Early in the last decade, administrators at Frontier Nursing University noticed that minority students were more likely to drop out because of a lack of family support and other issues, not academic failure. Another concern arose about the same time.
“We were concerned about graduating culturally competent practitioners,” says Dr. Susan Stone, president and dean of the school based in rural southeastern Kentucky.
This year, Frontier Nursing University launched a program designed to help address both problems. Built on more than a year of outreach and recruitment at minority-serving institutions, the federally funded PRIDE program has attracted 26 students who are training as either nurse practitioners or nurse midwives. Those students are receiving support to help them handle family pressures and feel less isolated socially and academically as students in nursing fields with few minorities.
“Nursing is not a diverse workforce,” Stone notes. “People who are minorities could provide more culturally competent health care.”
According to federal figures, about 11 percent of registered nurses are minorities: 4 percent are African-American, 3 percent Asian, 2 percent Hispanic and 2 percent mixed-race. About 11 percent of nurse practitioners are minorities, while 7 percent of nurse midwives are minorities.
Nurse practitioners provide medical care that is usually associated with doctors, such as performing physicals, diagnosing illnesses and prescribing medication. Nurse midwives treat pregnant women under a doctor’s supervision, deliver babies and instruct patients in health routines to follow before and after births.
The African-American and Hispanic students in PRIDE, which stands for Promoting Recruitment and Retention to Increase Diversity in Nurse-Midwifery and Nurse Practitioner Education, follow the same curriculum as other Frontier students. They receive most of their instruction through distance learning or in their communities, where they do a clinical practicum with a nurse practitioner or nurse midwife. The goal is for graduates to stay and work where they live.
In 1989, Frontier became the first school to create a distance learning program in nurse-midwifery. Full-time students take two years to complete the program if they have a bachelor’s degree; three if they start with an associate’s degree. Nearly all have already been licensed registered nurses for at least a year, including PRIDE students.
The school’s distance learning program differs from others in requiring all entering students to come to campus in Hyden, Ky., for a four-day orientation. The orientation promotes team-building and connecting to the school’s mission of serving families in rural and other underserved areas.
Students who usually are from the same region are grouped into teams of six to eight. All assess health care in their communities and use an online forum to share what they find so other students can learn about different populations and how to serve them. Before doing a community-based practicum, students return to campus for hands-on training.
The first PRIDE students enrolled this summer and fall. They live in Florida, Mississippi, Texas, New Mexico and Arizona and are evenly split between nurse practitioner and nurse midwife tracks.
The program’s coordinator, Kimberly Trammell, helped recruit the new students. She encourages them to accept mentorship from more senior students and is available to counsel PRIDE students on family issues. Stone says those can include the pressures that come with being the first in a family to finish college and explaining why, after becoming a nurse, they are paying for more education.
Since 2009, Frontier has received $1 million in advanced nursing education grants for PRIDE from the Health Resources and Services Administration, or HRSA, part of the Department of Health and Human Services.
Elizabeth Senerchia, a spokeswoman for HRSA, says Frontier has been “reaching out to historically Black colleges and universities, Hispanic-serving institutions and tribal colleges in an effort to foster partnerships” and aims to offer a “seamless transition” to advanced education for graduates of PRIDE-partner institutions along with supportive services to ensure completion of the master’s programs.
Partner institutions are Central Arizona College, Del Mar College in Texas, the College of Nursing & Health Sciences at Texas A&M Corpus Christi, all HSIs, Lone Star College-CyFair in Texas and Holmes Community College in Mississippi, whose enrollment is predominantly Black.
Stone says attracting minority students to an Appalachian school, now independent, was aided by its long affiliation with the storied Frontier Nursing Service.
In 1923, a nurse midwife named Mary Breckenridge rode on horseback and mules to assess health care needs in southeastern Kentucky. Two years later, she founded the nursing service to run hospitals and clinics there.
The service created Frontier Nursing University in 1939, an affiliation that endured until September when a private hospital chain bought the service’s hospital and clinics. The school has about 100 minority students and a total enrollment of 1,200.
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