Archive for May, 2007

President & Dean’s Letter

May 24, 2007


I proudly present the 2006 President’s Report. This report outlines the accomplishments of a very talented and dedicated team that includes students, faculty, staff, alumni and Board of Directors. There is much of which to be proud. Enrollment at our School is at an all time high and is currently double what it was two short years ago. We have completed our transition to a degree granting institution. We have launched the ADN-MSN option, a long time dream that is now becoming a reality. We have made some important changes that we believe will improve the learning experience of our students.

These are challenging times for the health care system of our country. How do we provide excellent health care that is affordable so that the graduates of this School will contribute to the solution of that dilemma.

It is such a pleasure to work in an organization that is truly making a difference in this world. I want to express my great appreciation to those individuals that support us in our work. This includes those who donate generously to our School and the Frontier Nursing Service as well as our committed Board of Directors.

Susan E. Stone, DNSc, CNM, FACNM

President and Dean


What’s New at the School

May 24, 2007

The year 2006 has been a transition year for the Frontier School of Midwifery and Family Nursing. We began the year with the realization that although we were admitting more students than ever, we also had many students leaving the program without finishing. We spent time taking a deep look at what we were doing and how we were doing it. We started with an on- campus retreat of the Administrative Team in January of 2006. Faculty participated in the retreat via conference call. We looked at all of the potential reasons why attrition had been increasing.

We reviewed the results of student surveys and focus groups that had been completed during 2005. We reviewed the literature written on attrition in distance learning programs. These resources led us to believe that many students felt that they were not getting the support and structure that they needed to stay enrolled and finish the program. We read about ways to decrease attrition

Pic #2 and reviewed many studies that had been done. We found that many of our students simply got behind; as a matter of fact they often got so far behind that it was hard to catch up and they ended up not finishing. A huge factor contributing to this problem was that there was minimal accountability to anyone except themselves to set timelines and adhere to them. Most human beings do better when they have a set timeline in which to accomplish their goals.

Another important factor was a lack of regular interaction between students, and between students and their faculty. The system under which Frontier operated allowed students to set their own schedule, to take as many months as they wanted to complete courses, to start a course and stop that course without finishing and go on to start another course, to put coursework down for a month or more and then start up again and to have minimal faculty and student contact or more faculty and student contact depending on their needs. At first glance this sounds ideal for an adult learner. The system has been beneficial in many ways as it has allowed our adult learners to deal with life issues as they come along. The problem occurred when students became so busy dealing with life they fell behind in their studies and ultimately ended up withdrawing. We left the retreat feeling that we had identified the problem but not the solution.

We continued this exploratory work through conference calls and discussions in the faculty forum. We began to form the idea of going to a system of set terms. We again went to the literature and reviewed the advantages and disadvantages of different schedules including semesters, trimesters, and quarters. We had many lengthy discussions about the risk of taking away students’ flexibility.

The challenge was: How do we design a system that will allow adult students to deal with their everyday lives and still meet their educational goals? Faculty advisors were torn. They wanted to stop being the time police who spent an inordinate amount of time tracking down students who were not making adequate progress. And yet, they wanted to be able to give advice regarding how to fit a scheduled term of study into student’s busy lives. We fully recognized that our student body was comprised of busy professionals who were often working, raising families and attending graduate school at the same time. How could we help improve their educational outcome without setting up an impossible schedule?

Faculty expressed the desire to design courses in which they would be able to have students learning from faculty and from each other and where there were cohorts of students who came to know each other and to learn from each other. We had this incredibly rich and diverse student body representing the entire United States as well as England, Germany, Costa Rica and Spain. How could we capitalize on that richness? We also knew from our review of the literature that more high quality interaction equals higher completion rates. The current system did not truly allow for that. When students are all starting and finishing courses at different times and taking different lengths of time to pace through a course, it is very difficult to have meaningful interaction. We knew that the technology available today would allow much more creativity in course design.

We held meetings with student council representatives and all students attending Level III in an attempt to get their feedback on these issues. We also surveyed the Level IV students to ask what they would think of the implementation of a system of terms. The response was overwhelmingly positive. We took away the following points from our investigations:

  • Distance education programs typically have higher rates of attrition when compared to traditional programs.
  • Distance education programs that are self-paced and unstructured do not work well and can lead to even higher attrition rates.
  • Students must be taught how to fit school into their lives and how to accomplish “time on task”.
  • Distance learning classes that build community and encourage interaction are more successful and increase student retention in distance learning.
  • Helping students to feel that they are a part of a community is crucial to persistence, learning and satisfaction .
  • The path to increased student retention is to improve program design and student services .

In March of 2006, we reached agreement to implement a system of four Twelve Week Terms each year. We chose this schedule in an attempt to meet the needs of many different students. Some want to move fast through the program. They want to start courses, finish them and move on. The short terms would allow for that. They could take several courses each term and finish the program at a fast pace. Other students want to move more slowly. PIC #3

This system would allow for that by having students enroll in lower number of credits each term.

Why did we call the system terms instead of quarters? We decided not to change our credit system. In most colleges on a quarter system, they change their credits to units. A unit generally reflects a lower number of hours to complete. Approximately 80% of colleges in the country use semester credits. Since many of our students come to us with credits completed in other places and many go on to further education after leaving Frontier, we wanted to keep semester credits. Our students could then easily transfer credits in from other schools and have their transcripts easily read. We presented the plan to the Board of Directors at their April 2006 meeting where it was approved.

We spent the rest of 2006 preparing to transition to terms. The entire curriculum was reviewed and revised to adapt it to the new system. Faculty Pic #4 worked to add more interactive activities and to make use of the technology available to reach students with different learning styles. We received approval of our plan from each of our accrediting bodies, including SACSCOC, ACNM, and NLNAC.

Our student management system was revised to accommodate terms. We designed a new system for registration. Every student had a meeting with their advisor to design a new program plan and to discuss how the terms system would affect them. We developed a roster system that allowed faculty and students to view the names of other students who were taking courses with them. The catalog and student handbook were combined into one document. Every policy was reviewed to see if adaptations were needed for the new scheduling system. New policies were added where necessary. The new FSMFN catalog was made more user friendly. We held lengthy discussions with student council representatives and in student forums explaining the plans. A new forum was opened specifically to discuss the Twelve Week Terms system and answer questions. Not everyone was happy about the proposed plan. Students helped us identify strengths and weaknesses. Adaptations were made based on the student feedback we received. We held education sessions at the October faculty meeting in Hyden to assist faculty in meeting students’ advising needs. Additionally, we hired a Student Services Coordinator. The position is to facilitate the admission process and act as an ombudsman for all students helping them to solve everyday student problems, including how to fit school into their lives.

Mary Breckinridge Tour of Scotland

May 24, 2007

To be held in conjunction with the International Confederation of Midwives (ICM) Triennial Congress in Glasgow, Scotland June 1-5, 2008.

Make plans now to join fellow alumni on the Mary Breckinridge Tour of Scotland. This tour will retrace the path Mary Breckinridge took when she studied the Highlands Nursing and Medical Service. The tour will begin in Glasgow, Scotland, site of the ICM Triennial Congress. Anticipated stops of the tour include Edinburgh, Perth, Oban, Castle Bay on the Isle of Barra, the Isle of Eriskay including stops in Deliburgh and Benbecula, the Isle of Harris, the Isle of Lewis and Stornoway, the town of Fort William, Inverness and Loch Ness.


Birthing Tub/Scotland

Along the way you will visit with midwives working in the remote and hard to reach Scottish Isles, as well as, midwives from larger practices serving hundreds of women. Visits to maternity units at large and small hospitals will demonstrate the diverse conditions experienced by midwives in Scotland. Thoughtful discussions with midwives of the remote Outer Hebrides will provide for a rich sharing of knowledge and practice. You will learn from and share practices and stories with your fellow midwives in Scotland.

In addition to visiting maternity units of hospitals, private practices, and other women’s health facilities, you will have the opportunity to tour Scotland up close and personal! Traveling by bus and ferry, you will see countless breathtaking views and stunning countryside. You will get to know Scotland and its culture through visits to authentic restaurants, pubs, and bed and breakfast inns. Shopping trips and leisure time will allow you to explore the small and large towns along the way. And no trip to Scotland would be complete without the Loch Ness tour in search of Nessie, the Loch Ness Monster!

We are now taking names and contact information for alumni interested in the Mary Breckinridge Tour of Scotland. If you would like to be included in future mailings concerning the tour, please contact Denise Barrett at (859) 253-3637 ext. 5014 or

We anticipate having more information including exact dates, costs, and itinerary available in Fall 2007.

For more information on the International Confederation of Midwives (ICM) Triennial Congress visit The ICM Triennial Congress is an international event where midwives from all over the world come together to informally network, and share knowledge and experience by means of an outstanding scientific and professional program. Together with the ICM, the Royal College of Midwives will deliver a truly memorable congress focused on the global impact and importance of midwives to women and the newborn across the globe. Alumni and current students can benefit from this conference and we would love to see a large Frontier presence in Scotland!

(Odd Insert, place wherever you need/have the room)

A cool map of the world showing where the midwives are:

FSMFN Hires New Staff Members

May 24, 2007

By Kristy O’Neal

The Frontier Family is growing! The following people have joined the staff of FSMFN:

Nancy Melton, Director of Financial Aid

About Nancy:

I have been blessed to be able to work in higher education for 30 years. It has been a great joy assisting students enter college, receive financial aid, watch them work hard, graduate, and go into various professions. One of the more memorable students was a student I knew when he entered high school with my daughter, who set his sights to be a pediatric doctor. He was able to so with the help of scholarships and hard work at a former college where I worked.

About 10 years later, never did I ever dream that because of Anthony’s skill and the Lord’s help, he saved my grandson’s life who was diagnosed at birth with pulmonary-hypertension. My grandson was in the U.K. Medical Center intensive care unit for 30 days where he received excellent care and attention. We are looking forward to celebrating my grandson’s first birthday this May.

Yes, financial aid can be confusing, frustrating and sometimes aggravating. I never said when I was growing up I wanted to be a financial aid director, but that’s what happened. I’ve never regretted the time I’ve been able to help serve students through the years. But, as a colleague of my once said, “our job is to get the right money, to the right students, at the right time” and I agree 100 percent.

I’ve enjoyed working with students at the FSMFN and looking forward to getting to know more of the students and seeing them reach their future goals.

Michelle Lawson, Administrative Assistant to the Director of Financial Aid

About Michelle:

I currently live in Lexington, Kentucky but I am originally from Hazard, Kentucky. I have lived in Lexington going on 12 years. I am still a country girl at heart. I love spending time with my family, my friends and my two nephews (Dustin and Dalton). I enjoy going out shopping, going for walks and just being outdoors. I am the Administrative Assistant to the Director of Financial Aid, Nancy Melton, here at The Frontier School of Midwifery and Family Nursing. I started working here February 2007. I help students receive loans. I make sure hours are received for satisfactory progress and then schedule loans to be disbursed on a timely basis. I also assist Mrs. Melton on a day to day basis with answering e-mail correspondence and sending out award letters and assisting students in any way I can to help them receive their financial aid.

Sharon Feltner, Secretary

About Sharon:

I’m originally from the London-Somerset, KY area. I have worked for the past 15 years in the staffing industry.

I am the new kid on the block at FSMFN & in the town of Hyden. I have been with FSMFN since April 23, 2007and I am excited to be working with such a great school and great team members.

I moved to the Hyden area in December 2006 after getting married to my wonderful husband Bill Feltner. I have two step-children, 13 yr old Darrin and 2 yr old Noah. I am very thankful for my family & all the support they give me.

I am the first voice you hear when you call the FSMFN campus. I am responsible for the smooth operation of the school by managing the front office. I provide secretarial support to faculty & administration.

Millie Stevens, Quality Assurance Coordinator

About Millie Dee:

My name is Millie Dee Stevens. I was born and raised in Hazard, KY and currently own my own home there. I attended University of Kentucky and Kaplan University to obtain a Bachelor’s of Science in Criminal Justice plus 106 hours in Business Administration. I am the mother of 3 grown children, Melissa Quillen, Jon Wood, and Sean Wood and the very proud grandmother of 3 beautiful grandchildren Alex 12, Bennet 7, and Kaiden 2. I am currently the Quality Assurance Coordinator for Frontier School of Midwifery and Family Nursing and thoroughly enjoy my work here.

As the Quality Assurance Coordinator I am responsible for securing, maintaining, and updating student clinical and preceptor information. This includes ensuring that every clinical teaching site has an affiliation agreement in place and that all documentation regarding ongoing clinical site evaluations and credentialing is maintained per accreditation agencies guidelines. I assist students in locating clinical sites and preceptors.

New Name here, Student Services Coordinator

Bio Insert

Joseph Ucuzoglu, Multimedia Design Coordinator

About Joe:

Joe recently moved from Southern California to Hazard KY with his wife of 2 years. He graduated from Cal State Fullerton with a B.S. Degree in Business Administration with a minor in Management Science and Information Systems. He reports adjusting to small town living and being very happy to find this technology position with FSMFN which allows him to continue to utilize all his “geeky IT skills”.

Brandon Fields, Multimedia Design Coordinator

About Brandon:

I’m the newest member of the Multimedia Team. I’m a Graphic Designer which means I am responsible for creating the visual side of things here at FSMFN.

I’m a native of Leslie County and have lived here my whole life. I’m a graduate of Cumberland College with a Bachelor’s Degree in Art (Graphic Design Emphasis) and a minor in Mass Media Communication.

I’ve been at FSMFN for a little over a month now and am enjoying the work and the working environment. I’m getting to flex my design skills while learning whole new skills. I’m an avid learner and love the process of learning something new.

I’m married to my lovely wife Crystal, whom I have known just about my whole life. She is, and always has been, a supporter of all that I do.

Our Faculty additions include:

Please insert Pics of each staff)

Rhonda Arthur, Teaching Associate

About Rhonda:

Rhonda Arthur has been a Registered Nurse since 1988 working in various positions including public health, critical care, and labor and delivery. She completed a Certificate in Nurse Midwifery, Women’s Health, and MSN at Frontier in 2003 and a MSN at Case Western Reserve University in 2003. She returned to Frontier to complete her certificate in Family Nurse Practitioner in 2004. In 2007 Rhonda completed her DNP at Case Western. Rhonda currently works as a Family Nurse Practitioner in a rural community in Southwest Virginia. Her clients range in age from newborn to 100.

Rhonda reconnected with Frontier and became a teaching associate in 2006. Currently, Rhonda works with Julie Marfell in NP 607 Role of the Nurse Practitioner and loves reading the community assessment papers. In addition, Rhonda works with Kathy Wheeler in NP 614 Primary Care and finds this is a great way to keep up to date with current recommendations.

When not at work, Rhonda has also been involved in working toward favorable health policy reform for nurse-midwives and women in Virginia. Other interests include white water boating, spinning and weaving, and reading.

Mary Bidgood- Wilson, Regional Clinic Coordinator

Bio requested, No response

Jacquelyn Chapman, Regional Clinical Coordinator

About Jacquelyn:

Jacquelyn Chapman, RCC for FNP track for LA, MS, FL, GA, AL, SC also RCC for CNM track for AR, LA, MS, FL. I originally trained as a CNM in London, England. I married a Brit shortly after going there. I lived and worked in London for 13 years until I divorced and returned to the US. I could not immediately return to being a midwife for several reasons so I worked as an L&D nurse while being a single parent to my children. In 1995 my place of employment offered to pay for me to return to be a midwife which is when I first returned to CNEP. In 2002 I decided to become an FNP as well. I finished CFNP in 2004. Last year I decided to take the part time job as RCC. This job is perfect for me as it allows me to travel frequently and meet new people. I look forward to seeing more midwives as time goes on.

Billie Gebb, FSMFN Librarian

Bio requested, No response

Nena Rashed Harris,Teaching Associate

About Nena:

From the moment I discovered midwifery, I knew immediately that this was what God had in store for me. A couple of years later, I attended one of the birth center workshops (I had received the exact amount I needed to go as a graduation gift) and met Kitty Ernst. After hearing her speak about Frontier and meeting some Frontier students, I then knew immediately where I would learn to become a midwife. I am a recent graduate of CNEP (February 2006). Becoming a midwife was my primary passion, but I also enjoy providing primary care to women and children. As a result, I decided to also become a family nurse practitioner. I am now certified in both specialties and am working on yet another passion of mine: research and teaching. I have completed course work towards my PhD in nursing and will soon be ready to begin my dissertation research, which will focus on incarcerated women’s experiences with violence/trauma and substance abuse. I am interested in looking at how childhood and adult violence and trauma play a role in HIV risk factors. I currently live just outside of Atlanta, GA with my husband and baby boy, Kyle, who was born November 2005 at the birth center where I completed some of my Level 4 requirements. I look forward to putting into practice the clinical skills that I have learned as a student. I am excited to be a part of the Frontier family, now as faculty member, and I look forward to learning more as I assist faculty with their courses.

Laura Hollywood, Teaching Associate

Bio Requested, No Response

Rhonda Johnston, Course Coordinator

About Rhonda:

My name is Rhonda Johnston. I live in Pueblo, Colorado with my husband. I love to hike, bike and explore the high country. Most recently I learned how to drive a BMW 1200 cc motorcycle and spent the summer exploring the high country.

I am currently practicing as a Nurse Practitioner in a very busy Veterans Administration clinic and part time educator. I am in the midst of writing a pathophysiology and clinical pharmacology textbook with the FA Davis publishing company.

My previous work experience ranges from staff nurse to administrator in a regional medical center. I also established school based health centers in an urban school system. My teaching career has been spent at Colorado State University, Grand Canyon University and University of Phoenix for over 16 years as a Professor in the graduate and undergraduate programs.

I have multiple advanced degrees that include a PhD in Post Secondary Administration and Resource Management, a Masters degree in Adult Health Promotion and Illness Management with certifications as an Adult Nurse Practitioner and Family Nurse Practitioner. I am also a Clinical Nurse Specialist in Nursing Education. My education prepares me to bring theory to the online classroom and shows a strong commitment to lifelong learning.

Laura Manns James, MSN, CNM and Angela Mitchell, DNP, NP Receive Governor’s Awards for their Contributions to Improving the Health of the Community

May 24, 2007

On March 5, 2007 Governor Ernie Fletcher visited Hyden to spread the Get Healthy Kentucky (GHK) message. The Governor discussed components of GHK, a statewide wellness initiative, with Leslie County residents at Mary Breckinridge Hospital. During his presentation, Governor Fletcher linked the importance of physical activity, nutrition and tobacco cessation.

Insert Pic #6

“The fundamental message of Get Healthy Kentucky is to encourage Kentuckians to make good choices about their health and experience the benefits of regular physical activity, a nutritious diet and not smoking. Adopting the Get Healthy Kentucky philosophy will make a difference in the life of Kentuckians who use the program,” said Governor Fletcher.

The Governor’s Wellness Council administers the wellness program, which includes a Web site, where Kentuckians can join GHK. By incorporating physical activity, nutrition and tobacco cessation components, the GHK Web site offers access to information and resources about healthy living and preventing chronic illnesses such as diabetes and heart disease.

During the program, the Governor honored two Frontier School faculty practice members for their contributions to improving the health of the community.

(Insert Pic #7)

Dr. Angie Mitchell, DNP, CNM joined the Frontier Nursing Service as a Family Nurse-Practitioner at the Kate Ireland Healthcare Center in 2002. Very quickly, Angie became one of the most sought-after primary care providers in the area. Early in her work with the families of Southeastern Kentucky, Angie recognized that many of the conditions she saw on a regular basis…hypertension, obesity, and high rates of smoking to name just a few…very often began with habits learned as children. Armed with this knowledge, Angie set out to attack the problem at its base. Working directly with the Clay County Board of Education, and Anna Carey, Executive Director of the COLLY organization (County of Leslie Lifting Youth), Angie has helped to establish a number of school-based clinics in both Leslie and Clay Counties. These clinics are staffed regularly with licensed practical nurses, and on a rotating basis with family nurse-practitioners such as fellow FNS nurse Sarah Noggle at the Stinnett Elementary School in Leslie County. Indeed, some of the children whose lives have been touched by these clinics were in the audience during the presentation. Angie’s commitment to preventive healthcare is truly in keeping with the work Mary Breckinridge set out to do 82 years ago.

(Insert Pic #8)

Laura Manns-James, MSN, CNM first came to Frontier Nursing Service as a student at the Frontier School of Midwifery and Family Nursing graduating as a nurse-midwife in 2001. She went on to earn her Master of Science in Nursing degree at Case Western Reserve University in 2002. We were very lucky when Laura decided to return to Frontier three years ago to join the FSMFN faculty practice. For the past three years, Laura has been caring for mothers and babies in both Clay and Leslie counties. She was instrumental in establishing maternity outpatient services at the FNS Kate Ireland Clinic in Clay County. She has worked tirelessly towards the goal of reestablishing the Maternity Service at Mary Breckinridge Hospital. Laura is absolutely committed to providing the best care possible to the mothers and babies of this region. She has worked very hard to start a Centering Pregnancy Program in an effort to improve the prenatal care experience of the families in her care. Her commitment to high quality, safe care has been evident as she led the team that revised and renewed the policies and procedures for the Maternity Department. She always thinks very deeply about what it is that the families want out of the experience of childbirth and how can we safely provide that. She is very in tune with the needs and desires of the women being served. Laura is an excellent teacher. She has taught classes to the maternity nurses as well as teaching women’s health classes to current students at the Frontier School. Laura currently serves as the Director of Nurse-Midwifery.

Congratulations to both Angie and Laura for your very much deserved awards!

Faculty Floor

May 24, 2007

Congratulations to KITTY ERNST, new President-Elect of the ACNM. As the founder of our online program and as Mary Breckinridge Chair, we’ve seen what a fabulous leader and visionary she is to the field, as well as to all of us at Frontier!

(Insert Pic of Kitty)

Research, Presentations and Papers:

Congratulations to Mary R. Nichols, PhD, APRN, BC, FNP a FSMFN Faculty and Course Coordinator for her outstanding accomplishments in 2006:

PRESENTATIONS (* data based, + refereed)

Nichols, M. R. (2006, July). Prenatal maternal role transition: Primigravidae and multigravidae women. Paper presented at the 17th International Nursing Research Congress on Evidence-Based Practice, Sigma Theta Tau International. July19-22 Montreal, Canada. * +

Nichols, M.R. & Roux, G. M. (2006, June). Primigravidae and multigravidae women: Innovations in prenatal adjustment to motherhood. Paper presented at the 2006 AWHONN convention: Innovate, Lead, Care. June 24-28 Baltimore, MD. * +

Nichols, M.R. (2006, June). Assessing supportive care for the laboring woman: The Therapeutic Labor Support Inventory. Poster presented at the 2006 AWHONN Convention: Innovate, Lead, Care. June 24-28 Baltimore, MD. * +

Paper submitted/under review:

Nichols, M.R. & Roux, G.M. (2006). Primigravid and multigravid women: Prenatal perspectives. * + Under review.

Frontier Faculty Contributing Editors in A guide for Midwives and Women’s health providers:

Julie Marfell, ND, CS, FNP, FSMFN Department Chair of Family Nursing and Course Coordinator, and Deborah Karsnitz, MSN, CNMI, Course Coordinator both were contributing editors in a Chapter in a text book.

Wyner, E., Marfell, J., Karsnitz, D., & Rousseau M. E. (2007). Cardiovascular disease in women. In B. Hackley, J.M. Kriebs, & M.E. Rousseau (Eds.), Primary care of women: A guide for midwives and women’s health providers, (pp. 481-500). Sudbury, MA: Jones and Bartlett.

Additionally, Deborah has become a member and co-coordinator for Postpartum Support International in Louisville Kentucky. She is currently a member of a new grassroots organization in Louisville for Postpartum Depression. The working group is comprised of professionals from Kentucky and Indiana with a common goal of decreasing, preventing, or getting women with postpartum depression to early treatment. The name of the organization is the Kentuckiana Postpartum Coalition.

To Learn more about this organization, please visit :


Congratulations to:

Robin Jordan CNM PhD

Course Coordinator Antepartum Care CNEP/CFNP who recently graduated with a PhD in Health Sciences August 2006, from Touro University International
Her Dissertation was titled Preceptor Practice Behaviors and Midwife Student Self-Efficacy to Therapeutic Presence and Non-Intervention in the Absence of Complication
The purpose of the research was to describe the care practices of midwife preceptors, and explored its influence on student confidence, conceptualized as self-efficacy, in performing care practices congruent with midwifery philosophy. Two of the sixteen hallmarks of midwifery practice; Therapeutic Presence and Non-Intervention in the Absence of Complication; were chosen for the study. Data on preceptor practices, student motivation to become a midwife, and student confidence to perform hallmark behaviors were gathered from new midwifery program graduates of all US midwifery programs over a 12 month period. Results indicate that preceptor practice behaviors and student belief in the benefit of hallmark behaviors to laboring women are predictive of increased confidence to perform care practices congruent with midwifery hallmarks of care. Three papers based on this research are in manuscript phase for publication in nursing and midwifery journals.

Congratulations Trish McQuillin Voss, D.N.P., M.S.N., C.N.M.

Director, ADN to MSN Bridge on your outstanding accomplishments in 2006!

Presenter: So You Want to Be a Midwife? Concurrent session presentation on Advanced Nursing Education, Michigan Student Nurses Association Annual Meeting, Ann Arbor, MI, February 9, 2007.

Presenter: Student Portfolio as an Indicator of Student Achievement of Course Outcome(s). Concurrent session presentation, National Organization of Associate Degree Nursing Annual Meeting, Charlotte, NC, November 7, 2006.

Presenter: Innovative Graduate Educational Pathways for Associate Degree Nurses. Poster Presentation, National Organization of Associate Degree Nursing Annual Meeting, Charlotte, NC, November 2006.

(Insert Pic of Kathyrn)

Kathryn Osborne MSN CNM, FSMFN Course Coordinator, received the Region IV Award for Excellence (given yearly by the American College of Nurse Midwives).

(Insert Pic of Francie)

Francie Likis, DrPH, NP, CNM, who is a Frontier faculty member and graduate, became a Deputy Editor of the Journal of Midwifery & Women’s Health in January 2007. She began working with JMWH as an Editorial Consultant in 2002. She became a Contributing Editor in 2003 and an Associate Editor in 2004. She encourages the Frontier community to submit to JMWH!

Alumni Events 2007

May 24, 2007

By: Denise Barrett (Insert Pic of Denise)

The Alumni Relations Office is busy planning events for our graduates all across the country. Receptions will be held at the ACNM Annual Meeting in Chicago, the AANP Annual meeting in Indianapolis, and the AABC Annual meeting in Anchorage, Alaska!

The Alumni Relations Office is working to provide more opportunities for our alumni to stay connected to Frontier and to each other. The first edition of the Alumni Magazine was mailed in March. Visit to view the magazine online. Always check the website for the latest news and events postings. Finally, alumni are encouraged to plan events for their classes or their region. The Reunion Program has been established to provide some assistance to alumni wishing to plan Frontier events on or off campus. Details on this program are also available on the web.

We always love to hear from students and alumni. Call the Alumni Relations Office at 859-253-3637 ext. 5014 if you have questions or suggestions!

May 28 – FSMFN Annual Reception at the American College of Nurse-Midwives Annual Meeting

Chicago, Illinois

June 21 – FSMFN Annual Reception at the American Academy of Nurse practitioners Annual Meeting

Indianapolis, Indiana

October 5 – FSMFN Annual reception at the American association of birth centers annual meeting

Anchorage, Alaska

Ongoing – Case Days!

Case days are held throughout the year and all over the country. Case days are provided for students to meet and share cases with one another. All Alumni are encouraged to attend to participate in the discussions and share experience.

Jessie Anderson, CNM, MSN (Frontier CNEP Class 34)

(Insert Pic of Jessie Anderson)

Jessie Anderson will begin practicing full-scope midwifery in March, 2007. I was a CNEP student in Class 34/7, and graduated in July 2004. I am very excited to begin practicing with Rebecca Cohen, MD, in Jeffersonville, Indiana. She is a FP doctor who I originally met at the Birth Center Conference in 2001 in Nashville. Our ultimate goal is to open a birth center.

Holly Powell Kennedy, CNM, PhD, FACNM (Frontier 1985) has been selected as a 2007/2008 Fulbright Scholar. Dr. Kennedy will be at King’s College London from January – June 2008 conducting research on midwifery practices that support optimal/normal birth. She will also be exploring the issues of “optimal” birth with numerous midwives. As the co-chair of the Research Standing Committee of the International Confederation of Midwives (ICM), Dr. Kennedy will be working with the Scientific Program Planning Committee in the lead up to the ICM Congress in Glasgow, Scotland June 1-5, 2008. Dr. Kennedy is Associate Professor and Coordinator, Nurse-Midwifery Specialty at University of California San Francisco (UCSF).

CNEP Grad in the News … Home Birth in NC

May 24, 2007

Here’s one reason why we’re on our CNEP journey, future CNMs! This is a story about a birth attended at home by Frontier grad, Nancy Harman (CNEP Class 3) published in the Raleigh (NC) News & Observer. Just remember this when the homework piles up and the going gets tough…

Submitted by: Kathy Mercer, RNC, SNM


(Insert Pic #9)

Leah Friedman, Staff Writer

Staff Photo by Juli Leonard
DURHAM – Jennifer DeWolf’s face shifted between smiles and panic as she paced the beige carpet in her family room. She wore only a pink shirt, a bra, an untied white robe and striped socks.
She stopped, then screamed.
Her husband rushed to her side. She bent over the back of a kitchen chair and urgently told him where to put his hands on her back.
Jennifer, 31, was in labor, and the baby was in a hurry.
Just an hour after her water broke, her contractions were already five minutes apart.
But the couple didn’t lunge for overnight bags. Nor did they warm up their Volvo station wagon for a race to the hospital.
Instead, they called 20 friends and family members to come watch the birth of their second child.
Jennifer would be delivering the baby in a plastic bathtub set up in front of the family room fireplace.
No doctors. No epidural. No ice chips.
Jennifer was going to bring this baby into the world as our foremothers used to do it.
Naturally. At home. And with a midwife.
When Jennifer was pregnant with her first child three years ago, she found an obstetrician. But at every appointment, she had a nagging feeling he wasn’t right for her. She didn’t even know whether he would be the one to deliver her baby. It depended on who in his practice was on call that day.
So 26 weeks into that pregnancy, Jennifer told Dennis she wanted someone else to deliver their baby.
She found a midwife at Rex Hospital in Raleigh.
Dennis reluctantly agreed. At least she would be in a hospital if anything went wrong, he reasoned.
Even with the right support team at the hospital, Jennifer didn’t like the internal exams the nurses did while she was in labor. She hated the fetal monitor they wrapped around her bulging belly, even faking contractions just so they would take it off.
She ended up hiding in the shower sitting on a birth ball, so the nurses wouldn’t touch her.
In the end, she and Dennis, 32, had a healthy baby boy — Dennis “Trey” DeWolf III.
After her hospital experience, Jennifer didn’t want to go back. So, when she became pregnant with her second child, a friend told her about a midwife who delivers babies at home.
Dennis, a more by-the-book guy, wasn’t sure.
Then he met Nancy Harman, a midwife and registered nurse, who has delivered nearly 1,000 babies.
“I’m drawn to confident people, and she had a firm handshake and looked me in the eye,” Dennis said. “I knew if something happened, she would know what to do.”

Birth day
As Jennifer was putting dinner in the oven on Dec. 14, she felt her water break.
Harman happened to be near the DeWolf family’s Hope Valley Farms subdivision on her way to a meeting. When she got to the house, nestled in the middle of a cul-de-sac, Jennifer was doubled over with contractions.
Harman canceled her meeting.
She and her assistant, Chanel Carrell, quickly and quietly prepared for the living-room birth.
They set up the medical supplies they might need: oxygen, suction equipment, IV fluids, medication to stop bleeding and stitching supplies.
Dennis filled the birthing pool, the size of a hot tub, with water from a new garden hose hooked to the clothes washer’s warm water spigot.
The lights were dimmed and hypnotic, New Age music played from the stereo in the kitchen.
“God made your body perfectly, and you are capable of having your baby,” Harman, 58, tells her clients. “You have everything you need within you to birth well.”
With all the babies she has delivered, Harman has only had to call 911 once, when a baby’s heart rate dipped too low. By the time the ambulance arrived, the healthy baby had been born.
Harman says she relies heavily on prayer.
“I start praying a month before the birth,” she said. “I clearly ask God for what I need, and God honors that.”

A group effort
Jennifer, a former sixth-grade teacher, planned her home birth right down to the towels she would use to clean up.
She assigned most of the guests a task:
One sister-in-law to make caramels from the book “The Baby Catcher.”
Other sister-in-law to bake a birthday cake.
A friend to put up balloons on the mailbox after the baby was born.
Another in charge of taking pictures.
Her brother to light a fire. Dad, brother’s backup. Her mother to watch 3-year-old Trey.
But if he wanted, Trey could stay for the birth.
“Mommy will have these faces,” she said, showing him scrunched-up looks she could have during a contraction.
Trey laughed.
Dennis teased Jennifer, comparing her planning for the home birth to their 2001 wedding at Meredith College’s Jones Chapel.
Harman came to their home a few weeks before Jennifer’s due date. Dennis called it the rehearsal. He even asked if he should put tape on the floor to indicate where people should stand.
“And I’m the best man,” he said.
Calling everyone
Once Harman arrived, Dennis called everyone on the list of about 20 family members and friends that Jennifer had put together.
“Hey, it’s Dennis,” he said into the cordless phone. “Jennifer’s in labor.”
Friends soon appeared and let themselves in. Daniel and Brie Johnson, Jennifer’s brother and sister-in-law, drove in from Charlotte. Wendy Albano, Dennis’ sister, walked from down the street. And Dan and Carol Johnson, Jennifer’s parents, and Kim Johnson, her little sister, were driving fast from Morehead City.
Jennifer sipped water through a straw in between contractions. Harman squeezed clear liquid on Jennifer’s belly and used a portable fetal heart rate monitor to check the baby’s heart rate.
“I’m overwhelmed,” Jennifer said, adding that she wasn’t ready to get in the tub yet. “It’s so inviting, but I’m nervous to get in. I feel like when I get in there I’m going to go.”
Intense cramps shot through her back.
“Oh, ow,” she said.
“Good job,” Harman whispered.
As the contractions intensified, Jennifer took off everything but her flesh-colored bra and stepped into the warm water.
Another check of the heart rate.
“That’s a happy baby,” Harman declared.
“That one’s in the front, all belly,” Jennifer moaned.
About 9:15 p.m., Harman and Carrell headed into the living room. Jennifer, ever the hostess, had been fretting over her guests, and it was slowing down her labor. Harman wanted her to focus, so she left Jennifer alone with Dennis, Trey and a few friends.
Harman tracked Jennifer’s progress by listening to her moans — Harman referred to them as birth music.
About 15 minutes later, Harman returned to Jennifer’s side. A naked Trey was in the tub splashing around as if it were bath time.
Jennifer’s eyes filled with tears.
“Thank you all for being here,” she said to the family and friends sitting around her.
With the next contraction, she sounded like an opera singer warming up. She hit all the notes.
Trey got out of the water.
“I think I need to push,” Jennifer said, more to herself than anyone else.
“Just let it build and build,” Harman whispered as she sat next to the tub. “You’re doing great.”
“Honey, will you support me some more?” Jennifer asked her husband. “Do something, please!”
Dennis rushed out of the room. He pulled off his shirt and pants with Superman speed and came back wearing red swim trunks. He climbed into the pool.
Jennifer constantly switched positions in the tub, from leaning on Dennis to all fours. She lay quietly between contractions while guests in the kitchen started cooking.
Others sat on the couch, chairs and floor, mesmerized. Harman shined a flashlight in the water to see if the baby’s head was out.
Contractions were every two minutes.
Just as Jennifer started to push, her parents ran into the room.
Harman pulled her long, brown hair back into a ponytail and took off her watch.
“When the baby’s head comes out, stop pushing so I can check for the cord,” Harman quietly instructed.
“It’s there, Nancy, it’s there!” cried Jennifer as she felt the baby’s head between her legs.
One, two, push
Jennifer invited everyone to touch the head, which was covered in black hair. Her sister reached into the water. Others moved to get a better glimpse of the baby’s nose and ears.
“Trey, do you want to touch?” Jennifer asked her son. He shook his head no.
Harman checked the baby’s heart rate, then asked Jennifer to push.
“I can’t push through it. I’m so scared,” Jennifer said.
“Three long pushes back to back,” Harman calmly told her.
“I’m tired,” Jennifer said. “I can’t. Just give me a minute. Can you guide me through the pushes?”
One. Two. With one final push, the baby was out.
“There she is!” Jennifer exclaimed.
She pulled the baby from the water.
“Hi, baby,” she said. “Mommy is so glad to see you.”
Tears flowed from the onlookers. Harman cleared the baby’s nose and mouth, and the newborn let out a big cry.
It was 11:09 p.m., just five hours after Jennifer’s water broke.
Jennifer and Dennis climbed out of the tub, careful not to tug too hard on the umbilical cord, which was still attached to the placenta. Jennifer plunked on the couch next to the pool.
Soon after, Jennifer had more intense contractions. She didn’t remember it hurting like this after Trey was born.
She pushed out the placenta. Harman handed Dennis scissors, and he cut the cord. Then Harman put the afterbirth in a silver serving bowl and examined it to make sure it was normal and healthy.
Dennis held the baby and announced her name to the room.
Caroleen Marie DeWolf, named after Jennifer’s mother, Carol Marie.
Jennifer’s dad passed around birthday cake and glasses of champagne as Dennis offered a toast.
“Thank you all for coming,” he said. “I never dreamed it could be like this. It’s everything Jennifer described and more.”
“To Caroleen.”
Afterward, Dennis said, “That went better than our wedding.”
Jennifer was pleased, too.
“In the hospital when I had a contraction, they made me push through it,” Jennifer said. “This time I wanted to focus on my body and let my body do it.”
Harman filled out paperwork, including documents the family would need to get a birth certificate from Durham County. Then she stitched up Jennifer and took her temperature.
Jennifer’s father emptied the pool water using a pump and the hose placed down the clothes washer’s drain.
Everyone else passed baby Caroleen around.
Jennifer showered in her own bathroom and climbed into her own bed.
Harman then weighed Caroleen.
“You’re not going to believe this,” Harman said.
Caroleen was a whopping 9 pounds, 4 ounces and 21 inches long.
“Get another scale,” Jennifer said in disbelief. “I guess the preemie diapers are going back.”
Pink balloons were tied to the mailbox, and the DeWolfs said goodbye to their guests. They finally went to sleep about 2 in the morning. But now, their king-size bed seemed a little smaller with two children bundled between them.

Faculty Member Studies Quality of Care for Mothers

May 24, 2007

Series of journal articles provides review of literature on maternity services

Mayri Sagady Leslie, CNM, MSN (Frontier, CNEP Class 11) an Instructor, at the Nurse-Midwifery Program, School of Nursing and Health Studies at Georgetown University has published new research.

Washington, D.C.—Eleven years ago, the national Coalition for Improving Maternity Services (CIMS) released a list of 10 steps to improve care for new mothers during pregnancy and childbirth.

New research by a faculty member at the School of Nursing & Health Studies at Georgetown University Medical Center indicates that those 10 steps—described by CIMS in the Mother-Friendly Childbirth Initiative—do work.

Mayri Sagady Leslie, MSN, a certified nurse midwife in the school’s Department of Nursing, is among a team of national experts and CIMS members who has published its findings in the winter 2007 supplement to The Journal of Perinatal Education, a peer-reviewed publication of Lamaze International.

The group of researchers systematically reviewed 15 years of scientific studies that applied to each of the 10 CIMS steps. Sagady Leslie, along with several colleagues, specifically reviewed published literature that involved steps one, six, and seven. The summary of work as published is called, “The Evidence Basis for the Ten Steps of Mother-Friendly Care.”

Those steps say that mother-friendly care: (1) offers all birthing mothers unrestricted access to birth companions, labor support, and professional midwifery care, (6) does not routinely employ practices, procedures unsupported by scientific evidence, and (7) educates staff in non-drug methods of pain relief and does not promote use of analgesic or anesthetic drugs not specifically required to correct a complication. In addition, Sagady Leslie contributed to the appendix, “Birth Can Safely Take Place at Home and in Birthing Centers.”

Sagady Leslie pointed out that in 2005 the national cesarean rate for the United States reached a record high of 30.2 percent, while more than 20 percent of all labors are induced.

“I believe one reason for the increase in the use of technology for birth is that mothers are not getting the whole story,” she said. “Our publication will give mothers and their care providers new and important information they can use in making choices for their birth.”

CIMS is a collaborative effort of numerous individuals and more than 100 organizations representing over 100,000 members. The organization’s mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs.

The release of the series of articles coincides with the 2007 CIMS Mother-Friendly Childbirth Forum and Annual Meeting, which is taking place from March 7-11, in Atlanta. Sagady Leslie will present at the five-day conference, which is titled, “Turning the Tide: Making Mother-Friendly Childbirth a Reality.”

Care Supporting Normal Birth is Best for Mothers and Babies: Acrobat_IconDownload this press release as an Adobe PDF document..

Findings from a two-year review of the science behind maternity care indicate that the common and costly use of many routine birth interventions, such as continuous electronic fetal monitoring, labor induction for low-risk women, and cesarean surgery, fail to improve health outcomes for mothers and their babies and may cause harm. The Coalition for Improving Maternity Services (CIMS) Expert Work Group study entitled, Evidence Basis for the Ten Steps to Mother-Friendly Care, reviewed the evidence in support of each of the Ten Steps of the Mother-Friendly Childbirth Initiative for Mother-Friendly Hospitals, Birth Centers, and Home Birth Services. Research findings include:

Ponte Vedra Beach, FL (PRWEB) March 1, 2007 — Findings from a two-year review of the science behind maternity care indicate that the common and costly use of many routine birth interventions, such as continuous electronic fetal monitoring, labor induction for low-risk women, and cesarean surgery, fail to improve health outcomes for mothers and their babies and may cause harm.

The Coalition for Improving Maternity Services (CIMS) Expert Work Group study entitled, Evidence Basis for the Ten Steps to Mother-Friendly Care, reviewed the evidence in support of each of the Ten Steps of the Mother-Friendly Childbirth Initiative for Mother-Friendly Hospitals, Birth Centers, and Home Birth Services. Research findings include:

• Women whose labors are induced for non-medical reasons are more likely to suffer from intrapartum fever and more likely to end up needing forceps, vacuum extraction and a cesarean surgery.

• Inductions add to the risk of poor outcomes for the health of the baby. Artificially induced labors increase the rate of fetal distress and a serious complication of labor called shoulder dystocia (when the baby’s shoulders have difficulty passing through the mother’s pelvic bones). Elective induction babies are also more likely to need phototherapy to treat jaundice after birth, and are at higher risk for breathing difficulties and admission to neonatal intensive care.

• Use of electronic fetal monitors is over 85% on low-risk women. They fail to reduce the number of perinatal deaths, the incidence of cerebral palsy or the number of admissions to the neonatal intensive care unit. Continuous fetal monitoring puts women at increased risk for an instrumental delivery, cesarean section and infection.

• Overall 1 in 3 US women give birth by cesarean surgery. The majority of the operations are repeat procedures with no medical indication.

• When compared to women who have a vaginal birth, cesareans put women at risk for infections, hemorrhage requiring transfusion, surgical injuries, and complications from anesthesia, chronic pain, adhesions, hysterectomy, pulmonary embolism, placental problems with future pregnancies, and death. Babies born by cesarean are more likely to suffer from surgical lacerations, respiratory complications, and to require neonatal intensive care.

• There are more than 4.1 million US births a year with a cesarean rate over 30%. The health and economic impact of high tech birth is significant. In 2004, hospital costs for deliveries totaled over $30 billion dollars. The record high cesarean rate contradicts the national goals of Healthy People 2010 to reduce cesareans for first time mothers to 15% and increase VBAC (Vaginal Birth After Cesarean) rates to 63%.

The CIMS study found that harm is also caused by routine use of intravenous fluids (IVs), amniotomy (breaking the bag of waters), withholding food and water from women in labor, and episiotomy. CIMS recommends supporting normal birth for birthing women and limited use of many common and costly birth interventions.

The CIMS Evidence Basis for the Ten Steps to Mother-Friendly Care will be published as a supplement to the Winter Issue of The Journal of Perinatal Education. The results will be premiered at the CIMS Forum on March 8th at the DoubleTree Atlanta-Buckhead in Atlanta, Georgia.

Members of the CIMS Expert Work Group include: Henci Goer, BA, Project Director; Judith Lothian, RN, PhD, LCCE, FACCE, Project Coordinator; Mayri Sagady Leslie, CNM, MSN; Amy Romano, MSN, CNM; Katherine Shealey, MPH, IBCLC, RLC Sharon Storton, MA, CCHT, LMFT; Karen Salt, CEE, MA; Deborah Woolley, CNM, PhD, FACCE

The Coalition for Improving Maternity Services (CIMS), a United Nations recognized NGO, is a collaborative effort of numerous individuals, leading researchers, and more than 50 organizations representing over 90,000 members. Promoting a wellness model of maternity care that will improve birth outcomes and substantially reduce costs, CIMS developed the Mother-Friendly Childbirth Initiative in 1996. A consensus document that has been recognized as an important model for improving the healthcare and well being of children beginning at birth, the Mother-Friendly Childbirth Initiative has been translated into several languages and is gaining support around the world. For more information about CIMS and the Mother-Friendly Childbirth Initiative, visit

To learn more about the research conducted by CIMS, visit the following websites:

Indian Health Service recognizes Thorkelson for work with Navajos

May 24, 2007

Tuesday, March 27th 2007
| Journal Staff Writer

A Cortez nurse earned a prestigious award recently for her passionate work with diabetic women on the Navajo reservation.

Shelley Thorekson

Shelley Thorkelson, a Cortez resident, and a nurse midwife and diabetes and pregnancy case manager at Northern Navajo Medical Center in Shiprock, N.M., recently garnered a National Nursing Leadership Council award for her work there.

Care about people

A few of Shelley Thorkelson’s many achievements working with Navajos follow:
• Improvement of the rate of planned postpartum visits from 39 percent to 91 percent.
• Decreased the days elapsed between abnormal testing and treatment of gestational-diabetic mothers from 67 days to 23 days.
• Sought and received training as a sexual-assault nurse examiner.

init(); Shelley Thorkelson, a nurse midwife who’s worked at Northern Navajo Medical Center in Shiprock, N.M., for 10 years, received the National Nursing Leadership Council Award for Exceptional Performance Feb. 26 in San Diego.

Just four out of 17,000 nurses under the Indian Health Service garnered an NNLC award this year. The NNLC is under the auspices of the Indian Health Service. Dr. Charles W. Grim, IHS director and vice chairman of the Intradepartmental Council on Native American Affairs, presented the award.

Thorkelson doesn’t care for the recognition. She chooses instead to focus on her call to help pregnant American Indian mothers dealing with gestational diabetes.

“I’m not focused on awards — it makes me uncomfortable,” Thorkelson, a Cortez resident, said during a March 20 interview. “When I found out about this, I felt ridiculous. They’re giving me an award for going to work?”

Thorkelson, also a certified diabetes educator, earned her bachelor’s degree in nursing at the University of Phoenix, her master’s at the Frontier School of Midwifery and Family Nursing in Hyden, Ky.

Thorkelson is pleased that her endeavors as gestational diabetes case manager benefit others. Gestational diabetes occurs during pregnancy.

Pregnant women diagnosed with the condition are sent to Thorkelson, who explains the situation to patients, provides equipment for checking blood-sugar levels and helps ensure a successful pregnancy.

She also helps her clients set goals for stabilizing their blood-sugar, has drug-prescriptive authority and makes recommendations to doctors on matching medications with blood-sugar levels. In addition, Thorkelson issues postpartum weight-loss programs to help patients prevent diabetes in the future.

“Gestational diabetes patients have a 70 percent risk of developing Type 2 diabetes within five years (after a pregnancy),” she said.

Nationally, gestational diabetes affects about 4 percent of pregnancies. But the Navajo Nation figure — at 14 percent — is much higher, Thorkelson said. The Navajo Nation Medical Center alone has about 4,000 diabetic patients in its registry.

In her position, Thorkelson carries an average of 50 patients per month, with a laundry list of about 30 items for each client to follow for good care. They include a postpartum check after six months monitoring glucose tolerance to see whether they’ve developed Type-2 diabetes.

Apart from regular duties, Thorkelson’s accomplishments are legion, said Dr. Kim Mohs, the center’s director of the Diabetes Education and Counseling Center.

“Shelley has taken it (her position) and taken it to a new level,” said Mohs, who nominated Thorkelson for the NNLC award.

In her nomination letter, Mohs fired off a list of Thorkelson’s contributions, including the following:

•Implementation of a post-partum weight-loss program for women to prevent Type 2 diabetes.

•Development of a computerized tracking system for gestational-diabetes cases.

•Improvement of the rate of planned postpartum visits from 39 percent to 91 percent in the center’s Obstetric and Family Medicine Clinic.

•Decreased the days elapsed between abnormal testing and treatment of gestational-diabetic mothers from 67 days to 23 days.

•Gave numerous presentations for the Navajo Nation’s Special Diabetes Program.

•Sought and received training as a sexual-assault nurse examiner.

•Developed a pregnancy tool kit for diabetic mothers that has been sent to IHS headquarters for printing to be used throughout the IHS.

Mohs cited Thorkelson’s other accomplishments in her letter, which are too numerous to fully recap, Mohs wrote.

“It is hard to summarize on only two pages, all of the initiatives and new programs that Ms. Thorkelson has been responsible for in only two years,” Mohs said. “Her efforts have already improved care dramatically at NNMC and are positioned to improve the care of patients with diabetes in pregnancy across the IHS.”

For Thorkelson, her efforts honor the spirit of her late father, who was one-quarter American Indian, with Chickasaw and Choctaw heritage. She also wants to be a caring presence for pregnant women, for whom bad health-care experiences can be especially traumatic.

After all, Thorkelson received bad treatment from an obstetrical nurse while having her first child.

“That was the catalyst that drew me to it,” she said.

Reach John Crane at