Swinging Bridges of Opportunity and Challenges: Memoirs of an African American Nurse Practitioner Pioneer on Providing Primary Care for the Underserved

By Brown, Viola D.; Marfell, Julie | Journal of Cultural Diversity, Fall 2005 | Go to article overview

Swinging Bridges of Opportunity and Challenges: Memoirs of an African American Nurse Practitioner Pioneer on Providing Primary Care for the Underserved


Brown, Viola D., Marfell, Julie, Journal of Cultural Diversity


Abstract: This article presents the memoirs of Mrs. Viola D. Brown, RN, FNP, a pioneer African American nurse practitioner, on opportunities and challenges involved in providing primary and public health care for underserved populations in urban and rural areas of Kentucky. Mrs. Brown began her career with a visit to Mary Breckinridge and the Frontier Nursing Service, and she was elected into the University of Kentucky's Department of Public Health Hall of Fame in 2005. This article is an adapted version of the closing keynote address presented at the 13th Primary Care for the Underserved Conference held March 2005.

Key Words: African American Nurse Practitioner, Pioneer, Primary Care for the Underserved.

Introduction by Julie Marf ell

Our keynote speaker this afternoon at the 13th Annual Primary Care for the Underserved Conference at the Frontier School of Midwifery and Family Health Nursing in Hyden, Kentucky is quite appropriate given our historic Appalachian setting and conference goals. Mrs. Viola Brown is a nurse practitioner who visited Mrs. Mary Breckinridge in Wendover, Kentucky during her initial nurses' training. Mrs. Brown was the first African American student accepted into nurses' training, as it was referred to at the time, in Lexington, KY. She was a member of the Northeast Lexington Health Council that established the Hunter Foundation for Healthcare, Inc., Kentucky's first Health Maintenance Organization (HMO) in 1970. She was also one of Kentucky's first nurse practitioners.

Additionally, Mrs. Brown was the first African American woman to become the Executive Director of the Office of Public Health Nursing in the State of Kentucky. Under her leadership, the Office of Public Health Nursing expanded from employing a workforce of 350 to 1,400 local public health nurses, 11 to 33 health consultants, and 2 to 65 nurse practitioners. Mrs. Brown was elected into the University of Kentucky's Department of Public Health Hall of Fame this year. We were honored when Mrs. Brown agreed to come and share some of her experiences and stories with us. It is a great honor and privilege to introduce Mrs. Viola Brown.

The Swinging Bridge: Visiting Mary Breckinridge

Good afternoon. Words cannot express the joy I felt when I received your invitation to come here to address this conference. Almost 50 years have passed since my first visit to this county, accompanied by other wide-eyed students from the Nazareth School of Nursing in Lexington, Kentucky. During our junior year, we completed the classroom component and clinical rotation in obstetrics and gynecology (OB/GYN). The reward for sheer endurance (with a capital "E") was a field trip to the Frontier Nursing Service (FNS) (Breckinridge, 1981; Castlenovo, 2003).

There was such a spirit of anticipation and excitement in the air on the morning of our departure since we were going to meet a legend! What student nurse had not read about Mary Breckinridge? And which of us did not admire, even secretly envy, the adventurous lives of nurse midwives who were recruited to ride on horsebacks into the far reaches of their territory, delivering babies and caring for pregnant women and their children? In that day, we did tend to romanticize a bit!

It was my first trip into the mountains of Kentucky, and enthusiasm slowly turned to anxiety bordering on fear as we left smoothly paved roadways and began to follow the steep, mountainous incline to Leslie County. Even though we arrived without incident under a sun-filled sky, nothing had prepared me for the sight of a swinging bridge, stretched high above the waters between where I was and where I wanted to be: Wendover, home of Mrs. Breckinridge and the Frontier Nursing Service (FNS). The "devil" sitting on my shoulder was of no comfort as he chided:

How in the world did you get yourself into this predicament? One flip of the rope, and girl, you 're out of here. You know you can't swim or drink that much water, and what is your mother going to think really happened to you? …

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