Chasity Frakes, CFNP believes FNU enabled her to realize her dream of making home visits. The path to her dream was a series of surprises. 

Chasity graduated recently and believes FNU enabled her to realize her dream--making home visits. The path to her dream was a series of surprises. Chasity earned her BSN from University of Louisville and worked for six months as an RN in a hospital in Louisville, Ky., until her husband got a new job and they relocated to Berea, Ky. There, she enrolled in the FNU master’s FNP program. Chasity started clinical training in women’s health and midwifery with an FNU alum; the last day of her rotation, on February 1, 2013, her father was diagnosed with lung cancer. Chasity was able to go home to nurse her father and to be with him during the last weeks of his life because her final clinical training was delayed for two months by FNU paperwork required for her preceptor arrangements with rural health clinic in Mt. Vernon, Ky.

Chasity lived in Berea for two years before she graduated from FNU and finished clinical training at Rockcastle Family Wellness clinic, which is affiliated with a small hospital with an acute care unit. She applied to work for the Rockcastle system, which had only one job open: a position to begin a home visit program staffed by an FNP. Chasity would visit patients in their homes after they were discharged from the hospital’s acute care unit and would also make home visits for clinic patients. Chasity assumed protocols for the program would already be defined but was challenged to design the protocol for the program—great experience for a new graduate. Mt. Vernon is a small town; many of the employees and patients and their families—of the hospital and its associated clinic where Chasity’s practice is based—all know everyone else. Chasity had to make friends with the entire county at once.

Chasity found the stories about Mary Breckenridge’s Frontier Nursing Service were a great introduction for patients who had no experience with home visits, only she arrives in a Camry instead of on a horse. Many elderly patients who take medication for chronic conditions must meet Medicare requirements for a medical visit every 90 days but have challenges with access to transportation to attend office visits. Chasity’s visits reduce the periodic ‘trips to the clinic.’ She loves the care and concern for everyone she experiences as a part of Rockcastle’s system. Chasity keeps clinic hours one weekday and Saturday mornings to get experience she will need to precept FNU students.

She recently opened an afternoon Saturday Acute Care Clinic to reduce trips out of town or to the emergency room. The home visit program impacts the community by reducing Medicare fines to Rockcastle for readmissions from their acute care discharged patients—money remaining in the hospital’s patient care system, which benefits the medical facility, the community, and the patient.