guest***

When I do home visits I sit on the floor in a stadium seat, sort or Janpanese style, with the client sitting in a comfortable chair. Since using this method I very rarely have back discomfort. You can get these seats at sporting good stores. It was the best investment I ever made!

I know of some upcoming courses and events, but since I am participating in some, I guess I can not post them on this site. If anyone wants further information, they can message me. One will be in Santa Rosa, the other in Portland. Both 3 day course.

Just to let you know. The course in Seattle is non-profit and I am speaking for free. This was not an advertisement. There is a company paying my airfare there and that is all. I am taking a loss so I can share free information with other foot nurses. Laura

I talked with the one in charge of the program today and she is open to possibilities for nurse presenters. Regarding FNANA- there is a project that really needs to be done someday, you may want to give it a shot. EVERY board of RN for every state needs to be emailed and requested to submit in writing the portion of their nurse pracitice act that addresses foot care. I hope to get this done and post this on my website so every nurse from every state knows exactly where he/she stands in regard to foot care.

I have finally gotten the material on the FNANA, Foot Nurse Alliance of North America. I am going to try and breathe life back into it. I think it will eventually transform into a real Association. For now it is just a free Alliance to keep nurses networked and provide support. There will be a website up in a few weeks. It looks like I will be presenting at the Seattle Conference. They had no nurses on their agenda, Mara was unavailable this year, so I will try and fill her shoes with information on instruments, tools, infection control, and information on starting an independant practice.

I think I have sucessfully uploaded the only form I have on WORD that might be useful. I have not used it, but after looking at it again, may consider adding it to my charting. Hope it helps. Nurse Diagnosis & Intrvention.doc

I think I have sucessfully uploaded the only form I have on WORD that might be useful. I have not used it, but after looking at it again, may consider adding it to my charting. Hope it helps.

About 7-8 years ago a woman (one of the original pioneers of foot care nursing in the US) named Jane Kelly started an association called F.N.A.N.A. FOOT NURSE ASSOCIATION OF NORTH AMERICA. (pronounced fananna) Her husband was very ill and she was nearing retirement so she passed the presidency of this association on to two nurses in Arizona. The association has been in a sort of suspended animation for the past 2 years. These nurses have been so busy with their own business that they have had little time to deal with the association. I think there are about 35 members. I will be meeting with these nurses in August, when I move my daughter to Tuscon to go to college. We will discuss reviving the association. I believe starting a real association is sort of a big deal, lots of red tape, and since it has already be done, it would be a shame to have to go thru all that again if we do not have to. I will be taking this information back to the foot and nail exam committee when we meet again in Kansas City MO. in October. We all know that an association is needed and if this one is no longer active, then the committee will be dealing with starting one. The WOCNCB is well connected and will know how to properly do this. So I would advice you to hang in there until October and see what happens after this meeting. There is a benefactor of sorts, who may be donating resources for this. We will also be discussing a website devoted strictly to foot care nurse where nurses can freely discuss anything on their mind, including who they are, what their business are, and how their business might help others who need their services. So there will be a lot of news regarding the future of foot care nursing in late October. There will also be discussions of mass trainings for foot care nurses. It is too premature to say anything more about the trainings. I will let you all know, when I know. Hang in there!

Stainless stell nippers of various sizes ( I will use up to 3 different nippers on one person's feet) Buy German and buy the best. I prefer straight, not curved. Rasps are totally different and used for the corners to prevent spicules. I do not find diamond debs effective at all. There are much better coorifice diamond files out there by a company called Erica, they cost about $25 each, but worth it. Tools are everything. (or almost!) Electric nail filing system with various bits that can be sterilized. Currettes, scalpel (if you are an RN) with #15 blade or a minibeaver blade with a #64 for IPK's. That's all I can think of for now.

I am gathering information about the best electric nail filing systems and bits, as I feel, aside from good nippers, this is the most useful tool there is in foot care. Dremmels should be thrown in the garbage. I was an expert witness on a case involving a dremmel use and the resulting 4 amputation surgeries that followed. Chicago Podiatric supplies are good Sally's Beauty Supply Go to some of the podiatrist sites like Podiatry Online and sign up for their forums. They have used equipment sometimes. Ebay has used autoclaves and dopplers BUT before you go out and buy this stuff, you should be very committed to this feild as it can get pretty expensive. Many nurses I have met over the past 10 years think this is a great "get rich quick" feild. They do not consider the time involved becoming skilled. It takes doing literally hundreds of nails before you can truly feel confident with whatever nails you come across. Good tools are essential. Good luck!

Moore Medical supplies has extensive podiatry supplies, call or write and get a catalog. They are at mooremedical.com I think! They are incredibly fast with deliveries and this is where I get almost all my medical supplies as well as nippers.

http://www.wocncb.org/foot_nail.htm I just found this site. It gives complete details on the upcoming certification as well as information on more foot courses going on. Check it out.

http://www.musc.edu/nursing/continue/CON_FOOT_CARE_BROCHURE_2004.pdf Check out this site for a great one day foot care course on August 28th in Charleston, South Carolina. The instructor, Dr. Theresa Kelechi is my friend and mentor. This is not a solicitation, I have nothing to do with this couse. Theresa is the queen of foot care and anyone who can go should go. Tell her Laura sent ya!

Thank you so much for you quick response. It sounds as if the situation in the UK is very much like it is in the US. Almost every nurse I have ever met here in the states, believes that nurses can not trim nails. They think it is out of our scope of practice. I personally remember being taught in nursing school (30 years ago) that we could not cut nails, that they had to be referred to a podiatrist or the family had to do it. However, it is now known that nail care is within our scope of practice, but there are very very few training courses out there. It is a delema! The Canadian nurses are far ahead of us. They have 40 hour courses in their colleges for training in foot care nursing, as well as courses in how to start your own foot care business. I had the pleasure of attending a foot care seminar in Winnipeg last fall. It was incredible! I was in a room with 100 other foot care nurses. Yous see, I am one of a very few nurses who do foot care in the states. I am the ONLY foot nurse that I have heard of who has their own office. I also do home visits. I was trained by a podiatrist 10 years ago. When I discovered that it was both legal and possible to have my own business, I started in very gradually starting to build up a practice. I now have over 350 regular clients and a very satisfing life. I have 2 daughters and have been able to participate in their lives much more so than I did when I worked in a hospital or clinic setting. But my main point of all this is that in order to prevent foot amputations from diabetes, that there has to be A WHOLE LOT MORE medical people performing quality foot care and nurses are the most logical choice. I am hoping to get back to London the next time that Dr. Andrew Boulton holds his diabetic foot course. If I am really lucky, I may be able to do a short presentation there or at least have a booth at the Vendors Fair. It is an area of great need and great reward. I am hoping someday to have a traveling nursing foot course to teach any nurse anywhere how to safely perform foot care. My professional goal is to help as many nurses to become educated in this field so that they in return can help their diabetic patients keep their feet right where they are supposed to be, attached to their legs. So if any of you are looking for a new field. You might see if a podiatrist would hire you in their office. Thanks again so much for answering my questions. Ta Ta, Laura

Hello, I am a foot nurse from California. Last summer I spent 10 days in England (remember when it was 105 degrees? I was on a tour at Windsor Castle on that day). I was fortunate enough to be able to spend a full day at a diabetic foot clinic at the King's College with Dr. Ali Foster, an extraordinaryily remarkable D.P.M) I asked her if she knew of any foot nurses like myself in the UK. (I specialize in preventive foot care for non-high risk diabetics, providing nail trimming, corn and callous care and fungal nail debridement. I have an independant practice and have been in business for myself for 8 years.) She said she knew of only 3 nurses in the UK who could cut nails. Surely she can not be right! I am writing to try and connect with any nurses who do this sort of thing. I would love to find out more about how routine foot care is provided in your country and if whatever system it is, is adequate. Foot Nursing is a wonderful specialty and I am on a mission to spread the word that it is up to the nurses of the world to help prevent the complications of diabetes that can be so easily prevented with proper nail and foot care and patient/caregiver education. Diabetes in a global problem and I am very interested in someday starting an international foot nurse association so we can share ideas and techniques (as well as travel to foreign places and meet new and meeting exciting people!!! plus get continuing education and have a great tax write-off) Anyone interested, let me know. Would love to hear your comments.

As soon as I get details, I will pass them on. As of now this is what I know. This is a one day conference sponsored the a group I believe is called The Foot Nurse Interest Group. They have an anual conference on the first Monday of October. This year it will have a second day that will have break out sessions. I may be doing a session on the use of electric nail fining systems where nurses will be shown these machines and get to use them on each other. This is a great group. I went last year and did a presentation on making medicinal salves. There is going to be a second course in late October, also in Winnipeg. It will be a 5 day Complete Foot Course. I am hoping to go to that also. I should have more details within the week and will keep you posted.

One way that I have known people to get experience with nail trimming, is to approach a friendly podiatrist and see if he wants a nurse to do nail care in his/her office. There are many young, hot shot podiatrists who have no interest in nail care and would love to provide that service in their office, with someone else doing it. You may want to say you would follow them around for free for a bit to give it a try, and then if it works out, get a percentage of every patient you see. You could be an independant contractor and still have a lot flexibility and be in control of your life. It is my opinion that in order to be a sucessful foot care nurse that you need to have experience doing A LOT OF NAILS, before you are qualified to set out on your own. Some podiatrists are great and would welcome the help. It could be a win win situation.

There will be a 2 day foot course in Winnipeg in Oct on the 4th and 5th. I AM NOT INVOLVED IN PUTTING ON THIS COURSE. I might be a speaker.

If I were you I would do the following. Call the local chapter of SCORE and make an appointment to get some free advice from them. They are great and free. Also, call your local small business administration and do the same. They put on a lot of free and low cost business workshops. There is an incredible amount of help out there for the small business person. The JC's also have many short courses. I have my own (free) lawyer that is helping me with my business through my local chapter of the small business administration. I have seen him for 3 visits, one hour each. My husband is now going with me to these visits to help as I have a hard time "getting" with the business end of things. I have been in business eight years and am a sole proprietor, but am investigating incorporation. I have way too big of a business now (about 350-400) regular clients) to not know what I am doing. I just wish I had done some of this stuff years ago. I do not think I will incorporate, too complicated, but am still looking into the pros and cons. You can start out as a sole prorietor and then change. It is not hard to file for a fictiscious business name, and will probably be more memorable to clients. Getting the accountant or a good book keeper on board early on is a great idea. They should be able to help you with many of these questions. Start a seperate business checking account right away. That will really help you sort out things. There is talk of a Canadian Foot Care Course (48 hours long and very comprehensive) coming to California and possibly Tucson Arizona. Maybe as early as next spring. Anyone interested, pm me and I will put you on a mailing list. THIS WOULD BE A GREAT COURSE! Probably cost about 2,000. But when you think of the potential earning power it will give you, not to mention the peace of mind and thrill of having your own business. It would be well worth the investment. There are times now, doing group homes, that I make $200 and hour. I have a lot of overhead, and these clinics really help cover those costs. I do a great job, the clients are happy and the relatives who I bill, are happy. Do contact your state board and have them send you the citation in your nurse practice act that covers what you will do by providing foot care services. It may be a very general clause or very specific to feet. I think Wisconsin has some specific verbage, because of Tara Beuschar's work, but I could be wrong. You need to have something in writing to defend yourself when you start getting flack from podiatrists!!! It is worth it. You go girl!

If I were you I would do the following. Call the local chapter of SCORE and make an appointment to get some free advice from them. They are great and free. Also, call your local small business administration and do the same. They put on a lot of free and low cost business workshops. There is an incredible amount of help out there for the small business person. The JC's also have many short courses. I have my own (free) lawyer that is helping me with my business through my local chapter of the small business administration. I have seen him for 3 visits, one hour each. My husband is now going with me to these visits to help as I have a hard time "getting" with the business end of things. I have been in business eight years and am a sole proprietor, but am investigating incorporation. I have way too big of a business now (about 350-400) regular clients) to not know what I am doing. I just wish I had done some of this stuff years ago. I do not think I will incorporate, too complicated, but am still looking into the pros and cons. You can start out as a sole prorietor and then change. It is not hard to file for a fictiscious business name, and will probably be more memorable to clients. Getting the accountant or a good book keeper on board early on is a great idea. They should be able to help you with many of these questions. Start a seperate business checking account right away. That will really help you sort out things. There is talk of a Canadian Foot Care Course (48 hours long and very comprehensive) coming to California and possibly Tucson Arizona. Maybe as early as next spring. Anyone interested, pm me and I will put you on a mailing list. THIS WOULD BE A GREAT COURSE! Probably cost about 2,000. But when you think of the potential earning power it will give you, not to mention the peace of mind and thrill of having your own business. It would be well worth the investment. There are times now, doing group homes, that I make $200 and hour. I have a lot of overhead, and these clinics really help cover those costs. I do a great job, the clients are happy and the relatives who I bill, are happy. Do contact your state board and have them send you the citation in your nurse practice act that covers what you will do by providing foot care services. It may be a very general clause or very specific to feet. I think Wisconsin has some specific verbage, because of Tara Beuschar's work, but I could be wrong. You need to have something in writing to defend yourself when you start getting flack from podiatrists!!! It is worth it. You go girl!

Right now there are no courses, it is self study and there will be a list of resources and articles from WONCNCB. I think the certification is for 5 years, not sure. You can email the wocncb site, ask Beth. She should know the correct answers. In the future there will be courses popping up. I will post anything I hear about on this site, or you are welcome to pm me. I am sure there will be a Foot and Nail Nurse Association down the line too. This is the start of a whole new specialty in nursing and I am just so excited to be an active part of the process. It is the actualization of years of "creative visualization" on my part, and many other nurses I know of. Truly a dream come true.

There is new information on the nail certifcation at the www.wocncb.org web site. Look under the newsletter heading and there is information on the eligibility requirements for the Foot and Nail Nurse Certification. Check it out!

Good point. I do about 40 clients a week on average for the past 5 years. This is spread out over a 3 1/2 day period. I have more upper back and neck complaints and get massages when I can. I also use up to 2-3 sizes of nippers per client (4" fine for ingrowing and small nails up to double action 6 1/2 " for thick nails, and every size in between) so am frequently changing the position of my hands. I have never had wrist problem but my back is getting to me. I am now giving new clients to my associates and going to spend more time on educational programs. It is a challange to find the balance that is right for you. Is there anyone else in your organization that does nails? If not you may want to suggest that so you have back up. You might also see a PT and get some excersise and stretching routines going. Good luck.

This is taken from a newletter put out quarterly by the Wound Ostomy Continence Certification Board. "The WOCNCB is very enthusiastic about moving one step closer to a new foot and nail credential, the CFCN, which stands for Certified Foot Care Nurse. This credential will validate the knowledge and competencies of nurses caring for patients at risk for complications related to the foot. When the credential is ready to be offered, the WOCNCB will have spent a significant sum of money and a great deal of time to develop a legally defensible exam for the CFCN. When the Foot & Nail Advisory Panel met on September 14 with experts in exam development from the WOCNCB’s testing firm, Applied Measurement Professionals (AMP), they learned just how costly and labor-intensive a new examination can be. For those of you who have never been involved in exam development, you would likely be surprised at the amount of time and effort involved. Here’s a brief overview of what’s required to deliver the final product of a legally defensible certification exam. A “job analysis” is the first step in creating any new WOCNCB certification exam. To compile a job analysis, the WOCNCB convenes a panel of practicing individual “experts” from across the country to write a job analysis survey. The survey items are developed as the panel discusses the necessary skills and knowledge required for safe practice. The survey is then sent to nurses who practice foot care, requesting them to fill out and return the survey to AMP. After the survey results are compiled and analyzed by the testing firm, the advisory panel will again meet in person to discuss the results. A major focus of their discussions is whether practice patterns of survey respondents reflect what is considered to be “standard practice.” Each survey item is then discussed by the advisory panel. The returned surveys are then compiled, categorized and analyzed by the testing firm. The test content will subsequently be a reflection of practice patterns from information collected in the job analysis. The job analysis phase of examination developments costs between $20,000 to $30,000, including survey printing and postage. Add to this an estimated $1,100 for per-person travel expenses for the five to six people on the panel, plus two AMP representatives for each of the two meetings, and the total cost for this phase comes to $33,200 to $43,200. The second phase of test development will occur once the test content or blueprint is developed. During phase two, an examination committee is formed. The examination committee is faced with the challenging task of developing test items. All items on the exam must meet specific requirements before they are added to the item bank. Ideally, the item bank" The exam committee is what I am on and I just returned from a meeting in Kansas City. www.ocncb.org (I think!) is their web site. Keep checking for updates. All I can tell you now is that they are shooting for early 2005 for test availability and ANY RN is eligilble. This is the only certification they have that an Associate Degree RN can take. There will be other eligibility requirements, so keep looking at their web site. Very exciting stuff is happening here! :balloons: ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○

http://www.care-ed.com/footcare.asp Here is another site. It is amazing what you come up with if you just do a general internet search using the words foot care course. Do that periodically and you will come up with intersting information. Every September, there is a foot care course in Seattle, at least I think so. If you work for an institution with a good library, you can have the librarian do a search for you on foot care. That is how I go started on my self study program 10 years ago. There are a lot of very good articles out there written by nurses (and other professionals too) There is a lot of information out there, you just have to dig! It is like a treasure hunt. Happy Hunting