Frontier Nursing University Courier Program, Hyden, KY
During the summer of 2019, I traveled to the Appalachian region of Kentucky to spend my time as a Courier Intern through Frontier Nursing University. This is a region of the United States to which I had not previously traveled, save for passing through on the drive up to Canada. Though my parents were skeptical of moving to such a rural and mountainous area for eight weeks, I made the roughly seven-hour drive up to Hyden at the beginning of June and found myself immersed in the fascinating culture of Appalachia.
The Courier Program is run by Frontier Nursing University, formerly Frontier Nursing Service, which was started by Mary Breckinridge in 1939. However, it is not necessarily an internship for nurses, or even for students planning to enter the medical field. Rather, this was an internship for people who were looking to come out to Kentucky and gain experience—both in a clinical sense and a cultural one.
All nine of the Couriers were given an individual local placement to serve. My assignment was to alternate between working at the Red Bird Mission in Beverly and at the AdventHealth Hospital in Manchester. Hyden, Red Bird, and Manchester are all about a 45-minute drive from each other, so every day I spent at least an hour and a half driving to and from work. Often times, I drove three hours instead because I was paired with another intern who did not have a vehicle. At times, driving these distances on winding Appalachian roads felt very tedious and frustrating. Many of these roads were extremely narrow and did not have lines painted on them, nor did they have two full lanes of space. Rather than gentle shoulders to pull onto, these roads frequently were crumbling at the edge of sharp drops, which was made slightly more terrifying by the frequency of animals in the road and the tight squeezes when you were unfortunate enough to pass other drivers. Even after eight weeks of driving in the area, I always held my breath while passing cars at certain places, hoping neither of us were too close to each other or the edge.
The Red Bird Mission is an outreach ministry of the United Methodist Church that serves the community during all stages of life, from pre-natal support all the way to elderly outreach. For part of the week, I worked with their summer youth program. My job was technically overseeing the counselors, but since they were veterans in the program, it sometimes felt like they were overseeing me. Through this position, I was able to interact with many of the local children ages five and up. This was a very valuable experience in learning about the culture of the region, as children are often unfiltered in a way that adults are not. Because of this, kids can provide a clearer insight into life within a society through their interactions with each other, with outsiders, and through play. They taught me about the importance of religion in their community, and the strong family ties that exist in Appalachia. I learned about the significance of language, in fact the kids expressed difficulty in understanding me if I was not using my Southern accent (being from Georgia, I can turn it on and off when needed). I also picked up some of the local slang, like how they use “you’uns/yuns” instead of the “y’all” I was accustomed to hearing, how a “holler” is not a shout, but instead a hollow between two mountains, and how the flying black-and-yellow insects are “waspers” instead of just wasps. More importantly, I also learned about the health of the population from these “young’uns.” It was through them that I first understood how southeastern Kentucky is truly a food desert, and how scarcely people receive good dental care, among many other medical services.
At the AdventHealth hospital in Manchester, I shadowed with several medical professionals in the pediatric office within their primary care building. Through this experience, I learned a great deal about the different types of medical certifications, and I further confirmed my desire to attend medical school. A large portion of the patients that come through the Manchester Pediatrics office need vaccinations, so I was able to watch the administration of immunizations with babies as young as a month old and as old as teenagers. It was interesting to learn about the distrust of medical providers in the area, and hear about different patient-doctor interactions within the office.
All of the Couriers were also given $500 stipends for a Community Impact Project. We were given the freedom to choose our own project and design them with the ultimate goal of leaving a lasting impact on the community. My site partner and I decided that we wanted to create “baby boxes” for the local health department to hand out to new and expecting families that were receiving counseling and aid through their HANDS program. We assembled 25 shoe box sized containers with lots of basic items for babies (bibs, burp cloths, baby books, pacifiers, etc.) as well as information about local resources. We hoped to help families in their preparations for a new chapter in life, as well as help them feel welcomed by the health department.
Overall, this summer felt very important to me as a part of my path to becoming a healthcare professional. It may be one thing to learn about rural healthcare in a classroom, but going and experiencing those frustrations and challenges firsthand is entirely different. Living in this area and struggling to get the doctor’s appointments that I needed, the fresh produce I wanted, and the cellular network I did not have were unexpected challenges from the summer, but ones that truly helped me grow. Without this summer, I would not have understood what it meant that the number one issue in rural healthcare is access.
Further, I have learned more about where I see myself entering the field of healthcare. This area of Kentucky was one of the birthplaces for midwifery in the country, and Frontier Nursing University continues to graduate new nurses and nurse-midwives. To be able to learn about birth and women’s health from the lens of nurses and midwives was an incredible experience to contrast against my time spent shadowing OBGYNs. In addition, one of my fellow interns, and now a dear friend, has worked as a doula and provided extra insight into the medicalization of birth. I have learned so much over the summer that has truly increased my passion for women’s healthcare, and I am so excited to continue my career in that direction.
I am so thankful to the Class of 1972 for providing the support to make this life-changing summer possible for me. It was as frustrating as it was amazing, and I made memories and friendships that will last me the rest of my life.