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hotflashion

hotflashion BSN, RN

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  1. hotflashion

    Ethical dilemma

    The rest of the story: Here it is more than 4 years later and I'm very happy where I landed. I told the receptionist what my experience had been in the office and she gave her notice. I stayed longer than I perhaps should have but I have to say that the experience has been invauable in my current practice. As unpleasant as the working conditions were, I treated it as a way to get an education and get paid. The doctor was generous with his knowledge, I learned a lot, and I didn't go (further) into debt. I now work independently as a private duty nurse making house calls or working at clinics, and the independent part is the only part that I don't like about what I do; I would rather be an employee. My ideal job is one where I work (as a nurse!) part time in the office and part time doing home calls and clinics. I do foot care. I'm a foot care nurse. But it seems that podiatrists don't want to do the routine care that I find so satisfying, nor do they want to employ nurses to do it. So, there is more than enough work out there for me, with much appreciation from and benefit to the people I care for.
  2. hotflashion

    To any and all footcare nurse business owners

    You can care for anyone's feet as long as the care you provide is within the scope of practice as defined by your state board of nursing. Contact your board and find out what they say you can and cannot do specifically regarding foot care. e.g., do you need special training and if so, how much and what kind? Do they require you to be certified? Who can do it, LPNs? RNs? Etc. In my state, the guidance re: foot care is in the form of an advisory letter and it is very broad, not detailed, and I have called them in past with specific questions.
  3. hotflashion

    Are we trapped by our nursing degrees? Is nursing worth it?

    If I wasn't past 60, I would consider something different, maybe OT. I am now too old. Not too old to learn, that's never the case, but too old to take on more debt, too old to be willing to work odd hours. When I got the BSN I was 59 and ready to work whatever crazy hours were available; not now. I don't recommend anyone go into nursing. It's funny, the other old student in my class, closest to me in age, has been fired or under close supervision for her entire (short) career. She's had several hospital jobs, but they all turn sour eventually. She has experienced lateral bullying. I think she's smart, thorough, and conscientious, and would love to work with her, but others seem to experience her as a royal pain. On the other hand, I've been hired into jobs with working conditions that are so bad or so dead-end that they require me to quit and don't add to the resume. The last job I had, in a one-physician private office was low paid, and I wasn't used to my capacity. It was a specialty care office, the doctor was generous with their knowledge, has a pleasant and sometimes amusing personality, great with patients, skilled in diagnostics and treatment, but a lousy business person, so that several times in my 1.75 year employment, found myself the solo employee doing all the front office and back office tasks. My pay sometimes lagged behind because there were money management/flow problems. On the plus side, I learned some things, I'm able to list a job on my resume that lasted more than a year, it was a 15 minute commute, and the hours were weekday only (unless I had to play catch up). Overall, it's not been fun. I'm currently on hiatus d/t a pressing personal issue, and will take some time between now and the new year to decide my next direction. I don't want to give up nursing but I don't know if I'll be able to find anything acceptable and enjoyable as a nurse.
  4. hotflashion

    Foot care nurses?

    I'm a foot care nurse in this great state. I know of a few others, I'd like to find more: find out who you are, what led you to foot care, and if you are practicing as a foot care nurse, what form that practice takes. I'm currently doing foot care in the home and at a couple of clinics, independently and as a contract worker for another nurse. I work in a podiatry office part time and am trying to become a foot care nurse in the practice. I recently attended the Canadian Foot Care Nurses Association annual conference and it was exciting to be among so many others with the same interest and practice as myself. Are you out there? I would love to hear from you!
  5. hotflashion

    Footcare: equipment, etc.

    Hello everyone! 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!
  6. hotflashion

    CFCN Foot Care Eligibility Changes

    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.
  7. hotflashion

    Nature's Classroom?

    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.
  8. hotflashion

    Certified Foot Care Nurse (CFCN)

    Ok, I probably don't have the right terminology. I wanted foot care to be its own category under Nursing Specialties.
  9. hotflashion

    Certified Foot Care Nurse (CFCN)

    I knew the discussion was there, I was asking for our own thread.
  10. hotflashion

    Certified Foot Care Nurse (CFCN)

    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. "Nelly"
  11. hotflashion

    Ethical dilemma

    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.
  12. hotflashion

    Ethical dilemma

    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.
  13. hotflashion

    Protocol for blood pressure?

    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?
  14. hotflashion

    Protocol for blood pressure?

    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. Thanks, "Nellie"
  15. hotflashion

    Who's excited about Single Payer in Vermont?

    Any current news on the single-payer implementation in Vermont? Is it rolling out? Are the questions getting answerred? Enquiring minds want to know...
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