hotflashion, BSN, RN 5,939 Views
Joined Oct 8, '09 - from 'New England'.
She has '1 fractured' year(s) of experience.
Posts: 279 (29% Liked)
I got my CFCN last year and I'd like to hear from others who are practicing or considering it.
I started working as a footcare nurse last fall, and am currently doing homecare and one clinic at a senior center. I'm working contract for another nurse who started a footcare LLC and had more demand than she could handle on a part-time basis. I also work part-time in a podiatry office but do not do footcare there. That may or may not change; the doctor I work has mentioned the possibility of my doing footcare but this has not become a reality. In the meantime, I like the regular income I get from this job and the access to the doctor's accumulated knowledge.
I would really like to someday have a location where clients come to me for care. I'm not sure this would make any financial sense, but I'll be figuring that out this year. In any case, footcare is the niche for me, and considering my age it may end up being just the perfect part-time retirement job. The service I provide is very much appreciated, and I get a lot of job satisfaction from this.
I just thought I'd write about the equipment I've bought so far and if anyone has any questions or anything to add, that is welcome! I do have a question about autoclaves, so I'll start there.
I don't like the amount of chemicals I'm using currently, and don't want to chuck these down the drain. I've been disposing of the used disinfectant in a 10 gallon bucket, and I'm hoping that once the weather gets warmer, I can just put it in the garage without a cover and let it evaporate. Whatever doesn't evaporate, I'll channel through hazardous waste disposal. So, I want to by a small autoclave. I'm considering a small clave by a company called Revolutionary Science in Minnesota. They have two small models, the RS-SC-102 and RS-SC-200. If anyone out there is using one of these, I'd love to hear about your experience.
As for equipment I aready purchased:
I'm not very good at detecting pulses, especially pedal pulse (!) and have a numb left hand index finger, so I bought a doppler, which has been invaluable.
I also have a power file from Medicool, the Pro Power 20K, which is quite nice. I went to Medicool beause the podiatrist I work for has that brand in the office. Since I'm doing home care and clinics, I bought the portable one with a rechargeable battery, and it's been great. I initially bought and used a set of diamond bits, but for grinding thick mycotic nails, I think the miniature sandpaper drums (or tubes) work better. I wear an N95 mask for this. I will also be making some (hopefully attractive) back-tie gowns as I really dislike being covered with fungus nail dust. I tried to find some that were not crazy expensive and not disposable but haven't found any yet, so I may just make some.
For disinfection, I've been using Barbicide which is easily obtainable at any beauty supply shop. I may switch to Benz-All (benzylkonium chloride). Benz-All is what my podiatrist employer uses and it's covenient as it comes in pre-measured concentrated doses that you just add to a gallon jug of water. But I'm not sure it's the best and I have to do research on this.
Ok, I've got to get to work so I'll quit for now. I hope to hear from others!
afrosandtiaras, scope of practice is determined by your state's board of registration in nursing. In Massachusetts, where I'm at, the BoRN has an advisory that spells out in pretty good detail what is required for a nurse to provide foot care. While not specifically required, certification would probably satisfy the Mass. BoRN's requirement that nurses "may perform nursing techniques and procedures related to foot care only after appropriate education and demonstrated clinical competency."
The business question is separate, I think, as you can run a business without actually providing the care yourself, as long as your care providers are practicing within the scope of their license.
Hope4673, I'm not sure who you were asking, but I never worked there. Good luck, it still sounds like a great place to work.
Ok, I probably don't have the right terminology. I wanted foot care to be its own category under Nursing Specialties.
I knew the discussion was there, I was asking for our own thread.
As a CFCN, I would love to see a Specialties thread devoted to this niche area of care. I believe that foot care nursing is teetering on the edge of exponential growth, as more and more people become in need of such care and fewer and fewer podiatrists are willing to provide the quality care that patients deserve.
As a new foot care nurse, I have questions -- and possibly answers -- and I don't want foot care topics to be lost in other threads. There may not be many of us out there right now, but it's hard to tell without our own thread. And in any case, I think that will change.
Thanks for considering it.
Saying not to work below my level does not help. The fact is, I have almost no experience as an RN in the 6 years after graduation, and the experience I have had is piecemeal at places where you wouldn't want to work. The current job has just about served its function, which is springboard to my next endeavor, an independent RN-based endeavor in a specialty area of practice. This job provides money and relevant background experience, so it has been valuable. The ethical dissonance I feel is in not being upfront with the new employee. I feel like I am using her as a stepping stone out of the alligator-filled pond, all the while saying the alligators are rocks and logs and the water is just fine. I also don't like to run out on people, even when they do not uphold their end of the relationship. So, I have my issues in that regard.
I don't know if this is even appropriate for Allnurses, but here goes. I'm working in a one-doctor office. Though I am an RN, I was hired to fulfill a medical assistant role, which was ok with me as a means to an end beyond this particular job. I thought I'd work there for a year, learn what I could and then move on. I've come 2/3rds of the way.
Long story short, I am the only one left in the office besides the doc and because of this I have had to do the front office tasks, i.e., answer the phone, re/schedule patients, check in/out, take payments, all the administrative tasks associated with a doctor's office. Plus I room patients and do some minor documentation in the charts.
There is more work than I can do, and it is of such an intensity that I am exhausted. The doctor massively mismanages the business, and I regularly field calls from patients who do not get their tests or prescriptions called in as requested, who do not get test results once the tests are done, who are confused and angry because there is no follow up, or from creditors who shut off accounts for nonpayment. On top of this the paycheck does not come regularly: I am paid biweekly, am 1 paycheck behind, and the latest check is late.
The doctor was totally unprepared for ICD-10 adoption on October 1, and we are now unable to bill. It is a setting of utter chaos. I also happen to know that the doctor is now under warning from the local hospital professional organization for not paying dues and not charting within the required time frame.
I am currently training a medical receptionist. I'm very organized, have kept the front desk "together," and feel like a complete and utter fraud with this woman, a very nice woman who needs her paycheck to be regular. She likes me, and I evidently put on a good show of having it all under control. I am not telling her that she should run away now, though that is what I think she should do.
I got into this mess because I wanted the job, I wanted it for a year, and I was willing (and able) to put up with alot of nonsense. Then things happened and I ended up being the last employee on staff. I'm not sure what I'm going to do, but I'm miserable right now and having a tough time sleeping.
I'd love to read your thoughts. Opinions, please.
OP here, I'm sorry to post and run, that wasn't my intention. I've never worked in a Dr's office before and it is a specialty office, not primary care and certainly not a cardiology office. It is relatively recent that the practice has been taking BP on its patients, though this was instituted before I was hired. We are so busy that I basically run in the door in the morning and we don't stop running until we're out the door an hour late in the evening.
Assuming for this post that a patient exhibits a "high" BP reading, denies symptoms and exhibits no signs, what do you do? And, do you use the American Heart Association's category definitions for normal, pre-HTN, HTN Stage 1, HTN Stage 2, and HTN Crisis?
I want to know what you do in your office, I'm not asking anyone to tell me what I should do in my office. Does this help?
I work in a medical specialist's office. The hospital system with which we are associated now requires that we get certain info from our patients -- height, weight, smoking status and blood pressure.
We have no protocol for high blood pressure, and I certainly think one is necessary. I'll be addressing this soon, but until then I'm interested to know what others do. What do you do at your office?
Yes, I have insurance.
Any current news on the single-payer implementation in Vermont? Is it rolling out? Are the questions getting answerred?
Enquiring minds want to know...
I agree. And from what I've seen in the job ads, I will be competing with medical assistants for a position at a podiatry office. They may not have the same scope of service (I don't know what they are allowed to do, I haven't researched it) but from the job descriptions I've read, it sure sounds like they do most of what I might do as a foot care nurse in a podiatry practice; visually, MAs and RNs are like two overlapping circles. From what I've seen, outside the hospital setting, MAs and (to a lesser extent) LPNs fill the traditional role of nurse, i.e., someone who works under the direction of an MD.
It's getting way off-topic but I can't resist: "Why do the colleges even offer the ASN if we aren't 'good enough' anymore to provide excellent care?" They offer it because it is one of the avenues towards RN and they want students. Why does RN allow two vastly different pathways toward the license? That's a big 'ole can of worms! I think nursing education and preparation is way out of whack.
I think the requirement for BS is a bit much as well. I've got the BSN thank goodness, as I am just beginning the process to get certified, and while I also agree that the current requirements are lax, I will be personally happy if I happen to squeak under the wire. It's putting the cart before the horse, but I hope to become employed in a setting that will allow me to see and care for many, many feet. That's my plan, anyway.
footqueen, what is a "foot care company"?
I was actually trying to find the program that started at the Shira Ruskay Center in NYC. It's since become its own entity (Doula Program to Accompany & Comfort) and has moved here: Doula Program to Accompany & Comfort - Home
And here's an article written about the implementation of the program at Baylor: Comfort and caring at the end of life: Baylor's doula program
The people doing the doula work are volunteers. I don't know how this service can be translated into an income generating operation.
I wanted to talk to someone who has worked for Nature's Classroom. Looks like a lovely operation. There are 13 sites in New England and New York, and other "associated" sites around the US.
If you have worked for Nature's Classroom, please respond here with your experience or message me.
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