“Even the Frontier Nursing Service hasn’t yet reached that section of the mountains,” he told Bertha.
–From Cherry Ames,
Mountaineer Nurse, p. 8
Mary Breckenridge was a pioneer in not only the development of women’s midwifery in America but also a leader who founded the Frontier Nursing Service. The contributions that Mary Breckenridge has given to America have made her a symbol of strength, determination, leadership and of love. Her dedication to the cause of helping those in frontier and providing nursing services is unparalleled and she remains one of the foremost figures in nursing today.
This short discourse will shed more light into the life of this amazing woman. The first part of this discussion will delve into the life of Mary Breckenridge and will also seek to analyze her accomplishments. It will also include a personal analysis of the impact that she has made on the practice of nursing. The final segment will include a personal reflection of the influence that Mary Breckenridge has had upon this writer’s personal leadership plan for nursing and for life.
Biography:
This section will highlight the key points in the life of Mary Breckenridge in an attempt to show just how she was able to achieve her accomplishments and also to show just how much of an impact this great woman has had on the practice of nursing today.
i.) Background
Mary Breckinridge was born in Memphis, Tennessee on February 17, 1881. Unlike many pioneers and inspirational figures, she was not raised in poverty and neither was she oppressed or challenged. She was born into a prestigious family and was the daughter of then Arkansas Congressman, Clifton Breckinridge and the granddaughter of former vice-president John C. Breckinridge (Collins 1971).
Her family life was sad, however, as she lost her first husband and her two children to early death. Mary Breckinridge married Henry Ruffner Morrison, who was a lawyer, in 1904. Due to certain complications, her husband died only two years into the marriage (Wilkie 1969). Mary Breckinridge and Henry Ruffner Morrison had no children during their union. Shortly after the death of her husband, she enrolled in a nursing class at New York City’s St. Luke’s Hospital. There she remained for three years before completing her degree in nursing in 1910. In 1912, Mary Breckinridge remarried and wed Richard Ryan Thompson (Wilkie 1969). It was during this union that she bore her two children, Polly and Clifford. Polly was born prematurely and died within six hours from birth and Clifford died due to complications related to appendicitis. To complicate matters, her second husband was a philanderer and she divorced him in 1920 (Wilkie 1969).
It was because of these tragic losses that Mary Breckinridge decided to devote her time and energies to the practice of nursing. She personally committed her life to “raise(ing) the status of childhood everywhere,” as her memorial to the memory of her lost children (Collins 1971). During this period in her life, she spent some time as a public health nurse during the First World War. This was a very important stage in her life as it was during this period that decided to help the children in rural America by establishing the nurse-midwife concept (Wells 1998).
In order to accomplish her goal of developing the nurse-midwife concept in rural America, Mary Breckinridge underwent further training and studies and took additional nursing studies and midwifery training. She went to Kentucky in 1925 and it was there that she began working towards achieving her goal (Collins 1971).
Breckinridge, descendant of a distinguished family that included a U.S. vice president and a Congressman and diplomat, lost her first husband and two children to early death. She turned to nursing as an outlet for her energies, committed to “raise the status of childhood everywhere,” as a memorial to her own lost children (Wilkie 1969). She spent time as a public health nurse during World War I, and became convinced that the nurse-midwife concept could help children in rural America. After additional nursing studies and midwifery training, she went to rural Kentucky and began work in 1925 (Wilkie 1969).
ii.) Education
The educational background of Mary Breckinridge was solid. She was also blessed with having been given a good education and at a young age already had private tutors in Washington, DC and in St. Petersburg, Russia (McKown 1966).
Upon her return, Mary Breckinridge decided to study public health nursing at Columbia University. It was there where she decided to alleviate the problems that were prevalent in Eastern Kentucky which was an inaccessible area of few roads and no physicians. She was convinced that if her plan regarding the nurse-midwife concept was to work here then it would possibly work everywhere (McKown 1966).
Mary Breckinridge also joined the American Committee for Devastated France and it was while she was in Europe that she met British and French nurse-midwives (Wells 1998). This was pivotal because it gave Mary Breckinridge the inspiration and made her realize that nurse-midwives, with their training, were very capable of meeting the healthcare needs of most of the mothers and babies of rural America (Wells 1998). Since there were no midwifery courses being offered in the United States of America during that time, she returned to England where she received her formal training at the British Hospital for Mothers and Babies and was soon after certified to practice midwifery by the Central Midwives Board (Wells 1998).
After her training and education, she moved to Kentucky where she began the Frontier Nursing Service with the goal of providing for the health care needs of the mothers and babies of Eastern Kentucky.
iii.) Major Roles in Nursing
The role that Mary Breckinridge played in nursing is certainly one that is not easy to define because of the number of wide-reaching accomplishments that she has achieved. The success of the Frontier Nursing Service (FNS) that she established is unparalleled. The reason for this is because of the contributions that she has made towards the development of the practice of nursing on the frontier (De Leeuw, Adele and Cateau 1961).
Mary Breckinridge, during her trip to Eastern Kentucky, saw that there was a high maternal mortality rate. In relation to this she also developed the system of providing healthcare to children during the prenatal period, focusing on birth and a child’s first years (De Leeuw, Adele and Cateau 1961).
Returning to Kentucky in 1925, Breckinridge began the work that would introduce a new type of rural health care system in the United States. Though the FNS was primarily supported by Mary Breckinridge’s personal funds, it was able to grow so much so that within five years, the FNS had aided more than one thousand (1,000) rural families in an area encompassing over seven hundred (700) square miles (McKown 1966). The FNS was designed around a very simple system. It features a central hospital and only one physician. The effectiveness lies in the number of nursing outposts designed to compensate for the absence of any reliable roads or other modes of transportation and thus many nurses were on horseback in order to have access to even the most remote of areas in all kinds of weather (McKown 1966).
An important facet of the practice of nursing that Mary Breckinridge masterminded was the necessity of raising funds and generating enough publicity to enable the service to not only expand but also to maintain its functions (Wells 1998). She also developed the system for sustaining the system by establishing another branch of the FNS which was the Frontier School of Midwifery and Family Nursing that was in charge of training hundreds of midwives.
Presently, the FNS hospital in Kentucky, which is now named the Mary Breckinridge Hospital, still continues to fulfill the mission of this amazing person; living up to the comment of Mary Breckinridge, “The glorious thing about it is that it has worked!” (Wilkie 1969)
Analysis of Accomplishments:
This section will discuss the major accomplishments of Mary Breckinridge and the Frontier Nursing Service (FNS) which she established. It will also highlight her personal accomplishments that have made her become highly recognized as one of the foremost Nurse Leaders in the history of Nursing.
i.) Accomplishments
There are many accomplishments that are attributed to Mary Breckinridge. Most of these accomplishments are related to her work with the FNS. Throughout its history, the FNS has served as the model of rural health delivery for the entire United States and the rest of the world. It was the pioneer in establishing a decentralized system, which was one of the keys to the success of the FNS, and also a method by which the team of nurse-midwives were able visit their clients at their homes and district nursing centers. The FNS also had a hospital that was fully capable of serving an area of seven hundred (700) square miles (De Leeuw, Adele and Cateau 1961).
The FNS was also able to successfully lower the maternal mortality rate for Leslie County, Kentucky from one of the highest in the United States to a level well below the national average. The American Association of Nurse-Midwives, which was a precursor of the American College of Nurse-Midwives in 1929, also became the first American school of midwifery in New York in 1932. The FNS School of Midwifery and Family Nursing, is presently the longest continually operating nurse-midwifery program in the country and this was also established by Mary Breckenridge through the FNS (De Leeuw, Adele and Cateau 1961).
ii.) Accomplishments Leading to Recognition as a Nurse Leader
The success of Mary Breckenridge has led her to be recognized as a Nurse Leader. One of the factors which led to her recognition as such was due to the success of the FNS, which she established and even supported financially. Since its establishment in 1925, the FNS has registered over 64,000 patients. In the first 50 years of its operation, it has “delivered 17,053 babies with only 11 maternal deaths,” which is quite an amazing feat by any standards (De Leeuw, Adele and Cateau 1961).
Presently, the FNS still provides healthcare services for Southeastern Kentucky. There is a hospital in Hyden, four rural health clinics, a home health agency and the School of Midwifery and Family Nursing.
All of these achievements prompted the American College of Nurse Midwives to formally recognize Mary Breckinridge as “the first to bring nurse-midwifery to the United States.” This has also led to the recognition of the Frontier School of Midwifery and Family Nursing as “a leader in nurse-midwifery in the United States and a tribute to the accomplishments of Mary Breckinridge and her contemporaries.” (De Leeuw, Adele and Cateau 1961) Finally, in 1982, Mary Breckinridge was immortalized in American History with her induction into the American Nurses Association’s Hall of Fame for her numerous contributions to the profession of nursing in women’s health, community and family nursing, and rural health care delivery (De Leeuw, Adele and Cateau 1961).
Personal Analysis:
This section will briefly cover the author’s personal analysis of this great woman and show just how the achievements of Mary Breckinridge have greatly improved the practice of nursing in not only America but the entire world as well.
i.) Characteristics Admired
The characteristic that one admires the most about Mary Breckinridge is the fact that she devoted her entire life toward the fulfillment of her goal which was the improvement of the healthcare situation of mothers and children in rural America. Though she was a member of a very prominent and influential family, she still devoted her life to helping people whom she had never really met before. She gave her life to helping the cause of those who are sick and needy and ensured that through the FNS her legacy lives on.
The strength and resilience that was exhibited in the creation of the FNS is a testament to the character and will of Mary Breckinridge. Never one to let challenges daunt her, she stood strong and made sure that the FNS was adequately funded, even if it meant taking money from her own pocket. The determination to succeed at all costs in the face of adversity and all the elements of nature just to accomplish her goal is a characteristic that is well instilled in the hearts of all future nurses.
ii.) Role Model Factors
There are many factors that make Mary Breckinridge a role model for not only people in the nursing profession but in life as well. Perhaps one of the traits which really stand out aside from her determination and passion is her ability to convince people to support her cause. The FNS was poorly funded at first and Mary Breckinridge had to support it financially with her personal funds. In order to sustain the operations of the FNS, Mary Breckinridge was able to generate enough publicity and solicit ample funds from different sources. This act speaks highly of her ability to bring people to support her cause.
The reason why such ability makes her a role model is because of the fact that it takes a lot more than just effort to achieve one’s goal. It is sad reality that one of the things necessary to achieve a goal, such as the one which Breckinridge was able to achieve, is funding. The rural areas do not have ample medical facilities because of the lack of funding in that area and the underdevelopment of the infrastructure in that area necessitated the implementation of costs effective plans and the generation of funding.
It was because of this that the FNS was able to expand and provide the quality of healthcare service that it is known for. It has also ensured that the legacy of Mary Breckinridge lives on.
iii.) Impact on Nursing Practice
The impact of Mary Breckinridge is that she has been recognized as the first person to bring nurse-midwifery to the United States of America. Her training in Europe and subsequent certification as a midwife complemented her training as a nurse and enabled her to provide better healthcare to the mothers and babies of rural America. Mary Breckinridge is also recognizes as one of the first nurses to emphasize the importance of prenatal care. She also focused on maternal care and was able to reduce the incidence of maternal mortalities in Kentucky.
These practices and achievements have not only greatly influence the practice of nursing as it is recognized today but have also changed the way maternal and prenatal care is conducted throughout the world.
Impact of Mary Breckenridge on my Personal Leadership Plan:
The impact of Mary Breckinridge on my personal leadership plan is monumental to say the least. From the story of how she educated herself and travelled to Europe to train in midwifery, Mary Breckinridge stands as a symbol of hard work, passion and dedication. A woman in the patriarchal society in Kentucky, Mary Breckinridge was able to go against all odds to establish her system of providing healthcare to the women and babies in rural America. She is a strong woman who will never be replicated but can only be emulated. That she gave her life in the service of those who desperately needed medical attention is an example that every person, not only nurses or midwives, must strive to emulate.
On a nursing level, she has inspired me to maintain the same level of quality of service and aid that she herself provided during her lifetime. The various innovations that she introduced and the manner by which she was able to garner support for her cause is another aspect that has greatly changed my personal leadership plan. She has also taught me that one does not have to be the stereotype nurse who just comes in when needed but has encouraged me to take a more active role in my practice of nursing.
On a personal level, the example of Mary Breckinridge has inspired me to devote my life to the improving the life of others through the exercise of my profession. There are those who are destined for greatness and those who live to become great by living greatly. I am certainly not sure which type I am but there is no fault in wanting to be great and help others through the profession of nursing.
References:
Breckinridge, Mary. Wide Neighborhoods: A Story of the Frontier Nursing Service. Lexington: University Press of Kentucky 1981.
Collins, David R. “Mary Breckinridge: Nurse on Horseback,” in Great American Nurses. New York: Julian Messner, 1971.
De Leeuw, Adele and Cateau. “Frontier Nurse: Mary Breckenridge [sic],” in Nurses Who Led the Way. Racine, Wisc.: Whitman, 1961.
McKown, Robin. “Mary Breckinridge,” in Heroic Nurses. New York: Putnam’s, 1966.
Wells, Rosemary. Mary on Horseback: Three Mountain Stories. New York: Dial Books for Young Readers, 1998.
Wilkie, Katharine Elliott. Frontier Nurse: Mary Breckinridge. New York: Julian Messner, 1969.
