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Hi, Nursing foot care is physically demanding but in a very different way: - you have a lot of equipment to carry - repetitive strain injuries i.e. carpal tunnel are common - working in a seated position but having to lift legs from this position can be hard on the back - always mask and glove to avoid lung problems and fungal infections, etc. - neck and shoulder strain from always leaning over Awareness, precautions and taking care of yourself definitely help. It is also dependent on the area in which you work i.e. house calls can be hard on positioning but you see less clients and get a break in between. Clinics are busy with lots going on but you may be lucky enough to have better equipment i.e. a podiatry chair. Do you know some foot care nurses that you can talk to? Or, better yet, follow for part of a day? It is a great job and offers a great deal of flexibility that you may also find beneficial i.e. clinic one day and home visits the next to break it up, shorter hours, etc. Good luck, J

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Hi All, I hope this clarifies some issues/questions that have been posted recently. Foot care is considered a clean procedure but that does not mean that sterilzation of tools between clients is not essential, especially due to the potential for injury and infection. The simplest product (and safest) for cold sterilization is accelerated hydrogen peroxide. The brand I use is the Accel CS20 by Virox. There are other brand names available (I am in Canada but I do know there is soemthing in the US). For a mask, I use an N95 as it is the best protection available. Whatever products you use, it is imperative that you read the manufacturers instructions and MSDS documents - not only about using the product but also about disposal of it. Pricing will vary depending on how you set up your business. Start with a base salary (what you want to earn per hour or person) and then add all your expenses. That should give you a ball-park figure. Don't forget things like travel time. Having solid policies and procedures/protocols in place when you set up your business/practice is critical. The first few can be tough but then they get easier - I promise. A word of advice: Always practice to the highest standard! It is the best for you and your clients and it is probably only a matter of time before it becomes the minimum standard. For the nurses in Vancouver - good luck with your conference. Link up with Foot Care Canada and other resources (such as those that host conferences elsewhere in Canada). I would be interested in the Alliance if someone wants to PM me

Hi, I havve my own business and had to write all of the policies and procedures. I'd be willing to help. It can be a huge job. I spent about 1 year writing them in my spare time before I took on staff. :typing J

PM me as I believe it would be against the rules for me to say too much about courses in nursing foot care. J

When pricing yourself...always ask yourself: what would I make working as a nurse elsewhere what hours am I expected to put into this what expenses am I likely to incur add it all up, double check that it's comparable and you have your number... Hope that's helpful,

The client can use OTC antifungals such as Canesten cream, Lamisil, etc. I recommend they speak with the pharmacist. Fungal infections of the nails are very hard and slow to treat. Topicals take a very long time (read 18 months or more), and aren't always effective. This client seems to want to treat it. Other remedies besides tea tree oil are Vick's Vaporub and wild oregano pills. There are other homeopathic remedies. The client should pursue it with her MD and pharmacist to make sure there are no interactions, etc. Good luck,

Hi, There are practitioners that I am aware of that incorporate TCM or other alternatives into their practices. The first thing I would do is go the the college of nurses (or board) and find out what there position is. Many have very clear guidelines. Also check out what is available in other states - they can be useful guides. It would be very difficult to try & separate the two and legally & ethically, you are required under both to treat each client using all of your training. You can't ignore either side/view when trying to treat your patients. It can be tricky but you are not the first to be faced with this challenge. There are guidelines out there. I have taken a course on medical acupuncture and we were instructed on how to incorporate it into our nursing practices (there were MDs, PTs in the class as well). Good luck, J

There are lots of valuable resources out there. I have my own agency and spent a year just researching & writing policies & procedures, having contracts drawn up, etc. etc. etc. It is a huge undertaking in order to do it properly. (And I lucked out by having a great deal of support & resources given/shared with me). When dealing with the government, you need to do even more research. Most times you have to wait until the contracts come up for tender & then submit a proposal at that time. The proposal is another time-consuming task and you are competing with companies that have more staff and are allocated time (usuallly locked in rooms for days) to work on the proposal. I've had my own business for years and I am still always stunned at how much I have to learn all the time. There is so much to know and do. An agency requires that you learn /insurance/tax/incoporating/employment issues, etc. etc. etc. I don't want to discourage you but I wish I'd realized just how much is involved. It can be done and it is the best thing I've done (in every way but financially at the moment - read need lots of capital or accept going into debt). Good luck & keep us posted J

I have been doing foot care for over 10 years in many settings and a sore back does seem to go along with the work. What I find that works best for me is to remind myself constantly while providing care to watch my back. It's easy to get lazy & tired and then start to slouch. Bend at the hips and try to keep your back & neck as straight as possible. I also stretch every time I stand up between clients. I need that minute or two to move and realign everything. The other thing that has helped me is Pilates. The exercises are gentle, help you stretch and work on increasing the strength of your core muscles which help support your back. A good instructor can help you modify them if necessary. My favorite instructor always showed the moves at 3 different levels of difficulty so you could gear the class to how you were feeling. It's been a real back-saver for me! The hard part is that we are always trying to accommodate the environments we're working in like people's homes, nursing homes where the clients are in special chairs, beds and haver to work around equipment and footrests etc. etc. etc. It is a real health & safety issue. While we do our best to protect ourselves, sometimes the job has to be done any way you can do it and clients don't/can't always assist in making it comfortable for both of us. Another one of the challenges of this job, I guess. Good luck, J

The first step is the Business Plan. Look up Interactive Business Planner on the web. This is a great site. It walks you through the process of doing a very thorough business plan. It saves it for a month or so (don't quote me on that!) so you can log on and make the necessary changes as you change your mind a million times :chuckle :chuckle Formulate the plan of action and then work it through. Do your research. Do a SWOT analysis (Strengths, weaknesses, opportunities, threats) as you go through the business plan. It's remarkably like doing nursing care plan so it's a lot easier than it looks. Being independent is about knowing yourself, your community, your job and your clients. I'm independent and love it! Two years ago I expanded to hire staff and now I have 7 nurses working for me. We're always expanding. It's not without it's challenges but the rewards are worth it. J

I agree. Call the College of Nurses of Ontario & find out what they say. Get what you can in writing. J

Doing foot care is never going to be easy on the neck and back! The ideal is to have a chair that lifts the client, tilts them back etc. I work with the clients in podiatry chairs, gerichairs, raised recliners or any other type of chair. I have a Rubbermaid toolbox/stool that I sit on. It's just the right height for me and my clients. I find it too hard on my legs to be on the floor. The client's foot is on the chair leg rest or on my lap. Occasionally, they're in bed & I sit on my stool at the end of the bed. It depends on the client & where I am. There is a leg rest that you can buy to help support the client's leg. You have to be careful that they are not straining their hips & knees. The first thing I do is get myself & my client in a comfortable position. Hope that helps. I'd love to hear more from others about how they operate. J

Hi Sherese, The first thing you should do is take a nursing foot care course. A lot of the courses do include some information about starting your own practice. How you market your business will depend on how you want to do business. Are you going to do house calls? Are you going to set up an office? What are your goals for the business besides doing it full time? A business plan is a must, and will guide you to the research you must do before starting and will also help you see your progress. Nursing Foot Care is a good business to be in but to be successful, you do need to do your prep work. What is your competition like? What are your strengths and weaknesses? Having a business has its ups and downs. When I started my business, I kept my other jobs (this was in the time of lay-offs and no nursing jobs) and built up my clientele. Network, tell everyone you know that you've started your own business. If you're trying to reach out to seniors that are isolated, they can be hard to reach. I love having my own business and now have others working for me. We have expanded to other services as well. It is the most challenging and rewarding experience for me professionally. I hope this helps... J

I have a BScN. Let me tell you about a good friend of mine - she was an incredible college-graduated RN. When she started into her BScN for a job she wanted, she couldn't understand the importance of it. I used to sit and listen to her go on about it. It didn't take long for her attitude to change. She sees the balue of it even more now that she is putting it to daily use. It is not just the education, the extra that you learn, but also the different way of thinking and looking at and analyzing things. Whenever I question the value of going on in school and taking extra courses, I just think of her experience and go full steam ahead! Good luck