Foot care training - page 4

I have been interested in starting a foot care service for some time now and after reading posts from LoisJean feel this is something I can do. I would like to start out by receiving some kind of... Read More

  1. by   Tutti
    You have been so great with giving us information. Thank you. I am disappoionted that I won't be able to take this course, I will admit. But that's okay. I'm happy for you and I'm sure you will be a great resource for helping with the exam. I know there is so much controversy with using the dremel. Lots of my Patients want me to use the dremel. I purchased a special burr especially for foot care that Podiatrists use. Any thoughts on that? It can be soaked with disinfectant. I've used one of the pedicure electric files, but it doesn't do the job in some of the tougher cases. Keep us posted for sure, Laura! This is so exciting! If I only could, I would run out and get my A.S. degree immediately! Keep up the good work!

    Last edit by sirI on Nov 14, '08
  2. by   hoolahan
    Foot Care for Salon Professionals by Dr. Oscar Mixx published by Malady Press ( I think) Look on Great book, should be called Foot Care for Health Care Professionals. WAY beyond the scope of practice for pedicurists. I took an 8 hour class by him that was great and was given at a trade show for the Cosmetology Professionals in Sacramento last year. Good luck!
    I got this book, and you are absolutely right, it should be called Foot Care for HC Pro's. It is excellent!! Thank you for the recommendation. The author is a pod who just wants everyone to have good feet, and his philosophy, much like Lois Jean's, is that if he can spread the word to anyone who cares for feet, and hone their assessment skills, he will be getting them a step in the right direction, pun intended! I would have loved to see this guy in person, he seems like a wonderful doc, generous with his knowledge.
    Last edit by sirI on Nov 14, '08
  3. by   guest***
    Glad you liked the book. It is one of the best. The only error I found in it is in the part that addresses capillary refill time. It says it should be under 30 seconds and that is a typo! I think he meant 3 seconds. I use 5 seconds as my cut off for referral to apodiatrist.

    Dr. Mix is an incredibly nice guy. Too bad he is nearing retirement. He could be a great asset to foot care nursing workshops. I was fortunate enough to take an 8 hour workshop with him. Someday I may have my own classes going. We will see. Right now I am inundated with my current business.

    Also, I just found on the WEB that Dremel has now come out with a more sophisticated tool, an electric system, designed for nails. This is a different drill than their old battery operated tool. The battery operated one is now being packaged and marketed toward nail professionals as opposed to the crafter. However, it is the same tool. You can see some of these new files I am talking about by going down to your local manicurist. I have 3 different files ranging from $300 to my $1750.00 Orthofex that is made in Holland and has a vaccum near the bit. The electric nail filing systems are much better. They are more comfortable for the client. It is worth the investment!

    That site has more information on those systems.
  4. by   guest***
    Check out this site by the American Orthopaedic Foot and Ankle Society. They have an anual COMPLETE FOOT CARE COURSE that targets all health professionals dealing with feet and has a special tract for nurses! It is a 3 day course, May 14-16 in New Orleans and I am going to go. I have always wanted to attend one of their conferences. MD's and orthopedic surgeons are much more nurse friendly than podiatrists, generally speaking. So check it out. If anyone ends up going, let me know and we can meet for lunch!
  5. by   adrienurse
    Wondering how a 3 day conference can be considered a complete course, when my course involves 44 hours of in class lectures and a practical componant.
  6. by   guest***

    You are right. Complete Foot Course is sort of false advertising. However, it does look like a good course. It is put on by MD's and RN's so there is not the competative factor like the Seattle Foot Course. It is slim pickins for foot care courses in the states and this looks like one of the better ones I have seen advertised. These types of courses are great for networking. And there is always something new out there in the foot care world. It would be a good place for nurses interested in this field to go. But we definetly need a REAL complete foot course with lots of hands on. Where is your course? Did you teach it or attend it?
  7. by   Tutti
    I have a question I am hoping I can get some help with. I need to make a consent form for my foot care clients. Do any of you use one? I need to know what information I need to put on there. And if the Patient cannot sign for himself, and there is not a family member present, what then?

    Thank you in advance!

  8. by   guest***

    Am going out of town for the week end but will post you what I am using. However I have no idea how legal it is. I used part of a consent form that my Canadian nurse friend uses and added my own part about also allowing me to photograph for teaching purposes. So check again, I should have it posted by Tues. It might be a start anyway. Probably consulting a lawyer would be the surest way to do this, but expensive.
    Last edit by sirI on Nov 14, '08
  9. by   Tutti
    Thanks! I appreciate it! You're the best!

    Last edit by sirI on Nov 14, '08
  10. by   LoisJean
    Thank you, all of you...

    I can't recall how long ago it was when I first came to this forum and shared my experiences as a Nurse Entrepreneur--owning and operating my own private duty foot care nursing service. I am in my 10th year of business now. For the first 7 years I worked by my self, now I have another LPN and two BSNs on board. I am an LPN.

    I have been an LPN for 30 years--and perhaps, because of that, I am not easily intimidated by those who would tell me that I am not allowed to practice this worthy nursing service...a service which is so desperately needed by so many and that is provided by so few.

    Thank you so much Tutti and Laura for your wonderful information. It will all be shared at my next nurse's meeting and the reference materials you have suggested will be obtained so that we might better serve our clients.

    I am, (as some who frequent this forum know), HOT on foot care being provided by competent and dedicated nurses...LPNS/VNS AND RNS, to all who are at risk for serious complications and amputations... problems that can rob a person of his independence and often his life. I am appalled at the lack of knowlege on the part of nurses and doctors alike, who deem the body to be the proverbial temple, but consider the feet something less than worthy of even a quick peek. AND! I don't even want to go into my experiences with the podiatrists in my area...

    We are busy! Very busy. Nightengale, I have not forgotten you or any of you who have been with me since we first got on the subject of foot care as a Nursing Entrepreneural adventure.

    I will try to get back on board here--and stay on board.

    Peace and Brightest Blessings to All;

    Lois Jean
  11. by   Tutti
    Lois Jean,

    I was very excited to see a post from you. I have read the old posts you have written. I have been an LPN for 12 years, doing foot care for 3. Considering I work for a facility, it has been a huge success. I still have a Podiatrist to compete with there. We have actually been through three different Podiatrists in the past 3 years. I am in a stage where my employer wants me to do more foot care and less of my other duties as that is the only piece of my job which brings the money in. They have continually tried to get me to increase my rates and each year I say No! long as I can get away with it, I will. The only way I can bring in more clients is to advertise to the surrounding community and even other facilities in the area. The problem with this, is that most places already have something in place and It's usually a Podiatrist. I am trying to come up with ways in which to sell myself to these places. It's tough. I also have the visiting nurses to compete with. They are everywhere! Please do keep in touch! You are an inspiration!!!

  12. by   guest***
    I strongly urge all of you with either an LPN or LVN license to ask your state boards about a certification process for your profession. I know the Canadians are looking into that right now, as most of their foot nurses are LPN's. They are incredibly organized with protocols, procedures and standards of care set up by their state boards ( or whatever their equivilent is!) . That is what has to happen in this country to give creedence to our field. It will also help protect you from litigious situations. We are pioneers and hold the responsibility of doing this the right way. And it is happening! I too have been a foot nurse for 10 years and a sole proprietor for 8 years and now have 2 LVN's and a few RN's waiting in the wings for when our possible government contract comes through or the need arises. But the podiatrist will likely make trouble so it is important to have all these legalities in place. It is an exciting time for us.

    Anyone check out the electric nail filing systems yet? I tell you it will change your practice for the better. They are awesome, safe and time saving.
    Last edit by sirI on Nov 14, '08
  13. by   LoisJean
    Thank you so much, Tutti! I agree with was tough! And, for me at times, still is. With the addition of nurses working along side of me--all with the same goal in mind and with their individual and unique talents, I am now able to realize a greater goal...hopefully for the greater good for our clients and the communities we serve. But it's a hard road and it takes a lot of determined PUSH to part the waters of ignorance and arrogance on the part of some professionals.

    First, I salute you, as a fellow LPN, who provides this wonderful nursing service. The fact that you have maintained your position for 3 years is testimony to your skill and to the response of the people who receive your care. It is my experience that Public Opinion is worth everything.

    In my geographical area, people do not respond well to those who provide a service for the sake of the service only. As I have mentioned in other posts here, we provide a complete care. We provide, as a part of our service, (that means: AT NO EXTRA CHARGE), a full assessment of the feet and legs-with appropriate care and/or physician referral for ALL PROBLEMS FOUND; vital signs; heart and lung sounds; medication reviews; assistance with environmental needs by networking with community agencies that can fill those needs.

    We act as a liason between our client and their docs...if we find, during our foot care visit, that the client is, say, not tolerating a medication well, we will communicate that to their doc for them...because often the patient is hesitant to do that for themselves or are unable to.

    From medications- to monofiliment testing- to physician interaction -to advocating- to optimum well being--we do these things and more, AT NO EXTRA CHARGE. Many of our clients are elderly, disabled, financially compromised; many of them are well off and environmentally comfortable--but, all of them are at risk for serious complications due to their respective diseases/disorders. My business does not discriminate between the haves and have nots- everyone receives the same care at the same out of pocket fee for service.

    We instruct. We teach our patients about their feet; if they are able, we give them pointers on self care; if they are not able we instruct their caregivers. If they are unable to care for themselves and have no caregiver, we see to it the appropriate community agency provides one. We provide our clients with information on their medications...(another area of nursing care I am HOT on)-we teach them about their meds; we teach them simple, easy exercises they can do to increase circulation and muscle strength in the lower extremities. I could go on and on about what we do at NO EXTRA CHARGE in the span of a hour to a hour and a half home visit... and that is why my business is successful. The bottom line is the client. Period. And I put THEIR money where my mouth is.

    Tutti, in all these things there is no competition. Personally, I believe that competition is for children playing in the sand box...not for well seasoned, talented and caring nurses who wish to provide a nursing service to the community at large.

    And, yes, we do have foot care clinics set up in Senior Centers and Senior Apartment complexes...all of them successful. We are in Adult Foster Care Homes and we provide foot care in LTCs as private duty care at the request of the patient's family/guardian.

    This is where the Entrepreneural Nurse, who wishes to provide direct patient care, shines. This is where the art and science of nursing comes together to provide a service which not only fulfills the needs of the client but also fulfills the needs of ANY nurse who is sick and tired of being denied her/his right to practice beyond the limited and egocentric scope of an arrogant minded health care system...a health care system, which in this country, is so stuck on serving itself that it ignores those who pay it to care for them.

    Why on earth would I want to participate in a system which I personally abhor? Am I afraid that I will starve? Am I afraid that I will go bankrupt? Am I afraid that I won't get my worthy monetary dues? Do I really think that I could get to more people if I prostituted myself to a pimping government health care insurance system? Well, maybe. But at what cost to me? What would I have to give up in principle in order to participate in what others may see as practical? Fact is, I suspect that those who continue to play the Medicare game are ultimately doing so because they like the assurance of a 'regular paycheck'. Never mind what hoop they have to jump through--and never mind that the hoop gets smaller and smaller. And never mind that the one who gets squeezed out ultimately is the patient. Fact is, it costs a health care provider more to participate in Medicare than it does to simply 'agree to serve' for an 'agreed upon' out of pocket fee for service.

    I like simple contracts. I like the philosophy behind the, 'Gentleman's Agreement'. My business is based on that. I could care less about what a Podiatrist says; I could care less about what some other person who speaks like one in authority says about what I might or might not do. My little business will continue to succeed because Public Opinion has made it so.

    I am free to serve. I am free to set my fee for serving. I am free to design a plan of nurse delivered service. Now there are 4 heads designing plans of care not just mine...(not to mention a certain head that calls itself Hoolihan who has shared with me some great ideas, too), exciting is that!? And now, not just my success, but the successes of other nurses who share in my passion.

    Foot care is the Primary focus of my business...affordable foot care nursing services available to EVERYONE, ANYWHERE who is at risk. I would not be able to claim any success at all if my clients were not successful, too...those people who still maintain independence on two feet because the circumstance which would have resulted in the inevitable amputation was caught early and treated. They are the real success stories.

    I have received support, encouragement and WORKABLE suggestions and business solutions from nurses on this Board Forum since the first day I joined in. Entrepreneural Nurses understand each other in a way that is uniquely different and heartwarming. We have a wealth of experience that goes far beyond the norm. We can help each other in ways no other entity can.

    I, and the nurses working with me need to hear from everyone who provides this type of service. We need your input, your experience and your insights. We need to know how you got started, what procedures you use, your protocols for assessments. Everything.

    Lois Jean