# She wants to be a foot nurse **URL:** \ **Category:** Miscellaneous and Personal Stuff I Must Share\ **Created:** [November 7, 2018, 6:22pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147 "2018-11-07T18:22:34Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [November 7, 2018, 6:22pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/1 "2018-11-07T18:22:34Z")
Mrs. L.A., RN, BSN, has been in her ‘dream job’ for nearly four years. She visits patients in their homes and treats them. But she hasn’t been happy with the new management at her company. Last month she visited a patient. The patient said she didn’t want nursing. The caregiver said they don’t want nursing. Mrs. L.A., in her professional opinion, determined that in-home nursing wasn’t needed. So she did not sign up the patient. Her boss was livid. She (the big boss) sent another nurse out on a weekend. The patient declined service. Nevertheless, the boss chewed Mrs. L.A. a new one. Mrs. L.A., a medical professional, was angry because she was in the right and the boss, an administrative type with no medical experience, was wrong. She was also hurt at how she was treated. The boss also chewed out another nurse, and possibly a third one. She apparently was ranting on ‘numbers’. It made for a poor start to our ‘staycation’. A week later, while Mrs. L.A. and I were relaxing, Mrs. L.A. found out her boss had been fired. In addition to berating nurses, she also berated an office staff member (Mexican descent from San Diego) for her accent. Said staffer filed a complaint with Corporate. The boss was fired the same day. (NB: Mrs. L.A. found out her boss had been fired while we were on vacation, but only found out the reason Monday when she went back to work.) Mrs. L.A.'s immediate boss turned in a month’s notice that she was quitting, the same week the ‘big boss’ was terminated. I thought that Mrs. L.A. would be relieved that the ‘big boss’ was gone, and she was. But the damage had already been done. On Monday, Mrs. L.A. gave her two-weeks notice. In order for a nurse to attend to people’s feet, he or she needs to be certified in foot care. I’m not exactly sure why, but apparently it’s dangerous to clip toenails on certain patients; for example diabetics. There is _one_ ‘foot nurse’ in the county, and she’s not taking any more patients. Mrs. L.A. decided she is going to go into business for herself. Once she’s out of her current position, she will take some online classes to get the necessary credits; then she will attend a class (taught by the same instructor that a former colleague, now in another county, had) and take the test for her certification. Her current colleagues congratulated her, and they all emphasised that this county needs someone to do what Mrs. L.A. is setting out to do. A Corporate person from Portland was in the office Monday, and she told Mrs. L.A. that she could stay on part-time while she’s setting up her foot care business. Mrs. L.A. appreciated that, but is not sure she wants to. Mrs. L.A. won’t make as much money being on her own, but being her own boss is worth it. Incidentally, her immediate boss, who had given notice that she was quitting at the end of the month, was ‘let go’ yesterday. She said to Mrs. L.A., ‘It’s probably a good idea you’re quitting now.’ I’m not sure how to take that. Was Mrs. L.A. on the chopping block? Or will there be changes in the office that Mrs. L.A. would very much not like? ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [November 7, 2018, 6:44pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/2 "2018-11-07T18:44:51Z")
> [@Johnny\_L.A](#): > > In order for a nurse to attend to people’s feet, he or she needs to be certified in foot care. I’m not exactly sure why, but apparently it’s dangerous to clip toenails on certain patients; for example diabetics. In the case of diabetics, part of the reason to have them go to a medic for toenail clipping is to give the feet a general check: one symptom of diabetes is a numbing of nerve endings (mainly on the periphery), and feet are a place where it is relatively easy to get small wounds which for a healthy patient are super-bothersome but a diabetic patient may not notice at all. By making the patient go to a medic “for the toenails”, those small wounds are found and treated. Another is that many people tend to clip nails too close. Have you ever seen someone whose nails were cut or bitten so close to the pink that the tip kind of bumped over the edge of the nail? If you do that to your toes, it hurts a little; if done to someone who can’t feel that bit of pain it’s another possible source of wounds. In the end, all that boils down to less amputations. And re. the boss’ remark: it’s likely to mean about the same as when someone makes that “point to their eyes in a V, point the V at you” gesture. They mean it as a threat, but IME it actually translates to “I’m a jerk”. ---
**Author:** ![Lancia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lancia/32/17174_2.png) [@Lancia](https://boards.straightdope.com/u/Lancia)\ **Post date:** [November 7, 2018, 6:53pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/3 "2018-11-07T18:53:36Z")
When I worked in healthcare (I worked in hospice) we had a foot nurse come by our facility a couple times per week. She always had a full roster on each visit and our patients absolutely loved her. Diabetics got first dibs on her services, and then anyone could sign up for a visit if there was enough room in her schedule. I have no clue how she handled billing. I think it’s a wonderful service and kudos to Mrs. L.A. for doing this. Plus, toxic work environments are miserable and it sounds like she’s doing herself a solid by getting out of there ASAP. ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [November 7, 2018, 6:54pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/4 "2018-11-07T18:54:58Z")
> [@Nava](#): > > In the case of diabetics, part of the reason to have them go to a medic for toenail clipping is to give the feet a general check… Now that you mention it, Mrs. L.A. did say something about that. Thanks for the other points. > [@Nava](#): > > And re. the boss’ remark: it’s likely to mean about the same as when someone makes that “point to their eyes in a V, point the V at you” gesture. They mean it as a threat, but IME it actually translates to “I’m a jerk”. She and her immediate boss like each other. They even talked about meeting socially after they’re both out of the company. ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [November 7, 2018, 6:59pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/5 "2018-11-07T18:59:45Z")
> [@Lancia](#): > > I have no clue how she handled billing. Mrs. L.A. says that foot nurses get $50/visit. I _think_ she said Medicare can’t be billed, so the patients pay directly. She says she’s going to try to find a bookkeeper, or perhaps learn Quickbooks and do it herself. She says that of the $50/visit, she’ll probably pay herself $20 and put the rest back into her business. She says she can probably pay herself more once it’s up and running. She thinks she can do three patients per day, four days a week to start, and then go to five patients per day once she gets faster. One issue is that it’s a big county, and as a home-health nurse she spends a lot of time driving. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [November 7, 2018, 7:03pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/6 "2018-11-07T19:03:09Z")
> [@Johnny\_L.A](#): > > She and her immediate boss like each other. They even talked about meeting socially after they’re both out of the company. Well, in that case, I guess she could ask him! ---
**Author:** ![Hari\_Seldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hari_seldon/32/5173_2.png) [@Hari\_Seldon](https://boards.straightdope.com/u/Hari_Seldon)\ **Post date:** [November 7, 2018, 9:19pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/7 "2018-11-07T21:19:24Z")
I have diabetes and have a nurse who does footcare. But I come to him although in a space provided gratis by our town. He also treats my wife who is not diabetic, but has trouble clipping her own nails. We go every six weeks. ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [November 16, 2018, 4:55pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/8 "2018-11-16T16:55:47Z")
Mrs. L.A. has one patient today. She’ll do her charting and join the conference call on Monday, then turn in her computer and tablet. Then she’ll start on her CEs and start studying before the ‘toenails’ training. By the end of December she’ll be certified, and in January she can start her business. I wish she would have stayed with home health care until she’s certified and has everything set up, but this is how she’s doing it. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [November 16, 2018, 8:36pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/9 "2018-11-16T20:36:19Z")
How does she find clients? Also, has she run the numbers - $50 per visit, eventually twenty-five visits a week, minus gas, minus expenses, minus taxes, minus either paying a bookkeeper or minus the time to do the bookkeeping herself, minus bad debts. How did she arrive at the $20 for me, $30 for the business figure? Is she going to bill her clients, or expect COD? Anyway, best of luck to her (and you). Regards, Shodan ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [November 16, 2018, 9:21pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/10 "2018-11-16T21:21:17Z")
She’ll find clients through her current (until Monday) employer. Everyone there says how much they need a toenail nurse, and they will refer patients to her. She also knows a couple of doctors in town that have patients that will need her services. The going rate is $50 per visit. She’ll take $20 for herself, and put $30 into the business. How did she arrive at that? Who knows? She’s going to start out with three patients per day, and she only wants to work four days a week. She doesn’t want more than five patients per day. She’ll be making a lot less than (more than) $35/hour she’s making now, but it’s worth it to her to not have bosses. Payment will be at the time of service, in cash or by check. If it doesn’t work out, she can always go back to home health. But she really wants to be her own boss. ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [December 16, 2018, 2:20am UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/11 "2018-12-16T02:20:37Z")
I had to commute to Seattle Tuesday, so I left before Mrs. L.A. woke up. She went down to Issaquah to do her training, and she’s been there ever since. I just got off the phone with her, and she’s done! They said she can start working on toenails right away, but she’s going to take the certification test, get her business license, etc. before she does. She’s staying one more night down south, and she’ll come home tomorrow. Been missing her. (I kinda like her. 😉 ) ---
**Author:** ![Sunny\_Daze](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sunny_daze/32/438_2.png) [@Sunny\_Daze](https://boards.straightdope.com/u/Sunny_Daze)\ **Post date:** [December 16, 2018, 4:43am UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/12 "2018-12-16T04:43:24Z")
Congrats to Mrs LA!! ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [December 16, 2018, 6:53am UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/13 "2018-12-16T06:53:06Z")
Would she also be able to find clients by putting the word out at senior centers, or private-pay nursing homes? Can she also bill insurances other than Medicare? This sounds like an adventure for both of you. 🙂 ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [December 16, 2018, 10:38am UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/14 "2018-12-16T10:38:56Z")
> [@Johnny\_L.A](#): > > Mrs. L.A. says that foot nurses get $50/visit. I _think_ she said Medicare can’t be billed, so the patients pay directly. She says she’s going to try to find a bookkeeper, or perhaps learn Quickbooks and do it herself. > > She says that of the $50/visit, she’ll probably pay herself $20 and put the rest back into her business. She says she can probably pay herself more once it’s up and running. She thinks she can do three patients per day, four days a week to start, and then go to five patients per day once she gets faster. One issue is that it’s a big county, and as a home-health nurse she spends a lot of time driving. I say this to everyone setting up a small business - you really need to spend a little time and money and speak with both a CPA to make sure you a solid system for tracking income and expenses and reporting your taxes properly, and a lawyer to cover any potential issues there, including possibly collections on delinquent accounts. That doesn’t mean thousands of dollars or keeping anyone on retainer, but you need to have access to real professionals in that area because problems will come up. If she’s using her personal vehicle for business travel deducting travel costs as a business expense might be a possibility. Quickbooks, Turbotax, and other programs are useful, but for setting up a small business you really should talk to a human being knowledgeable about these things at least initially to make sure you aren’t missing anything. The IRS has no mercy or forgiveness. ---
**Author:** ![smokey78](https://avatars.discourse-cdn.com/v4/letter/s/82dd89/32.png) [@smokey78](https://boards.straightdope.com/u/smokey78)\ **Post date:** [December 16, 2018, 11:06pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/15 "2018-12-16T23:06:58Z")
This sounds like a great flexible hours small business. I wonder if I have foot nurses around my town too? I was diagnosed with Psoriasis, and the only manifestation (not scales) is that my big toenail is growing (half of the toe is nail color of white) so clipping isn’t going to work. it’s growing into my flesh like ingrown toenail. The sad part is 4yrs ago I did have ingrown toenail removal so everything was peachy keen til this year. ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [January 28, 2019, 11:09pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/16 "2019-01-28T23:09:07Z")
Mrs. L.A. is on the phone now, setting up her first client for next week. The patient’s daughter was referred to her by Mrs. L.A.'s recent employer. 🙂 ETA: I guess ‘foot nurse’ or ‘toenail nurse’ aren’t the preferred terms. Mrs. L.A. is a Certified Foot Care Specialist. So: Mrs. L.A., RN, BSN, CFCS. . ---
**Author:** ![Procrustus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/procrustus/32/2994_2.png) [@Procrustus](https://boards.straightdope.com/u/Procrustus)\ **Post date:** [January 28, 2019, 11:25pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/17 "2019-01-28T23:25:43Z")
Did she get insurance? One claim could eat up a year of income. Or worse And Congrats to Mrs LA. Sounds like an exciting change ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [January 28, 2019, 11:28pm UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/18 "2019-01-28T23:28:07Z")
> [@Procrustus](#): > > Did she get insurance? One claim could eat up a year of income. Or worse Yes, she has insurance, EIN, LLC, and a business banking account. ---
**Author:** ![Sunny\_Daze](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sunny_daze/32/438_2.png) [@Sunny\_Daze](https://boards.straightdope.com/u/Sunny_Daze)\ **Post date:** [January 29, 2019, 2:04am UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/19 "2019-01-29T02:04:37Z")
Congrats to Mrs. LA. 🙂 ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [January 29, 2019, 3:19am UTC](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147/20 "2019-01-29T03:19:25Z")
Terrific! Hope her business is very successful. [Next page](https://boards.straightdope.com/t/she-wants-to-be-a-foot-nurse/824147.md?page=2)