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Robert L. Brown History of Medicine

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Then and Now: Nursing in Remote Communities

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“Is he dead?” I whispered.

Sallie shook her head. “I don’t think so … there is a faint pulse … He must have jumped,” Sallie continued. “See there is his plane. Clear across the field.  Jammed into a haystack …”

We were enormously relieved when one of the nurses came tearing up to the fence and through the corn to the place where the patient lay. She was a fresh faced English girl and we came to know her later under the name of Jim … Jim took charge of the situation like a general on the field of battle. We thanked God for Jim. “Get an axe,” she directed. “Cut a couple of stout poles. Get ready a stretcher. We are going to have to take this man to the center. One of you men take my horse and ride like the wind to Manchester. Get the doctor. Bring him here as fast as you can come.”

FNS LOGOThe above scene illustrates an event experienced by nurses who were members of the Frontier Nursing Service. The Frontier Nursing Service was an organized midwifery service in the United States founded in 1925 by Mary Breckinridge. It was established to elevate the level of healthcare in very rural areas by bringing trained midwives out to homes in Kentucky’s Appalachian Mountains region. The midwives not only participated in delivering babies and providing prenatal care, but also in preventative care for citizens. According to the Frontier Nursing University Website, Mary Breckinridge demonstrated that care provided by nurse-midwives acting as nurses to the total family would drastically cut infant and maternal mortality and also morbidity and mortality for the entire community.


Still today, nurses and students participate in programs similar to the Frontier Nursing Service – even our very own UB nursing students and faculty, along with other health professions students at UB! The UB School of Nursing offers various service learning experiences, one of which is through the Remote Area Medical (RAM) Program. RAM provides student volunteers the opportunity to travel to a rural area, where a mobile clinic has been situated, to provide medical care to an undeserved, isolated or impoverished community – much similar to the assistance the Frontier Nursing Service provided.

While health care in the United States has come a long way, there still exists a need for services such as these – programs like RAM continue to provide individuals and families with vital services – and we can credit Mary Breckinridge as the forerunner in establishing a program that provides health care to those who may otherwise lack access.


UB Nurses working in the Remote Area Medical Program (RAM).



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