To provide and promote training, education and professional development for dedicated Foot Care Nurses.
Hi all! I am at the end of my nurse practitioner program and have previously been an RN for 7 years. I am very interested in a foot care business in Florida, due to the high need I encounter in the area. I am looking into training programs currently. But would like information regarding Nurse Practitioner scope and reimbursement through Medicare if possible. I have found Podiatry reimbursement, but nothing referring to nurse practitioners or physician assistants. Any help is greatly appreciated.
Anna M Richards says:
Is anyone from the houston area planning on taking the WOCNCB foot/nail care exam in the new year? I need to retake again. I live in College Station.
I am looking for a study partner.
Is anyone from the houston area planning on taking the WOCNCB foot/nail care exam in the new year? I need to retake again. I live in College Station.
For FC nurses in Seattle Area: Veterans Stand Down event happening Dec 13-14th, 8-4pm. I had signed up to volunteer, thinking there would be a large number of vets needing services, Not as many as I thought and I travel from E Washington. If anyone interested, can post the link
When is use of lidocaine appropriate for routine foot care? Have a DM client with very sensitive distal toes when trimming. Nails aren’t complicated, except bilat hlx. Appreciate any responses before contacting his MD
I don’t see a problem with it. It’s a standard topical pain relieving agent. Other things you can use are some of the OTC arthritis or pain relieving gels. They usually create a cooling sensation that distracts the nerve pathways a little. Apply those near the area and for several inches proximal. The nerve impulses proceed proximally on their way up to the brain. So anywhere along their course is an effective place to put the cooling gels.
Additional comments about patients with low pain tolerance and concerns about tolerating a foot care session.
For my patients with concerns I give emotional support. There have been rare times I have suggested pre medicating with Tylenol or Ibuprofen 1 hour before our appointment. We always tell our patients that our foot care sessions are quite painless. I have not used any topicals and following those tender footed clients appointments I do ask them how their feet are feeling after our session is completed. 100% have liked and most love their foot care sessions. Even those with tender feet and low pain tolerance. The feet look and feel great. The client is a happy customer. 9 years experience doing foot care.
Thank You, Dr. Overstreet. Will look at different creams–
I was told by another footcare nurse that as long as a client brought their own personal product (Bactin spray) that it was ok to use prior to nail trimming.She explained since we didn’t have a doctor’s order, this would be ok. Is this true?
On Mon, Nov 12, 2018, 2:42 PM FootCareNursing.com wrote:
> Pamela pasquale commented: “Thank You, Dr. Overstreet. Will look at > different creams–” >
Found a great resource to explain what Medicare covers and doesn’t
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MedicarePodiatryServicesSE_FactSheet.pdf Printable format available
Is anyone using Electronic charting (EMR) and if so which one? I don’t like my paper charting and would like to change it.
We use recipe cards
Keep it simple and free
Name, address, phone number
Date of first visit
Date of each visit with difficulty rating and brief note. We developed the 1 to 5 difficulty rating.
Emergency contact name & number
Source of referral: friend or doctor or clinic, etc.
Major health diagnosises eg. Diabetic or joint replacements. Heart, CVA, MRSA, hepatitis. We don’t care about minor things.
All fits nicely on the card.
Alphabetical and pull the ones for our day. Clip then in order that they are scheduled onto the appointment book. When done with their foot care session bottom of the stack and on to the next customer.
Chart as you go or when you get back home at the end of the day. Simple, easy, efficient.
Our foot care sessions do not change. Terrible nails or those with an easy trim. All get the same routine. Same high quality care. Same tools and products. A diabetic gets the same high quality professional foot care as any other patient
Same charting and record keeping. Kept in the file cabinet. For the many senior buildings that we have clinics we have those patients cards in the folder labeled with the name of the facility & town. We have clinics every 2 months so easy to pull that folder and pull the patients cards and put them in order for the day. Most rebook and are regulars. If someone misses a time or two you see the date of last visit and can give them a reminder call.
We have used this simple easy system for 9 years.
Hi! I am an LPN in Buffalo, NY & I am very interested in becoming certified in this. I’ve been trying to research this but can’t seem to find specific answers. Does anyone know if, as an LPN, I would be able to do this/would it be in my scope of practice (with certification of course)? Also, are there any LPN’s in or near Buffalo that are doing this? Thanks for any help!
I’ve had many RN students and a few LPNs too.
There is so much business out there just waiting for you whether certified or not.
I don’t provide in person 3 day training program any more but I have condensed the program into a comprehensive training packet for nurses wanting to start their own Professional Foot Care businesses. It includes a tool set and samples of all the necessary disposable products. The tool set can be purchased separately if a student buys the online version of the training.
Good luck to you and get started! You are welcome to call.
I am very interested in your training and would like to know when it is available and the cost. I am a student and am researching online for programs now, hoping to find some training over my winter break, if possible. Thank you for sharing your knowledge!
Need some guidance! What does everyone who has their own business do for malpractice insurance? I obtained a quote through NSO for a business and it is $517-617/year. Do I have to do business insurance or could I just do individual nursing insurance?
Brandi. According to NSO guidelines; if you do not have a business license or a “company”, you can apply for liability insurance as an individual. Depending on your state of practice the premium will range $125-$195 +/-. If you do have a company license and business name, you need to file under the business category in order to get the appropriate coverage. Depending on your state, the premium will range $500-$600 for about the same coverage as above. Keep in mind your are protecting yourself and your company. Also, they fail to mention that the premium includes a rider to cover stored HIPAA sensitive info in the event you are hacked. This is optional, but we are never informed of the option. (About $100/yr). I do business in washingston state. The premium for my business is $592/yr with NSO. It’s the cost of doing business. I need to be able to sleep at night. I have been a nurse for 50 years. I have carried my own professional liability policy for 50 years – no matter if I was an employee or self-employed. I sleep fine 😀
Thank you for the reply Bonnie, I sure appreciate it! I thought I was doing the right thing by “naming” my business, but I thinking now, at least to begin with, that was not smart. And it wouldn’t be so bad except they want the payment up front and I don’t have $517 to give right away. I have not officially started my business so do not have any funds to support it yet.
Brandi. Did you formally start a business with license, filing and all? Or, did you just get a business card and put your chosen business name on it? The former is a business status; the latter is an individual status. If you have inadvertently signed up for the wrong category with NSO, call them and explain. They will reissue an appropriate policy. Make sure you ask them about the optional policy they “tack on” for our own good. Yes, it’s a good idea, but it’s also our decision. Maybe next year when cash is flowing in – instead of out, eh? Good luck B.
I filed a DBA with my State Secretary office. I will ask about deducting the HIPPA endorsement and you are right, perhaps next year when I have clientele to support it, I can add that back on or beef up my insurance plan. Thanks again, I sure appreciate your thoughts on this.
Unless there is another malpractice insurance co has a better rate, I would stick w/ NSO/Aetna. Expensive, but covers your independent practice procedures and business.
Very good article. I absolutely appreciate this
site. Keep writing!
Somewhere I missed this article. Would someone resend the location of this article. Thank you.
If you work in a hospital, do they let you do foot care with muppets & dremel?
I’m a home health physical therapist and am thinking about getting my certification in foot care. I’m interested in starting my own company and making house calls for individuals with co-morbidities that require foot care. I work in Idaho. With a certification from AFCNA, am I able to bill Medicare for foot care in these individuals? If so, what is the fee for these services?
Also, what am I looking at for start-up costs for tools/supplies? Fee for test?
Any information is much appreciated! Thank you!
Travis Greene, PT, DPT
Not likely. Medicare pays for licensed home health agencies to provide.
Hey y’all! Does anyone have Snowbird patients coming to central Arkansas for the winter? I would be happy to “bridge the gap”! Thanks, Rebecca Carraway RN
Now that I have Oveido, Florida, taken care of (thank you, Ramon!) I have a couple more snowbirds heading to Anthem, Arizona on Nov. 1. Usually they hack away at their nails themselves as they weren’t happy with the MD who they saw down there, so I offered to try to find them a foot care nurse in their area–they were delighted. I have a list from the Foot Care Assn. site but I was wondering if there’s anyone near there who would be interested. Thanks!!
This is Teamwork
Maybe 3 years ago I searched members as well as put out a blog request for any Professional Foot Care Nurses in Florida, Texas, and Arizona to contact me as my company is huge and so many northerners are ‘Snowbirds ‘.
I got 1 response!
My poor patients are forced to go without foot care over the Winter months or resort to the corner nail salon. Importantly nail salons are NOT professional foot care. A pedicure is for beauty. No Diabetics should have to go to a nail salon. Dangerous to say the least. Then with the doctors and Podiatrists turning them away that do they do?
As AFCNA has grown larger I encourage those of you who have your businesses up and running to step up.
We northern nurses will gladly give you referrals for our Snowbirds.
I am starting my own foot care practice in Florida and would love some referrals!
I have been doing footcare for 9 years, I took Dr Julie’s course and worked with and under other footcare nurses before starting, 9 years ago. Now I have to take more classes to continue as a certified nurse? Do I get any credit for taking the class 9 years ago?
What is FCBN
I’ve just posted WHY CERTIFY
Adding to the conversation regarding preparation for writing certification exams…
I completed basic and advanced foot care nursing courses four years ago. While continuing to learn through conferences, workshops and collegial networking has kept my knowledge base current, reviewing past notes and researching new techniques in preparation for both certifications has enhanced my foot care nursing practice, increased my podiatric vocabulary and inspired further research. Here is what assisted me to successfully pass the exams.
CFCS EXAM Preparation
Reviewing notes from my initial basic and advanced foot care course, past Wound & Foot Care Conferences attended, and online foot care related resources including
Rainier Medical Education site
Canadian Association of Foot Care Nurses (CAFCN) https://cafcn.ca
– becoming a CAFCN member https://cafcn.ca/join-cafcn/membership-benefits/
(annual membership fee is $100 Jan-Dec & discount fee for current foot care students $50)
enables access to annual conference presentation information as well as discounted rates for annual conferences that rotate across Canada each year
WOCNCB CFCN EXAM Preparation: (including repost of Feb 18 info and accurate as of 18FEB2018)
I found reviewing notes from past Rainier Wound & Foot Care Conferences and study notes for the AFCNA CFCS certification exam was invaluable. Reviewing the text from my initial foot care course in addition to selective internet browsing on Google enabled me fill in the WOCNCB outline with further in-depth knowledge. It is possible to focus on this alone for preparation though you would be left wondering about what the question format might be.
webwocnurse online review course. It certainly is not the only preparation to be done yet if I had to name a single factor in my WOCNCB based resources that was most beneficial, that course was top.
Thank you to Lois Peloquin for emphasizing the importance of “knowing when and who to refer to”! You can expect to know that for the exam.
Prep for the exam – resources available – choose what may assist you with the particular foot care nursing knowledge deficits you identify as you review the WOCNCB outline for the topics covered in the CFCN exam:
The free sample test from the Castle site was very helpful in understanding the test format and knowing how to navigate it was a time saver.
On the same page:
$45 Certified Foot Care Nurse (CFCN) Self-Assessment Examination – while these questions were not on the exam I completed, the question format was the same as the actual exam.
Online Review Courses:
$225 Foot Care 5 CE Online Course Bundle – all 5 modules
If you know the basics, you could review your foot care course notes and cover the rather simplistic and basic information of Module 1 & 2 on your own and save that cost.
$50/Module You can judge what your own knowledge deficits may be. What I did like about the modules was the specific focus of information that was an excellent preparation for the exam.
If your wound care knowledge is top notch, reviewing your own theoretical notes and borrowing some wound care texts such as the WOCB wound text from a library may be of assistance.
Not knowing what form the exam questions would take was a concern for me and the end of module review questions were a complement to the sample tests and the CFCN exam certainly used different questions but I was prepared for all domains and for the question format. (I must say the CFCN exam did include a question using a term I had never heard of so be forwarded yet don’t let that undermine your confidence; just ensure you answer all the questions and then go back to the questions you flagged!)
$69 Pearls Review Foot Care Nursing (CFCN)
The presenter has (is?) affiliated with the WOCNCB. The information could be updated, and comparing the two review courses, if you were choosing only one, I would recommend the webwocnurse offering.
However, to maintain CFCN credentials, it is necessary to accumulate CE and the Pearls Review full year subscription includes many courses that may be a resource once you have attained certification.
WOCNCB Certified Foot Care Nurse (CFCN) Detailed Content Outline
Going through each domain outlined was a great way for identifying knowledge deficits.
NURSING FOOT CARE MANUAL – 8th Edition 2015 by Susan Tremble, RN, BScN
$54.40 paperback ($63.69 Kindle) or borrow from library
Wound, Ostomy and Continence Nurses Society® Core Curriculum: Wound Management 1st Edition
– Chapter 26 Foot and Nail Care – 28 pages
Baran, R., Dawber, R. P. R. , Haneke, E., Tosti, A., Bristow, I. (2003). A text atlas of nail disorders: Techniques in investigation and diagnosis (3rd ed.). New York, NY: Dunitz & Taylor Francis Group. Retrieved from http://www.rusmedserv.com/mycology/html/Atlas_of_Nail_Disorders.pdf
Researching State Nursing Board Regulations regarding self-employed Nurses providing foot care is interesting. Consulting directly with the Nursing Board of the State in which a nursing license is held ensures current regulations are known, as they do change and evolve. I agree wholeheartedly with Kathryn that we do not “work for the Nursing Board” of our jurisdiction; rather they are professional resources to assist us as nurses to understand and abide by the legal standards for nursing education and nursing practice even as the Board upholds our integrity by safeguarding and promoting public health, safety and welfare through nurse licensing and ensuring standards are met.
The Alabama Board of Nursing team responded promptly to my query and here is what I have learned.
“The ABN does not limit what certification a nurse can obtain however care must be appropriate for their licensure practice in Alabama. The nurse can obtain the certification in Foot Care, however they must practice within their scope of education and the current rules. LPN and RN must have Physician oversight. Please see the Alabama Administrative Code 610-X-6 Standards of Nursing Practice section 610-X-6-.13 Standards For Wound Assessment And Care. The healthcare facility/office in which the nurse is employed should have a policy and procedure that deem them competent to practice in their facility/office based on their certification. If seeking independent practice you must have the physician oversight to include patient assessments and physician orders for treatment you will be providing care.”
Joyce Jeter, MSN, RN, NEA-BC may be contacted for further information: email@example.com
As a licensed nurse, it is very empowering to be self-employed. Yet along with the privilege to use the title “nurse”, we are obliged to be aware of and abide by the nursing state board regulations we are licensed by. EACH state has its own regulations. The use of the title “nurse” may only be used by individuals currently licensed by the state in which they practice.
Foot Care providers who are not nurses are free of the state’s nursing board regulations but are required to work within their state, county, and municipal laws, which includes the requirement for a business license. In my research of some states including California and Florida, I have noted foot care providers who are not licensed as nurses must be licensed under the state cosmetology boards; laws established to assure minimum standards are met by practitioners to ensure public safety.
Hello. So glad Foot Care Nurses are being able to build a company for themselves. For those who are working with Podiatrists- Was it a clinic you were already working with and the Podiatrist supported you to become a Foot Care Nurse. I know some Drs. don’t want to pay a nurse and will train a MA to do certain procedures for less cost. Lissa
Exciting to get started with your foot care business.
I’ve never heard of such a thing. She must contract and get paid by or though the doctor or his clinic. Working for them.
We all own our own businesses. Registered through the state as a private business. LLC, S-Corp, Solepropriatorship. We get a tremendous amount of referrals from our local doctors or Podiatrists and clinics. We do not work for the state nurses associations. We are PRIVATE businesses that we own and develop into the best high quality foot care services available. Patients young and old. The worst of the worst nails and also easy trims. Thousands and thousands of patients over the years know they can call and set up appointments and we will be there. Dependable high quality insured service they can count on and trust.
Learn all you can learn from everybody. You need to be expert and really like feet to be successful in this business and there is a huge need everywhere.
Just starting the process of certification and found another nurse in my state (Alabama) that has her own foot care business. She says that she has to be under the advisement of a doctor to practice here. She has a director that she works with, that signed off on her business. Does this set up sound familiar to any of you?
I’m excited to learn from her and possibly proctor underneath her but I don’t have any
I have a client who will be in Oviedo, Florida which is near Orlando, for part of the winter and needs a foot care nurse down there. Is anyone near there who can potentially help her out?? Thanks!!
I actually have 3 in that area.
Email me and I’ll get the names & numbers
Hi, Kat, I’m having problems posting my comments here. Give my information to Judy. I cover Oviedo area
That’s exactly my plan when I hear from her via email.
I’m planning on recommending you & Dafny and forwarding your business card to them in an email.
Working as a WONDERFUL Florida team to cover the state.
I know my Minnesota patient will be calling to set up appointment once they are moved and settled. I see her q2mo.. gave her your info.
Gracias my friend
Yes, I can, I cover that area /Ramon Martinez, RN, CFCS/Healthy Steps/(407) 801 3388
I don’t, as I’m providing routine foot care. I will provide handouts for tx of tinea and toenail fungus. And, a referral form for f/u treatments by the DPM, mostly partial removal of ingrown hlx that are too embedded and painful for in home care.
How wonderful to be a member of AFCNA.
Find a nurse
I reside in a small town in Minnesota of 2200 people. Yesterday I got an email requesting my services for her Mom who lives with the son and daughter in law. They found me through the site. I’ve had many new patients over the years through AFCNA Find a Nurse.
The interesting thing about this new patient is that they live 2 1/2 blocks from my house.
They were so pleased with my Professional Foot Care Session that I was tipped $5 in addition to my $75 fee. They asked for another extra business card for the elderly Father who lives across own about a mile away. She said he desperately needs foot care too.
I’m so busy I’m not trying to grow my business. Kind of like semiretirement but don’t mind a couple of privates close to home.
If you have joined and registered your business info you will get some calls and new patients.
I’m quite surprised that you can charge that amount in what appears to be a small rural community. About the max my clients are able/willing to pay is 40$.
Dear Colleagues: I would like to ask you if any of you give a written document to the client once the service is finished.I believe Dr. Overstreet has recommended a document in writing but I do not know if someone does it and if it is given to the client or it is for our own record. I will appreciate any clarification in this regard.
I give the verbal instructions also in writing.
Currently reside in Central Wisconsin. Interested in taking a course on foot care to obtain the certification. The only local education I have found was a one year course through the technical college as part of school of cosmetology .
U/W Eau Claire Continuing Education….April and October, a 5 Day Course gives you 40 hours and about 7 Didactic….more on line coming in the future. Rainier Medical…in Seattle has a lot , on line and Hands on…….Taylor Health has classes… Emory has on line..no hands on….Google any of them to find out details.
Google any of these…U/W Eau Claire Continuing Education Nail and Foot Care……..Rainier Medical, out of Seattle and on line……AFCNA……..Taylor Health…….Emory University has on line, no Hands On….Sanford Health in Sioux Falls, SD….All are very good!
I felt like the WOCNB test was odd. Lots of obscure questions, not very practical. And expensive. Knowing when to refer is key. It’s also timed, so you need to read carefully, decide on the best answer quickly and keep moving. I passed, but felt lucky to do so. I studied a lot, to the point where I had to just go take the test and get it over with.
Anna. I know that WOCNCB Exam is a blister, and Expensive, I consider myself lucky I passed the first time. I too used Pearls Review and attended MANY classes. But being in this Educational Process .. for a long time….I might advise to go the AFCN Certification first, then WOCN. I do not Necessarily think you need to do the WOCNCB after becoming a ACFCN but sometimes that gets to be a personal goal, and might be required by some healthcare facilities. Taylor Health at one time had some good test prep classes, but I have not checked lately. I also used the WOCN Text…chapters on Neuropathies and chapter on Nail and Foot Care. All in all, Education, then keeping updated in Nail and foot care is fairly expensive with travel, hotels etc. But nice to see nurses keeping this Nursing sub-Specialty a necessary proud to be a part of Specialty. Am hoping we get many comments on your start of this subject on the Blog. Lois. CFCN CFCS
Thank you Lois. Actually am not familiar with the AFCN Certification. I will look into this today. I feel like I have been “trudging through weeds”, so to speak, as I have several resources. But I’m not exactly sure if my work here in my dept has been a deterrant :/…given my inability to “decode” this exam. I am a good nurse clinician in our podiatry dept. My patient’s are grateful for all that I do for them; and the work load that I do carry has helped the surgeons I work with.
Again, thank you for your encouragement.
Anna. I feel I can never push anything…but AFCN has the program on line. You are able to take the exam on line. AFCNA I think the pass rate is VERY good! When I sign my name with my credentials I sign both, as I am equally proud of both certifications. If you can not able to find it on line, let me know. Lois
Thank you Lois. I tried to reply earlier, but had trouble from my phone.
Again thank you,
It should be AFCNA. Then the certification is AFCS
I also failed the WCONC Foot care exam, the first exam I’ve ever failed and I have 3 certifications, including the National League for Nurses educator. I tried to protest to them and requested my exam be scored by hand and to have the questions evaluated for rigor: validity and reliability. There were many questions where 2 answers could have been correct. but they didn’t respond in a professional manner. Go for the AFCN
I passed the WOCFN but felt that at least 1/3 of the questions were irrelevant and were heavy into obscure cleaning solutions and a range of useless material. I did see my score but do not remember how I did that. I have not renewed it as it has just lapsed and I found that it did not help me in the least. I too have been an ACLS Instructor Trainer and a CCRN and this test felt the worst of any of them.
I thought it was a terrible test and like you I felt many questions were irrelevant and due to the fact that you have to do it all over again as expired in 5 years I chose not to renew.
For my company a doctor has never asked nor required certification. We are private nurse owned business legally registered with the state. We do not work for the State Nurses Association. We own it and provide the best cares for our patients. We believe in training & education to be your best. Certification is great and if working for an agency or clinic it may be required.
What truly does matter is that we are highly trained providing expert high quality care and that we are RNs.
A few test questions don’t make you a better Professional Footcare Nurse.
Do you know where I can obtain study materials for the exam?
Lots of places to study for the exam.
I recommend my students study:
Mayo Clinic foot and toenail disorders
My Foot Shop Learning resources
Also EVERYTHING on Dr Julia’s Rainier Med Ed site
All these are free.
So appreciate the reply Nancy
My friend who is amazingly talented didn’t pass first time but I used the wocn practice tests n studied how to study for this test n made the foot care chapter of the wound care book by Ruth Bryant my study guide. I got a 4th edition for $5 on Amazon.
Golly, Pam thank you. I also wanted to reply earlier to you as well. I will keep you posted!
I agree with you completely on the WOCFN testing. There was a lot of material on the test that did not pertain to what I will be doing as a foot care nurse. I also was not treated very kindly when I raised questions and tried to point out flaws in the test. My personal opinion is that the WOCFN testing is geared more towards nurses that have already obtained their wound care certification.
Kerry CFCN CFCS
My name is Anna, and I have felt it to be a great privilege to work as a nurse clinician here @ BSW Health in College Station, Texas. I have worked here in our clinic for ~ 4 years now, and have learned so much. However, I am not writing to shout of my love for podiatry nursing care. I am writing to ask for some “listening ears” – as I have just taken the CFCN exam for the 3rd time, and still have not passed. I am so disheartened, I am not sure what to do.
Can someone please help me?
tearful nurse :'(
Hi Anna, I understand. I did not pass on my first try. I did flash cards on glossary of Podiatry terms. I had a picture of a bunion, Charcot and what it was on the other side. I would have a friend show me the photo and I would tell them what it was. Have you checked out the Pearlsreview by Nurse.com .It is -view course list, testing for the CFCN. It runs $69.00,but has great questions. It breaks it down-toenail care, foot wear. Check it out. I hope that helps. Lissa
Thanks for your input Lissa. I hope we get many more comments. We see the desire for Certification in many of our Nurses now. Am very interested in what others are doing!
Thank you so much Lissa. I did renew the Pearls Review this year, and had used it prior to my “2nd attempt”. I don’t remember there being a ton of questions offered? I did go through Emory last February, which was highly detailed – did well on the open book exam @ the end. I was in the middle of the course “Prof Ed, LLC, which I did like format here. What’s so frustrating is I’m not sure where I’m doing poorly on this exam
About the WOCN exam…when one leaves the room, you have no idea what you probably got correct and what you got wrong. I went in feeling I knew everything and left feeling I knew nothing. Lois
Thank you very much Lissa. I will check out the Pearls Review again. ai’m grateful that I have found this blog here 🙂
Looking to retire in 5 years but already very busy. I’m in the Green Bay/DePere WI area and have connected with one excellent Certifed Foot Care RN but want more help to do in home visits. Anyone out there looking for business? Would like to hear from anyone who is looking to build their own business!
Hi Kathy, What part of Texas do you live? I am in Houston and working to obtain my certification. Maybe we can network together?
Just had to share a happy circumstance that occurred today. A new referral was being set up by phone when they asked if they could do a random act of kindness n pay for someone else who couldn’t afford foot care. I replied absolutely! In fact I recently was told by someone it didn’t fit their limited income. I’ll give this thoughtful person a gift certificate for their donation when I see them tomorrow.
I then called back this other random referral call. When I told her someone would pay her visit her reply was “Are you kidding me!” They are so thrilled and so am I, to be the conduit for this thoughtful gift! Just thought I would share this sweet moment!
How thoughtful. That is a great!
I use Gift Certificates in my business too. It’s my “sliding scale”. If someone desperately needs foot care and can’t afford it (usually at a senior center for Senior Housing) I will present a Gift Certificate instead of offering charity, I get them at Beauty Supply house (pack of 25 for $10). I also donate them to Health Fair Drawings & Raffles. It is great advertising. They always come back and some bring a spouse or a neighbor. These things pay for themselves. .
Love hearing about generosity. 1 act of kindness always comes back 10 fold.
Gift certificates are great and you are so right. Offer to someone that say that they will pass and can’t afford a session. Donations at your senior buildings for raffles or drawings.
We get our gift certificates from Vista Print and have our logo and company name printed.
Very professional and inexpensive
Hello all. I came across the blog searching for information on independent foot care as a certified foot care nurse in Texas. Is anyone here from Texas? If I become certified can I open a home foot care agency here in Texas? I’ve been trying to find info but haven’t found any luck.
I’m just putting finishing touches on the new training packet:
Comprehensive Training Course for RN Footcare Nurses
How to Build a Successful Footcare Business
Very soon available on my web site. I’m also currently writing a book:
So You Want To Be A Footcare Nurse
That won’t be available until after the first of the year.
You are welcome to give me an email or call. I’ve helped many launch their Footcare business. Consulting and guidance.
Kathryn, I would love to see your packet when it is done. I hope to continue with doing Foot Care on my own at some time. I am in NM. Thank you.
Looking forward to updates in the footcare business info pack. Any word on CMS billing changes? I see there is a bill going forward to allow NPs to order Diabetic shoes…we shall see. Thanks for all you do Dr Julia!!
Thank you so much , Kathryn O’Shea.
I received your Patient Handout for Fungal Toenails. I’m happy to share this info with my clients.It’s always nice to have instructions for them to take with them.
Appreciate your sharing,Patty
Really well worded response and reflects my feelings perfectly.
More thoughts on soaking the feet….and there are a lot of people out there with much more knowledge than I ….1. soaking is drying 2. water can act as a vehicle for bacteria to enter the body through a open wound or sore 3. It may be harder to see the line of demarcation of a corn or callous 4. And clients tend to do what they see us do….so if we soak…they soak….Then….will they have the water to hot and not feel it due to neuropathy….will they use some type of basin, that we have no idea what it was used for previously ….and will they add something to the water that they should not….a soap that is too strong….bleach…some type of cleaner of disinfectant….these scare me the most. I like all the inputs, and I know we all have our ideas and thoughts…and we all can continue to increase are knowledge.
Never had any of these listed problems in 10 1/2 years of providing high quality professional Footcare.
As far as wounds or ulcers seen before we start we ask, “any problems I need to know about?” They would be told to see their physician ASAP and we would not provide foot care at that time.
As far as corns & calluses I find it is much much easier to pare them down or use the bur to sand down the smaller ones after the feet are softened. Removing cores of corns is less painful for my patients if the skin is softened and I see edges better and remove cores much easier.
I feel it’s important to have clean feet and a top quality moisturizer applied with a little massage the end of their Footcare session.
This is what we do and I share ideas and information but ultimately get all the education you can and develop your skills, policies, and procedures that you like and are comfortable with to provide the best care for your patients.
5-10 minute shower is barely enough time to wash your hair? Sorry Lois. People with neuropathy need to be clean too. I’ve studied extensively and never heard that they should take brief showers.
What I really feel sorry about is that there are so few Professional Footcare Nurses out working in the field and over 26% of our seniors with Diabetes have nobody to call so they are at the mercy of the pedicure salon down at the corner.
I have had the doctors send me sooooo many that ended up with infections. See the doctor to get care and instead are told, “ we don’t trim toenails.” Hand them a script for antibiotics and told to call me!
I’m working hard to build a Team in Florida. SENIORS who need us!
I just researched Web MD.
Good Neuropathy tips.
It does say to sand corns and calluses after the feet have been moistened to make it easier and more effective.
It said wash feet daily and apply moisturizer.
Inspect them too. Many seniors can’t flex or reach their feet.
It is excellent when we see patients with neuropathy whether diabetic or not.
A real good look & inspection. Wash the feet. Take care of the nails and anything else we see. Lotion and massage.
Answer their questions and provide educational tips for them to keep those feet healthy.
What an important conversation about soaking feet. I want to take a moment and share my thoughts…. I work in a variety of settings. From high-end senior communities to Seattle’s homeless and “under-served” communities. I absolutely understand that it is often necessary to clean the patient/clients feet as part of our foot care services. But cleaning is different than soaking. Cleaning is accomplished with any number of products. They range from herbal essence infused water on one end to Hibiclens on the other. A basin/bucket may be used to accomplish this. To prevent cross contamination that basin/bucket should be lined with a disposable plastic liner. A small garbage bag is cheap and works perfectly. Regardless of any product used to try to clean basins between use, it is not safe to use the same one with multiple patients. We would never do that in a clinic or hospital setting. And with good reason.
Soaking, if performed, is the longer term submersion of the feet. A wonderful luxury in salons. But not a justifiable medical/nursing protocol unless there is significant dirt/debris on the feet. We are all working hard to have Foot Care Nursing accepted as a nursing sub-specialty. We demonstrate our competence and professionalism thru attendance at training programs, watching online foot care education programs, working with mentors and working to achieve Foot Care Certification. We make business cards and sometimes websites in an attempt to demonstrate our professional approach and that Foot Care Nurses are highly trained and offer medically appropriate care.
I have seen conversations on this Forum about such issues as taking monetary tips. The comments varied but most that I read stated that as specially trained nurses it would damage credibility and place Foot Care Nurses in a league with pedicurists. While pedicurists also provide needed services, the Nurses are set apart by their ability to determine and provide medically appropriate care and to assess the patient and their feet for medical problems and make appropriate recommendations including the necessity for physician intervention. That is our place in the health care continuum.
Many of us spend an enormous amount of time educating the public and other healthcare providers regarding the dedication, professionalism and training of the Foot Care Nurse. Pampering our patients/clients is something that we all try to do. Whether it’s thru conversation, a nurturing touch or a gentle foot massage, it can be rewarding to both the nurse and the client. If you choose to include a brief, relaxing soak in your care plan, please add it in a manner which does not compromise infection control/cross-contamination. And please never forget that we are not providing spa treatments. We are bringing a lifetime of nursing skills and knowledge to the care of our often high-risk patients/clients.
Thanks for all that you do to improve their lives!
Thank you Dr.Julia,
I very much appreciate your response.
You’ve approached several subjects that I have had questions of.
Patricia Adams LPN
Thank you Dr Julia.
Great information and I very much appreciate your sharing & caring comments.
Our routine here in Minnesota does include a dip in the warm water as you know.
We love using the Footsie bath as it has a one time use disposable liner we fill with just enough warm water to submerge the toes and lower foot.
No cross contamination. We do provide a little pampering with that but the benefits of cleaning the feet. Rinsing off the dust and debris and being able to clearly visualize the toes clearly after trimming is great. Making sure all the edges have been filed and additional removal of dead skin and debris that appears when the foot comes out for final inspection. Beautifully clean and ready for lotion massage.
Never one problem or adverse reaction in 10 1/2 years. The patients love it.
Each Professional Footcare Nurse can set up their business the way they want to. Water, no water.
Choices in equipment and tools. Build their own policies and procedures. Build successful business and help many.
Education is key. You have so much to offer my friend.
I value your point of view and understand .
Thankyou so much
I also attended the National Hansen’s Disease Program and class at Sanford Health Care. All…no soaking. Hansen’s Disease, even said…the person with neuropathy should only take a 5-10 minute shower. Washing is fine…and I could give reasons for not soaking but will leave that to someone else. For facilities and health care units that had soaked…it was hard for the clients to accept no soaking…but surprising with the good foot care given, they are perfectly content now.
Thankyou so much for sharing your insight on cleansing feet.
Advice well taken
Dr. Julia Overstreet ,Podiatrist comments in her training ,”never soak feet for nail care”
yet you, Kathryn O’shea RN suggests using the Footsie Bath Ulrasonic .
Who is correct?
We have always put the feet on warm water with a few drops of wonderful milky foot bath contains Epsom salt and peppermint. Cleans and softens the skin & nails. The feet are in the water briefly and then a full inspection. Next trim and debridement loose dead skin. Softening the feet in the water really makes all the debris remove easily and painlessly with the curette and the curved pick tool and easy to check clearance before trimming or nipping the nail back. So much buildup and we find it’s like cement with dry feet. When I remove ingrown a couple extra minutes in the water and the skin retracts and we can debridement the dead buildup so easy and little pain. Slip the pick in. Clear and clean. Remove the ingrown. Beautiful. There are times that the nail the patient thinks is ingrown and painful is not ingrown at all. It is often just the buildup in and around that side causing the pain and once cleaned out. It’s good.
Foot goes back into the water after trim. Often tons of dust after using the bur taking down big thick nails. Once second foot done. It goes into the water. Out comes first foot. Your towel on your lap. Dry thoroughly and between the toes. The terrycloth towel exfoliates just enough. Recheck everything. Additional tweet of needed. Many seniors can’t reach their feet and between the toes sure needed cleaning. Always there is more dead skin so curette that off. Now ready for the Foot Miricle moisturizer and a nice brief massage in those beautiful clean feet. Never between the toes. Up the front and down the back. Happy customers. We do the Footcare session in 30 minutes. Feet look and feel great.
Hello. I am a starting my business in foot care and wondering if you use a computer system for charting patient assessment or do you complete a paper form assessment w/locked cabinet. If you do use any computer system which have you tried or prefer? Thank you
I use paper and a locked cabinet. I used to use a Word document and pay for secure online storage through Sookasa using Dropbox, but it’s cheaper and easier to use paper in my opinion.
Several of my accounts are special needs group homes and when done with their professional Footcare session I am asked to chart in their chart and document what I did and also any recommendations as well as set up the next visit which is in x2 months.
My private customers as well al all patients we use a basic recipe card. All 450 are in a file alphabetical in my home office.
Then first visit
Next line the date & time of appointment
A 1 line note. We rate our patients 1 to 5 rating scale. 5 being the worst requiring a referral to a doctor or podiatrist and 1 is normal nails. ‘Rare’
Most are 2, 3 , or 4s. To be a 4 it is quite bad. Scalpelling corns or calluses huge nails needing major debridement. 2s and 3s are often bad but it’s your judgement call. My note may say, major debride. Very think on all nails. 2 calluses on L ball. 3/5 1 line.
Top right on the card will say where the referral came from. Clinic referral or doctor referral. Or eg. Diabetic support group referral. Also I write the price I am charging them and if they are private or clinic. (My clinic)
Bottom left line is emergency contact name & number.
Bottom right is short list of the patients health problems. I ask and nice to know most health problems but I only write down major problems.
Diab. 1 or 2, pacemaker, HTN, blood thinners, seizure, s/p CVA L or R
We don’t need vs
We don’t need med history except to know if on blood thinners.
My appointment book has the date & time as well as address. Often it will say shoes or socks if I will be needing extra minutes for writing up a shoe order or orthotics or support hosiery which I need an extra 10 minutes or so.
A private appointment makes me $75
Add on a shoe order another $90
$165 for a 45 minute appointment. The shoes are delivered usually with the next appointment for the fitting.
You can spend time writing up a whole health history. Med list. Vitals.
We do not do that and it’s cerainly your choice. We keep it short. Easy. To the point. All Footcare sessions are exactly the same. Whether a Type 1 Diabetic or a healthy gal that can’t reach her toes because she had a knee surgery. Nothing changes.
We own our own private businesses. We don’t work for the state board of nursing. It’s very different if you are working under someone else’s company. Like a home care agency or major clinic. Lots of charting and documentation.
Your own private company/business you set up your way. You set up your own policies and procedures. Tools and sterilization. Your own choice of products. As RNs we know so much along with all our Footcare training we can develop our own businesses and be our own boss. And make LOTS more money.
Best of luck.
So where do I purchase a Footsie bath Ultrasonic?
Amazon or Sally Beauty Supply.
I like either place.
Sally Beauty has a Sally Card. Free. It gives you discounts. It’s not a credit card.
Once you have that you will get their monthly mailer and the Footsie bath and case of disposable liners is always advertised ant a cheaper price with free shipping.
I tend to buy from there.
I’ve read that each certified foot care RN is an independent vendor. I work in a primary care clinic. Would I be able to provide these foot care services while working under the clinic?
Yes, you can work for an employer. The certification just shows our training and specialization, like your WCC. I’m a CWCN in a hospital based outpatient clinic and working on my foot care certification to be better at my job. It’s a great addition to your wound certification and will give your clinic the opportunity to advertise your expert services. My clinic has paid for my certification education 😁
WOW! Vicks Vapo Rub, who knew! Thank you.
Give me a call I’ll send you the handout for patients that you recommend Vick’s Vapo Rub protocol.
I smile when I tell them, “Nose and Toes”
Look up: Mayo Clinic Toenail fungus.
Mays has tons of wonderful education and it includes great pictures.
They also recommend Vick’s treatment for people with fungus.
I had an interesting case 2 days ago.
White cores like corns but no callus. Painful like a corn. Several on the Sole.
I text my Podiatrist that I consult with. Asked about these. Described them. Chronic. She picks at them. Pain. I’ve maybe seen these type of spots on the dole a time or two in the past 10 years of doing Footcare but this patient I could feel a slight protrusion and they hurt her.
I removed the painful ones with my 312 blade. Easy. Used the bur to gently sand them. Relief. She was elated. I told her I’d try to find out what they are or a do.
Dr Buren knew right away. Rather rare.
I went on the Mayo ed. Site. There it was. Picture and description and education.
Exactly what I did. Removed the painful ones. Suggested a good insole with cushion in her shoes. Clean and fry and apply Urea cm.
If you have active Footcare business I suggest looking up: Porokeratosis.
Study lots and become expert and knowledgeable. I study nightly and I’ve been doing Footcare for a long time.
If you wouldn’t mind, please send to my email: firstname.lastname@example.org. Thank you.
Email me your name & address
I’ll be glad to main it out.
I just mailed out a couple today.
Yes, I also recommend Vicks to those on a budget. Wal-Mart has the generic- Equate that states on the from every Vicks has in it. Best to reduce the thick nail as best a possible. Takes about 9 months to a year to improve. As the new nail grows in , it is healthier.
Exactly. The generic is perfect at $1.94 compared to actual Vick’s Vapo Rub @ $4.68
Active adults are usually the ones I talk to about starting on the Vick’s regimen.
I have patients that after 6 month to a year have nails greatly improved looking almost normal.
Never cured. But under control.
I also tell my patients that without regular Footcare the nails will back to the way they were.
The handout I wrote has good education and additional tips.
Clinical question: A client had one nail which was too thick to nip. She claims she had trauma to the nail many years prior and it has since grown irregular. She stated it had been reduced only one other time. I reduced it with a burr and found it to be very soft and moist under the initial plate layer. I left a semblance of a nail for cosmetic reasons, although much more could have been scraped away. Will this nail dry up over the next few days? When it dries, is it likely to crumble away or harden? Will an OTC anti-fungal be helpful? Should I have removed all the soft material? Thanks for any guidance.
Thank you for the great description. We see theses frequently. Over The Counter ‘OTC’ fungus medication is a waste of money.
Take down that type of nails reducing them as much as you can. It’s loaded with fungus.
Often you will get down to some good healthier nail below. Sometimes not. A tremendous amount of dust from the bur.
After a couple minutes in the footsie bath ultrasonic before you start. We use a couple drops of milky footbath with Epsom salt & Peppermint in the water. Cleans and softens the feet and nails. Good for the skin. Then the trim & debridement. Back in the water while we trim the other foot. Now bring it out of the water. Very clean. More dead debris. Use your curette and remove all loose white and tweak the nail a little more as needed. Done. Dry completely and do your lotion massage with Foot Miricle Theraputic Lotion. Last of all. Put your patient on the Vick’s Vapo Rub protocol.
Tell your patient you want to see them every 2 months. Thin layer ov Vick’s on all 10 nails once daily for 2-3 weeks. Keep feet clean and dry. They will again resume the Vick’s following the next appointment.
The nails will improve greatly and improvement will be seen every session. I often photo before and after these nails on the real severe ones.
Now the nails are smooth and level. Happy patient. Often can’t believe you could do so much and the feet/nails haven’t looked or felt that good for years!
I welcome you to call or email if I can be of any additional help or questions.
Thanks. I did suggest the Vicks VapoRub, but unsure of consistent results. I have been in business just a few months, and have only seen a handful of patients a second time. So, I don’t have the personal experience to see results yet. I don’t normally soak feet. I have yet to recommend an OTC anti-fungal. This is the first fungus I have seen with this texture. Thanks for the input.
Thanks, Kathyrn. I’ve run across those in the past as well.
What state are you? We have nurses malpractice liability ins. company that we use is much more reasonably priced.
There is no universal business insurance but you just register your business with your state as a Sole Proprietorship or a LLC is all you need in most states once you choose the name for your company.
I suggest to do your sales & marketing with your Podiatrists and nearby clinics with the family practice doctors. Like I said in previous blogs, they will be very happy to use you for referrals sending you Footcare patients. The doctors do not want to trim.
It’s an exciting time for you and good luck.
I am in Nebraska. Thanks for all the great advise. One other question is about calluses. We can do callus care with a file or emery board but we cannot use a 15 blade. Is that correct?
We do use a scalpel blade and it’s disposable of course. We are not doing surgery. We do not cut.
We do use our drill with the bur to take down smaller calluses but with huge callus we shave the thickest part of those large ones. Once the large hard dead part removed then either file the rest down or easier and quicker use the bur.
With experience it gets very easy and you stop before you go to far. Lots of touching as you go to remove the thick hard callus and to the point that the skin has softened and not pink.
We only use the 312 blade in the handle/holder. Secure the affected area making the callus & skin taught. Always shave towards you, not away from you. Hit the very thickest part of the callus and shave it down. A little practice and you are a pro.
I know of NO states that would prevent you from shaving a callus.
Email me and I’ll be happy to send you before & after pictures and also picture of the 312 blade and handle.
It comes in a metal package that you use to secure the blade while it’s in the metal package peeled back keeping it sterile when inserting into the handle. To remove the blade insert the sharp end of the blade into the metal package. Grasp the outside of the package with the sharp end inside. Hold your handle with the other hand. Twist and blade is now loose. Pull and the dirty blade now removing it inside the metal package. Safely removed. Fold the metal package enclosing it. Fold ends in. Dispose. I think rack blade is $.44
Always ask your patient if they have corns or calluses with your initial exam before you start. With huge calluses or corns this blade is fantastic. Tilting the blade to the corner and go in slightly right next to the core of the corn (big or small) and you can pop the core up and then a shave across the top and it removes and core is gone. The core in a corn is exactly what is causing the pain for your patient. Core out. Calluses shaved Pain gone. Happy patient. Problem: it’s a shoe/insert problem. Pressure on a specific area of the foot. Feel inside the shoe at the spot that coresponds with the corn. Tell the patient the corn will come back and now education for the patient. New shoes. New inserts. Custom orthotics to off load the problem areas. Maybe they have other shoes they can wear.
I’ll be glad to send you pics if you email me.
I just got my certification. I have a few questions. What do you charge for toenail/foot cares per person? If at a nursing home or hospital setting is this just cash pay or does insurance or medicare cover this? Do you always do vitals, review of systems and medications? If I see a diabetic patient does a MD,podiatrist, or FNP have to see the patient also?
No need to do vital signs. No need to have your patient see the doctor or Podiatrist prior to you seeing them for Footcare appointments. If you however see something concerning during your inspection and evaluation you recommend to then to make an appointment and have the doctor look at it. I have text directly to 2 Podiatrists and photo and send the picture and ask if they need to be seen or if they agree with what I’m recommending. They get right back to me and I’m able to tell my Footcare client that I recommend as well as the doctors. At times the doctors says, have them come in.
Then I tell my patient to call for the appointment and say that I want them to be seen ASAP or next week or however urgently they should be seen and also to say that the doctor wants them to get in ASAP too. Often that would be if infection suspected.
Cash-Check-Credit Card. No insurance.
$75 for private in home appointments and $55 for clinic price. Eg.: many people on the same day in a senior building, nursing home, assisted living residence. You should be able to do 6-14 people per day.
Remember: you cannot provide care to a nursing home or even assisted living residence as they are vulnerable adults. You must go through the family or executor that manages the health and decisions for that patient. Even the nurse working there can’t give you a new patient there. You must first get the approval from them as that who writes out the check and pays you.
It doesn’t matter if Diabetic or not.
All your Footcare procedures will be exactly the same. Same tools. Same high quality care. Develop a ‘30’ minute session with consistent routine. They will love it. They will love you for providing such a needed service.
August 1st my 3 day training program will be available in a packet form that includes a full set of tools and samples of all the disposable products and every detail of how to start a successful Footcare business. Watch my website in August to order. I know a whole lot of you are waiting for this.
I’m in the beginning or researching foot care nursing business in Florida as well. I was curious about what I would need to get started. I’m interested about learning about your team as well. I currently work in a hospital and I have been an acute care/floor nurse for 4 years. How do I get a hold of you? I just found this website. Thanks!
My info is right there below my blogs.
FEEL FREE TO GIVE ME A CALL/ EMAIL
We need more more RN Footcare Specialists certified or not certified.
So many patients just waiting for our services.
In my experience here in Washington State, what you charge depends on your community. While I would love to charge 50-60 dollars a visit, the folks in my community here in rural Wa state can’t pay. They have trouble with 40$/visit. I provide a discount to married couples and folks in 6 resident adult family homes
I don’t believe hospitals allow 3rd party vendors to provide services, unless they are a DPM, ARNP, or PA. Patient bill of rights in skilled nursing and assisted living do allow for private contracts with outside providers, if arrangements are made with the client or family. I have HIPAA forms and a permission slip signed on behalf of the client for the facility. Plus charting where appropriate, as Dr Julia emphacises. It doesn’t hurt to market your availability as that can be a benefit for potential assisted living residents. . Most SNF patients are Medicaid and I do understand there is some possibility of Medicaid contracts, depending on your state and license. Medicare won’t reimburse as you are not a licensed provider. Insurance won’t, either.
If setting up a new business, be sure to register with your state to get a Universal Business Identification number. Then a biz license for the primary community you serve. Nursing Service Org RN Malpractice charged 500 dollars. All of these are tax deductible.
Looking for nurses who do foot and nail care in the state of Florida – need some direction and how to provide services…any information would be appreciated – Tami
Please call me. I’m hoping to put a team of Footcare nurses in Florida.
My website has my number and email.
I would love to be part of your team
Honeywell hepa filter. About $50 from Amazon works super great for the dust and I suggest the Medicool 2100 Nail Glide.
It’s the Cadillac. Burs click in and out with a simple twist. No vibration so your patients and yourself will love how it feels. Nice small easy to hold hand piece. Has a reverse. Adjustable speed.
Also available on Amazon about $250
I’ve heard that Medicool was a good brand. I hadn’t seen that model before. Thanks for the recommendation!
What kind of clinic do you work at? The clinic I work at felt with the Dremel we had , with a vacuum hose, it was to much of a cost to clean and concerned with JACO, were concerned about flying particle, so they removed it from the clinics. Is that a concern with you employer?
My employer has agreed to buy a new nail drill to replace our old rechargeable Dremel. What is your favorite nail drill and why? Recommendations appreciated.
Am i missing some posts? My last one May 17
Hey there Footcare Nurses,
I saw a new TV commercial this morning advertising a homecare company. A beautiful detailed commercial about their complete services available for people needing inhome help with All aspects of home care and also light housekeeping.
I had not heard of this company before so I looked them up on the internet. It looked promising. Care plans designed by RNs.
My question for them was: Are they a small local company or regional or nationwide?
Most importantly do they contract or partner with anyone or company to provide Professional Footcare?
I called and spoke with the branch manager for Minnesota.
My questions were answered and here you go.
This is a Nationwide company and ‘NO’. They do NOT have anyone to use for referrals to come in and provide Professional Footcare. They are not trained for this service and they were DELIGHTED that I called to offer my company as a referring partner for their patients.
I emailed a couple documents. My business card. My logo and a copy of my informative flier.
I’m now set up to meet with them next week and begin taking referrals.
What I’m saying to you is if you want to grow your business and it seems difficult just keep your eyes and ears open. Sales & Marketing is NOT hard to do.
Know what you are going to say. Present yourself clearly so they know the key points. Who you are. What you have to offer. What it costs. Keep it brief about those important facts and most of all make them want you.
Here in Minnesota our Team of RN Footcare Professional Footcare owners each cover their own territories and refer patients to each other so that the patients get the best care in a timely manner with the nurse that works in their respective area.
Here you go:
Look up & call BrightStar inhome healthcare.
Good luck. Any questions please give me a call or email.
Another great day
I’ve been looking @ doing a little more sales & marketing in my area of service.
I noticed an upcoming meeting for the Northfield Diabetic Support Group.
I called the number listed and chatted with the lead nurse. I offered to be the speaker for their June meeting. I’ve put together a 15-30 minute educational seminar to talk about Footcare. Talk about the importance of good Diabetic shoes, socks, and support hosiery. I bring handouts and samples to look at.
I’ve done many of these type of speaking engagements and this is a fantastic way to get your name out there and information about the services you offer.
Each time I can offer this it leads to many new Footcare customers and grows the business. It’s very easy to do and rewarding.
Business is good.
I have a dilemma: Next year will likely be our last year here in South Africa. The closest person doing footcare is 100 KM away and charges for her services. The clinic is asking me to train someone to do what I do but the only candidate I have encountered is clearly only interested in charging for her services and has shown no interest in actually learning anything. So far I have picked up a melanoma, treated hundreds of corns, callous and ingrown nails. Last week I debrided a horribly infected thumbnail as I was the only one with the equipment and expertise to tackle it. One of our physicians did a wide excision of what she called a corn (on the arch of the foot) and when I saw It I knew it should have had a biopsy instead…certain it was no corn. I really don’t know what the right thing to do is… I know my good equipment would be ruined in less than a year… appreciate ideas.
Hello Nancy clearly with limited info on your surroundings, the clinic etc I would say you must find another person/persons to train. Perhaps a group of young ladies who may aspire to be nurses of some sort. Is there any nurses training going on anywhere near you? Who delivers the babies? Maybe a midwife type? Not enough info to really accurately comment. Good luck.
You might also look for someone doing pedicures, there is a huge need for medical nail technicians. At least they would already have experience working with feet. Go to a few nail salons!! Ya never know… ( if there are any in your area that is)
I am an RN in Colorado looking to start my own foot care service on the Western Slope. I was wondering if anyone out there knows where I can receive the training that I will need. Any help would be greatly appreciated.
Rainier Nail and Foot Care , or. ,,,,,,,U/W Eau Claire Continuing Education……..google them. …both have classes.
I am doing a bit of teaching thru YouTube… LauraRoehrick FootCareExtraordinaire. Free and can access 24/7 LOL
Thanks for responding Laura. I really appreciate you taking the time. I willove check it out.
What is the best way to approach a podiatrist about training you after you completed the 24 credits of CE?
Rainier has Conferences yearly. In fact one this weekend in Alaska. The conferences are great and as Medical Professionals we need too keep up ongoing education. Our nurses in hospitals, clinics and others do. We should be no different. As you all know…we had nothing in nurses training on nail and foot care. Rainier also has hands on classes. I have attended several and they are very good. We are lucky that there is a Physician that will train us for this professional career of nail and foot care. The U/W in Eau Claire offers one day Didactic and 40 hours of hands on nail and foot care. They do this twice a year. Does education cost money…it sure does…but as we all know….Education is priceless. Someone from Boston University quoted to me…….”.Education should be framed by the concept of Lifelong Learning. All learning undertaken through life. Improving Knowledge and acquiring new competencies within a personal, civic, or employment perspective should be considered a necessity rather than a luxury.”……………………I love being a nail and foot care nurse….but I want to be considered the best of the best medical professional. Lois
Thank you so much for the information! I will definitively look into attending a class. I love working with the elderly, they are such an underserved population they need all the nursing care they can get.
Just remember….If wanting your experience to count….you must have the check off sheets , that you can download on line both from AFCNA or WOCN. And observation does not count…you must do the skill. Also…a Certified Foot Care nurse is able to sign you form….when she observes you. Once I had a student that was just a few hours short….she lived out East…so I had her contact a friend of mine…certified in nail and foot care and they were able to meet and she could get her few short hours documented as she observed her.
Day I of Rainier Nail and Foot Care Conference. Great! Just when you think you know everything…you find out there is sooooooo much more to learn. Meeting others involved in Nail and Foot Care is another benefit of days like this.
Sent from my iPad
Pick a Podiatry doctor near you and call or write and ask if you may come to clinic explaining your intent.
Also that once you begin your business you would like to partner with them for referrals.
My podiatrists are right on my phone and I will photo the foot or area of concern and send the picture via text with a short statement and consult with the Doctor whether my recommendation it good or if the patient needs to come in to be seen.
The Podiatrists pass out my business cards to their patients needing Footcare inhome appointments. Having the support of the doctors in your area of service is a key thing to quality and credibility of your business.
It’s nice to write, “Recommended by Physicians!” on your advertising.
I just picked us another group of 58 Doctors at one location in my territory of service that are asking for boxes of business cards to pass to their patients needing foot care. Understand that doctors do not want to trim toenails. Podiatrists do not want to trim toenails.
The doctors are very happy to pass that business to you. My Podiatrists even send patients to me for callus removal. Ingrown toenail removal.
Attending clinic with the Podiatrists shouldn’t cost anything. They love to teach.
As I was looking for a correct definition of onchyphosis online, I came across a free access copy of Practical Podiatry by Alfred Joseph, 1918 – no time to read it all now but it has a nice glossary! https://archive.org/stream/practicalpodiatr00jose/practicalpodiatr00jose_djvu.txt
What did everyone go through to obtain the 14 CEs to complete the necessary 25 CEs? I have the 11 CEs from the class, just did not know where to go for the rest! Thanks!
GOOGLE THESE: RAINIER……AFCNA…EMORY…..INDIAN HEALTH SERVICE……………….PEARLS REVIEW…….all have some on line.
I live in Michigan any suggestions on where to take the class for certification?
Two Certifications available…CFCN. CFCS…….so a few options…..Emory, AFCNA…Rainier…..U/W Eau Claire Continuing Ed……..there is a fair amount on Line and more coming! Hands on, Rainier and U/W it is really getting exciting on number of nurses interested in Nail and Foot care, and increase availability of options.
Emory, Rainier, U/W Eau Claire. Google all.
Do anyone know how I can found out about foot care conferences near Greenville SC? Also I am having a very difficult time getting foot care nurses to return my call, which makes me wonder are nurses really doing foot care or is it false advertisement. This is very discouraging to someone like myself just getting started.
Please reply; (words of encouragement)
So good hearing from all of you….I am going to look up that mine…never heard of it. You al all great with input. Lois
I am foot care certified and am interested in joining your team.
Hello colleagues, What is the best method to obtain an adequate lighting in home visits, to use a head lamp? I’m having problems with that, any help? Well, maybe my clients’ homes are very dark?
3 headlights for $9.99
And they include batteries and adjust perfectly onto your foot.
That’s a good idea. Thank you
Love my brim LED lights. I wear a cap that I’ve attached to it I got my cap light at Menards that takes 4 AA batteries
I use a Fenix HL60R. IT IS AWESOME! It has an optional 3200ma battery that has a micro phone charger input right in the side of the battery. No other charger needed. I carry three batteries but have never needed more than two as I always have one recharged and ready to go last about two sessions. I use 400 lumins and see great. It goes to 950. its about $60 and comes with one battery. the extra battery was about $10. SO WORTH IT!
I was the first nurse I know of to think of using a headlamp 24 years ago when I started. This headlamp is one of the best I have ever had
How much will you charge per visit?
Senior building and or clinic: $45
Private in home: $75
A great day. Another new account. A senior >55 apartment building. 64 apartments. I’ll be doing a 30 minute educational seminar in late May. The building manager is going to advertise it in the monthly news letter and put up my fliers & business cards.
I’ll be able to provide professional Footcare services using the beauty shop in the building. Nice.
My clients pay cash, check, or credit card.
There is NO insurance or Medicare coverage.
A recent person asked recently about NPI and billing Medicare.
To even get Medicare certification it is very expensive. Over 10K and you will be required to have your own brick & mortar business.
This is NOT worth doing. You cannot trim enough clients to even break even. Rent. Insurance. Heat. Water. Electric bill. As well as the cost of your supplies. Computer & phone. Everything needed to have a clinic. Maybe a secretary person to work the front desk while you are in your office trimming. You cannot make a penny with all that overhead and will be closing or bankruptcy due to high cost and expenses.
Keep it easy and profitable.
Cash, check, or credit card. I’ve researched and fees can cost. The lowest and best and free to sign up and get I’d PayPal. They send you the little device. It clicks into your phone. Fees are low. Then as soon as you want to just move your money into your business checking account.
I love how easy it is at the end of the year to check and print totals. Monthly and or annual.
I am a nurse (LPN) in New York State with a nail technician license as well as esthetics license. Im looking to start my own foot care business. I’m just seeking guidance as to how to obtain the CE credits as well as the proctoring necessary for the certification. If there are any foot care nurses from NYS that can help, I would greatly appreciate it. I am also open to any nurses advice in regards to the certification and business aspects.
Hello, all. Myself and a RN colleague share FC in a smaller, rural area in Central Wa state. She has notified her clients, all of whom attend her outpt clinics that she is retiring Oct 31st. We are brainstorming how to transfer her practice as I am not interested in adding her clients to my caseload. Question: Can she offer her practice for sale? Any thoughts would be appreciated.
I want to thank Dr. Julia for getting me off to a good start with her foot care conference and hands-on-feet workshops! I’ve been getting more practice and should be ready to launch my own business soon!
A question for you Julia – do you have any experience with the SteriShoe ultraviolet shoe sanitizer? I found it recommended on a local podiatrist group’s website with a link to the SteriShoe+. Here’s the SteriShoe page on use as an adjunct to treatment for fungal nails: http://www.sterishoe.com/why-sterishoe/toenail-fungus/
Sorry for the long delay in answering. I’ve been doing a lot of travelling to teach. Just now catching up on phone calls, emails, etc. Thanks for your kind words. I love all of the people that you’re going to help and glad to set you in the right direction! I haven’t done any literature or technical search on that particular ultrasonic device. Generally those modalities work well. But since most of what we deal with are chronic fungal infections, not primary/acute fungal infections… no need to spend the money on it. :))
Hi Tari and Laurie,
I’m still figuring out how reply works too. I end up “starting new discussions” thus far and my responses are currently “awaiting moderation” too.
I’m still figuring out how reply works too. I end up “starting new discussions” thus far and my responses are currently “awaiting moderation” too. So Tari: pg 33 of catalog
Both the Rainer Spring Conference and the CAFCN Annual Conference are having Sessions on Burring. Maybe we can learn more then on the Spicula.
Test entry – I’ve tried contributing twice before today, have never found my posts in the discussion!
Well, I now can see this test message, and a reply to Tari’s comment that I made yesterday…but the reply is showing up as “waiting for moderation.”
My favourite bit for reducing spicula in the nail fold is Busch’s 39RS / 009 It is made of stainless steel
Catalog Pg. 33: third row
Hoping Dr. Julia can start stocking them. Currently, the only source I can find is NASP Toll Free: 855-622-6277(North American School of Podiatry) located in Toronto, ON.
Bit order # is NSP-39RS 009HP
They have a local spot in Edmonton that sells their bits. It would be nice if an American distributor could be identified – anyone know of an American supplier that carries the European “Busch” brand bits?
Whoops – Meant North American School of Podology
My favourite bit for reducing spicula in the nail fold is Busch’s 39RS / 009 It is made of stainless steel
Catalog Pg. 33: third row
I don’t know if they carry all of them, but Chicago Medical Supply has some Busch bits.
I’d like to know max RPM on the Busch bits. Anybody have that information? I have mostly Rotatool, and the maximum recommended speed varies by bit type from 25,000 RPM TO 50,000 RPM (my extra coarse carbide is rated up to 250,000! But I have to wonder if that’s a typo).
Apparently if your response was listed as ‘waiting moderation’ one cannot reply. Went to an older post of yours and was able to reply. Anyway, thank you for your reply and valuable information.
Having difficulties replying to you. Thank you for your help, page #, etc. Just figured out that if your previous message is ‘awaiting moderation’ it will not take a reply. Scrolled down to an earlier message and it posted. Any, thanks!
Hi Debbie, Went to the Busch website via your link and not able to find the bur you like for spicule. Could you send me a link to that specific tool? When I entered the catalog number it was rejected. Know I am doing something incorrect … looks like a wonderful manufacturer.
Thank you for your help.
Try this: http://www.busch.eu/en/produkte/hand_fusspflege/
From that webpage, open the “hand and foot care” catalog in the left hand column. The burr you are looking for is on page 19. However, I don’t see any pricing…I also have a question for Debbie – do you order directly from Germany? – Thanks, Laurie
Please email me. I am ready to get started on the foot care industry in Central Florida!! I have requested info from an out of State practitionner, but please reach out to me.
Please give me a call or email.
Info on my web site @ ProToes USA.
Did you look at the schedule for the foot care day? Every hour will be worth it, even if you have previously attended. Great info re: infection control, assessment of the lower leg, feet and nails, updates on paperwork and licensing,plus more this time w/ smaller burrs. Julia really enjoys providing these classes and it shows. I’ll be there, 3rd class, 2nd of the advanced CE. I’m not a wound specialist, so don’t attend day 2
Pamela, I am in WA state and interested in any information related to your comment on Medicaid AFH & AFL with DSHS. Having trouble finding the comment on blog board and got it in my email box. Feel free to text or call 509-760-4144 Joe Barbee RN
Pamela, you are absolutely right about Dr. Julia’s conferences. It has been my experience too, that each conference is fresh, relevant and topical. I’m looking forward to the power point presentation on burs and the latest sanders available on the market. I really need a hands-on demo to get the feel of all the new burs out there. Other fun, new things are planned for this conference as well. There will be drawing(s); in addition to a Sock Drive. SOCKS for CHANGE will be collecting socks to be donated to a local non-profit organization. The recipient is BEAUTIFUL SOLES. They are a local group that provides assistant to homeless women and children. They need socks in all sizes for kids, men & women. We are also collecting spare change to donate to their operating budget. What a great opportunity to network with colleagues, check out new equipment & supplies, learn new skills, and meet with the vendors. I hope to see you there.
Lois do you mind telling me what the Fl Board said?
Some back and Forth communication between several staff members….as always a gray area…send me your email address and I will send you information quotes. email@example.com
Thank you very much for the responses to my question of a foot care business name being misinterpreted to be a pedicure service. I’ve just added the word “Nurse” to my business name to convey my service as a health care professional. Now I just need to figure out how to update my AFCNA listing…
You’re right, Gloria, Erin King, RPN, registered the term Podortho and founded the Ontario Podortho Nursing Association Inc. To use the term, foot care nurses must apply and register with her association. Even if were freely available to adopt, it may well be a yet another title to add to the public’s vocabulary and confusion concerning Podiatrist and Pedorthist.
Any suggestions for the best Liability/Malpractice Insurance Company?
NSO, Nursing Service Organization. For full coverage, liability, practice, it will run about 550$/yr. However, it is a deductible expense for your business.
Who would be the best person to approach at a facility to introduce yourself and your business?
By just leaving a business card and flyer with a receptionist I feel that it might be discarded.
Always go to the top dog.
You may or may not be able to see them that first time you stop in. Don’t worry.
I suggest leaving 6 business cards and a brochure or flier about your business.
What you have to offer
Short and to the point with important information.
Important question to ask them: Do you have a foot care nurse here or Podiatrist here?
If only a Podiatrist you want them to know you are the ‘alternative ‘ to the Podiatrist. Explain that what you have to offer is so much better.
I’m never afraid to explain that I offer a 30 minute session that is beautiful and painless. That the Podiatrist has about 5 minutes per person and is often painful and requiring Bandaides.
If you aren’t able to talk to them ALWAYS call back in 1 week. Try to set up a 5-10 minute meeting to talk with them.
Sometimes you will get a no. Smile and thank them and say, “I’ll check back with you in a few months. And, say. If you do have any questions or need my services please call.
Look them in the eye. Always extend your hand. And always smile.
Even with a Podiatrist coming to the building there are families that want the alternative for Mom or Dad. Better high quality care vs the 5 minute chop job. Your great care and happy customers tell other families and your business will grow.
Once you gave a building make use of the bulletin boards and also every building had a monthly news letter.
It’s all about good sales & marketing!
Thanks Kathryn for your reply! Your expertise and knowledge is much appreciated for me as a beginner. I’ll put out into action.
Out of 5, one visit has paid off in 3 months when I stopped by in person, dropped off my brochures and business cards. It’s a small care home and when I was contacted and mentioned there’s a discount when there are 3 or more clients on the same day, I received a return phone call with 4 patients whose family members have given the OK which I require in advance. Keep up and if you get one or two, the word of mouth will also help. Connections will help too. I continue to get VA patients because of one happy client and an RN I know who does home health with the VA. Just like Kathryn says, offer to do a presentation and have a 5 minute or shorter speak ready when you go to the facilities because you’re not “just dropping off brochures,” you’re marketing and that is an art. Also,, sometimes what we’re asking leads to something better! In October I called the Senior center to see if they’d let me offer a foot care clinic (ambitious but with reservations) and while they cannot allow that due to no money can exchange hands for services since there’s a tie to government funding….they called me back and suggested I come speak at the end of their business meeting as they needed a speaker (10 minutes) for December. That helped me find 4 new clients. There is competition on every corner out here a new pedicure spa opens however my presentation for the seniors explained not just about me and my background but what some of the differences are with pedicure vs. nurse foot care specialists and I allowed space for the licenses nail technicians who are specialist too.
Thank you so much. I really appreciate your feed back, very insightful. I know I have a very long way to go before I am ready to start my business. Can you give me any insight into the billing aspect of the business as far as NPI numbers? Would this type of service be billable through Medicaid? Again thanks for responding!
Hello, Is anyone using the Dremel for the thick toenails in homes or assisted living communities. Are you just wear a mask and offer a mask to the client.
I am a Dr. Julia educated person plus I am also WOCNA certified. I ONLY use a dremel and there is no way I could put a mask on a patient… they would run screaming from me. I Know I have a lot of nail dust in the air as most of my nails are severely mycotic but I just try not to lean into it… pretty crude but in 7 years I have had no issues…I hold on to the fact that Dr. J. says there have been no documented cases of mycotic transmission to our lung fields.
The U /W Eau Claire uses it in their Nail and Foot Care Classes. I think they have since the beginning. The nurses do wear a mask, but we do not put one on the client. I too am comfortable with the use. I think I will continue until I see more research that it should not be used. There seems to be plenty of articles out there we should not soak feet. We do not soak feet. It is great to see so much interest now in Nail and Foot Care. I think we will continue to learn….and continue to benefit many, with the greater need. And it is also great we are keeping in touch.
No. Never a Dremmel as to much vibration and to much chance of dead or weak battery.
We use the Medicool 2300. Literally no vibration and it’s electric and you can control speed. And reverse which is great depending on if you are a lefty like me or a righty and you need the spin the correct direction. I’ve blogged many times before and this Medicool is the Cadillac if you want to have a successful Footcare business.
Dust is never a problem. Our primary burs don’t kick up much dust and we wet the feet for a few minutes b/4 the work and rinse & dry thoroughly when done. Clean dry. Easy to visualize on the final recheck in case you need to tweak a corner. Then provide a nice moisturizing massage. Little dust. Clean feet that look and feel great.
I agree…once you can fit it in your budget, something other than the Dremel sure would be nice….but for a big group the Dremel is perfect. Those of you that only volunteer your services I know the others can be a bit expensive. I am waiting for JanL…they have a new one coming out…that should be great on Onychogryphosis. Will be good to see what it does. Am going to both, Seminars…Alaska Rainier Spring Conference and the CAFCM AGM and Conference in Regina Saskatchewan. Will be good to again talk with others and also see what is new on the horizon. Lets always keep in touch. Everyone has so many things to add to this. It is also exciting to see so many nurses getting interested in nail and foot care. Classes fill up fast, and different education facilities are adding much. Look at Ranier…Emory…U/W. I do agree, we can put a lot of expense into education and nail and foot care equipment. Nothing is very cheap. Use what you can….just so we keep doing it…..And we must not forget to educate our clients….that is a number one goal. Lois
How many batteries do you carry?
For us here you couldn’t pay us to switch back to Dremmels
I bet not…once you have something other than the Dremel…you would not go back. About how many batteries do we carry??????? for class always have extras ready to go. Number I do not know. When I volunteer….I have two Dremels….but I never volunteer to do more than 5 clients, a day. Lois
I have 2 dremels n 4 battery. My clinics vary. Some as few as 6 others 14. I even see pts before n after clinics.
I trim 8-14 people per day 2 days a week.
I have 3 old Dremmels and 4 batteries in my closet if anyone wants them. Free.
The size and space of 2 Dremmels in my case would take up more room than 1 Medicool.
i would take 1 dremel and 2 batteries. What model? I live in Wenatchee, Wa and would pre-pay shipping
Medicool 2100 Nail Glide
Amazon is best price.
Email me and I’ll send you a picture of our 4 primary tools, best burs, and my ‘Cadillac’ Medicool.
Responding to your offer of your dremel and batteries. IS there a charger as well?
3 chargers and 2 Dremmels.
Can’t get the bur out.
Tried and tried.
Remember how dangerous those Dremmels are
The first day one of my Team Footcare nurses put a bur into her new Dremmel. 7300
She flipped on the switch. She thought she had the bur tightened in properly.
Nope. The bur took off like a bullet across the room. Hit the wall made a dent in the wall where it hit. Thank God it didn’t hit a person or take an eye out. Very dangerous.
The Medicool has a simple safe twist in the handpiece that locks the bur in place. Safe. Then when done twist the hand piece the other direction to the open position. Remove your dirty bur. Put it in your dirty bin. Wipe down your equipment. Ready for the next client.
No tool required.
How quiet is your Medicool?
Almost silent. No vibration. Comfortable to use and safe.
I actually Googled it today and saw the lowest price ever: $198
This is so tempting. Where and what model? I’m thinking about switching from my stemmed n if I don’t need a vacuum I would be thrilled. Couple questions, how heavy is it and does it need extra battery or only works plugged in?
Email me and I’ll send you a picture.
Buy your Dremel from Amazon… very good price and fast delivery
I have 2 Dremels with band sanders (rather than a disc) and have 3 spares… I had a protracted conversation with Dremel about how short their battery life is but I think the tool we use is primarily used in a veterinary market. They do quite well if I charge them the night before my clinics as they do not maintain a charge well as they age.
Have you tried the Cap Sander?
Great suggestion… will look into it further… changing the belt sanders even with the so called “quick change” is really hard. Here people are often provided heavy steel toed boots for work in the cannery’s, farms, etc. however many of the boots are not properly fitted… usually too small. Lotas of callous… some just beyond the ability to walk….they all beg me to sand them down. Thank you for the suggestion.
When I first tried the Cap Sander….I had a difficult time getting the cap off the Mandrel….did call the company…I think it was janl….His suggestion was cut the bottom of the cap a bit….which I thought was a poor answer…but it has gotten easier as I’ve used it. It is not that I am recommending it or anything…..I just like to try different things. Every toe is different…so interesting to try what is out there. Lois
Hello, Are there any Foot Care Nurses in New Mexico. I know there is a need among our senior population. It would be great to have a partner. I have been volunteering Foot Care in one of our homeless shelters in Albuquerque. I have sent a couple people to health clinics for care. A couple diabetics . With our weather here that goes back and forth, cold to warm. Some times with the bad shoes they wear. their socks get wet. They are not able to take off their shoes and socks. With a cotton sock, it holds moisture. One man had his socks and shoes on for a month. He had an interesting pattern on his feet. I sent him to the clinic, with a gut feeling as a nurse it did not look good. He allowed me to take a photo. It was classic pitted keratolysis, a bacterial infection. Something to be aware of for those who help people in flooded areas and aren’t able to get housing for awhile. I’m looking for a sock that does not hold moisture and not to expensive to donate to homeless shelters. These people are so appreciative to have a couple pair of fresh clean socks!
Thank you for sharing.
Lissa….thank you for sharing…I honestly never know who I am answering on this. Yes…I hate the thought of putting the old sock back on after I do foot care….I have been getting them at the dollar store….One of our church Thrift stores carries new Diabetic socks…but again they have gone up in price….and I swear the ones in the Dollar store….are being made smaller.
The last time I did volunteer foot care the rain in Oregon was pouring down… my population lives in the streets and all our well practiced advice of wearing a clean pair of dry socks every day and looking for shoes that fit really evaporate… my biggest “Come to reality” moment was watching a young girl walk out into the heavy rain, feet heavily mycotic in a pair of useless tennis shoes with a new tent that she had been given…I want to come back from Africa to serve that population but my concern is the litigious society we are in and safety. Very frustrated as we are planning to return next year….
Get signed up with an account with Dr Comfort.
Seniors on Medicare that quality, and most do are able to get 1 pair of new beautiful shoes yearly. Dr Comfort has the best socks. Bamboo.
I sell tons of socks. Also fantastic support/compression hosiery.
The ‘Extra Roomy socks are especially great for morbid obese. They go right into the washer and dryer. They stay in place and don’t leave ridges. On and off easy too.
I think ALL Footcare nurses should be selling and providing these products to seniors or anyone needing good footwear. This goes perfectly with your business and you can get your certification free. Make great additional income. Over half of the Doctors fail to tell their Diabetic patients about the shoe program and they are missing out on a Medicare ‘preventive ‘ service.
Brian Lane has sent me numerous boxes of shoes for the Homeless VA facility and the Free Clinic….all never worn…when we give out…must try to fit as well as possible…but it is better than an old worn out shoe. The shoes he sends are brand new…they are returns.
Maybe the shoes can be recirculated to another shelter. I do try to get diabetic socks where the elastic band at the top is not so tight. With people not being able to go to a Dr. , some have lower extremity edema. So having a sock that does not cut in so much and leave an indention I feel is best. Thanks for your information.
I am so happy to hear this. Wonderful.
Brian teaches the Certified shoe fitter class all over the country. It’s great and of course you can get certified for free on the web site for shoe and support hosiery but then I recommend signing up for the class he teaches. Then you really have the confidence to fit those new shoes perfectly for your patients. I do a tremendous about of cash sales through my own account with them.
Brian is a good friend of mine.
The company cannot resell the shoes. They used to send them to the dump. Sad. Then they developed a program to give them away.
Anyone in the country can contact Bob or Brian about doing a shoe giveaway.
You would only get random sizes and styles however.
They are based in Mequon Wisconsin
You could have all kinds of top quality equipment including Medicool drills which are only about $250. I have just 1. I can’t imagine how much $ you have spent on travel, hotels, and classes at your age.
Dremmels are $50-$89 for a piece of equipment that is POOR.
All the best helping the poor @ free clinics.
I do pro bono foot care for some when a call comes in and the new potential client says, “I’ll call you back or I’ll think about it. You just know that they can’t afford the cost. I offer to come in and do a free Footcare evaluation and when I get there I hand them a gift certificate for 1 session.
Often these people are wonderful people just trying to survive this expensive cost of living.
Let me tell you all. Be kind and be generous. When you help others it comes back ‘10’ fold.
They are so appreciative and they tell their friends and your business grows.
I have used a dremel mini mite 750 unit for my practice and the RPM’s are similar to other units It has better control as I can hold it with my entire hand, not like a pencil. When participating in volunteer health clinics, we only had the smaller unit with the sanding discs but wore out my thumb at the end of the day. . I use the drum sander attachment with different grits for thickness of the nail. I also learned an important method of sanding from our local podiatrist: starting from the nail bed and sand distally. 3-4 passes seemed to remove a lot of thickness.
We do not use discs or barrels. So much dust.
Our bur is quicker and wonderful
The everything bur and the course everything bur are all we use.
The beauty is they NEVER wear out. Safe. Lest dust. Sterilizable
I was shocked when I tried out disposable discs and barrels. Never.
I’m using a mask plus a vacuum that’s lightweight n rigged a hose to it with Velcro. Sometimes I skip the vacuum especially with dementia patients
Sorry everybody… I should have qualified my answer about using a Dremel with no mask… I am working in South Africa and I already have plenty of people with “Foot Fear” so a mask would really put my clients over the top….
Would love to hear more about your work in Africa!!!!!!!!!!!!
Thank you for your input. Yes, over half of the clients I do nail care on have the thick nails. I just wanted other input. Making sure the situation is safe. Thanks.
Hello everyone, Thought I might join in.
I’m new at this website, looking for other nurses that do footcare. Anybody?
Find a nurse members list is a great resource.
scroll down through all of the comments. Lots of information here and from FC Nurses
Kathryn, do you know of any nurses in Texas. I am in the process of getting certified and looking for someone to proctor me. Any information would be greatly appreciated! Fancnanc40@gmail.com
Call or write the Florida Board of Nursing. The responded to me Quickly.
I went twice. Excellent. Uses the Sanding Disc much of the time. You will like it. You get plenty of experience. I would love to go again.
Has anyone been to the hands on foot care conference in Seattle? I am going next month and was wondering what to expect.
I’m working in Florida right now.
‘Millions’ waiting for good Footcare nurses so they can stop going to the dirty little nail salons on the corner.
Give me a call.
Can anyone tell me if we can do footcare nursing with out a Doctor in Fl. I can’t decifer our boards scope of practice. Thank you!
Yes. I have NPI number and it was for billing private insurance so we could get paid.
I dropped both insurance companies and devoted to only charge cash, check, or credit card and the lowest fees and easiest it the PayPal device to easily attack to your phone. Swipe the customers card. Then transfer your funds available in your PayPal account to your Footcare business account. Easy.
The insurance coding wasn’t all that easy and often rejected payment needing to be resubmitted 2-3 times then finally the check would arrive. Paperwork time consuming and I was already so busy doing 10-14 clients a day Footcare in my clinics and some days going to private homes as well as having students come in for my 3 day training program program learning the Footcare business. So I dropped them. To busy for all that paperwork. Insurance clients were referrals coming in maybe 15% of our business.
The cost of hiring someone or a company that does coding is expensive and takes to much away from your profit margin.
Where in Florida are you?
I’m doing several patients on Wednesday if you are close by I invite you to observe.
Call or email.
Im trimming at Over 55 RV and senior resorts. Just got home from a busy morning. So many new customers and they are telling their friends.
Help. I think I’m getting to busy.
Call me if in Central Florida and I’ll be glad to send you a bunch.
No… private pay. It’s for private duty and complex case management
It is my understanding that with a NPI number you can bill Medicare/Medicaid???
Some one mentioned the WOC not giving Nail and Foot Care Nurses assist and support. Their planning Committee meets June In Philadelphia. Give me some ideas what Nail and Foot Care Nurses need and would like from them. I will pass it on.
I am wanting to connect with CFCN nurses in Texas. Especially in the Houston area.
We also have a travelling DPM, from the Seattle Area who comes to Wenatchee doing 4 Alf’S, Not sure if he takes medicaid. But still leaves some residents in Adult family homes who would need care. However, we as independent foot care nurses cannot get reimbursement for Medicaid as we are not licensed home care agencies. That said, there are families who recognize the need and will pay a reasonable fee. My current market bears about 40$ per visit and I give ALF discount to 35$ as I don’t need to pack up my equipment between visits. The point is that DSHS is addressing foot care needs of older adults and disabled. Contact your local DSHS Aging and adult care office to talk with the Residential Care unit social workers
CAFCN IN MAY IS MORE NURSING ORIENTED AND IT IS ON THE WEEKEND.
What is Your Favorite Electric File Bur?
Some e-file burs are “must haves” in my foot care kit. I have yet to find a “one stop shop” that supplies everything and through trial and error I have found burs from various sources that work well for me for specific purposes. I may not use some of them every session but it is great to have them available when a challenge presents itself. For example there is one fine point diamond bur from Germany that is perfect for managing hard to access spicules ($16 Catalog #4514307000/8863-012, http://www.busch.eu/en/).
E-file burs are made of a variety of materials and come in many shapes and sizes and I am very interested in learning more. You may have an ideal “problem solver” other nurses are not aware of. Please share what bur(s) you “must have” in your kit, what makes it special, and where it can be found and at what cost.
My new company is exploding too.
Lots of doctors and Podiartists as well as home care agencies calling and sending me new clients.
I don’t dare advertise. I’m plenty busy and only want to work 2 days a week.
Everyone books back. Actually I could use a couple of partners here in the south metro of the Twin Cities. The Team approach to partner is great. Hate to send people away.
If anyone out there is interested please let me know.
The support I get as a foot care nurse is incredible with the AFCNA versus WOCN. Love the attention Dr Julia gives. My practice here in GreenBay is exploding. I’m barely able to keep up with my referrals. Just raised my rates n really needed to increase them again after talking with a local podiatrist. Just know that my clients are on limited income.
I’m looking for foot care training that may be offered over the weekend. Also any suggestions on where I can go to build a website and how should the website look. What are some of the marketing strategies you used when promoting your foot care business. What are the averages clients you seeing per month.
Check Dr, Julia Overstreet’s site. Ranier…….she has 3 weekend classes coming up. I have attended previously…each year is different. Very good!
a lot of previous posts on this forum re: strategies for you business marketing. be sure to scroll through. I built a web site for a previous business by a web site builder on line. it was really easy and my local web master thought it was professional looking
For my Wa St colleagues: DSHS residential social workers/case workers are evaluating foot care needs as part of Medicaid resident care plans in AFH’s and maybe ALF’s. It might be an opportunity for FC nurses to make contact with these facilities as many residents are unable to leave the home or local DPM’s don’t want to do care for low reimbursement. I do FC in the home and am getting calls in Wenatchee and if I can do more than 1 in a home, I reduce my rate for a multi client visit. I can post more information if you wish.
Hi, I am interested in hearing more about Washington state and Medicaid. Right now there is 1 podiatrist that does all of the residents in every assisted living facility and every nursing home within 20 miles of me. He is very territorial. I only see patients that don’t have Medicare coverage to pay for the visit.
What would you deem an appropriate amount for multiple Clint’s? Thanks.
I am having problem with responding on blog? I am very interested in more information and in WA state also. Joe Barbee (509) 760-4144 feel free to call or text.
Where can I find continuing education credits on line to be certified?
Does anyone have an NPI number? I can’t find our specialty on the list and under RNs there were only the APRNs listed. If you have one, was it easy to get?
Only physicians, nurse practitioners, and PAs have NPI numbers. it’s necessary for billing Medicare, Medicaid and private insurance. For more info, see: http://searchhealthit.techtarget.com/definition/national-provider-identifier-NPI
I have a NPI number and I’m a RN.
So, you are able to bill Medicare for foot care?
I have had an NPI # since 2006. I needed it when I did Nurse Case Management for Wa State DOL (workers comp, Medicare set-aside cases, HIPAA compliance). I don’t use/need it in foot care. It was easy to get. Google and follow steps.
Advanced Foot Care Nursing – Establishing Clarity
With the labels of “Medical Pedicure” and “MediPedi” becoming more prevalent in the esthetic industry, the lines are becoming blurred from the clients’ perspective.
Is the name of so many our businesses, mine included, adding to the confusion when we call ourselves “____” Foot Care or use catchy marketing names that may unwittingly suggest pedicure rather than foot care nursing? Would it be wise to include the word “Nurse” or “Nursing” as part of our legal business name?
How may we differentiate our nursing service from esthetic services’ pedicures; clearly and effectively conveying the essential healthcare service we provide?
Hi Debbie – Just getting your message. I like the term Podothic Nurse. However, I believe that term has been copyrighted by a Canadian company.
I think it is imperative to use the word Nurse. It immediately gives a message of professionalism and trust. It needs to be the top selling point. We do MUCH more that pedicures
100% AGREE my friend.
Learned a lot from you! BTW: I was told Avon not selling the milky bath anymore. What are you going to use?
Just to add to the %100 AGREE.. you remove the word Nurse and you set foot care back by a quantum leap… even here in South Africa it essential that I provided documentation proving that I am an accredited Registered Nurse in the USA. In the townships where I treat the indigent… they view me as a Senior Professional Nurse which translates to them a higher standard of care than that which their neighbor with a set of clippers provides…they feel very lucky that they are receiving care for free that they would not be able to afford.
I think “Professional Foot Care Nurse” sound good.
What an interesting situation.
A client who goes to a hospital to get their footcare should reasonably expect a safe and regulated service.
This inspired me to do an online search and here are results for regulations in California:
-state documents found do use the word “nursing” in relation to nail care
-nail and foot care, provided by health professionals (whose practices are regulated and licensed), is considered a part of essential personal care within a healthcare setting. I also note here an RN must practice within her regulated scope of practice, knowledge and level of competence, which in this case would require advanced foot care training and experience. Prior to delegation, the client would need to be assessed by the RN who would remain accountable for the client’s treatment and to whom she delegated treatment.
-nail and foot care provided to the public by practitioners outside the medical profession, from what has been found thus far, must be by individuals whose practice is regulated and licensed by the California State Department of Consumer Affairs – Board of Barbering and Cosmetology “The State of California requires them to be licensed to protect the health and safety of the public.”
CALIFORNIA BOARD OF REGISTERED NURSING
Understanding the Role of the Registered Nurse and Interim Permittee
According to the Nursing Practice Act, the California Code of Regulations, and Selected Sections of Title XXII
– P. 2 “RN is accountable for an ongoing comprehensive assessment that includes data collection, analysis, and drawing conclusions/making judgements in order t0:
> delegate to nursing care competent staff to deliver required care”
Title 22 CA ADC § 72315 BARCLAYS OFFICIAL
CALIFORNIA CODE OF REGULATIONS
https://govt.westlaw.com/calregs/Document/I35D1C4005F7B11DFBF84F211BF18441D?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=(sc.Default) Personal Care
§ 72315. “Nursing Service – Patient Care
-“Provide needed personal care services including… cleaning and cutting of fingernails and toenails.”
California State Department of Consumer Affairs
Board of Barbering and Cosmetology
Statement on “Medical Pedicures” March 2, 2009
“The Board of Barbering and Cosmetology (Board) has received several inquiries regarding defining the term of “Medical Pedicure”. Although the Board does not define or regulate medical procedures, the manicuring industry is governed by the Board and shall adhere to the Board’s Laws and Regulations when performing manicuring services in any facility within the State of California.
The Medical Office offering manicuring services must maintain a valid establishment license issued by the Board.
The Medical Office manicurist performing services must maintain a valid license issued by the Board.
The Medical Office manicurist are not licensed by the Board as medical professionals and may not engage in services outside the manicurist scope of practices as defined in the Board’s Laws and Regulations.
Any licensed manicurist providing services whether in a salon or a facility identified as a “Medical Office” (i.e. Podiatric Office, Hospital, Medical Clinic, etc.) shall provide manicurist services to include the nail care practice of cutting, trimming, polishing, coloring, tinting, cleansing, or manicuring the nails of any person or massaging, cleansing, or beautifying the hands or feet of any person.
Any licensed manicurist shall not use razor-edged tools or other instrument to remove calluses. Callus removal is not within the manicurist scope of practice and shall not be performed by a manicurist in the State of California.”
California State Board of Barbering and Cosmetology Act and Regulations at January 2018
BARBERING AND COSMETOLOGY ACT
Chapter 10 of Division 3 of the California Business and Professions Code
Professions and Vocations Generally
BARBERING AND COSMETOLOGY REGULATIONS
Title 16, Division 9 of
the California Code of Regulations
ARTICLE 2 Application of Chapter
7316. Practice of Barbering; Practice of Cosmetology
Board of Barbering and Cosmetology
(c) Within the practice of cosmetology there exist the specialty branches of skin care and nail care.
(2) Nail care is the practice of cutting, trimming, polishing, coloring, tinting, cleansing, manicuring, or pedicuring the nails of any person or massaging, cleansing, or beautifying from the elbow to the fingertips or the knee to the toes of any person.
Establishments offering cosmetology services require and establishment license. Licensed cosmetologists must work in a licensed establishment unless they hold a special permit.
California Department of Consumer Affairs Board of Barbering & Cosmetology
Manicurists and cosmetologists are licensed and regulated in California by the Board of Barbering and Cosmetology. The Board works to ensure that manicurists and cosmetologists follow State law and established infection control standards.
Searching Kaiser Permanente for foot care service – southern California – the only location reference to foot care is Bellflower Medical Offices, just outside Los Angeles and general references mention podiatrists of it may be that the service is not mentioned online.
Is it possible an independently practicing RN, as a foot care nurse, contracted by Kaiser might lease space and partner with a licensed nail tech who has license the premises as an establishment offering cosmetology services; perhaps co-leased space as a licensed spa and separate distinct area for foot care nursing? From each state Board’s regulations, the RN and nail tech would have to practice independently as how can an RN delegate to a nail tech who is not regulated to provide “nursing care”?! Perhaps such a set up would create a legal separation though its location makes it appear sanctioned / endorsed / part of the medical facility?
With the labels of “Medical Pedicure” and “MediPedi” becoming more prevalent, the lines are becoming blurred from the client’s perspective. Yet another topic for AFCNA discussion…
Where can I find CE educational online resources to acquire a CFCN for a reasonable price?
I tried “Reply” button but no luck so “New Discussion” that I hope may assist while this is all still fresh in my mind.
Two weeks ago, I passed the CFCN exam first try. It was a challenge and I was grateful for the webwocnurse online review course. It certainly is not the only preparation to be done yet if I had to name a single factor, that course was top.
Thank you to Lois Peloquin for emphasizing the importance of knowing when and who to refer to!
Prep for the exam:
If you know the basics, you could review your foot care course notes and cover the rather simplistic and basic information of Module 1 & 2 on your own and save that cost.
$50/Module You can judge what your own knowledge deficits may be. What I did like about the modules was the specific focus of information that was an excellent preparation for the exam.
Not knowing what form the exam questions would take was a concern for me and the end of module review questions were a complement to the sample tests and the CFCN exam certainly used different questions but I was prepared for all domains and for the question format. (I must say the CFCN exam did include a question using a term I had never heard of so be forwarded yet don’t let that undermine your confidence; just ensure you answer all the questions and then go back to the questions you flagged!)
The presenter has (is?) affiliated with the WOCNCB The information could definitely be updated, and comparing the two review courses, if you were choosing only one, I would recommend the webwocnurse offering.
Going through each domain outlined was a great way for identifying knowledge deficits.
I found reviewing notes from past Rainier Wound & Foot Care Conferences and study notes for the AFCNA CFCS certification exam was invaluable. Reviewing the text from my initial foot care course in addition to selective internet browsing on Google enabled me fill in the WOCNCB with outline further in-depth knowledge. It is possible to focus on this alone for preparation though you would be left wondering about what the question format might be.
$54.40 paperback ($63.69 Kindle) or borrow from library
Wound, Ostomy and Continence Nurses Society® Core Curriculum: Wound Management 1st Edition
– Chapter 26 Foot and Nail Care – 28 pages
I am studying for the CFCN test using Dr. Overstreet’s “Footcare for Older Adults” video and the book “Nurse Foot/Nail Care, 250 Questions and Explanations” but feel like I could use more preparation. Of the many tools you listed, do you have one that you think would be the best choice? Thank you!
I used WOCNS Wound Management Text Core Curriculum Wolters Kluwer It has one chapter on Nail and Foot care…then I studied the chapters on Neuropathic Disease. Some things I remember…Know who to refer too….know ABI..also the types of lotions. My friend thought the Practice Test, WOCN had helped her. Happy to hear you are interested in Certification.
Are there books or specific websites to learn about foot care certification?
LENORE. There are two certifications now….WOCNCB and AFCNA. They each have different mandates to take the exam. I think if you google them, you can get the specifics.
I’m preparing for an ABI testing certification exam and came across this reference – excellent learning and review! (Inspiration to research further updates.)
Does anyone know of clients who need foot care in the Columbus Wisconsin area?
I don’t think you just get clients. Get out there and do a little sales & marketing.
Foot care patients are everywhere.
So easy to build your company/business.
First: you need a good business name and register your business with the state. Once you have developed your routine and have your tools and supplies then you are ready.
Design an attractive business card and sit down and write up a flier. Keep it simple and 1 page.
Who you are. What you offer. Your contact info.
Do your homework. How far are you willing to drive. I go about 20 miles. Look up all your Podiartists and hospitals and clinics. Look up all the senior centers and senior buildings.
Make a list. Start with your own clinic and Doctor.
Remember that doctors and Podiartists do not want to trim nails. Get your cards and flier to them. Home care agencies will also love you and send you referrals. Amazing what a flier and 6 business cards can do. Cards are cheap.
Always best to make a follow up phone call about a week after sending or dropping off flier & cards.
Social media these days is super great to. We have 3 ‘town Facebook sites where people place things for sale and ads. Go for it.
I do recommend 4 sets of tools and and professional supplies.
If you need any coaching please don’t be afraid to call. It’s my mission to help other RNs be successful.
what do you think about have a fun day with foot care health fair
Thanks so much for feedback.
Have a well established client base in Portland OR area, desire certified Footcare Nurse with own practice to see clients on contractor basis to cover increased census, when I have to be away etc. I provide clients & NP provider support. You get to keep almost all of the fee which depends on type of location/ contract w facility etc. Generally this should yield about 50-60/hr. This could be a great way to supplement your current business and potentially grow as I am happy to share referrals. Am also willing to precept someone into the role. Please contact me at 503.888.0390.
I am looking for someone to take care of my Mother in law’s feet she has club nails. She is diabetic and while in Colorado seeing her daughter a nurse came to her home and was wonderful. She lives in south Carolina Do you know anyone near us that would be able to help my zip code is 29681
Call a wonderful Footcare nurse there.
Her first name is Eno
If she can’t help your mother in law she may know someone who can.
wanting to move up to Washington State from Oregon. I have an Oregon and Washington RN license, and have been doing foot care in Oregon for quit a few years. Any tips on how it is done in Clark County?
Sorry type o
Life is good
Helping others with info & support about what works. What doesn’t work.
So many just struggle
This site helps many.
Yes you’re such a inspiration. I need help with marketing.
Your local Small Business Administration is a good resource hub, SCORE mentors are very helpful and local community colleges sometimes have affiliations with SBDA small business development assoc. They have a specific class on marketing.
HIPAA not HIPPA
Yes,there is little or no information on foot care for Nurses in the Board of Nursing in my State, so I have purchased malpractice insurance for my registered business.
I’ve been working on starting a Foot Care Business in Oklahoma. I spoke with a member of the Board of Nursing and she directed me to their website for Certificate of Licensure for Incorporation. I filled out the form and sent to the board. I’m unsure of the purpose or requirements. I have studied the State Health Departments requirements of corporations for licensure. I never found anything that looks like it would pertain to an in-home foot care business, until I finally read definitions of “Home Care” on the States website. Have any of you been licensed or regulated by your State Health Department?
no. incorporated as a LLC with Wa St Secretary of state. I think home care rules and laws cover home care agencies, with a long list of licensure requirements, so that agencirs can be reimbursed by Ins, Medicare and state insurance for low income. state boards might not necessarily be the best ones to ask about private businesses. I’m registered and carry appropriate Malpractice insurance under routine care provider
home care agencies are the ones who provide hourly care, like for ADL’s for older adults and have the requirements to do so for reimbursement.
I just started a brand new Footcare business as I sold my old ‘9’ year old Footcare company. I couldn’t stand total retirement but want to work part time.
I registered with the state as a private business as a ‘Sole-Propriatorship’ I also have a good malpractice insurance policy
I don’t work for the board of nursing. I work as a private independent business. Through experience, research, and study I run my company top notch and all the same HIPPA laws and policies like a home care agency. I’ve written my own policies & Procedures.
I am paid: Cash, Check, or Credit Card.
I keep all receipts and expenditures and income carefully and the beauty of Sole Propriatorship, no extra work. File taxes at the end of the year. Simple. Easy. Just keep all your receipts. If no receipt you cannot prove it therefore you cannot deduct it.
Hello Kathryn I wonder if you and I could speak on the phone? I am trying to get my business here in San Diego up and running, coming into some issues with which insurance is best, if you could call me I would love to have a conversation. And thank you for ALL of your generous info sharing on this site. Sincerely Jen Dulmage my email is Jdulmagexo@gmail.com if you could email me I will give you my phone #. Thanks
Happy New Year! It’s nice to hear of your modified career plans! As a retired nurse, you are now free of the State Nursing regulations. Though you have registered as a Sole Proprietor, can you share how you managed to sidestep the state’s Cosmetology Board licensing and permits for home and Florida? I may have an opportunity to provide foot care in one of the southern states in the near future and I was hoping you may have information on this.
I am registered as a LLC (limited liability) with the state, keep my nursing license and foot care certificate current and carry good professional liability insurance. I am a single entity (one person business/no employees) and do not have contracts with other entities, so I do not require an EIN (employee identification number). I only take private payments, no insurance or Medicare/Medicaid. I have a separate savings and checking accounts to keep things differentiated from my personal bank accounts. I keep records of all my income and expenses and report the information for tax purposes to my CPA. I have a wonderful attorney (my husband) who happens to be very well versed in law pertaining to my business and health care, as well as an excellent CPA who also knows his stuff (I’m in Minnesota). The most important thing to protect my little business (the way it is – single entity/no employees/no contracts) assuming my license is in good standing, is having and maintaining my professional liability insurance. Hope this information is helpful 😊
Thanks for all the info. I was just concerned that I might be required to obtain a state health dept license of some sort.
Generally the term incorporation refers to the type business model you register with the State. Options varies by state but you can be licensed (primarily for tax purposes, fees and liability insurance determination) as a Sole Proprietorship, A Limited liability Company or Corp or be Incorporated which is a much more complex level of business that probably won’t apply but always …always check with your business Attorney and Tax Accountant as to which model is best for you. The coming thing is Hybrid models that are ‘for profit’ but act like a Non-profit – not in every State. Once you figure that out, you can apply for appropriate business & professional liability insurance. (I found the best rate for Occurrence professional liability and business liability policies to be with CM&F). As for the State Board, generally they want to make sure you are practicing within your Scope. In my State of Oregon, they simply look at your credentials and advise to see if your business fits within the Scope of Practice as your are currently licensed and certified. Again… check with your business attorney. As part of setting up your business with the state you will no doubt have to compose your Articles of Organization. You will need this to set your business up with the State and whatever Bank you choose. As a word of advice- see if your local credit union supports business accounts. If you go with one of the “big guys” they usually require substantial minimum balances. My credit union does not have such a policy and I even got a line of credit. Hope this helps. The NOLO how to books are great resources for setting up your business. As you know, folks NEED MORE Footcare businesses out there – sp ALL the BEST!! Mary
I came across your website and I have to say that I really like it. Would like to ask you some question..I graduated as a foot health practitioner in London and now moving to New York, do you know if my diploma will be recognized?
An interesting opportunity has come my way. I thought I would share it with you and get your feedback. My friend is purchasing a Nail Salon that she has been working in for some months now. She has a medical background and knows how important it is for folks with diabetes and circulatory problems to not have pedicures done by nail technicians and that is in addition to the fact they are not suppose to do it. She has witnessed other nail technicians, after the client informed them that they have diabetes, continue on with the service. My friend has taken a stand on that issue and has reached out to me to provide foot care services in her salon, by appt. only. I applaud her for caring about people more than money. What are your thoughts on this?
This is great, Kudos to your friend for recognizing and identifying the need to have a nurse services patient’s feet with diabetes.
I would think one of the most important aspects of this is to be very careful and get the correct malpractice insurance. For yourself and for your business. One thing that Julia stresses is policies and procedures, procedures, !! written down and available for review. Those are the things that come to mind when looking at your post
My clinic as well as other RN team members have rented a small space in a salon. Mine was a private room that used to house a tanning bed. Perfect size and privacy.
I built my clinic up and was doing 10-14 Footcare clients a day in there.
I of course booked my own clients for my clinic days. The salon had a front desk and I worked closely with the salon. They referred people and calls to me and my clients needing products and hair appts I referred right there to them. It was a win win situation and was fantastic.
Renting your own brick and mortar is not financially good. Way to much overhead. Partnering with a salon or medical supply store that has a space is ideal. Smaller Chiropractic offices sometimes have an extra room available.
I never had an electric bill. Heat bill. Rent. I paid a per person fee of just $5.00 each to the salon.
Way less than renting your own brick & mortar.
Paule and everyone else in this forum…I am curious to know..by what authority is it stated that it is forbidden for a nail technician to perform nail care on a diabetic ?
OR is it the policy of your friends salon, NOT to perform work on diabetics?
Is it a true infraction..stepping out of their licensed scope of practice? Or just an ethical moral decision. AND is this particular to the state in which you live? WHAT state are you in?
The reason I am asking is that here in San Diego several months ago on Indeed.com(a job posting site) Kaiser Permanente was looking for cosmetologists to hire them to do diabetic and routine footcare under the “supervision” of the RN.
My first thought was “oh great there goes my client base potential” but, also, the indignation that Kaiser would cut corners and money by employing a tech who is not even close to an RN in training. Just because they can be overseen by an RN.
It really undercuts us RN Footcare nurses here in the community because if someone can go to Kaiser and have it done for free…well..you get the picture. In terms of numbers, Kaiser is huge in San Diego…and rapidly growing. Also a client who goes to a hospital to get their footcare probably just automatically believes in the integrity /legitimacy of the service. Perhaps after the fact if they a crappy experience they may come looking for us, but if it is adequate they could combine it with a MD appt, or pharmacy run at Kaiser etc.
I believe Cosmetology is licensed by The California Board of Barbering and Cosmetology. It looks like Nail Technicians are NOT allowed to do anything that penetrate the skin, or affect any living tissue. So I do not know how Kaiser gets around this. I need to compare this standard to our CFCN scopes standards.
Paule please share your thoughts, and congrats on furthering our cause with integrity!!! I cannot wait for feedback from everyone. Thanks
I’m going to be attending Dr Julia Overstreets workshop this week and was reviewing what I would need for certification so came across this site. Are there really 260 foot care nurses in Colorado? Seriously? And the rest of the states have one or two if any.
Yesterday I performed foot care services for the first client in 3 years to ask for proof of my certification. I was very proud to do so. During our phone conversation the caller asked me if it would hurt? I told I was known for my gentleness. When I arrive at her home (do all foot care in the home) she told me that she had been seeing a podiatrist, but that his office closed. Her right great toenail was very thick and she wanted to know how I was going to take care of it? I explained that I would use a sander to thin it out. The client said, “You mean you are not going to cut it?” I explained to her that there was no need to cut it. She went on to tell me that the podiatrist always cut it. I was thinking that perhaps to save time , but I did not say that . I coaxed her into giving me a try and told her happy she would be and how painless it is. She finally agreed. She laid back in her recliner and we chit chatted while I worked. The client had already trimmed her other nails that had no problems. She could not believe how beautiful her nail looked and without pain in the comfort of her own home. She was so delighted she asked for several of my business cards to give to friends. She had no problem paying my fee to take care of one toenail and of course the awesome foot massage!
Thank you for your lovely and clear description of your Footcare case. This is exactly why you will be susscessful and enjoy your business happy customers and rewarding job.
The Podiartists do not have the time and we are the ‘Alerternative to the Podiatrist.’
Painless. Make those nails look and feel better than they have been in years. These are both phrases I use
Education for the client during their session and tips for them. Encourage then to book with you every 2-3 months. Most of mine book about every 2 months. Tell then every session their feet will improve and be better and better which is true. I also tell them that left untreated they will grow thick and bad again. Most are so pleased they go ahead and rebook and look forward to your next visit.
For a major debridement or for instance I tell them I’ll be calling them back in the next day or two to check on how the toe is doing or how the feet are doing. Step up and little things are very important to people and they know you care.
Like you mentioned, they tell their friends. Give them an extra business card or 2 or 3 for their friends. ‘Cards are cheap and key to others getting your name & number.
I ask them if they will be seeing their doctor in the near future too. Ask that they take their doctor a card and mention your business name. About your wonderful care.
There is no way a doctor knows you or the quality of your work unless they see it. To get referrals from the doctors you have to build a great reputation. Dependability and quality expert service your patients can depend on. We know a doctor does NOT want to trim toenails. If they have a great Footcare nurse owned business available to them they will give you those referrals.
Clinics in your area of service should all have an intro letter or flier and a bunch of cards. The calls come in. “How did you hear about us?” My doctor gave me your card.
This is exactly how I built my company to #1 in Minnesota to 8 clinics. A Team of 11 Footcare RNs all independent contractors and thousands of customers clinic and inhome.
You can do it to! What are you waiting for?
YEP there IS an APP for this thank goodness! Try going to your app store and check out a really good one by the British Association of Dermatologists. It’s FREE!! The title: Dermatology: Medical Student Edition. I found it in my playstore and it shows 10K downloads.
A client asked me to explain why she should come to me for foot Care instead of her podiatrist who she sees every 2 months at the local senior center for toenail trimming. Does anyone have a good response?
Easy.. “If you are fortunate enough to already have a relationship with a Podiatrist then I can see no reason to interfere with it. I meet the need where people don’t either have access or funds to pay for a Podiatrist. Enjoy!”
I would not do it in an unkind way because in my mind it is the truth… your client is the exception and not the rule.
Footcare nurses in business are the alternative to the Podiatrist. The doctor has basically 5 to 10 minutes time to spend with the patient to trim often times terrible huge nails. It cannot be done in that short of time. We often spend 30-45 minutes for a session with our clients. A complete job of high quality footcare transforming those feet to look and feel good again and most of us end the session with a great moisturizing lotion for a short massage which they all LOVE.
Our sessions are painless. Rarely a drop of blood.
The 5 minute chop job of the Podiatrist often is painful and can need several bandaides. Many clients and family members hate to see Mom go thru that and often I’ve seen that it looks like nothing much was done by the doctor.
When clients realize the quality of our service and the cost so reasonable they don’t go back to the doctor for Footcare. They tell their friends. Families tell their friends. Your business grows beautifully and happy customers.
So easy to build your company to a very successful small business.
Hello K. can you tell me what you charge ? In what form do most clients choose to pay? Thanks.
Cash, Check, Or Credit card.
This is a complete Footcare session in their own home.
Thank you Kathryn.
Would you be able to share what the range you pay for your RNs. ? Are they paid by the visit or by the hour? As an independent business person in my rural community $45 is about the max I can charge and that is a range of about 15 miles one way. So my income per hour ranges about 23 $ to 24$ after expenses. My RN colleagues in the Seattle area charge up to 60 $
They own their own business and paid a fee to join the team
We all provided the same cares..
Charged the same.
I sold the company and tried to retire. Couldn’t
To board and I love my work.
Now I have my new company and will work part time.
I used to do 10-14 patients a day. No more.
I’ll do only private appointments 4-6 per day 2 day a week. There just isn’t anyone providing this service in my area.
I think you are right on track with your pricing. I only recently went to $75.
At $45 per visi I got so many $5 or $10 tips that were added on to my fee.
A lot of discussion recently about tips. People that are pleased and happy with their service love to give tips. It wasn’t uncommon at all to get $5 to $50 per day in tips. That’s the clients choice and shows their appreciation and gratitude for your wonderful service. I always sa, “Thank you so much, that is much appreciated.”
It’s from the heart.
Another important reason I think for visits to a foot care nurse is ability to evaluate feet, shoes, walking, pain and medical issues that might affect feet and Mobility That provides opportunities to refer to local Podiatry for follow up, as well as establish that you have professional assessment as well as toenail trimming skills. Ultimately resulting in more direct referrals to you
I have a successful business in the Green Bay/De Pere area for over 5years and am looking for someone with foot care certification who is interested in working with myself and another nurse who will be hoping to retire in the near future. Prefer someone with foot care training and planning on working this area for many years.
I’d live to but it’s too flippin comd there hahaha!!! Good luck with your business. Congrats on expanding!
It maybe cold but wonderful clients!
Good Morning Sue
My name is Reanetta James and I’m in the Michigan area in the process of starting my Footcare business. I wanted to know if you can share any tips, recommendations or suggestions that made your business successful. Any strategies for marketing?
Sounds wonderful. I retired and couldn’t stand full retirement so I started a whole new Footcare company and work 2 days a week.
I’m hoping to find 2-4 RNs wanting to join my team and do Footcare in the South Metro of Minneapolis/ St Paul
Bloomington, Eagan, Burnsville, Apple Valley and surrounding towns.
Much Footcare to be done. Please contact me if questions or any interest.
MERRY CHRISTMAS & HAPPY NEW YEAR
I have tried to retire and have decided to continue providing part time professional Footcare in the area that I reside. We sold our home and sold my business in the north metro of the Twin Cities and now live in the south metro.
I started my new company, Pro Toes USA and have a nice web site. Clients new and old keep calling so many des pirate for a foot care nurse.
I still read the blog regularly and see many families friends and former students blogging.
God Bless you all and I wish you much success.
I have a marketing background and started to really look around my around my area for reasons my business is needed. I went to each of the podiatrists in the area and introduced myself and left them with an information sheet of my business and business cards after seeing if I could offer my services. Our podiatrists are too busy to do nail care and welcomed me and I in fact have two offices that give me regular referrals.
I also went to local assisted living and senior apartment complexes to see if they could use my services. I and another nurse have been able to develop over 8 “clinics” that we do regular foot care at.
Our city has the local resource of Aging and Disability Resource Center and through giving presentations on foot care I am now listed as a resource for foot care in the area. These folks are often with limited resources but some are my clients after they realize the benefits of my services.
Finally I bit the bullet and advertised at a local restaurant on their placemats. This place is close to my home and has many senior customers. In fact they go through 60,000 placemats in less than 6 months and it adds up to my paying less than 6 cents per mat to advertise! This is another resource for referrals.
Last of all I “gift” all my clients who give me a referral with an inexpensive glass file after I see the new client. I have also given files to many staff members that refer me. I’m hoping this helps you get out there to sell your business as you are the best person to tell them what a great product you have to offer!
This is exactly what I have done and we got so bust that no formal advertising is necessary. A small business needs to keep up with demand and have a reputation that clients and importantly the referring doctors know they can depend on you providing the very best professional foot available out there.
Keep your service the best and go the extra mile to make them want you.
A happy customer tells their friends and do suggest to them to give feedback to their doctor about your great Footcare.
You are spot on. My clients regularly use me I believe due all of what you said!
How did you sell your business?
Sold my business lock stock and barrel.
One of my students purchased my clinic. All tools, supplies, autoclave. Approximate 500 clients.
We sold our home and now are settled in our new home. Totally different area and no foot care nurses.
I’ll develop my new company. Build a new business and keep it part time for me.
People are begging as well as the doctors as they know me from my previous company I sold.
I’ve actually sent you some of my clients that moved to Green Bay.
Congratulations and good for the new owner. Enjoy..both of you!!!
Hi Katheryn, I just found out the Avon foot soak has been discontinued. Do you have any other suggestions? Best wishes to all for a Happy, healthy and successful 2018!
Dear Katie, you give me great joy at this beginning of the year. I read your last posts when you communicated that you were leaving. Now I see you new back again and it great to continue counting on your experience and support. We greet you from Orlando, Fl. ,as well as Dr. Julia and other colleagues who venture into this field. A happy 2018 for everyone.
Ramon and Dafne
Thank you lots.
Headed home from Florida right now and will be back for 6 additional weeks beginning Valentine’s Day thru April 1st.
I did foot care on 4 Florida clients as well as custom orthotics for 2 people.
So many are getting foot care from the little nail salons and the people told me horror stories. Infections and filth. We have chosen central Florida for our home base to live Winters each year. I’ll have several educational seminars on Foot care and foot & toenail disorders as well as fitting and selling Dr Comfort shoes and orthotics.
Part time. I am willing to work 2 days a week.
Hard for me to retire. I love my work.
Happy New Year Dafne & Ramon.
Hang on. As you do nails and they are ALL different you may change back and forth…Bur, Sanding Disc, and coarseness may change. I even used a coarse. CAP bur on very thick nails this week and I really was happy with it.
Merry Christmast to everyone!!!! HELP, I need a template or guide for personal contract form with LTC facilities that want me to do their nail care. Anybody, please help if possible. Thank you ALL and grateful to be a part of this wonderful group. (Cert coming very soon and will be doing some free care at local homeless warm shelter set up for Winter) Thank you all again and Shout Out to Dr. Julia!!! (do you want my sanding discs? I am a burr type of guy!!! Lol, not a single “boo-boo” since last Hands On)
Merry Christmas to all!! 🎄 🎅 🎀
Happy Holidays! Thanks for all your support.
What a great discussion on Infection Control! I thought that I’d help out by posting a “not-so-brief” review of the issues and literature. As you will see, the important thing is to choose a solution that appropriately protects your patients/clients. I challenge you to do the research on the solution that you are now using. You’ll see how toward the end of the post. You’ll be able to get the manufacturer’s data on biocidal effect and soaking time to achieve it. Researching the manufacturer’s data is the only way to justify your choices. Once you find the data on-line, print it out and keep it in your “Practice Guidelines” file. You have one of those, don’t you?!! That’s the best and most professional way to ensure that your foot care practice is literature based and follows “Best Practices”.
You’ll find the post on the new third tab on this site. “Best Practice Guidelines”.
Enjoy and Happy Holidays to all. Keep clipping!
I am logged on as Malay’s Yorkies but my Name is Mary Carraway, RN CFCS. Of Foot Nurse of Birginia, LLC
I have been using Cavicide for several years on the road and have had no issue’s.
Nippers, etc that come in contact with intact skin only require a low level disinfectant.
Refer to information provided on the AFCNA website-infection control.
Barbicide…is rinse after use…soak 10 minutes …rinse and dry.
Barbicide is a low level disinfectant.
When I first came to South Africa and started to look for something “cidal” that I could use to disinfect my equipment, I first started at the local clinic. What I discovered was a complete misunderstanding between something that is “cidal” and something that is being used widely that is “an enzymatac detergent guaranteed to remove 99.9 % organic material”. I was horrified and actually wrote to the company to clarify its purpose. Of course It turns out that it is only designed to clean off organic material and then a second process of disinfecting is required. That step is still not well understood and the idea of two steps often not done. I had to really investigate and finally purchased a medical compound from Johannesburg that supposedly is what I need but it is a powder and very hard to dissolve.
Would love to hear more about your work!
I use Metricide OPA plus. It is a high level disinfectant which is what you need. After washing/scrubbing/drying your tools, place them in the disinfectant for 12 minutes. Then rinse and dry again. The disinfectant is good for 14 days after poured, but must be tested before each use to confirm it is at the proper concentration.
I am actively looking for a quick acting disinfectant for nippers and nail files. Since we need to reuse the tools every half an hour I would like some suggestions what works fast and can be used to disinfect tools.p
Today is the first day that I have read this blog. Enjoyed it very much. I have been a CFCN since 2014. All foot care services are rendered in the home. I must say the part of my practice I enjoy the most is the establishment of relationships between me and my clients. Periodically, throughout the year, I will offer 15% off in my advertising campaign to attract new clients. When I do that, I also give established clients 15% off. It shows that I also appreciate my established clients. During the holiday season some of my clients have been inspired to give me gifts and I would not think of rejecting a gift from the heart. I do not feel that it is degrading to my profession in any way. Having been a home health and personal care nurse (owner), the reason for not accepting gifts is because Medicare and Medicaid regulations prohibits it. Why? Because they think that could be consider a bribe and increase the risk of fraudulent behavior.
Welcome to the site Paul. Where do you reside? I would love to speak with you 1:1. Thanks. JenD
Hi Paula, Great hearing from you! I agree with you totally about accepting gifts! Most of my clients love what we do for them and feel great about the service we provide for them coming to them so they don’t have to travel along with the footcare, they just want to show their gratitude! There is much Joy in giving! Love what I do and the wonderful mission I have been so Blessed to provide!
Busyness is going well and has kept me occupied so I’m just catching up on this blog. I love how easy this site’s new format is to navigate!!! Gratitude and Kudos to the web manager!
I’m currently studying for the WOCNCB CFCN exam and learning lots of fun information I was unaware of. Using precise, professional terminology in documentation can be a challenge yet it is essential to practice to communicate effectively with our interdisciplinary team members. Always on the lookout for assistive tools, I found this reference that offers some guidance with description of skin conditions: http://www.npstudent.com/derm.html It is certainly increasing my vocabulary!
Perhaps others may find it interesting…and maybe fun too.
“DESCRIPTION OF SKIN CONDITIONS
When describing the presentation of a rash, it is best to use the following equation:
distribution/configuration + texture + color + secondary changes + primary state”
Facial/Truncal/Acral (<medical Definition of acral. : of or belonging to the extremities of peripheral body parts. acral cyanosis ; 0 )
+/- Satellite lesions
As I remember the Exam…there were a lot of questions on knowing when and who to refer too.
I have received clients via the AFCNA website. Family members searching online for a foot care nurse for a loved one have come across the site and gone from there to contact me. One client, a retired nurse, found me on her own 🙂
Feet feeling good….Assessment, Social interaction should be part of the Service..Why does it deserve a tip?
My 40 $ fee per visit is what my local market will support and of that, I probably clear 27$ per visit after factoring in travel time, accounting and banking,, scheduling, instrument disinfection, printing, attending CE, marketing and taxes. Nurses for too long have felt they are in the profession to be caregivers and have undervalued themselves. My clients and families realize that I am an independent business that provides a quality foot care service. I don’t think accepting tips diminishes the role of the profession if we are looking at these endeavors as a business.
Great to Hear…thank you!
I’ve often wondered about why someone would. I AM a home health nurse and we are absolutely not allowed to accept gifts of any kind. I wouldn’t accept a tip for a nail care bisit either.
How many nurses are taking Tips from clients for doing Nail and Foot Care? Would we take a tip from a patient in a hospital bed? We are not Manicurist…..We are Medical Professionals! I hope. I know I would not to be considered on the list of Nail and Foot Nurses who take tips. I think it is embarrassing!
I have never accepted a tip. I feel it is unprofessional and moves us to the status of a restaurant server… as we are really trying to elevate what we do to the professional level it deserves… a hug and thank-you should do the trick. I certainly don’t tip my physician.
I’m interested the demographics of where successful foot nurses are practicing. Could you share if it is: rural/big or small city,
# of Podiatrist in the location
economic status of those who pay cash,
main source of referral
# clients in your practice.
That’s a lot of information so thank you in advance for your responses.
It would be nice to have a national data base resource for this information.
Happy Thanksgiving all–lots to be thankful for!
I provide in home services 2 county rural area, with population centers within 15 miles. We have 2 DPM clinics w/ 5 providers
Economic status for seniors in this area is a range, with many on state Medicaid and middle class. 40$/visit is what the market will bear
Referral sources: Area agency on aging; DPM, Home health/hospice;(2) Assisted living facilities (3)_, adult family homes, (9)
120 clients, 5 is the average per day
I am just starting out and if I go to a seniors center to offer services who is the person to contact for permission typically? Are these places typically ammenable, and if clients are candidates who pays the footcare nurse? Simple logistic questions. Thanks
I just checked the AFCNA.org web site. You joined as an “Individual” member. All you have to do is change your membership to “Business Owner”. That’s when your information will be searchable by the public. There’s no charge for this! Just go onto your listing and add the information that you’d like to show up to the public. Business name, contact info, areas that you cover, maybe a picture, etc. Then check the box to change your membership type to “Business Owner”. That’s it! You’re immediately listed for the public to find.
Thankyou I will change from individual to business.
I use Jan L
I just wanted to know ideas for marketing and if you can share a example of your marketing packet.Also what’s your average patient load how many patient you see per month, per week, or per day.
I provide in home care within 2 small, rural counties, mainly in the more populated parts of them in a 15 mile radius. I developed a 9 x 1 1/4 inch rack card with logo on one side, brief description on the other. Red and orange, so it stands out. Biz cards in same format. Market to the local Area agency on Aging; Requested shadowing local DPM’s for additional training to develop relationships/trust; Delivered brochures/cards to local home health/hospice agencies; visited local Adult family homes/Assisted living. Now have 120 clients all seen in their homes, averaging 5 day. Income level supports 40$/visit
How can I get my name and business info on the list of providers? Thanks.
Does anyone have a suggestion for buying good quality yet affordable tools?
I say find a good provider and stick with it. I had someone contact me that thought what I paid was too expensive. She found a Bur for 5$. I think both her and the clients will feel the differences. I think a good experienced foot Care nurse can probably feel the difference between a new Bur and one that has been used for a year. I still use the Dremel 7300. But I would certainly purchase a different drill if I had my own business. I only volunteer my services and at this time can not justify the purchase of a better one. I do feel both the nurse and the clients will fill the difference with a good drill. Keep in touch. Let us know what you decide. I know several…nurses…each using a different drill and each love what they use. Also will Say…the Ceramic Bur is coming into use. Had one nurse that is all she used. I do have two ceramic Burs, but have not used enough to recommend yet. If I were getting my equipment together as a new business, I certainly would have one. I think staying current with new equipment and Care is important.
Lois thanks for the input, however, I am looking for specifics..does anyone have a proven provider I need to purchase tools for a business, that have quality, yet reasonable? I am curious to know what y’all feel is reasonable to spend on one set of tools that we would typically need for one patient. And then I can go from there. Thankyou.
I also have purchasespd from Ranier.. I like PediFix for creams and other foot care products. Lois
I use JanL frequently too as both they and Ranier answer any questions you may have. Lois
I also do not buy a “set”. Just a specific Bur, curett, Knipper I want.
Hi Lois, Happy Thanksgiving to everyone!!!! Yes I guess once you have all the needed tools at hand for that patient, it will comprisewhat I describe as one set. Granted some are reusable etc, but in order todo at least one client….what would that cost? Thanks.
I also use a sanding disc,
I agree… as a volunteer the Dremel remains the most affordable but I have purchased my clippers through Dr. Julia. I use the double jointed clippers (which I did not learn on) and now have trouble with anything else.
I agree. Everyone has their favorites!
Hello everyone. I am curious to know if anyone has ever received any business from having our names on the List Of Footcare Nurse Providers from this site? I cannot imagine the general public would be browsing here? Perhaps I am way off base?
Yes, i have received several referrals from this site. Mainly people that are new to town and don’t have an established doctor.
Thanks for respondingSuzanne. May I ask what the going rate for routine footcare is in your neck of the woods? Jen
I have received inquiries and referrals from the AFCNA site. Adult children searching for in home foot care of aging parent(s); someone wanted to know the difference between podiatry and CFCS; some wanting regular care, one wanted a one time “emergency visit”. Because of my caseload, I need to be selective about the in-home cases I accept. If the client is mobile I try to direct them to the nearest senior center that provides the services of a professional FCN, or refer them to a FCN colleague. I like that the site is geographically oriented. All of my contacts have been nearby.
Thanks for the info:) I am in San Diego andtrying to determine a asking price for a home visit? Any thoughts from the group? I want to represent us well, butit must be a win-win.
$65 for a home visit
Rebecca thanks for responding. Jen D
I currently charge $50 for a home visit and will drive up to 15 miles from my house with no additional fee. I also go to some facilities and senior centers and then I charge $35. I set up in a room and the patients come to me. I can see 10 per trip.
I was to shadow a footcare nurse in Canada for one week. She also set up in the seniors center. Volunteers checked people into the waiting room, washed her tools prior to sterilizing. She had a similiar payscale. Footcare nurses are so mainstream in Canada, so I am wondering if anyone can share some best practices for acquiring clients here in the US?
I charge $35 for home visits and travel up to 15 miles. I want to remain affordable for those seniors who have limited income. This also leaves room for clients to tip me, and many who are able do.
Thanks for sharing.
I have said this before……as Medical Professionals, why would we take tips? We are not manicurists. Let’s keep our professional care. separate and special?
I understand your point about tipping. However, I guess I am trying to allow for some grace in my pricing. Many elderly clients like the feeling of giving me more than I ask, and by providing them room to do so gives them the opportunity to feel good. Maybe I’m wrong, I don’t know.
What is grace in pricing? A medical Professional is a medical professional….should a homecare nurse, hospice nurse, wound care nurse accept tips? Why are we different?
I agree, Michelle. My clients who do tip are very grateful for how good their feet feel after nail trim, the professional assessment and social nteraction.
Some are home bound and appreciate the extra time for the Foot Care and some social time for a cup of tea. It is a pleasant break in their day that can be long and lonely. Some still like to give back when they can.
I also have accepted tips. My prices are reasonable and if they feel the time I spent with them , the care for their feet, suggestions on appropriate shoes , going into their homes , it is personal care. I don’t expect it. I don’t refuse it.
I just added a few new forms to our “Free Forms” page on the AFCNA.org site! There’s a new form for providers to use to refer clients to you. And there are 5 new forms that are “Standing Orders”. Those can be used to justify and validate your procedures such as: gentian violet for macerated innerspaces; care of heel fissures; ingrown toenail care; and shoe inserts. I made them mostly for clinics. It allows the clinic nurses to do the work without physician orders for each patient. But for those in private practice, I think having this sort of documentation (Protocols/Guidelines) puts you on a “professional standards” level with clinics. We’re a new nursing specialty and still fighting for acceptance in the medical community. Keeping and demonstrating professional standards is critical for acceptance as well as for legal accuracy/documentation.
Here’s the download link for these new forms and many others. Enjoy!
Dr. Julia. Than you for the Standing Orders addressing the 5 areas that I frequently see in my work. I’m updating the Policy / SOC manual in my private practice in addition to the manual I created for Senior Center Clinic where I volunteer. The examples and color pictures you provided are excellent; and your explanations are straightforward and thorough. I frequently have nurses dropping by asking about volunteering at the Edmonds Senior Center. These Standing Orders are a welcome addition and help explain the scope of practice of a professional FCN in the community, I always appreciate your words of wisdom, and look forward to the next installment,
Yes….what would we do without Dr. Julia. I wish she was not so far away. Would like to go take her class frequently. Lois
Thank you for time and energy you’ve dedicated to developing such a great resource of forms!
I attended the Foot Care course in Wisconsin last Spring. I’ve been doing home health and want to make a switch to a Foot Care Business. I’ve seen many suggestions to check with state BON for any regulations. Oklahoma has no Nurse Foot Care businesses, that I can find. The BON site has no mention on the subject. I know from past experiences that they will not answer inquiries. Are there any states that have regulations prohibiting a foot care business?
Check with the Oklahoma St Nurses Association to help you interpret your state’s practice act. Most allow a nurse to work within their scope of practice, that includes providing routine nail care
They don’t answer inquiries??? What the…?? That’s ridiculous. That’s what they’re there for. Arkansas and Mississippi have a link to ask questions and someone specific to answer them. Maybe show up in person if it’s practical? Mississippi has a specific position statement on the subject of nurse-performed foot care. Arkansas has a decision-tree model. Kosher in both states. CMMS considers routine foot and nail care an ADL, so it does not require a doctor’s order.
Oklahoma has a dcision-tree model, as well. The BON does not post an email address, only a phone number and physical address. I have left phone messages on another subject and never recieved a response. I have heard from other nurses that it is best to appear in person.
Thanks for the suggestion. I sent an e-mail to the Nurses Association. They replied with contact information for a representative of the OK Board of Nurses. I actually was able to speak with a member who specializes in Nurse Practice. She was very helpful and assisted me with my vision of a small buisness. She helped me navigate what is acceptable from the BON in a nurse owned practice. I now need to formulate a plan to obtain DR orders on all clients. I will definitely persue this plan.
Why do they require doctor’s orders?
Nail care is considered a treatment in Oklahoma, so orders required. Most states it is considered ADL, I assumed it was the same in OK. I’m glad I talked with the BON. It will slow down my first visits, but I’ll get a process stream lined eventually. have checked out the forms on the site and I’ll make good use of them.
Good for you!! That’s awesome. Keep us posted.
Dr. Overstreet has a Referral form on her site. All you have to do is get your name put in there.
I am a CFCN in the Midwest and work for a health care facility. We have offer a “cash and carry” community nursing service for about 17 years now. However, there is some questions about Medicare billing at this time. We don’t currently do any billing, but we do have people who have Diabetes and Medicare come to us, due to their proximity to the clinic site (we travel to churches, assisted living centers and rural senior centers). We always let them know that a similar service may be covered by Medicare or Insurance at a physician or podiatrist, but they choose to come to us. Do any of you see patients with Diabetes? Any Medicare compliance issues?
As I understand, you have to be a licensed provider to meet Medicare reimbursement, either as a DPM,or home health working directly under a HCP orders to be reimbursed by Medicare. As long as you refer back to the HCP for any complications you should continue to provide your services. My clients are all private pay, tho some choose to go back to the MD.
Pam Pasquale’s answer is correct. Only physicians, advanced practice nurses and nursing agencies can bill medicare or any insurance. Be glad if you’re not able to bill! That’s part of the reason that most podiatrists don’t provide this care anymore. Billing for it is much harder than for most other procedures. LOTS of hoops to jump thru!
Free CE relevant to foot care found on MEDSCAPE: https://www.medscape.org/sites/advances/onychomycosis
You have some good resources to start with. Dr Julia is a good start. I recently got in touch with Janet McCormick who is a good resource http://www.nailcare-academy.com/foot-care-transient-homeless-nail-technician-special-touch/. Katheyn O’Shea poured into me in a shirt period of time when I saw her in Minnesota for 2 days. She has been soldier in this footcare game. Reach out to her. She ran the largest nursing footcare business in Minnesota before her retirement. http://twinkletoes2u.com. If you are on fb Kate Clayton-Jones. These are all women who are clinicians, successful in what they do and want you to be successful to!
Hello my name is Reanetta James. I’m a RN in Michigan. I’m in the beginning phases of starting a foot care business any suggestions on where to start.
u/w Eau Claire has a class in April on starting a business.
Decide on a Name….get business cards….register as a business etc.
I agree that some currets don’t fit well in small spaces. I never use them under the distal edge of the nail. That is usually painful for the patient and most of that debris will fall out as you shorten the nail. To care for the sides of the nail areas I recommend using something like what I call a “skinny” diamond burr in the lateral and medial nail borders. That can help remove nail, built up callus in the area as well as built up keratin debris. Our Canadian colleagues use what’s called a “Black’s File” for this. It’s an instrument similar to the curret but instead of the scoop it has a small rasp on the end. Lots of different methods to address this common problem of “debris” in the nail borders/edges.
There has been a great discussion on the issue of foot soaks in our care regime. Lois and I together have posted a fairly comprehensive discussion below. Please check it out!
Hi guys. Maybe I’m missing something. I need a scoop-shaped sharp curette. The one offered here with the file on the other end is too thick and has a hole in it for some reason. (Sorry Dr. Julia!). The one offered on RanierMed is the same shape. Both are too thick to get under any edge of the nail. So over $70 down the drain so far. Do I not need one? Do y’all use curettes? Should I just not use one?
I agree that they don’t easily fit under the nail edge. I teach that we shouldn’t be using an instrument of any kind to clean out under the distal edge of the nail. It can be quite uncomfortable (or even painful) for the patients/clients. And most of the debris (skin cells, sock fuzz, etc) will simple fall out after you shorten the nail. I’m happy to refund the cost of the curettes! :)) They just aren’t meant for that…
Please someone tell me how you get paid when you work at assisted living facilities. Does insurance pay or patients pay out of pocket. Someone please reply.
All of mine are private pay from families. They are glad to pay. I use self employed app (quicken) to bill.
I am just starting my business, but from my training I understand that this is not covered by Medicare or Insurance. The common method is cash, check or credit card.
The client pays out of pocket. I am able to bill to their room, however.
Let the ALF know you can provide foot care so they can let the residents know. You can’t take insurance because individual foot care nurses are an approved health care agency. Most routine foot care isn’t covered anyway. So you bill clients or families
I use most anything one can buy over the counter…I am blessed with a lot of samples, but that may change some day. Only work at Free Clinics.
Email me…if my comment did not get posted
Hello! I recently attended the foot care class and clinical in Wisconsin which was very good. In setting up my practice, I have a question regarding use of medications topically; tineacides, antifungals, bacitracin, silver nitrate sticks, etc. Having worked in clinics, there is usually a physician order. Is it “prescribing” to apply these without an order? Thanks.
No I will not use any topical without a Doctor’s order.
I do use.
Yes…I have samples I use..also Bactracin And bandaids if knic. Have policy written. The one NO. Is no medication patches on corns or corn solution .
I believe that if a medication is OTC whether it is Bacitracin or Tea Tree Oil is perfectly fine to SUGGEST or RECOMMEND it to a patient. Pretty soon we will be afraid to tell someone to use salt and hot water for a soak. I realize there is a lot of fear about this new ground we are breaking but the more fearful we act the more ammunition we give to critics.
Absolutely no soaking in anything is our policy.
You tell people in Africa that they can’t soak their feet when they have no shoes and their nails are unlike nothing you have ever seen… sometimes COLD water is ALL they have.
Washing for 5 minutes….
I know….try to tell the seniors who have had their feet soaked for years at the county foot clinics that you area going to stop…..I do not know what they will say. I am smiling.
So you are saying that no feet should be soaked?. How can foot care be done without foot soak?. Please someone answer me.
Dr. Julia…can you answer this. I have went to many Seminars….just returned from Baton Rouge…on Neuropathy. ALL say do not soak…there are about 4 reasons why not to soak…but i think you should here it from someone other than me. Foot soaks allow pathogens to get into body easier…calluses become to soft and the line of demarcation becomes less clear. Soaking drys out the skin. I hope this site is a learning tool…not one that we end up not being professional friends. I really DO NOT tell my peers they absolutely can not soak…but try to give them the reasons why they should not. The decsion to soak or not to soak is theirs.
Lois expressed my concerns about soaking very well. All current medical literature including infectious disease literature is very clear that soaking is not medically appropriate or safe. Washing is different than soaking, of course. I volunteer in many settings where it is definitely necessary to wash the client/patients feet. And washing can also be done in a plastic tub with a disposable trash bag liner in it. The disposable liner prevents cross contamination with the next client. Sometimes we wash with something gentle like baby bath soap. That allows us to clean the feet without damaging their fragile skin. Sometimes we need to get serious and use Hibiclens! Clients who initially reject the change away from soaking are persuaded by two things. One is a discussion about all of the “new bugs” like MRSA and “flesh eating bacteria”. “We want to take all steps to protect you”. The second is the assurance of a wonderful, relaxing foot massage after their treatment. Maybe even with botanicals or other pampering lotions.They want their treatments to be safe but they also want to be pampered! They LOVE the foot massage!
I believe it is the chronic soaking of feet that can lead to problems. Having a foot soak every 2 months with lotion applied afterward, is fine. I do both. Seniors who are looking for a salon experience get the soak. Those who are on bedrest, for example, get a cleaning. When doing a soak, however, I do use the Footsie Bath with the disposable liners.
Sandra Miller RN, CFCN
I believe one reason Dr Julia is anti foot bath with foot care is because when we soak feet we are modeling a behavior that she does not want clients to do routinely on their own because 1) they might use too hot water and injure themselves (especially if neuropathic), 2) they might use an unclean tub or basin which could introduce bacteria and 3) they might soak too long/often which can macerate and dry out the skin. After much thought, as well as trying out just cleaning clients’ feet with wipes and talking with my clients about their habits, I decided to keep the foot bath as part of my foot care visits. I came to this decision because I found that nearly all of my clients do not soak their feet between my visits. They just don’t practice that behavior. So, with that knowledge, and with the overwhelming feedback that my clients appreciate the foot bath, I feel comfortable with my decision. I do clean my foot tub with cavicide 1 and line it with a disposable plastic liner before every use, as well document that I do so. And I do talk to my clients who do soak feet (2 clients) about the potential dangers/issues. There is also the issue of soaking and calluses which someone mentioned before. I think you need to use your best nursing judgement for each client situation. Finally, there is also a time issue. It does take time to set up and clean up. Personally, the way I choose to work allows me the time to do this without a problem. But I know I am fortunate to be able to spend more time with my clients.
May I ask where you obtain the liners?
I guess I should qualify my answer in this Foot Care Blog since I amazed at the feedback about soaking. My bad… my memory serves that before I was a foot care nurse I was a NURSE. I have advised and guided patients in many ways they could do care that actually made them feel better. Perhaps I am a maverick but if I actually practiced the kind of mindless nursing that prevents us from suggesting a person might feel better if they soak their feet or teach them how to clean an abrasion and put some OTC antibiotic ointment on it (which saves them a trip to a Doctor that they usually can’t afford), I have used what I have described as sound, nursing judgement. Thank God most of us who have worked in ICU did what was necessary and not what what the Board of Nursing thinks is realistic. However, as this is a foot care forum… I also do not soak feet in Africa prior to giving care but for some people at home… that is as close to a spa as they will ever get.
It is totally out of a registered nurse practice to apply any medications to any patient without a specific doctor’s order. I have clients in assisted living facilities and there are orders on their medical records that allow the nurse to apply any topical treatments. It is a question if one can apply Neosporin ointment if you scratch under the guise of common first aid
Thanks everyone. There seems to be a lot of view points.
Thin nails..Vicks if they feel the need for something…Lambs Wool for maceration between the toes…Education..Education! Keep Dry between the toes..Dry shoes and Socks every day! And so you have not applies any RX
I am interested in starting a foot care business in Florida. I am an RN and have read the nurse practice act and am still unclear if this is allowed in Florida. Any information would be helpful. Thank you, Liz
Have any of you seen this torture device? https://www.amazon.com/dp/B01NANV7VC?psc=1
Check it out–
Anyone going to the Desert Foot Conference in AZ end of November? If you are, it would be great to get together and talk nursing foot care. I’m staying at the Sheraton with another FCN https://www.desertfoot.org/ehome/index.php?eventid=159552&
Start with Dr Julia’s free videos! Lots of great info. Then put together a basic kit and start practicing on friends and family members. It is the best way to build confidence. There are classes offered if you are interested in certification.
I want to learn more about foot care sine I’m an RN who have family members and church members who are diabetic and elderly. I would like to provide basic foot care to help them stay well and feel better. But, I don’t know where to start
U/W Eau Claire Continuing Education..7158363636 or google and see information. I went to the class several times…a very good start…..then also Dr. Julia Overstreet..went there several times….can google that too. I have went to others, but these two, you get the most Hands On experience.
Of course… Dr Julia changed my life! Rainier Medical. You are on a website that she founded as well as the AFCNA… she is the pioneer of these kinds of courses.
Any recommendations for a foot care training course for nurses?
U/W. Eau Claire Continuing Education Has a class in Oct and April. Google for information. Diadactic and Hands On
Is there a foot care nurse in Wenatchee, Washington area? My hairdresser (who lives in Scappoose, OR) has a mother who is diabetic and recently broke her shoulder and upper arm. She is in need of foot-care. Thanks, Nancy Forman
I live in Soap Lake and Wenatchee is about an hours drive. btw: I do foot/nail care and member of AFCNA. Will be at another hands on with Dr Julia in October. Give me a text at 509-760-4144 or firstname.lastname@example.org and put HAPPY FEET in subject so I can filter it from my spam box. We will get her done. Joe D. Barbee RN, iRNPA
Yes, there is. Pam’s portable Pedi Care (me)..Look for contact info on the AFCNA list of foot care nurses in Wa State
did you find Pam’s Portable Pedi Care on the AFCNA site for Wenatchee?
Yes and thank you. I have passed on all the information to my friend. I am leaving the “Long distance” dealings with her mother to her…I do not know how urgent her situation is but did my part in locating some resources for her. Again.. thank you for the quick response.
Is anyone from San Diego planning to attend the Autumn 2017 Conference Oct 21-22 in the Alaska location? Want to share a room?
Not this year…but keep me on your list for another time. At the moment attending a Seminar in Baton Rouge.
Is there a quality drill that’s 30k rpms but cheaper than the Medicool and doesn’t have a foot pedal? Thanks
I will be testing in the near future. Where is the best place to acquire study guides and practice questions. I do have a few sample questions but would like to review a few more. Thank you for any input you may have.
If you are taking the AFCA test on line? Her CEU’s are good. and a must ! I like Chapter 26 in Text Wound Management… Wolters Kluwer… also…on line for about 50 $ a year.. they have 5 programs on Foot care….Pearls Review.
For CFCS you do not require a BSN. For CFCN, you need a Bachelors, but I do not think it needs to be in Nursing.
So good to hear! Congratulations!
Just took my test for CFCS and you are looking at Doreen K. Cotter, LPN,CFCS
I passed the test with a %95!!!!! Yea.I have studied for months and went to preceptor with Dr. Julia herself for three days! Had a great time meeting the other nurses.
Congratulations!! I wish I could take test, but need a BSN.
Congrats Doreen. So happy for you. Bonnie Ackles, RN, ARNP, CFCS
Yea!! Congratulations! I have never had so many patients be so happy that I took care of their embarrassing feet. :)A joyful job.
You are CFCS #17117 !!!!
Sent from Yahoo Mail for iPhone
I’ve been doing a rehab center. It is nice because the facility itself pays me. So I don’t have to worry about collecting from each patient. I charge $55.00 per patient. I go there about once a month. That’s because they have patient turnover so there are enough new patients each month to warrant a visit. Some of the patients stay longer and I just check them but do treat or charge for them until the next time they need it. Usually 2 months total between treatments.
One other thing… These patients are in rehab because they are medically fragile in some way. And none of them are running races! So be very conservative with your trimming and sanding. The last thing you want to do is cause any type of trauma. My goal with them is just to relieve any current ingrown areas, trim whatever is necessary to prevent the toenails catching/tearing in the sheets or in socks. That’s about it. Just keep them safe. I don’t even take my sander there. Since they won’t be wearing shoes in most cases, the thickness doesn’t matter. And sometimes facilities have C.Diff, MRSA etc. and I don’t want to breath that.
So it’s a great contract to get. Good pay from the facility. But be very conservative with the care you provide. It’s mostly preventive since they are not that active but are very fragile.
Thanks so much on the care you do at the rehab. I will touch base with them.
Hello. Has anyone found employment doing Foot Care at a Rehab or another facility.Before starting my own business I want to make sure it will be profitable. I need health care and retirement benefits. Than do some part time work at senior centers on weekends.
Some time ago I saw a advertisement in Madison for a foot and Nail Care nurse….when I called…it was for Two hours in that role…the other 28….unit nurse.
Depends on what kind of employment you are looking for. If you are hired by the facility directly, you will probably be paid by the hour and without benefits as most of the rehab facilities are owned by for profit companies. It would be hard to do 30-40 hours a week, if I understand what you are looking for. I am occasionally asked to come into our Skilled Nursing Center Rehab, but only occasionally and for private pay. The trade off for you being in business is being able to determine vacation time, days off for family needs, etc. I do +/-30 clients just in one local ALF that has residents in multiple levels, but all private pay.
Pam, Thanks for your input. I am looking for full time work with benefits. Would like to do Foot Care only, but it may not work out like that. One of our hospitals has a Rehab close by, so maybe I could go to different units with in the institution.
Lisa. Please keep us all updated on your search. What I see, is Skilled Care Facilities cannot afford hiring someone for only Nail and Footcare. They work on a loss every day, if not a private pay facility. Our County Health goes to facilities once a month……Apartments….Senior Centers… Charge each client 25$. The Home Health Nurses do the Nail and Foot Care. So it is part of their load each month. So they really do other work not only Nail and Foot Care as an employee.
I will keep that in mind. With the competition of the Rehab Centers, maybe this would be a service they would consider, Foot Care/Nail trimming.
Hi. I am working as a Podiatry nurse in Qatar from a reputable Academic health center for more than 5 years now. My husband and I (both of us are nurses) are planning to put up a Nurse led/ foot care clinic back in our home country, however, we have no idea how we can start. I would really appreciate if someone can advise us and provide mentorship on how we can make things work to help people in our country.
Can LPN have their own foot care business in the state of Washington? Once they get certified?
I would check with the Washington State Nursing Commission. https://www.ncsbn.org/Washington.htm for details re: Independent practice. You also need liability insurance and I just renewed mine for 535$ through NSO so you would also need to check with them.
Scott, The WA Board of Nursing has made a statement about RNs having their own foot care practice. But they don’t mention LPNs. There are many LPNs in WA doing this. Make sure you have good charting, infection control, malpractice insurance and adequate training. Since foot care wasn’t taught in nursing school, it’s not in scope of practice until a nurse can demonstrate that they received training. Kind of like placing picc lines. There is a question about whether an LPN needs an RN or Physicians oversite of their work. So that’s what you need to check into.
Here’s part of their statement:
“RNs practice independently when performing nursing care. When carrying out medical regimens, they practice interdependently with an authorized health care provider (MD, DO, ARNP, PA, ND, DPM, DDS). Nurses can provide “routine” foot care. Medical regimens must be carried out under the direction of an authorized provider. Complex foot care may be within Scope of practice of an RN depending on if they have the training, knowledge, skills and abilities to do the activity safely and competently.
A primary concern is the competency of the nurse – does the nurse have the training, knowledge, skills and ability to perform the activity safely – and the current condition, chronic illness, setting and other circumstances should be considered based on nursing assessment. “
Thank you so much for your answer I really appreciate your help. It helps give me a starting point to do my research.
So is routine toenail trimming considered a medical regimen? I would have to argue it isn’t.
Does anyone here use 3WEA? It’s a wetting agent that softens nails and rough skin. I was trained using it and it works great. Buy it in a concentrate and mix it 1:16.
I bought some at while at Dr Juila’s conference and it is sold on the web site. I haven’t used it as yet and get it for callouses. Have my first candidate to use it on a f/u treatment.
Worked abit with a Podiatrist this summer. She did not mention it. Will check with her.
Kathryn, You’ve done so much to further foot care nursing. And you’ve contributed so much to this blog! Luckily, while I’m still travelling to teach foot and wound care in other states, I’ve gotten more organized about it! And much of my foot care legislation and podiatry outreach is going well. So I’ll be able to post here more regularly.
I wish you the best in your new endeavors. Please keep in touch! You’re a real asset to foot care nursing! Thanks!!!
I am an RN, Certified wound care nurse, and certified foot care RN (all certifications through WOCN CB) who is currently working in a wound healing facility. Could anyone tell me the steps I must take to obtain all info needed to practice foot care independently, including how I am legally able to charge, and exactly what I am able to perform. I live in the state of Nebraska. While continuing to practice wound care in our clinic, I would like to initiate an alternate outlet to help the many many high risk patients that are begging for help with their nails, but are turned away by our local podiatrists (reimbursement issues?). Our state rate of amputations is shameful and I feel some preventative care and education could help this.We are able to see some of the highest risk patients for trims in our clinic but we are extremely busy with wound care so are very limited. If there is anyone that could provide guidance I would so appreciate it. Thank you.
We need you!
Thank you Dr. Julia
Sold the clinic and business. Looking forward to retirement and a few new adventures. I have loved the blog and all the knowledge and information learned.
My mission has been to develop and grow my business to be the best possible and share all I’ve learned networking through this wonderful venue to all the other nurses to help those struggling and make it easier, efficient, and profitable to go ahead and start up their own successful foot care companies.
God Bless and keep up the great work. This is very important work. 🇺🇸
I so happy for you! Keep in touch:)
Recently I was looking to take a FOOT & NAIL course. After many weeks exploring numerous websites, finally I found a great company. It is called Professional Education, LLC at http://www.prof-ed.com, which provided necessary information and training about FEET & NAILS. Upon completing the RN course with this company, I passed my national exam with a high score. Also this course is been approved by WOCNCB. It meets their requirements for 24 contact hours and covers the materials.
I asked Dr. Overstreet: How you can integrate this course in your website so other students like me will know about this amazing FOOT & NAIL course? She told me to post it here for you to know about it.
Emory begins there OnLine Coarse this week. I was disappointed they are not going to offer Hands On.
August 31st 2017
Retirement day for Twinkle Toes 2U The Foot Care Company of Minnesota is coming fast. The web site is gone. The phone is gone. My clinic is sold and the new owner, Janet, RN begins Setpember 1st.
It’s been a fabulous 8 year run. I’ve loved the blog for 2 1/2 years as well as all my students that came. Friendships that will last.
I’ve produced 3 training videos as well as a book in the works.
My new company is Pro Toes USA. I updated my info and new email.
WOW…congratulations! You’ve taught and inspired many. Enjoy yourself!
Well deserved day for you. Thank you for all the support you’ve provided to help all us foot care nurses! I’ve met Janet and know she’ll do a fabulous job moving forward.
Best of luck for your future!! Would you be so kind as to send a list of your former students to my personal email so I can keep in touch with them, I would really appreciate it. I look forward to your book!!! Best regards, Sandra
Thank you. You became a very special friend. I am so proud of you.
Congratulations to you on your retirement as well as in your new venture. Wishing you lovely days full of relaxation and horses 🐴 Take care!
Hi friends. I’m looking for a good SHARP dermal curette. Does anyone have a link or a website? I ordered one with a file on the end and the file works great, but the curette end is as round and dull as a baby’s butt.
Trying to get a foot care business started im Arkansas.
the Foot Nurse LLC
I like the one on Raniermeded.com site. I have another and it’s too long to handle comfortablely.
Haven’t checked in awhile. I’m in Central Washington St, with an in-home practice, currently serving 120 clients in a 15 mile radius, including memory care units, adult family homes, assisted living facilities.
I use Barbasol after a hot soapy water and brush (I use a plastic drink cup), 20 min soak. Clean instruments in a Pizza box by Systema (high quality) marked Clean at Dr. Julia’s suggestion and used instruments in a covered container marke Used.
I was gifted a dremel 7100 cordless rotary. The new brand is dremel 7700 with rechargable batteries. Drums from E-bay in different grits. Plus some bits. Plastic costco garbage pan liners for the buckets that are cleaned and bleached at the end of the day.
Did you mean ‘Barbiside’ rather than Barasol?
All I see is shave cream.
We use a Rubbermaid take along and it has a sealed lid. All dirty tools go into it. We call it the ‘dirty bin’.
End of the day we soak the tools in 2oz. Barbiside per 32oz water. Time required is 10 minutes. Then we use our great brush and Don gloves. Love the sudsing action of the Barbiside. Pick up the tools and scrub quickly. Rinse well with water. Lay on paper towels to dry.
We use a plastic bin with compartments to put the clean tools in once try and ready to go.
We do not use barrel sanders or disks. We do not use Dremels.
We use the electric powered Medicool and the ‘Everything Burs’ both regular and course.
Thick nails can be leveled quickly and easily with the course bur. Very little dust.
We use the regular bur for maintanence foot care. The course also take down calluses nicely and often you don’t need to scalpal only the huge calluses. Then sand with the course bur to smooth all the edges of the calluses. Often you cannot even see that there was a callus. Experience helps of course as you don’t want to take down to much. Lots of touching and take the callus to the point of where they feel flex able and soft. Not pink. Stop. Then you may have gone a little to far. Grind/sand. Touch. Several times until it’s just right.
The easy on and off of burs and smooth very little vibration of a Medicool the Cadillac of the business. If you are building a quality foot care company have the right tools.
Throw away the Dremel or take it out to the garage for your husband!
Hope this is helpful,
Thanks for your reply and information. Yes, Barbicide. I’ve collected a variety of different instruments that will last a couple of days and they are washed in hot soapy water, rinsed and put into the barbicide solution. Dr. Overstreet suggested that my instrument containers be labeled clean/used. I like the dremel and use a variety of drill bits as well as different grits for sanding. My local podiatrists use the dremel as well as Dr. Overstreet in her videos about removing ingrown nails. I don’t have the training to use a scapel for taking off callouses, but do smooth them with the light grit sanding drum, or a sanding paddle that I provide my clients.
I am in the Basin here in WA, just starting up and would you email me direct??? email@example.com Sure would appreciate the collaboration.
Does anyone know if Oregon foot care nurses are having trouble providing foot care? They have a stringent Practice Act that is very onerous about having orders, treatment plans, etc. ?
Yes this is a hot topic. What I observe is a growing absence of foot care nurses as my referrals have sharply increased which is very sad because there is no way I can serve all these in need clients. This is definitely is an access to care issue. Hope to learn more as we go forward as to how this most recent ruling will be interpreted and tested. It is impacting the free clinics as well from my experience with being asked to perform the role of ordering provider which doesn’t really turn out to be practical because there has to of course be a documented exam/ eval then a follow up notation of some sort. I understand that some foot care nurses are contacting Primary Care Providers ahead of time for orders but don’t know how that is working out. In the meantime, I am hearing patients plan to seek out esthetitians/ strip mall nail salons. On the bright side, the AFCNA website has been a great help in our area as I hear folks refer to it frequently, even Kaiser hands out pages of AFNCA member contact info for their ‘non-medically necessary’ nail care patients who i’m sure the majority of whom are dangerously limited in their ability to do the necessary self care for their feet.
Oh boy, do I have a story to tell about this. First, a little background. An LPN friend of mine, I’ll call her B., did nail care for some local senior centers, as well as low income housing facilities in Portland, for at least 20 years. She was trained by a local podiatrist. She asked me to be her delegating RN and I agreed, after observing (and also learning from) her. We made a plan for me to observe her every 6 months, and document it. We were also in touch with the OSBN and asked if there were any requirements/guidelines. All the emails said it was in my scope to be the DN, and in B’s scope as an LPN to perform foot care.
At the same time, I worked at a senior center in Portland for over 5 years, and got to know another RN who I will call S. She got her foot care certification, and became very vocal about how only certified RN’s and not LPN’s should do foot care. During this time, I also got the opportunity to take over a foot care program from a home care company in Portland. My business partner was an LPN. Our company, “Foot Care Nurses”, inherited some large clinics and some smaller ones, so we kind of lucked out that way. We grew, got more clients, had to hire and train more nurses. One of these nurses was S. Understand now that one of her “bosses” was an LPN doing foot care. We were always very secretive around her as to who else he contracted for foot care to; except for one day, he was rather distraught because he accidentally didn’t renew his license, and continued to practice. S heard this story, and 2 days later G (my partner) got a phone call saying that he was no longer needed, due to practicing without a license. He essentially lost his bread and butter.
S was told she was no longer needed at our foot clinics, but fortunately other nurses stepped up. All in all, we had around 750 clients. We did quality work and had good customer service, got many referrals from podiatrists. There were very few complaints. S started some clinics on her own, and things seemed to be going well for everyone until S saw a foot care signup sheet at one of the low income facilities where she did some people independently.
She must have figured out that I was her delegating RN, probably due to the fact that she knew that I knew B, and I never agreed with her ideas and her mission in foot care, to have only certified RN’s practicing. Both B and I got letters in the mail from the OSBN saying someone filed a complaint, and were going to be investigated. We had our initial meeting with the Nurse Investigator (who incidentally made us both feel like criminals). She said that practicing foot care was not according to the Nurse Practice Act, although we were taught and proven that it indeed is. I was given the suggestion that I should retire that day, B was told she should surrender her license. I was told that I could not delegate to an LPN when she was working independently, without a nurse on site.
In addition, the nurse investigator told me that our documentation did not reflect the “nursing process”, therefore could not be used for renewing our nursing licenses. In essence, they were trying to say that we were not legal.
We both got the same attorney (thank god for NSO insurance). She was very methodical and supportive and had much experience in dealing with the nurse investigator.
Dr. Julia went over and beyond researching the Nurse Practice Act, and was convinced beyond a shadow that foot care is indeed in the scope of practice. We assembled our defense. By the time the Board reviewed our cases, my case was unfounded, and so was B’s case. HOWEVER…..in the meantime, they passed the new foot care policy. No input, no research, no comments were invited. It was passed in a hurry. Therefore, Foot Care Nurses had to abruptly quit our clinics, all plus/minus 750 people were denied their foot care. They were understandably upset, as were the directors of the senior centers who sponsored and supported us. To continue would have been to be out of compliance.
I know that S was reported also, for practicing out of scope. She ended up giving up her clinics (other nurses took over) and has now let her RN license expire. Of course I have no contact with her.
All the nurses that contracted with Foot Care Nurses lost their income. I lost my income as owner of the business, and as practicing foot care. Many people lost their means of the foot care they needed.
How did the Board’s knee-jerk response to some complaints by another nurse, who was trying to pursue her agenda, help anyone?? I am convinced that the OSBN does not care about nurses, they don’t care about people. I am jaded. I am also retired so I can say this. Luckily for me, this whole sh*t storm happened when I was thinking about retiring soon. I would have found a way for the service to continue if there would’ve been a time line to figure something out. B’s life was disrupted more, since she was the main breadwinner for her household.
Just so many lives impacted, our dear seniors let down. There are still RN operated foot clinics in Portland and surrounding areas, they are taking their chances that no one will file a complaint for being out of compliance. The whole thing stinks.
PS “S” saw a signup sheet for B’s clinic at the housing facility.
Jackalyn – what a terrible thing to happen to you. However, it does demonstrate the urgent need for foot care nurses to band together to support each other. A strong organization is needed to educate and and lobby legislators as well as the general public that we are indeed a specialty within the field of professional nursing and have been for almost forever. This should NOT have happened to you.
OSBN hmmmm, I do know what you mean about these ‘State’ employee nurses that treat you like a criminal. This is within our Scope of Practice in WA and OR must be nuttier than WSNA can tend to be, but the ANA seems more focused on acronyms behind a nurse’s name than their actual experience and needs of the whole profession. This is a totally shameful act on OSBN’s part and surely there will be more said about all this insanity. Accountability is our life and you can be totally within the Standards of Care and Best Practices while still being vilified. Nurse eating nurses are very ugly. We should be represented not persecuted by our State Boards of Nursing.
What a horrible story. Is it possible to keep the company going but hire a medical director(would that help?)?
I would love to start a company like you had here in Texas. There is a need for this type of service. If there are any footcare nurses here in Texas. I would love to build a routine footcare company with you. I am a Podiatrist practicing in the DFW area. Email me and lets chat firstname.lastname@example.org.
Charlton Woodly, DPM
Can somebody please jump on this! Stat!
Thanks so much for your interest!! It’s exciting to have another Podiatrist understand the value that these awesome foot care nurses bring to our patients and to the healthcare community!! Please email or call me at your convenience! 425-223-5173 or Julia@DrJulia.com
Foot and Nail Care for Nurses……4 day program…October 17 through 20. 2017. 7 Education hours and 30 Clinical Hours. University of Wisconsin Eau Claire. Continuing Education. Email ..email@example.com. Or call. 715 836 5435. https://ce.uwec.edu/programs/foot-and-nail-care-education-nurses-expanded-clinical-option/
Nail and Foot Care Class. U/W Eau Claire Continuing Education. firstname.lastname@example.org
Address should be….email@example.com. Or call 715 836 5435. For Nail and Foot Care classes
Hello Roman please send me the i formation that you haves out statr regulauons in foot care. Ismhere in Maryland. We did vommumicatr before. So how id budiness?. You may also call me please. Thanks. Rose Tangham, RN, MSN, CFCS
Where is a good site to get CE hours so I can take the certification exam? Thank you.
I took Dr Julia’s CE courses, as well as those through WOCNCB – they have a series of 5 online foot care courses. I also supplemented with some courses through Western CEUs – care of the diabetic foot, and lower extremity examination. Good luck!
BSN, RN, CFCN
Response from Lois Peloquin….Programs I took to submit to WOC to take the Certification Exam for Nail and Foot Care, are:..Taylor Health LLC. I attended a week of her classes in San Diego .She does have classes in many areas of the country……U/W Continuing Education Eau Claire Wisconsin.Well known and accepted without any difficulty. …Pearls Review…this is on Line….they have 5 classes and you pay around 50$ for the year. They have many other classes, but at the time I took, only 5 on Nail and Foot Care….Wound Care Education Institute had one on Skin and Nail Changes in the Diabetic Foot, which they accepted. But now, there may be more on Wound Care that you can take. I do not know which Exam you are taking…WOCNCB or American Foot Care Nurses Association…AFCNA has many CE’s you can take on line for about 25$ a CE. I feel, they really are the only association that has helped us with available classes that are convenient. That and U/W but you only get 8-11 from then. You can get around 30 hands on. I also attended 3 of Dr. Julia Overstreets classes…4 days of hands on and 2 days of Didactic in Alaska. I think every Spring she gives seminars in 3 different cities. Emory is working on having on line classes. They should have then on pretty soon. My understanding, they are only going to have on line Didactic now…no hands on. Keep an eye on their classes, as I am. If you attend any classes, be sure you submit the Agenda too. It took them a month to go over the materials I sent in. You now can take and submit 9 hours of Wound Care…please check if the 9 is correct. This Fall, I am attending the Hanson’s Disease Conference in Baton Rouge….I do not know if they will accept that, although they should because it is a lot on Neuropathy. Please keep in touch. Would love to see what you end up finding and what they accept from you. Hope this all makes sense.
Thank you for the information on options for obtaining CE hours for the foot certification exam. I no longer can put it off by thinking I don’t know where or how to get the required hours.
Emory on line classes begin next week. About 800$ …3 months to complete. U/W has a class in Oct…with 30 hours hands on…..April 2018, they will have 40 hours hands on.
I also use the medical brand with carbide bits.
Good Morning Nail and Foot Care Nurses. I see no discussion for awhile. Anyone try anything new? Using something new that works or does not work? Problems, successes? Teaching ideas for the clients….Any problems with Certification? Are you finding places to volunteer? Lotions or creams you like? We are important….want constant improvement in our skills and client progress is a goal!
Would love to hear your discussion on drills again. What are you using? Any problems with facilities not allowing them…..etc. also Burs you use…anyone using the Ceramic Bur?
Medicool 2100 is the one I have. This was the recommendation from the last conversations about drills. Love it!!
So many need Battery. Volunteering in different countries…..camps etc. Any good Ideas?
Thenurseconcierge@gmail.com. Let’s get NY back on its feet!.
Not too far away from you. Currently in the Bx today. Located in Westchester. Shoot me an email. So now there are 2 of us in the area. Spoke with a Pod last week. Very welcoming. He heard of “us” but never met one. Would love to network with you.
what’s your email address?
Last Friday I worked on my first day of vacation. I received an email from a couple that live 60+ miles from my clinic. They very much both wanted to have foot care sessions with me. My regular clinic hours are full through the end of July. I’ve had to add some half days on Wednesdays just to cover all the patient requests for professional foot care. So many calls from new clients in my territory.
The lady stated she had thicker nails she had trouble trimming and she stated her husband, a Postal worker is Diabetic. He needed a trim and his feet evaluated and new shoes. He has quite severe foot pain in the balls of his feet within the first hour of arriving to work.
We met Friday at 1pm and I first trimmed the ladies nails. Not to bad at all. Mild thickening and discoloration. We rate difficulty 1 through 5. She was a 2 1/2. That’s an easy trim. Contour and reshape the thicker nails. Nice painless trim and education. Toe Nail Fungus handout given.
Then I cleaned clinic as per protocol and set up for the husband. Thick nails on most and especially the great toenails. Skin healthy. What he did have was a very wide forefoot and an extremely high arch or instep. I trimmed and contoured the thick nails back to a nice shape and size. He had very minor callus on the balls which I sanded with my bur. Looked perfect. During the session asking questions and pinpointing the problem areas.
He had never had custom orthotics and he wanted to purchase new diabetic shoes.
I casted the orthotics molds. He decided to order 2 pair as the second pair is half price. Great savings to buy that second pair. He found 2 Pairs of shoes he liked a lot.
I wrote up the order.
Shoes: $142.00 x2= $284
Orthotics: $140 + $70= $210
They also purchased 1 pair of Diabetic socks: $10
Generic Vicks Vaporub: $2.00
2 regular foot care sessions: $40 X 2= $80
I was in and out of my clinic in 3 hours. You make excellent $ selling shoes. Retail is double your cost on shoes, orthotics and socks.
Vicks is recommended topical treatment for toenail fungus OTC inexpensive and Mayo Clinic as well as my company recommend this. Most people have it already but I but the generic @ Walmart for $1.93 and resell it for $2.00. If patients need it. ‘Nose & Toes’ I keep several in my clinic for patients to buy then show them how to apply the recommended daily application. I give them a nice informative instructional handout that I designed. Everyone I recommend Vicks protocol gets the handout.
Re booked my 2 new patients for 2 months. They LOVED their foot care sessions. So happy with how their feet looked and felt.
Tipped me $20.00.
My 3 hours worked netted me a sweet $352 for 3 hours worked. I like making $117.33 per hour!
You can too. The shoes and orthotics will be drop shipped to their home. Takes 10 days to 2 weeks for a customer to recieve their order.
All of our Minnesota Team of nurses are highly trained foot care specialists and certified to measure, fit, and order shoes and products making great commissions. This goes so nicely to compliment the foot care services you provide ans a way to greatly increase your income. Getting the diabetic shoes for your seniors on Medicare is like a gift for them. No out of pocket cost usually for your patients. So many don’t even know they can get the shoes through this Medicare program once a year. Often the Doctors don’t even tell them they can get them. About 26% of seniors take advantage of this so there is a lot of untapped business out there.
Ok. Vacation. No patients now until a week from today. Seriously.
I wish this type of business could be a reality in Florida. I am currently working in NY as a wound care specialist doing minor foot care – mostly paring callouses. Desires more exposure doting toenails and to start my foot care business in Florida.
I am in NY as well. Whereabouts? Would love to see how you handle the calluses. I met a another FootCare nurse nearby in CT. I am certain that she would love yo network with you.
I work in the Bronx. Primarily managing wounds of the lower extremities. These pts are usually referred to a podiatrist. Foot care is not a recognized part of my function so I do it occasionally, as much as I can and as time permits. My intention is to volunteer some hours working with a Podiatrist practice to develop my skills & prepare for my own business.
Minnesota is ‘Rocking & Rolling’.
Very busy and our Team is in need of at least 6 more RN Foot Care Nurses as Independent Owners to cover the South half of Minneapolis and St Paul and southern suburbs as far south as Faribault Minnesota.
3 HUGE accounts have come to us and it kills me to turn them down. 😥.
Our Team needs coverage for south metro. We are well covered north metro.
Please contact me if you are in this territory and would like to be part of the #1 Foot Care Company in Minnesota. I have a strong sense we are the biggest nurse owned. Nurse managed group providing high quality foot care in the USA!
Nothing worse than turning people away that need our services.
Part time and full time opportunity so contact me if interested. High pay.
Kathryn can you please contact me at firstname.lastname@example.org
Do you live in the south metro of the Twin Cities?
Lots of patients and if you have interest in growing your business please call me.
Is anyone volunteering in Homeless shelters for Foot Care? I would think soaking would be an exception since this group have not had a regular bath. Will Epsom salt work, or maybe tea tree or lavender oil? What is best as a cleaning solution for tools used? NM
I’ve used the Bounty Dawn infused paper towels and bring a squirt bottle of water to wet them. does a good job on dirty feeet. . then rinse/ cleanse w/ baby wipe.
Try Coloplast No Rinse Foaming cloths. It works very well and is less expensive.
If you have a reasonably inexpensive source for these I would be interested. I only use the paper towels and baby wipes for Clinic such as the VA or health clinics. Otherwise I roll up Don Bounty towels and a package of baby wipes are considerably less per client
Hi Kathryn! How are things with you?
Where did you get the training and supplies for making the orthotic molds? I’d love to add that service to my foot care business.
The Dr Comfort Company our of Wisconsin has free on line training. Set up your own personal account with them. They provide catalogs and all the paperwork @ no charge.. I provide custom orthotics. Diabetic shoes, ((cash sales) for many people that have foot problems whether they are Diabetic or not. Diabetic socks, bamboo. Fantastic for anyone. I especially like the extra-roomy crew socks for my BIG boys. Comfortable for them and no more tight ridges or swelling lines on their legs from tight socks. Support hosiery. Training for this is available too. Many of my foot care patients are supposed to be wearing them but don’t because they just can’t get them on and off. What compression? 20-30s so I suggest a lighter compression that they can manage vs none at all. Sell a ton of them. Also slippers and sandals.
Shoe heat moldable inserts.
Partner with a medical supply store in your area that provides the Medicare coverage for the Diabetic shoes to get your Diabetic patients new shoes once a year @ no out of pocket charge for them. You make a great commission for each pair of shoes.
Bringing this in along with your foot care business is a perfect compliment. Greatly increases your income. Provides a great service for your patients.
Your business doesn’t have to be just trimming toenails!
A case of the molds for impressions come right from the company. A case of 12.
All the training is no charge from the Dr Comfort Company.
What do you disinfect your tools with. I need a 10 minute contact time,
I use Metricide OPA plus, a high level disinfectant. OPA is similar to glutereldehyde, but does not require mixing. It has a 12 minute contact time. But you also need to factor in time for scrubbing, washing and drying the tools prior to disinfection. Then time for rinsing and drying the tools after disinfection.
It’s also worth noting that you need test strips to check the solution before each use (once poured it is good for 14 days, but you must test it each time you use it), as well as Glute Out to neutralize the used solution before you can safely dispose of it.
This may seem complicated, but I have learned from Dr Julia that high level disinfection is the best (she told me she uses glutereldahyde) and safest, aside from autoclaving, for our patients.
Hope that helps!
I use Metricide OPA plus, a high level disinfectant. OPA is similar to glutereldehyde, but does not require mixing. It has a 12 minute contact time. But you also need to factor in time for scrubbing, washing and drying the tools prior to disinfection. Then time for rinsing and drying the tools after disinfection.
It is important to note that you also need tests strips to test the solution you are actively using (good for 14 days once poured) and Glute Out to neutralize the solution you are done with in order to safely dispose.
Hope this helps!
Get enough sets of tools for a day. At the end of each day. Clean them appropriately and set for the next day.
4 primary tools and a bur.
Same for everybody. Simple.
Maybe you are using the wrong tools.
What kind of nipper?
What kind of pick with file on the other end?
What kind of curette (spoon tool)?
What kind of file?
What kind of drill or power tool? Some beginners use Dremels.
Type of bur?
A dozen sets should fit nicely into your plastic case.
Do you have the ‘Special’ brush to scrub your tools?
I’ll send you pictures and tips.
Barbacide is a 10 minute soak. We use a nice hand held brush and put on our gloves. A quick scrub on each tool. Nice sudsing action. Be sure you get all sides of the burs and files with grooves. The soak kills everything. The scrub removes all and any debris in those small grooves. Rinse thoroughly and place on fresh clean paper towels. Dry additional moisture off your tools.
We have trialed and studied many products and developed our procedure standards to provide the safest and best service.
I’ve mentioned this before. Your tools are your money makers. Take real good care of your tools.
If you are tired after a long day. We do 10-14 foot care patients a day. The Barbacide has anti rust properties and you can leave your tools soaking overnight without any worry of damaging them. Many of my tools are older and in excellent like new condition.
In the field we carry a simple inexpensive Rubbermaid small container and place the dirty tools in it. It seals up. They last and last. I can get 6 sets of tools in my dirty bin. (Rubbermaid).
The majority of my patients are trimmed in my clinic. I drop my tools into a my container prepared. 1oz. Barbacide per 1 gallon of water.
My clinic container is about a quart. A jug of Barbacide lasts a long time and is inexpensive. Amazon or Sally Beauty Supply.
Safe, simple, efficient. Cost effective.
I am currently going for my RN and am looking to open a foot care business. Any ideas on whether you have to be contracted with the insurance companies or if these are services that the patient has to pay out of pocket for? I currently reside in Florida. Please let me know any good advice.
since you seem to have been doing some research, I have a question for you. Have you found any website that defines the nursing scope of practice for foot care in Florida? I can’ find anything specific to Florida for RN’s.
Yes, I have it states that mobile units are allowed along with events, Concierge off site is allowed but only permitted for the ill and home bound. The mobile unit must maintain a permanent address at the board. Along with prior to the beginning of each month a written itinerary must be submitted of when and where the unit will be in order to facilitate inspections.
What department of the state or who would you be required to submit your monthly itinerary? Never heard of this.
All of our nurses on our Team all own their own private businesses. Either LLC or Sole Proprietorship registered with the state. We are 100% independant and do not work for the Board of Nursing or controlled by State Health Department.
We have designed our own policies and procedures. We use all of our knowledge as RNs to design our business and provide high quality foot care to any and all clients, young and old who need our services.
We have 2 large corporations that recommend our companies to their patients. Well over 200 doctors and Podiatrists pass out our business cards and refer their patients to us. We see large numbers of patients in their own homes and just opened our 8th clinic so patients can come in for ther professional foot care session.
My clinic is every Tuesday and Thursday fron 10am till done. One patient every 45 minutes. That’s a 30 minute session and a 15 minute turn around time to clean and disinfect ready for the next one. All the same universal high quality care. Good feet. The worst of the worst feet. Same tools and products. Our Team all use the same tools. Same high quality care. Yes technically we are all slightly different. Lefties. Righties. But the result the same. The best foot care available. Like in our Mission Statement: “Service You Can Trust and Prices You Can Afford. This really says it. This year we are breaking numbers.
Privately owned we set the bar very high with every aspect of what we do. How we do it and the best foot care services available.
I need 8-10 more RNs in the Twin Cities to join our Team. We are soooooo busy. Very successful.
Today I was out doing private in home appointments. One of my patients told my she just had a lady visit from her health insurance company visit and evaluate her health and safety. When she asked her, “How are your feet? Are you able to trim your nails?” My patient told her that she had me, Twinkle Toes 2U do her foot care every 2 months.
She said the insurance lady kit us and a big smile. She said , “Wonderful, if you needed foot care I would have given you their card, I carry them.”
What a compliment. One of the biggest medical insurance companies in the state recommending us! And passing out our business cards.
When we get new patients calling we ask, “And how did you hear about us?” 90+% say their doctor recommended us and many say that their home care agency or their health insurance person recommended us.
We are independant and privately owned by RNs. No doctors. No big corporations.
Very proud and successful and we do it all, our way.
That is awesome to know is there anyway take some of your time and talk to you about what all you have told me and what it took for you to start up?
Look my web site up and all my phone numbers and info is right there.
Call or email me.
Hello Amy: (This answer may be clarifying for Karen, who asks about the scope of nursing practice) I live in Florida too, and I have been involved in opening the practice in foot care for several months, I am still pending to open the company . Apparently, there are not many nurses doing this activity in our state. I have been researching enough and understand that this is a private activity, not covered by insurance (by nurses), but there is a great need for foot care in the population, mostly elderly, who would probably be willing to pay for a good care, keeping in mind that it is a service that is not expensive and is provided from time to time. I am an old home care nurse and I have seen thousands of my patients in need of foot care.
In this state there are three general conditions that favor this practice: High density of retirees, heat and humidity, but in any case, because it is something new, the process to get patients should be difficult.
I have also been interested in the “legality” of this practice and spent many hours reading about the scope of practice, the conclusion I have reached is that nurses can do this job, but we need some kind of certification or preparation.
I have been fortunate to have two great sources of formation, Dr. Julia Overstreet, the creator of this blog and AFCNA (american foot care nursing association), with it I obtained certification of foot care last year. The other person is Kathryn O’Shea, RN, from twinkle toes for U, with whom I see that you have already exchanged some criteria. I will never tire of thanking Mrs. O’Shea for her proactivity.
Amy, I do not understand what you write about … “the Florida nursing board must have the monthly itinerary to do inspections”… I would like to exchange a little more with you about this information. I send you my mail I live in Orlando.
Sorry, this is my email:
I’d like to say I just returned home from my training session with Kathryn O’Shea. I have to say I learned soooo much practical information. It was well worth the trip (I am in Michigan). She is very passionate, professional and makes the experience very pleasurable.
Good morning Ramon,
I did some digging around and found the information on a site that checks what qualifications are needed per each states requirements. It may be that it was some spoof that I read. Like yourself I was looking for information on this, I agree though where I live there are a lot of retirees and I am curious to know about contracting with hospitals/assistant facilities that need people like this to aid in foot care. And that would be awesome we can trade off some information found.
Florida is in DESPITATE NEED of professional foot care nurses.
So many of our Minnesota patients winter there and have no one.
I have had a ton of patients return home and are desperate to get in and have their huge nails trimmed.
Last Summer I put out a call on our blog here so we could put together a list of Professional Foot Care businesses we could give them a handout so they could find service in Florida, Texas, and Arizona .
Sadly I got only 1 response.
Here in Minnesota we have a great Team of RNs that have trained and started their own foot care businesses. I’m sure we will have a new record for numbers of patients and growing.
We have ’10’ nurses as well as there are a couple others working not on our Team. Right now we could use at least 6 more!
If interested and live in Minnesota please call.
Yes, I am aware of that we have patients that have mentioned one being needed especially in Brevard. We see a lot of the elderly snow birds that come down we are looking to start a mobile unit once I am done with my RN and anything else that is needed. I don’t know if me working with a podiatrist for 6 years automatically puts me allowed to take the test for certification or not.
Once we get this end up and running I could send you some business cards for those who need someone.
My dear friends in the DMV (District of Columbia, Maryland, and Virgia). My foot business is already set up. Please let us join our heads together, and figure out a way in which we will be able to break through this life saving career (safe foot care by nurses). Let us work together to see if the board of nursing can implement some type of policy that can guide us to practice safely, without any concerns. We all know we can do this, all we have to do is to break through the obstacles.
Rose Tamfham, RN, MSN, CFCS
I am just wondering if anyone knows the legal way to start a foot care business in California. Is there a license for business necessary? I am CWOCN, CFCN
New client today. A 50y/o business man from Phoenix Arizona who is diabetic who is in Minneapolis frequently. His doctor told him he should never trim his own toenails. He hates having a Podiatrist trim them. He mentioned than he found a ‘Foot Care Nurse’ in Idaho and she was so much better than any Podiatrist. Kudos to the Idaho nurse but sorry, no name. This man found my web site and left me a phone message that his toenails were very long and he needed an appointment. My clinics are full. No openings so today on my day off I met him at my clinic for an appointment. He called in the morning and cancelled his 10am appt. but said he could come @ 4pm. Rush hour and a 50 mile drive. He was 1/2 hr late. Ok as I had paperwork for 5 new shoe orders.
Yes he had long nails. He stated left Charot foot with an expensive ‘$2500’ brace on that foot and stated it was 2 1/2 yrs old. Feet change year to year. His brace was causing to much pressure and only his doctor can fix the brace or reline or get him a new brace.
The lining inside the brace looked to be in good condition. He said he has no feeling in that foot.
I did my regular exam prior to the trim and he did not know that he had a quite severe pressure area close to blistering the size of a silver dollar on the bottom of the foot. The skin was still intact. It was white and almost ready to blister. The skin around this was bright red extending a good 1 1/2 inch all the way around it.
This is headed for disaster! In short order. I have a mirror in my clinic. I showed it to him and told him he MUST see his doctor ASAP. He said he has had ulcers on the foot long ago. Wound care nurse visits. He had no idea that he had this developing wound.
He was calling his Orthopedic doctor in Phoenix while he sat in my chair and got a Friday appointment set up. I’m so happy he’s getting in right away and he did say, “My Twinkle Toes foot care nurse said I need to be seen right away.”
The preventative care we do as we provide professional foot care is so very important for so many people. So many situations helping many. This appointment today likely saved him a huge amount of money for medical costs. Possible time off work due to medical visits. Wound care nurse visits. Infection. Unattended to in short order he could be suffering fron a huge foot ulcer. Surgery and possible amputation.
Recognizing the problems early is what we do with our training.
I received a lovely $50 tip and a big hug. A new patient who wants to be a regular and plans to see me q2mo. for his foot care session and nail trimming.
A lot of my patients drive quite far to come to my clinic. As far as 50-60 miles every 2 months or so. This is my first LONG DISTANCE ‘2100 mile’ Arizona patient! He said there were no foot care nurses in Arizona. I told him there was Hanne down in Tucson but none that I know of in Phoenix. He said he was thrilled to find my clinic and me and wants to be a regular.
Everyday is a new adventure. Life is Good.
What kind of disinfectant do you use to soak and disinfect tools? I need a short contact time. Pat
Pat. I use CaviCide Surface Disinfectant as a soak to disinfect non-critical instruments. Per package instructions, soak for 20 minutes after cleaning to achieve max disinfection. I use at least 2 sets of instruments, so one soaks while I work with clean set. I volunteer in senior center foot clinic that meets only 2 days/month. It is more practical and cost effective than solutions that require the additive and expire in 28 days. CaviCide Wipes are also good for surface cleaning and wiping down instruments. Hope this helps
Be careful NOT to leave instruments in the -cidal solutions longer than recommended. My husband who is a very clever engineer really educated me on the effects of many solutions represented as to be safe for instruments that really dull the cutting surfaces over time. I was fairly cavalier about the time thinking more is better…. NOT TRUE!
I carry enough tools for a full day’s work. Our 4 primary tool and I have enough tools for a full day.
Since Cava 1 came out we only use that. 1 minute. That’s for spray and wipe for equipment. Not for cleaning tools.
Tools however, soak, use your brush and scrub. Rinse. Dry.
If tired after a long day the tools can soak a long time. Overnight and then. Scrub brush. Rinse. Dry..
Look at getting ‘Barbacide’. You can leave the tools soaking with no worries. Read the label.. ANTI-RUST properties. It does not damage your tools. Completely disinfects the tools but all tools need a lovely handy comfortable to hold scrub brush. Skin and debris must be scrubbed with your brush out of all and any grooves. Burs and tools have caked debris. Soaking disinfects and loosens it but the nice sudsing action of the Barbacide takes only a minute or two. Rinse well. Paper towels to dry.. Wear gloves.
Mine are then run through the autoclave open on trays. Not bagged. I can do all my 13 sets of tools with autoclave done in less than 1/2 hour.
I don’t recommend spray and wipe or just a soak and wipe and usage. Our policy is as I described.
The procedure I described here is what all our nurses do. We don’t all have autoclaves and they do these steps and the tools are ready for use.
Remember to clean your tool case a couple of times per week. Cava 1. Perfect!
Do you have a recommendation for an autoclave?
Dr. Comfort has on line classes and in house classes all over the US. I did both…went to Mecquan for in house. The person I talk to most, is Brian Lane…he seems to be in charge of the education.
I first scrub my tools with a brush and soak them in hot soapy water to remove any gross debris. Then I rinse them well and drain them dry. Next I soak them in Envirocide. Envirocide is an intermediate level disinfectant. After they are done soaking, I rinse thoroughly again and set out to dry. It is important to know the level of disinfectant you are using. This March, at Dr Julia’s conference in Seattle, I learned that using a high level disinfectant is the best. Often this is glutereldahyde (sp?). However, I have found Metricide OPA plus, a high level disinfectant without the glute that you don’t have to mix, just use test strips. So I will be changing to that once my Envirocide supply is gone. Some disinfectants are low level and may be good for initial cleaning but tools will likely need a stronger solution for disinfection. I use Cavicide 1 spray and Sani Cloths to clean other equipment.
What kind of disinfectant do you use to soak and disinfect tools? Pat
Great information to share. Very helpful especially for visual learners.
And I actually sit w back to pts with feoot in pedicure stool and I sit on fold up foot stool- good height and work pretty well, except might find s small cushion for my stool – 🙂
Thanks for your input on seating style. Sounds interesting. I might give it a try. Yesterday I did heavy sanding w/dremel on 3 badly neglected senior’s feet over 4 hour period. Throbbing pain & spasms in RUE woke me during sleep last night. That was a hard way to learn a lesson. We’ll be spacing out the cases from now on.
Oh my! Are you doing foot care hoping to build a successful business?
If you only do a few per day doesn’t seem like you are doing this to make much money and why suffer.
If you sit properly the right height on the right stool you won’t have pain or spasms.
If I do even 10 per day and sell shoes socks and orthotics it’s usually a $600 day.
Last week I did 5 pairs of diabetic shoes. 8 pairs of socks. And 12 foot care sessions. That was a nice $800+ day.
No shoulder or back pain. Love my work. I wouldn’t do it if I was suffering with pain and spasms. I’m waiting to send you pictures so hopefully you can make some adjustments.
I volunteer at senior centers foot clinic 2 days a month with 2 other FCN’s. It was an unusual day with 3 clients in a row needing heavy dremel sanding for months worth of their neglect and deferred maintenance. Lesson learned about “overuse syndrome” of the FCN 🙂
I also do in-home, retirement & LTD facilities. I’m retired, so not trying to amass a large clientele. I want to keep my skills current and afford good equipment, certification and supplement retirement. I’m also interested in training & proctoring nurses interested in becoming FCN’s. Thank you for your posts. Very helpful. Bonnie. Bjackles@Comcast.net
Bonnie – I space my appointments out as well to protect my back. I typically see 2-3 clients a day and am very happy with that. I have a steady clientele. I enjoy my work and my clients! I don’t make big money, but I make enough to cover ALL my expenses (including travel to Seattle to Dr Julia’s foot care conferences each year) as well as have some extra spending money. It’s important to me to have time for my daughter and husband. This schedule works for me and my family.
I noticed you said you were using a dremel. I highly recommend investing in a medi cool sander (tip from Kathryn :)). It works great. You can easily change the burrs to meet your needs and the burrs are disinfectable so you don’t have to keep buying new barrels or disks or whatever you use. It may also be easier on your arm, as it it very simple and effective to use. Just a thought 🙂 Best of luck to you!
Michelle. thanks for mentioning Medicool. I will look into it. I spoke with someone at the last conference who uses & recommends Medicool. Maybe that was you. BTW I use two lighted Dremels drills actually. One for the sanding disk, and one for the skinny burr. No swapping-out burrs necessary. But, I’m definitely curious about Medicool now. I look forward to seeing you at the next Spring Conference. I wouldn’t miss it! 🙂
When you arrive at your clients home are you able to get in with 1 trip?
Sounds like a lot of equipment.
PLEASE SEND A PHOTO OF HOW YOU SIT. I AM STUMPED! I HAVE PATIENTS SIT ON A STRETECHER THAT IS HIGHER THAN ME AND DROP THEIR FEET ONTO MY LAP. I AM ALWAYS HURTING WHEN I DO THE HOOSPICE PATIENTS THAT ARE IN THEIR BEDS AND OFTEN ON THEIR SIDES… KILLS ME.
MY EMAIL IS: FORMANWIM@GMAIL.COM
kINDEST REGARDS, Nancy fORMAN
Hi Kathryn- weird that you can get my email- email@example.com 🙂 or text me pics at (715)797-0184. Thanks
Please send that to me. I will appreciate that very much. My email is firstname.lastname@example.org.
Rose Tangham, RN, MSN, CFCS
Kathryn- just curious what positioning u are using?
I looked on the AFCNA find a nurse to get your email so o could find your email. ???
I wanted to send you a couple of pictures.
If you could email me I will be glad to send pics of our positioning.
Recently some were blogging on stools and I did a nice descriptive blog on positioning and patient & nurse safety.
So many sit on the floor and many sit directly in front of the patient. We would never do that. Ever!
Sorry – I can’t figure out how to start a new thread… I made the decision to not start a business, but will start doing home foot care as a volunteer on an occasional basis. What is the cheapest/easiest/quickest method for cleaning my instruments???
Kathryn. I am also curious to know how you position yourself if you don’t sit directly in front of the patient. Bonnie Ackles
I just sent pictures to Betty and I’d be glad to send pictures to you.
Patient comfort as well as the nurses comfort is key to having safe body mechanics and care doing professional foot care.
See my email above in Betty’s blog.
Just finishing the training video and keep in mind. Learn from everybody. Then figure out what works best for you.
You need to develop your routine to get in and get out and complete a foot care session in about ’30’ minutes.
To do 10 to 14 clients per day you absolutely can’t get up and down from the floor and do this day after day and feel good at the end of the day.
My back and body feel great after a long busy day. I’m still able to finish up and go home and do things. I’m 67 yrs old and starting my 8th year fo being a professional foot care nurse. I’ve had 4 previous low back surgeries. I also garden and train show horses.
If I did 1 or 2 foot care sessions sitting in front of a patient reaching and working on feet I don’t think I could do it. I also could never visualize the toes well enough to do high quality foot care.
Our Team of nurses and all students here all learn this.
My population when I am back In the USA are (hopefully) migrant and homeless camps. I am looking into seeing how I can work and be safe. I have used an upside down bucket to sit on here in South Africa when I am not in the free clinic that has a stretcher and that kills my back. I would welcome good ideas especially as most of my patients cannot raise their legs very far up (in wheel chairs…. strokes, etc.).
Our stools are about as low as a 5 gallon bucket. Ours are very very comfortable and swivel. In 8 years I’ve never had Even 1 person that I couldn’t lift their lower let up to rest on my knee for their foot care session.
Email me and I’ll send you pictures.
I will also be glad to ship you a stool for free if you could pay the shipping.
Are you coming back to the states? I would love to donate a new stool and a few of our samples of products we use. The work you do is so important to helping the poor and underprivileged I would like to help in a small way if you would allow me. I look at it like this. Keep you healthy and comfortable so you can help others..
And those with Lymphedema cannot lift their legs.
Could you kindly send me your positioning information?I am working currently in a clinic setting wound care) and my back s shot after just a couple of my nail trims. We are not allowed to use rotary tool due to air contamination. What do you think of linear electric sanders like micro-mark etc) Do you think they could be effective. We only have access to nippers, bone or guess and Emory boards.
There are many in the same situation as you. Some instructors will not even teach the use of drills. Yes and the back problem too. I would like to hear from those that volunteer in foreign countries….what they do to save their back.
I have had to forgo much of the care that I do in the old folks home because the patients are in wheelchairs and are unable to raise their legs even to my lap. I do the worst in their beds but that is also very hard as many of them are on their sides. I move from person to person while sitting on a small stool the home has but am really hurting at the end of a morning.
At the clinic where I have a morning “session” the patient step up some wooden blocks and sit sideways on a stretcher. This way they can hang their feet down into my lap. That works much better for me as I often see as many as 12 people. (Africa)
What about using the Recliners?
Feel free to message me-I have done work in Guatemala and I might have some suggestions for you. My number is 715-797-0184.(Betty)
Sent from my iPhone…Betty Adsit RN CFCS
Sorry to laugh but recliners are a luxury seen in the USA. My guess is that in 12+ years in Africa I have yet to see ONE recliner. People who can afford one have resources that my population could not even dream of. Most of the poor people I see spend their days either sitting on a hard straight chair and leaning onto a tray table or in a wheelchair that is at least 20 years old. Shoes are often too small so their dependent edema creates toes that look like sausages. Coming back to the USA is painful as what we waste between patients could keep me in business for weeks. This is a phenomenon that has caught the Boards of Nursing by surprise and I only wish I were younger as I too would love to have had my own practice. Dr. Julia’s course was the best gift I have had as I have been able to pay it forward.
Nancy, Thanks for your amazing work with the undeserved. I can only imagine the the crucial role of foot care in countries who rely on walking for all necessary work and events in their lives. You are an amazing role model for all of us!!
Nancy. Going with Shelly Burnett Taylor to the Veterans Villiage…she has bought what look looks like a lawn chair recliner…heavy enough to fit the larger body too. Is that even impossible for you to bring? They were easy to carry. We need to save your back.
Just a shout out to Dr Julia and the great conference that she had in Portland! I have been in business for 5 years and it is wonderful to network with this group! Well worth the trip- can’t wait to come out again:) I highly rec. this for all of the business owners and nurses working in clinics.
I second the shout out! 😊 I always look forward to Dr Julia’s Foot Care Conferences each year. It’s so inspiring to be with other Foot Care nurses, learning from Dr Julia as well as from each other.
I called the Minnesota Board of Nursing as I was exploring this as a part time profession in a small town where I live. The nurse just about reached through the phone and grabbed me. She was livid, told me as an RN I would be working outside of my scope of practice since I am doing care without a Dr order. It went on and on. How are the MN nurses able to provide this care with Twinkle Toes?
If only we could post pictures here.
Could it be related to psoriasis?
http://www.rusmedserv.com/mycology/html/Atlas_of_Nail_Disorders.pdf Pg. 98?
This online textbook has color illustrations that may assist.
Thank you very much Debbie, I have looked at the atlas of the disorders of the nails and it seems to me a text of inestimable value.
Yes. 100% agree. Thank you Debbie. I think I read the whole book on line.
Wonderful study and educational pictures.
I was able to get right on it clicking on the email address you shared
Where can I locate this educational material? Pat Van Buren RN
Hi, Pat: This Atlas of Nail Disorders is a great resource – free to view online!
God Bless You Kathryn!
Thank you for sharing in what at times may seem like a wall of Silence – people ARE listening and being inspired!
I spent last week in Minnesota with Kathryn from Twinkle Toes. Everyone was surprised that I traveled from Washington to learn foot care, but I heard she was good and I wanted to see for myself! Yep, she’s that good!! I had a great time and it actually felt like a vacation. Everything was taken care of- driving, food, everything!! And the hotel was fantastic!
Yesterday I spent the day using my new methods and techniques. My first patient was pretending to hide when I arrived and when I left he said that I could come back tomorrow! I feel very confident being able to do foot care effecienty and effectively. Also, my back felt terrific. (I had written in about stools). I learned new positioning that was much easier to my body.
I am now have everything I need and am ready to start advertising and growing my business!
Thank you Kathryn O’Shea!!!
Thank you for the great email today. Time is money. 5 patients in 2 1/2hrs. You are averaging 30 minutes per client! I am so proud of you and I’ll bet you back is ‘no problem’. Patient safety and your safety. I truely don’t know how a foot care nurse can sit on the floor directly in front of the client. So many do. The strain on the shoulders and thoracic spine and low back. I don’t know anyone who could work 8 -10 hours in that position.
You want to feel good. Make money. Make those feet look and feel better than they have in a long long time. I know you are like me. Bring on the worst looking feet and let us do our magic!
Geez. Got a referral today that is to common of a problem in the USA. A man called my home office yesterday. I returned the call this morning. He said he desperately needed foot care. Is it covered by insurance he asked. I said no. It’s cash, check, or credit card only $40 if you can come on in to one of our clinics and $55 if one of our RN Foot Care nurses needs to come to your home. He told me he was a diabetic and he went to the clinic to get help with his feet and they told him they do not trim toenails anymore and he should call Twinkle Toes 2U. They sent him away without even looking @ his feet.
He told me he had no money. He also made a very concerning statement. He said, “I don’t have any insulin. I ran out. I don’t drive I’d have to take a cab to your foot clinic but I don’t have the money. My toenails are over the ends of my toes poking into the skin.”
He told me Allina referred him to me and as always I ask what town do you live in.
Coon Rapids and that’s a northern suburb of the Twin Cities.
This man is in serious trouble and without care real soon he could end up hospitalized. In surgery with amputations. Wound infections. Death.
We get these types of calls way to often. Less services for the poor. Low income seniors going without. Splitting pills or little or no food just to have a roof over their heads. So many poor struggling to get along. What a sad situation that we live in the richest country on the world and what is the answer?
I was compelled to make an immediate call to Allina and report this to try my best to get help for this man. I don’t know his story. A veteran? Alone vulnerable adult? He needs help. I got the run around and had to talk to 3 people at Allina but I made my point. Now I will think of him and Pray he gets some help.
Yes business is good. Great actually with referrals from doctors and clinics. I have his number and plan to F/U by calling him next week. Is he my responsibility because I got the call and he told me about his toes and running out of insulin. No he is not. He is a person that is all of our responsibility as human beings. Step up when you are called upon to help others in need. It’s easy to turn you back and walk away.
You will all get these disturbing heart wrenching calls from time to time.
Suzanne, what part of WA are you from? I am in Eastern WA and trained under Dr Julia Overstreet. Just received my business license today and getting ready to start my practice. Plan on taking the trip to MINN. asap and work with Kathryn and Twinkle Toes. Can’t wait!!! Would love to collaborate with you here in WA State. Thank you, Joe Barbee RN, AFCNA, iRNPA
I live in Oklahoma and do not know what the legal requirements on functioning independently. I have looked up on the site and they have a “Decision-making Tree” which makes it appear I could do it independently but on calling the board it left me confused. Is there anyone that may have an answer? Thanks!
Omega or pincer nails are very common here in South Africa. Often there is blood supply all the way to the tip of the nail as the underlying dermis is so compressed. I start with the smallest of “nips” OR I Dremel it to a safe thinness to clip if it is also mycotic. Very challenging but I often Dremel the majority of the nail completely off if I can.
I am hoping to contact the resources for the homeless back in Oregon when we return. That is my most rewarding population. My husband is afraid I will be sued so I need to begin to look into some of your experience to avoid that.
First day of Spring 2017.
Question for you active bloggers and followers:
What is the most Challanging type of foot or toenail problems you encounter in the field?
This forum is such an important way that new and experienced foot care nurses can learn and share so we can be our best. It’s not easy to be out there starting up and know how to tackle a problem or where to get an answer.
Good idea. For me it is always the severely involuted great toenail (Omega nails). You know, the ones that really would benefit from a surgical resection but this is not an option for the client. Sometimes I find I really have to experiment to see if the client is better off with me leaving the nail long or resecting down the margin to where you can get some good clearance. The latter always gives greater relief, especially if the toe is rotated due to bunion deformity and, provided ongoing care is regular, I can usually succeed with conservative management. Sometimes the nails are so brittle that they split down the margin anyway, even just taking the smallest nibble bites. For other toes, I find using the dremel is the safest option. Am I the only one with this problem??
My problem is that when I trim off the curved in edge of the nail, I have a terrible time getting out the residual “clump” of debris/hyperkeratosis underneath. I have to dig and dig. Causes pain. I’ve had to leave a little behind at times and I’m not sure if that will cause a problem. I use a pointed round edge tool and soften the skin with the soak. Advice??
I’ve got a GOOD one to share.
I had a new patient last week. Big guy. Can’t reach his feet or toes. He shared a fabulous thing he shared. First of all with every patient I do a quich lower leg and foot exam.
Large man. Can’t reach his feet. Feet very clean especially nice between his toes. Often patients have debris and sock fuzzys. Moisture as they can’t dry good.
He had great skin intact and clean. I mentioned to him that his feet and his shin looked very nice. Clean. He responded and I’ll tell you what he told me.
He said,” I use a baby bottle brush, the smaller nipple brush between my toes. It works great. Put it down between the toes and pull it through. Cleans them so easily!”
WOW. Inexpensive. Sturdy and safe. Soft brush bristles. Cleans between the toes perfectly. A creative way to solve a problem! So cool.
I’m going to shop and pick one up. Try it out. (I can reach my feet just fine) I’m going to test this out. If I like, I’ll recommend this to others that have a need.
A new foot brush for between the toes. How cool is that.
We are growing!
Exciting times growing and building new foot care businesses. So great to have this forum as a go to for questions and support.
OMG If that’s Miss Prego Kardashian, she REALLY NEEDS to go out & buy a bathing suit that covers up same of that wide load she’s carrying around now! For real, it’s not like she can’t afford a few, or even have one “custom’” made to fit her a$$ & belly just right….Worst pick EVER Kort…
Yes email me what you have please. My business is coming along well so far. I still have to break through by advertising it and proving myself as the profesdional that I am. I will keep you posted.✈️⭐️🏆.
Yes email me what you have please. My business is coming along well so far. I still have to break through by advertising it and proving myself as the profesdional that I am. I will keep you posted.✈️⭐️🏆
For what it’s worth… as both a Dr. Julia graduate and WOCNBC certified, AND as a total volunteer… I represent myself as a “Therapeutic Foot Care Nurse/or Specialist).
I work in Africa (where they were very determined I should license here and I refused) and in the US where my preferred population is homeless. If I were younger I would be on this like flies on paper but today that is not my desire.
I enjoy this blog but total agree….. that “nail tech” complete undermines and demeans what we are providing and how we want to be perceived. A “nail tech” conjures up a salon run by Asian women with no training and that has fast become the downfall of certified nail technicians in the NW.
Good luck…nancy Forman
Touche. We set the bar high with pride as Professional foot care NURSES.
Certified Foot Care Nurses. RN Foot Care Specialists. Never a nail tech.
Awesome Nancy, I just finished a Dr. Julia Conference this past week end. Had one Hands On last Spring under her supervision and hope to get another day (or two) asap. Hoping to be up and running in the next 2 months at the most. Have a Dr. Julia grad and she is also WOCNBC to provide proctor hands on. 30+ years in nursing and hopefully this keeps me with my tribe (patients and colleagues) for a few years to come. Lot to learn and I absolutely love doing the work. Look forward to a lot of input on this blog. It is setting up the buisness details that is NOT my thing!!! I will learn. I spent almost 7 months getting a certification as an iRNPA and wouldn’t trade what I learned or my cert. for anything, but am more focused on my foot care buisness for present and future. The other buisness will be on back burner, but can be utilized as need and $ arises. Lol
Hello Ramon…this is Rose from Maryland. We comminicated before. Please share with me the information that you have. That will be of great help.
Rose Tangham, RN, MSN
Hi Rose, here in Florida, I found different articules within Florida statues which allow us to practice in independent manner, whether visiting patients at home or in an office. I have been a bit doubtful about the legality of nursing practice, but I have found that if we can do it legally. I can send you the document to your email if you are interested in reviewing it.
I would like to know how the progress of your business is going.
This is exciting please send me the detail of what you have to my email of bsn email@example.com. Will you be able to charge medicare or medicare?.
I, and others including Ramon, certainly empathize with the feeling there is little regulatory guidance about the practice of foot care nursing specifically. For some jurisdictions, it truly is as simply as opening your business. (Oh, Kathryn, if only it were as simple for RNs to be compliant with a regulatory body everywhere as it is in Minnesota! [Though Minnesota LPNs do need to contact their state board]). Ultimately, I believe our nursing regulatory bodies’ focus is on ensuring those within their registry are providing safe, competent care to the public. With that in mind, we must objectively translate our regulated scope of practice as nurses to our specifically focused practice as foot care nurses and provide the documentation of specific training including hands-on experience required to provide foot care. That is what I have come to understand is necessary to have prepared when contacting the regulatory body as that is what they can review and gain assurance that a practice shall be in compliance with the established nursing regulations and be within the nurse’s scope of practice and level of competence, particularly when the nurse intends to practice as a self-employed nurse.
RNs have a greater scope of practice than LPNs/RPNs even as basic care and advanced care are similar and RNs may include that in the description of their practice. Clearly, we are responsible for being aware of the level of our foot care training, skill and competence level. Attending hands-on clinics that are proctored by credentialed, competent, and experienced practitioners enables us to become aware of further learning opportunities as we receive objective feedback for improvement in competency and expanded knowledge. I appreciate Dr. Julia’s clinics for the expertise and unique field of clients she gathers for nurses to learn; case presentations are great! She is very dedicated to promoting foot care for all and retaining life and limb through preventive care. The online and hands-on training and workshops she provides have been fundamental to my foot care nursing education.
I have gone through the process of translating RN general practice to foot care nursing practice for my jurisdiction and produced a written application that met my regulatory body’s requirements. As I did so, I practiced basic foot care, free of charge, and refined my skill. (As Dr. Julia points out, anyone can improve the condition of another’s feet without need of a permit; training, skill, and experience leads to betterment.) I now have the required permit to practice as a self-employed foot care RN in my jurisdiction and my client base is building quickly.
The good news is we are not alone and this AAFCN network is a great resource! There are usually other nurses practicing foot care in our own jurisdictions; finding them locally is often a challenge. I am coming to realize, as my own foot care nursing practice grows, that these other nurses are probably, as I witnessed at Kathyn’s TwinkleToes2U practice, very busy providing service. I am very grateful to her for sharing her wisdom here and through training at her facility.
Fortunately, the AAFCN website has a “Find a Foot Care Nurse” directory: http://www.afcna.org/FindFootCareNurse?&tab=1
There are four Virginia foot care nurses listed with their contact information posted; give them a call!
Building an interdisciplinary health network has been one of my best tips; the local doctors, podiatric surgeon, pedorthist, chiropractor, physiotherapists, massage therapists, pharmacists, and some of the podiatrists, are approachable, can be sources of mentorship and, taking the time to get to know them personally, you can recommend clients to them with confidence as needed. As well, clients will be referred to foot care nurses from these professionals as the role of advanced foot care nursing is understood – competent people need not fear competition as clients are perceptive of the practitioners able to meet the level of service they require. It is up to us to increase public awareness of the service of foot care nursing.
Becoming a member of foot care nursing organizations at all levels (international, national, state and local) takes time but the rewards are many; active membership increases the opportunity to learn and share as our own nursing regulatory bodies, and the public, are becoming aware of the immense value of the foot care nursing services we provide. For us to progress as a nursing specialized group, dedicated time is required to build on the framework developed by passionate practitioners such as the ones who initiated and established this American Foot Care Nurse Association and the Canadian Association of Foot Care Nurses.
For Anyone interested, Dr Overstreet is coming to Samaritan Lebanon Community Hospital on Friday, April 7th from 1pm to 4pm to give a talk. She is a wonderful resource and teacher. The cost is $50 for non-Samaritan employees, $25 for Samaritan employees. Email me if you have questions and I can send you information on attending the conference.
Thank you, Donna,
I just searched the internet for where Samaritan Lebanon Community Hospital was: 525 N Santiam Hwy SE, Lebanon, OR 97355, USA; just south of Portland. Though I won’t be able to attend this time, it was very kind of you to post this!
Amazon has a great picture of a Tot Spot chair
Apologies, it is called “tot spot”. The seat is 10 & 3/4″ of the ground and measures 13 1/2 wide by 12″ deep. The back is 13 3/4″ wide by 8 3/4″ high. It fold up just like a regular camp chair. I bought mine for $5.
Here’s a current ad just to see what it looks like:
Thanks for responding. I didn’t find a “tiny tot” stool online. I’m trying to figure out is if it would be better to be higher or lower than the patients feet. My back is not happy right now.
I use a pedicure stool for the PT leg- found on ebay and a fold up foot stool – plastic one that is 9 inches from the ground –
I’m enoying my foldable “Tiny Tot” brand children’s camp stool – rated for 200lbs. It weighs very little more than Cabela’s 3 leg but a lot more stable with its four stable feet and a good back support. No longer available new but can be found on Craig’s list – just Google the name.
Wanted to post that I ended up buying a Kore adjustable chair. It is a wobble stool that mimics an exercise ball. It has worked great and has been easy to transport. I got in on Amazon for $80.
NEW INFORMATION ABOUT SCOPE OF PRACTICE AND REGULATIONS IN FLORIDA
Dear Colleagues: Although I know that many of you have successful foot care practices, so far, I did not find in this state of Florida, any legal support that would allow me to continue my desire to start practicing independently. However, I have continued to persevere and found in “The Florida Statutes 2016”, elements that allow practice both in the home of clients, and establish a facility where you can provide care. I’m really happy about this and I wanted to share it with you. If someone wants a little more information, please you can write me to the mail.
I am in Florida and am attempting to start a foot/nailcare business. The board will refer you to the Florida Nurses association. After consulting with their attorneys, they will let you know that there are no laws/Regs preventing you from setting up a business using the skills you learned as a nurse. But they will encourage you to consider working under or with a physician. I personally do not want to have to go that route. Although I am a CFCN/CFCS, I have chosen to get licensed as a nail tech. According to the Florida board of Cosmetology, a nail tech can be mobile, if they work from a salon.
The whole thing is a big, frustrating mess, but it can be done.
Nail Tech??? I have never heard of a privately owned professional foot care business owned by an RN doing this and I don’t think you want to do this.
You will want to design and set up your own policies and procedures and not be controlled by cosmetology rules and guidelines.
There is a tremendous amount of business just waiting for you to start. Don’t make it difficult. Perfect your skills andyour routines. High quality foot care and make your mark as a trailblazer. Today I got 9 phone calls. About average for a day. All 9 were Doctor referrals and all 9 booked appointments. First time new patients.
We have 10 RN professional foot care nurses working as a Team and a couple other non Team members in the Minneapolis St Paul area. There is so much work here we could use a few more nurses. If we have this much work here that tells me there is this much potential foot care in every major city just waiting to be tapped.
Phoenix area has nobody. Orlando has nobody but soon there will be a wonderful couple starting their business. The sky is the limit!
Thank you dear Kathryn, I wanted to thank you publicly for the help you have given to us. It was a meeting of only a few hours, but very productive. I think you are sowing a seed in many of us.
Thank you very much.
Ramon and Dafne
(Mrs. O’Shea came to Orlando with her husband and we were reunited at my house, and thanks to her kindness, and totally free, she share her experience of how she has come to have a successful business)
Hi Paige, I do not think you have to have a tech. certification in nails. As nurses we can serve the houses and also do it in an office. I have all the information on these matters, which appear in the state statutes. Write me an email and I will send the document that I have extracted. I have also been very doubtful if this is legal to do so but finally and found the answer.
By the way, you are the first nurse I know here in Florida who is working in this field, I also started new, so we could exchange more information, if that’s okay with you. Where do you live? I am in Orlando.
I am in Oregon but would love the info you have found for your state.
Hello Tiffany, send my your email to send you the document.
But you did not say HOW to remove the loose nail. You just said it comes off easily. Do you just pull it off?
Oh my. Never pull anything off. Use your pick to closely examine. Checking clearance. Then smaller nips removing carefully until you get all loose nail off all the way to the attached good piece of nail.
Sometimes I feel like I’m whittling away. Very gentle with the correct nipper.
This patient is doing great. I also did a f/u call to her.
My Officer texted me today. Healing nicely and taking his antibiotics as directed. Removing the foreign bodies. Chunks of cotton ball that migrated deep beneath the nail was the source of the infection. He said redness was almost gone! Doing great.
When you have a complicated case it is always a good thing to do a f/u call.
What type of stool have any of you found works well? Or what height?
I am using a camping stool and the patient is typically in a recliner. Something isn’t feeling right about this position. Any advice?
I actually purchased a folding aluminum stool with carry handle from harbor freight. Very sturdy light weight lets you wiggle on seat to whatever position that you need. Clients are able to place there foot on my knee. My back feels fine. Very reasonable cost
My stool is 5 years old and so comfortable. Still looks like new. No signs of wear. It’s the $36 Cabella camp stool. Swivels. Adjustable height. I have mine low about 16 inches floor to seat. Heavy duty canvas seat tripod. 3 legs. Easy to get up and down. Light weight to carry.
I’ve had x4 low back surgeries. I never have a painful or tired back and I do a whole lot of patients each day.
For my clinic I sit on a professional rolling padded stool live every other doctors offices have. My comfort and safety is key to having a successful foot care business.
I’m on year 7 and thousands of Footcare sessions.
I’ve trialed many products and equipment and found durable quality equipment pays.
I’m a lefty and sit to the left side of my patient. The patients lower leg and foot rest on my thigh. I have a few ‘big’ boys with heavy legs. Doesn’t matter. No pain in my leg. Light or heavy patient. Great visual of the foot & lower leg.
I know many sit on the floor. Many sit directly in front of the patient. You develop your own technique that works best for you but take a close look @ body mechanics and take care of your back. Make it good.
What a wonderful save! Thanks for sharing. I’ve encountered cotton or Kleenex stuffed under nail edges, but nothing quite so dramatic. Good job!
Great story! Thanks for sharing
What a great outcome!
Thank you for taking the time to share an interesting day and case!
I love pictures – Dr. Julia: Is it possible to post pictures on this site?)
I frequently take b/4 and after pics but have never been able to post or attack them here.
I wish more members would post stories and experiences to share as we can all learn new things and tips that help. This is so wonderful to have the blog!
I could have never done this without the Footsie bath to clean and rinse all that pus to visualize. Able to see something and remove foreign bodies. And the great product we use. You know. You’ve been here. 👍
Rid the dust. Clean foot. Nice and ready to apply moisturizer & massage!
Can you please describe your process for removing that nail and the one that was still partially attached? I see similar things and don’t know how to completely remove the nail.
Loose white nail is always removed very easily. What nipper are your using??
An important next step is then to use your bur to take away any ridge that can catch on a sock or the bed sheets on the remaining nail.
Importantly to those loose dead nails still partially attached catch on everything. Most come in and have them taped.
Beneath them is always wet and or wet and mushy with debris. Can’t dry with that big dead nail over it. Most all the time you see the new growth beginning beneath. Clean out the wet debris and dry well when done. Sore or tender under there so bandaides and bacitracin. We recommend x3 days and give them the 3 bandaides and single packets of bacitracin. It’s so cheap from your suppliers.
100 great fabric bandaides= $1.44
144 single pkgs bacitracin= $8.67
We do not charge anything extra to give these but you certainly could incorporate an additional fee for the procedure & drsg. Supplies.
Mmmmm. I gotta think about that. 🤔
Go ladies, I am with you.
Sent from my iPhone
Thank you…I thought perhaps you were using a blocking agent… I too have had nails that were still attached with viable tissue that I really wanted to take the entire nail off but it was still viable and the person was in so much pain I could hardly get near it. I use Dr. Julia’s double jointed clipper and while I have many smaller… I am adept with it. I am still using a Dremel as I am in Africa and do totally volunteer clinics and the Dremel is still the most affordable option for me even though changing the sanding belt is a pain.
Very interesting day yesterday. Friday’s are usually an office day for me.
I had to trim however. The first was a reschedule from Tuesday due to the cold and icy roads. Perfect. Next.. A new patient. Emergency referral from the doctors office. Mmmmmm. They won’t trim. Send them away telling the patient to call me or my team. I told her I had time so come on in. Loose great toenail. Catches and some bleeding. She had a loose great toenail with mild fungus. The only attached area was a small strip medial. I gave her a professional trim on all nails and removed all the loose nail completely then used my Medicool drill and everything bur to be sure the edges on the remaining nail were smoothe and won’t catch on anything. Bandaides and bacitracin given for her to apply for 3 days. It looked very sore and so glad she cane in. A very happy patient. Rebooked for 2 months and will start on the Vicks protocol. New regular patient.
Next. Another emergency. I got a call from a handsome 40y/o police officer from a neighboring town. Neighboring state actually. ’80’ miles from my clinic.
He was desperate. Very severe pain in his rt. great toe. He said he hadn’t been able to go to work for 2 days. Hadn’t slept for 2 days. He went to the doctor and they told him, “Yes, you have an infected ingrown great toenail.” They handed him a script for antibiotic. Looked @ the toe. Did not remove the ingrown. Sent him home.
He began called hospitals and clinics to find someone to remove the ingrown. The clinic here in Minnesota gave my business name and referred him to me.
I take out lots of ingrowns. Lots of referrals from many doctors and clinics.
He came and I removed the ingrown. Then found the reason for the infection. Thank God he came in. 2 months earlier he had poked sone pieces of a cotton ball under the edge of that nail trying to prevent it from being ingrown as it was a chronic problem there and he was trying to lift it.
I probed and wanted to check closely that I got all the ingrown out. Large amounts of green/brown pus poured out. The toe was swollen and red. After the pus was mostly out I probed and in that hole beneath the nail was a rather large pussy chunk. Foreign body.. The cotton ball piece had worked its way in and under the nail. I probed and x3 fairly large chunks out. Kept coming. A huge hole tracked in under the nail! More pus.
100% the source of the infection. The cotton. Soggy and pussy.
With the pressure removed and cleaned out I gave him 3 days of bandaides and single packets of bacitracin. Instructions given. I of course applied the first one.
He put his shoe on and the pain already subsided substantially. He could walk again. He was sooooo happy and glad he came. I got a HUGE tip!
This morning I text him to follow up. Reinforce directions. Finish that course of antibiotic till gone and watch closely daily. 3 days of bandaids and bacitracin. Call me or see doctor if not healing.
He text back. Slept. Went to work. Walking normally.
I do believe he was headed to such a severe infection and the depth and size of the hole he could have gotten an osteo and possible amputation if the foreign body had not been removed.
You never know what is coming through the door!
Unusual day I wanted to share. Saved a toe!
Apologies for the delayed response! Super busy just now so my research regarding regulatory bodies has slowed. Minnesota RNs appear to be free and clear to set up practice while LPNs must communicate with the State Board for clarification of practice confitions.
I had begun my Florida research with the State Board but was referred for clarification with the Nurses Association. To be continued…
Thanks again Debbie, remember the link where I did my little research was : http://floridasnursing.gov/. From there, I went to several other links but I never found nothing definitely clear in regard of Scope of practice.
Ramon Martinez, RN, BSN,CLWT, CFCS
February 3, 2017 at 12:13 pm
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Thanks again Debbie, remember the link where I did my little research was : http://floridasnursing.gov/. From there, I went to several other links but I never found nothing definitely clear in regard of Scope of practice.
I just need to advertise the business Kathyrn. Reaching out again to my foot care friends, please give me more hints on how to market this million dollar business please. Thanks
On the floor is almost impossible, as it may be too hard on your back.
please check us out! For those of you interested in international issues
Thank you for this. Are you able to find legislation for LPNs independent practice?
No. We are a group of RNs only but 1 exception. My daughter is an LPN and practicing since 1999 and has never had any problem.
I only take RNs for my classes.
Precious Steps Foot Care Services, LLC. of DMV is the first nurse owned and operated foot care company in three States.
You are Presious Rose. You are on your way!
Just the word thank you is not enough Kathryn. You are awsome woman of Wisdom. I am glad I met you.
I got a call from a social worker from our local hospital wanting me to come out and do a patients nails. Has anyone else gotten this request? She said bring cards because there will be a lot of patients wanting this service.
There ya go. Once you begin. Work hard and build a good reputation. The calls will come. Accounts like that can grow especially as the doctors hear that you are providing a quality service. Soon the doctors will call asking for business cards. More and more. Ask questions and seek them out. Put together a nice introductory letter and call the clinic manager and specifically ask the manager to give your letter and cards to the doctor. Talk yourself up. Tell them what you can do for them. Believe me. They do not want to trim nails. Once they know you are not a fly by night but your company/business can be depended upon you are on your way to a successful business. You can’t be average. You must provide high quality care. Something special that you can do that is better than anybody else.
Thank you for sharing.
We also go into hospitals upon request for referrals to do foot care. These are mostly very bad thick long nails. Payment isn’t by the hospital. The families or legal guardian pays the fee. Often these patients become regular patients as you make recommendations that they ‘should’ have regular professional foot care q 2-3 months as needed if they indeed are unable to provide there own foot care. When the patients and families see the quality of your work and know you will be happy to set them up with regular visits in their homes or wherever they live it gives them peace of mind that their family member will get the excellent care that they deserve.
Often the seniors don’t even know such a service is even available as we are entrepreneurs and a relatively new field. Nurse owned businesses. How great is that!
Leave your business card and a nice brochure if you have one for the family. Also supply the facility with your information.
It’s all sales and marketing to build your business.
Several of us Team members are planning on attending the Senior Expo this weekend @ the Minneapolis Convention Center to promote our Foot Care Businesses. We will have a shared booth and can talk to people. Pass business cards and info.
I highly recommend once you have your business model set up and you have started get out into the community. Find shows or conventions that target seniors or Diabetics and promote yourself and your company. If you want to have a successful business you have to put the time in. It’s fun and rewarding. You can’t just get your certification and expect the customers to show up. Senior senters. Diabetic support groups. Activity directors @ senior buildings. Get your name out there so they know exactly what you have to offer and what a great company you have.