14651858.CD004667.pub5

FNU Celebrates National Midwifery Week in NYC

November 22, 2017 By frontieredu

By Angela Bailey, MA, Associate Director of Development and Alumni Relations

A group from Frontier Nursing University (FNU) had a blast participating in several events in New York City celebrating and supporting the work of midwives in honor of National Midwifery Week, October 1-7. FNU hoped to bring attention to our country’s high rates of maternal death and injury and the vital role that nurse-midwives play in filling this healthcare gap.

Here’s a look into a few of the activities we participated in:

FNU RCF Dwynn Golden with Today Show Host Hoda Kotb

Today Show Cameo

On Friday, Oct. 6, Frontier Nursing University (FNU) staff, students and faculty joined the outside audience at the “Today Show” in New York City to promote awareness of the rising U.S. maternal mortality rates and National Midwifery week. Faculty member and alumnus Dwynn Golden dressed in traditional FNS uniform while other attendees carried “babies” to draw attention to the issues.

Take a look at this video to see FNU faculty, alumni and staff behind Eddie Jackson and Carson Daly at the two-minute mark.

New York Case Presentation Day

NYC Case Day

Later in the day, 10 participants, including both nurse-midwifery and nurse practitioner students, three alumni and one preceptor from Mt. Sinai/Beth Israel, took part in our New York Case Presentation Day. Case Management Days are seminars organized by the Regional Clinical Faculty (RCF). They provide opportunities for group learning and networking within the region. Students doing their clinical practicum present cases to facilitate group discussion of management options and to promote the pathways of critical thinking. Learn more about case days in your area here.

Miles for Midwives 5K

FNU Regional Clinical Faculty Dwynn Golden and Mary Jones, along with staff member Angela Bailey, attended the 2017 Miles for Midwives in Brooklyn, NY.

Miles for Midwives 5K

The annual 5K Fun-Run and Birth Fair brings together midwives, families and the greater birth community for a day devoted to celebrating midwives and community wellness. This year, more than 200 attendees also raised money for those suffering in Puerto Rico. Several FNU students and alumni attended the event, including: Jocelyn Baker, Katie Sigler and Rebecca Feldman (Nurse-Midwifery Graduates). Current students in attendance were Alexandra Moskaluk, Jessica Couper and Jessica’s mother.

Thanks to everyone who took part in the week! Check out more photos from the weekend here.

Faculty Spotlight: Alyn McGee, MSN, ARNP, CNM

November 6, 2017 By frontieredu

For the last 4 1/2 years, Frontier Nursing University (FNU) faculty member Alyn McGee, MSN, ARNP, and CNM, has been fulfilling the mission of Frontier all the way from St. Lucie, Fla. McGee, a 2005 alumna of FNU’s MSN program, develops the next generation of nurse-midwives and women’s health care nurse practitioners as a regional clinical faculty member while serving as a CNM at the Maternal Fetal Medicine Group.

Based in St. Lucie, with offices around Southeast Florida, the Maternal Fetal Medicine Group is pioneering new ways to provide care to women with very high risk pregnancies who need midwives’ perspective and wisdom. McGee’s role at Maternal Fetal Medicine is crucial to the underserved community seeking care from the four offices she rotates among.

Working side by side with doctors, she reviews scans with patients, diagnoses and explains concerns and problems, and listens to each mother’s fears, dreams and questions. She spends time teaching patients, visiting subjects anywhere from diabetes, diet, hypertension and morbid obesity, to advanced maternal age, HIV/AIDS, cancer in pregnancy and drug use.

McGee also sees a wide variety of patients dealing with unique issues from In Vitro Fertilization and gender selection questions to an impoverished mix of drug addicts, legal and illegal immigrants, and women with Zika virus.

McGee’s journey with FNU began after working with three certified nurse-midwives to build a freestanding birth center in 1993. She was so inspired by the three women that she requested a catalog from FNU and 10 years later, enrolled in the CNEP program.

“It was always and only, FNU,” McGee says. “The first time I drove up that mountain and saw the old buildings, read the history, smelled the air and listened to Kitty and the other faculty, I knew it was all I ever wanted: to be a Frontier Nurse-Midwife.”

Aside from her accolades as a nurse-midwife and instructor, McGee has also received certification as a Sexual Assault Nurse Examiner (SANE) and Certified Diabetic Educator (CDE). Currently, McGee is working on a Survival Medicine Training Certificate, and in December she plans to pursue a Doctor of Nursing Practice at FNU.

Thank you, Alyn, for representing FNU as a student, alumna and faculty member!

2017 AABC Reception and Birth Institute Summary

October 25, 2017 By frontieredu

Frontier Nursing University faculty, alumni, students, staff and preceptors, as part of over 200 registered participants, traveled to Alaska for the 2017 AABC Birth Institute. The conference was held from October 5-8, at the Hotel Captain Cook in Anchorage.

Click here to view photos from the 2017 AABC Birth Institute

FNU Reception

The annual FNU reception during AABC was held on Thursday, October 5. There were around 40 attendees at this year’s reception that included faculty, staff, students, alumni and preceptors. Director of Development Denise Barrett welcomed everyone and gave news from Frontier including current enrollment statistics, updates from the Psychiatric-Mental Health Nurse Practitioner track, the Nursing Workforce Diversity HRSA grant, and progress on the new Versailles, Ky., campus. Kitty Ernst attended and inspired the crowd with her remarks.

FNU Exhibit Booth and PRIDE Student Essay Winners

The FNU Exhibit Booth recognized preceptors as “superheroes,” and we were happy to hand out blue superhero capes to all the preceptors attending. Every year our diversity initiative PRIDE Program sends students to represent FNU at the conference. This year the students who won the essay contest and attended the conference were Jennifer McKay and Stephanie Martinez. The PRIDE ambassadors participated in sessions held at the conference, attended the FNU reception and the FNU Gala, and assisted at the FNU exhibit booth. For more details on the PRIDE program, visit www.frontier.edu/prideprogram.

FNU Virtual Event – Panel Session

On Friday evening, FNU hosted a live-streamed online panel discussion from the AABC Birth Institute. The session titled “Freestanding Birth Centers: A Place for Woman Centered Care” featured co-editors and several authors of the recently published book “Freestanding Birth Centers: Innovation, Evidence, Optimal Outcomes.” The event was hosted as part of Frontier’s 2017 Virtual Event celebrating National Midwifery Week.

Courier Spotlight: Carolyn Gregory

September 14, 2017 By frontieredu

While she was growing up, Carolyn Gregory’s parents always encouraged her to seek new and meaningful experiences, which led her to Frontier Nursing Service (FNS) in 1947. Carolyn enjoyed her time as a Courier so much that she decided to remain at Frontier as the FNS Christmas Secretary and as an assistant to Agnes Lewis and Betty Lester in 1948.

Carolyn Gregory

“I truly enjoyed the spirit of the organization and what I was doing to help their cause,” said Carolyn.

During her time with FNS, she was especially impressed with the way the midwives understood the most intimate and special experience in so many women’s lives: the births of their children.

“The midwives handled deliveries with both the mother and her child’s best interest in mind,” said Carolyn. “I definitely believe that nurse-midwifery is integral to health care in this country and abroad.”

The midwives were empowering role models for Carolyn. The time she spent at Frontier Nursing Service was the first time she had seen women working independently within the medical field.

Carolyn had the opportunity to observe a birth as well as a death in rural mountain cabins while accompanying FNS midwives. She remembers these experiences vividly, and they have profoundly impacted her life. Because of these experiences, Carolyn believes she has gained a greater understanding of life, death, and what it means to be a human being.

After serving as a Courier, Carolyn later obtained a master’s degree from Northwestern University and has been a speech language pathologist for most of her life. She continues to carry forward the lessons she learned as a Courier.

Carolyn has remained involved with Frontier over many decades as a donor, member of the Courier Advisory Committee, and friend to Frontier Nursing University.

Thank you for your service to Frontier, Carolyn!

In 1928, Mary Breckinridge, founder of Frontier Nursing University established the Courier Program, recruiting young people to work in the Kentucky Mountains and learn about service to humanity. Couriers escorted guests safely through remote terrain, delivered medical supplies to remote outpost clinics, and helped nurse-midwives during home visits and births. Frontier has benefited tremendously from the 1,600 Couriers who have served since 1928.

Featured Preceptor: Kathryn Carr, CNM

September 5, 2017 By frontieredu

Frontier Nursing University (FNU) preceptor Kathryn Carr, CNM, from St. Elizabeth’s Medical Center in Boston, Mass., was honored as FNU’s “Featured Preceptor” for the summer term.

Kathryn Carr, CNM, (left) pictured with SNMs Nicole Mapes (center) and Cecile Sampson (right).

With over a decade of experience, Kathryn consistently takes several students each term in her Boston midwifery practice and provides a very high standard of care. She has precepted for FNU for over five years, and students find her positive, caring and an excellent role model.

Most recently she precepted FNU students Nicole Mapes and Cecile Sampson. In addition to her clinical practice, she is very active with ACNM leadership. She was recently inducted as a 2016 Fellow of ACNM and the Region One representative for ACNM.

“Kathryn has become a pivotal influence on my road to becoming a successful CNM,” said Mapes. “She has shown me what a joy and opportunity precepting can truly be, which has made me excited to teach future midwives. I am eternally grateful to have the opportunity to learn and grow from such a thoughtful, bright and selfless person.”

Kathryn is also an accomplished linguist and is trained in French, Portuguese, Italian, Swahili and Mandarin Chinese.

Kathryn will receive a Starbucks gift card as a small token of our appreciation for her being a great preceptor. Thanks for your investment in our FNU students, Kathryn!

Click here to read more on previously recognized preceptors, or to nominate a preceptor.

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.

FNU Launches New Innovation Center

July 17, 2017 By frontieredu

by Anne Z. Cockerham, PhD, CNM, WHNP-BC, CNE
Associate Dean of Academic Affairs and Professor of History

Building on FNU’s long-standing commitments to teaching excellence and innovation, we launched the Center for Innovative Teaching and Learning (CITL) in early 2017. CITL is a collaborative effort between Associate Dean of Academic Affairs, Anne Cockerham; Innovation Coach, Tia Andrighetti; our two instructional designers, Laura Orsetti and Ally Williams; and many faculty, staff, and administrators across the university.

The Center’s two major goals are to: (1) vigorously promote innovation as an iterative process of exploration, evaluation, and sharing, to improve student learning outcomes; and (2) safeguard student-centered, evidence-based teaching and learning as a vital task of the university.

The first major project for CITL is the development, implementation, and evaluation of a curriculum-wide program of simulations delivered at a distance. We chose this as the first CITL project because FNU faculty members are constantly seeking ways to enhance our students’ application of clinical knowledge, critical thinking, and diagnostic reasoning skills. We decided to begin incorporating distance-delivered simulations in online didactic courses in order for students to be able to engage in the content through the applications of concepts. An important goal is that the preceptors and clinical sites who host our students will benefit from students whose didactic courses prior to their clinical practica included extensive application of knowledge and skills to realistic patient situations. Ultimately, the clients served by our students and graduates will benefit from the intense preparation for clinical practice that our students will receive through simulation.

Our distance-delivered simulations will be aligned with the objectives and needs of each course and we’re using a variety of technologies and approaches. A few examples include: web conferencing software, standardized patients, student peer-interaction activities, branching case scenario software, guided reflection, student self-evaluation, varying assessment types, and debriefing.

Here are a few examples of distance-delivered simulations:

A breastfeeding phone triage simulation. A standardized patient plays the role of a new mother and speaks with each student by phone. The experience simulates after-hours patient phone calls. Following the simulation, the standardized patient provides feedback to each student about how they made her feel as a patient and then the student writes and submits a clinical SOAP note (subjective, objective, assessment, plan).
A health history, standardized patient/provider encounter. Students meet with a standardized patient in BigBlueButton (web conferencing software integrated in the learning management system/Canvas) for a face-to-face, one-on-one interview to elicit a basic health history. Session is recorded. SP provides feedback after interview then students submit a reflection and SOAP note
An interactive, branching case study using Twine. Students work through patient histories by reading a case study and answering questions about what information to solicit from the patient. Then they perform a physical exam listening to recorded segments of heart and lung sounds and decide what other data is needed. Students then form an assessment and plan based on their findings. Students assess their knowledge using a pre and post test and more information is available if they need more practice with the didactic content.

CITL is facilitating extensive support, coaching, and feedback loops to promote this initiative. Cohorts of four course coordinators per term will design and implement distance-delivered simulations in their courses by working through a formal training and simulation-development course: Innovation 101: From Imagination to Simulation. Additional faculty development support includes: in-depth debriefing training, a Simulation Resource Center, course faculty-specific simulation training, and ongoing support from the CITL staff. Members of a special subcommittee of the Curriculum Committee, Simulations Across the Curriculum, perform valuable service to the simulation initiative by serving as a simulation advisory group, providing ongoing support of quality assurance for simulations, addressing faculty development needs related to simulation, and offering a faculty Simulation Journal Club. Faculty that work closely with students in clinical practicum are providing feedback about clinical students’ knowledge and skills that could benefit from enhanced focus and application via distance-delivered simulations during earlier didactic courses. We are exploring ways for clinical preceptors to provide feedback to inform the simulation program.

According to CITL director and Associate Dean of Academic Affairs, Anne Cockerham, “Students are at the center of our teaching and learning activities and we keep that as a guiding principle of our simulation initiative, beginning with the planning stages of a simulation and continuing until after the simulation is over. We’re ensuring that students are well-prepared for their simulation experience, from technology- and content standpoints. We have an extensive evaluation process to gather feedback from students about their experiences, including how well the simulations contributed to their learning, whether they experienced any technological or logistical problems, and how the simulations affected their self-confidence in the content and skills associated with the simulations.”

We are excited about this new initiative and, especially, about partnering with students to deepen their understanding of course content and skills. If you have ideas or feedback, please contact Anne Cockerham at anne.cockerham@frontier.edu.