OPNA President’s message

Erin King Pod. Nurse/Reg. Practical Nurse

 Owner- Feet for Life Medical Foot Care Ltd.

 Facilitator- Ontario School of Podotho Nursing Inc.

Happy fall everyone, how very fortunate we are to have experienced such fantastic weather in our beautiful province. I am very excited to announce our new association The Ontario Podortho Nursing Association (OPNA). This has been a long time coming and I know many of you have been wondering what is going on in our industry and where we are heading. Your not alone as many Foot Care Nurses have been searching for this direction for many years myself included.  This has created high emotions for many of you who belong to other associations. I want to express to you that in no way is OPNA undermining the efforts made by any of the associations and in fact wish to collaborate with other like minded associations as it would be beneficial to our industry as a whole.

This was attempted with one association by three of our board members however; the small amount of board members were not ready to accept a proposal to advance the Foot Care Nurse title and profession as it would require some change to an old outdated framework. As a result a small majority of that board only (not members) turned down our efforts to advance our industry and team up together.  This seemed quite bizarre to us however, we know that if we don’t embrace change we could falter and our professions we have worked so hard to build could become compromised in this competitive industry as Foot Care Specialists.

It is exciting to consider all the opportunities that lie ahead for Foot Care Nurses in so many facets of the health care industry such as; home care, long term care, private practice, family health teams, and hospitals to name a few. I think about how far we have come as a profession and the FC Nurse leaders that have brought us to this point. I have also considered over the years how much further we need to go.

There seems to be a lot of confusion in our industry that has prevented us from growing, utilizing all our skills and increase our revenues to support our business models if were speaking from an independent business professional perspective.

Industry goals are important and an integral part of advancing in a respective profession. An association should be setting those goals in order to advance the profession. Foot and lower limb care for patients is a growing need with our aging population. Nurses still remain on the fore front. We are all very busy working hard and need an association that is dedicated to the advancements we require to move forward.

Many FC Nurses have indicated they are confused as to why the Ontario Podortho Nursing Association (OPNA) has formed. You might be asking yourself why another association? There are so many similar associations that have some of the qualities you may be looking for to assist you with your professional goals and practices however, our board of director’s felt our profession needed one that was specific to only Foot Care Nurses in our province of Ontario understanding legislation is different from one province to another.

OPNA recognizes that change can be difficult but yet the only thing constant in life and necessary at this stage in our profession to allow for growth. We feel that we need a strong voice that will consider all necessary changes to keep current with our health care profession that directly relates to the Nursing Foot Care profession in Ontario.

I challenge you to ask yourself does your current association educate the general public in your community about what a Foot Care Nurse is?

Do the insurance companies recognize you as a Regulated health care professional delivering medical foot care? Do they cover your fee or a portion of your fee for your clients? In many cases they do not. Why not?

Many of you would say well sometimes if I go to their home. My response is why only in the home?  Why should it matter where the care is delivered? It’s about the care provider so in fact is this discrimination against one particular profession? We need to delve deeper into the issues surrounding insurance claims. In terms of clinic based Nursing Foot Care practices there are many popping up. Congratulations to all who have brought their business to this point. It is a sterile, environmentally safe and bio-mechanically safe place to deliver care in an efficient manner. For those of you who deliver your care in a home visiting capacity I commend you as this is a convenient method in which to receive care for those who are not able to venture out of their home. Both models work well. And both should be recognized.

I will pose the question that I often do to FC Nurses whom I speak with. Are you making enough money to sustain your business model? What are the precautionary steps and efforts you as the  Regulated health care provider must take in order to ensure that your home or clinic foot care delivery method is efficient, effective, and safe for both you and your patient and at what cost? What does it cost you to deliver that care and what are you worth at the end of the day? Do you earn a decent living? Can you practice full time in your specialized area or do you have to subsidize your business with a second Nursing career to survive? Would you prefer to practice only Foot Care and focus on just this? In order to do something to the best of your ability you should be afforded the opportunity to practice this advanced skill on a full time basis?

These are many of the questions I have asked myself over my fifteen years in practice. Starting from a modest part time home visiting Foot Care Nurse to now owning a building were which I operate my Foot Care practice Feet For Life Medical Foot Care Ltd. and school, Ontario School of Podortho Nursing Inc. (OSPN) with my partner educating Nurses in advanced Foot Care skills and technologies.

How did I come this far I often ask myself. The answer is this. Forging ahead, Embracing change and adapting to it. Never giving up, focusing on the positive, keeping those positive role models and mentors in my life, implementing innovative treatments into my practice, participating in continued education, self directed learning and research, learning how to charge appropriately to sustain my business. I’ve learned that it’s ok to charge appropriately as we all need to take home a pay cheque to survive. We are all entitled to a healthy happy life earning a decent living when we work so hard.

In my second year of business my accountant said to me after completing my tax return “Erin is this hobby or, is this your profession”? Then he said to my husband that I was a “ball and chain” in terms of my career choice as my financial contribution to our household was very low. You can imagine my dismay. How dare he speak to me that way and tell my husband I was his proverbial “ball and chain”?

How many of us feel like this? We are working so hard but don’t seem to get to where we really want to go in our profession?

The hard reality was my accountant was 100% right. Could I actually call this a profession when I was barely taking a pay cheque home because I wasn’t charging enough for my service and my overhead ate up most of my fee charged to my patient?

What am I worth? I asked myself.

That was the most difficult mental obstacle I had to overcome. How does one place a value on themselves and the work they offer?  Nurses have been taught for years the caring curriculum and became accustomed to working in a civil service type profession.  Health care that is Government driven.  We know this has changed. We most definitely have a tiered health care system. Many of us are working in independent practice and have to learn how to make a living.

We saw a need for Nursing Foot Care. So what did we do? Well we started up our own businesses in Foot Care. How awesome are we?

We are Nurses but not Accountants and there has not been much direction in terms of suggested pricing guidelines to follow as Foot Care Nurses.

I asked myself one day, shall I just let my patient dictate to me what they are going to pay?

That hardly seems right as they couldn’t’ possibly realize the amount of training and education I have acquired to be able to provide them such advanced services. On top of that I come to them making it so convenient for them to have this service in the comfort of their own home. Of course they couldn’t possibly understand the standards I must incooperate into my delivery of care each day to ensure I’m following best practice guidelines as a Regulated health care professional.

What about the incremental costs associated with running my business? Travel time, equipment expenses, fuel, car maintenance, parking fees, time to set up and tear down my equipment before and after care, sterilization after my visit at my home at the end of the day. This all takes time and costs money.

So I ask you all. Do you allow your patients to dedicate what you should charge them? Because they tell you “well dear I’m on a fixed income”.

Hum…. that very concept might also put you into that preverbal fixed income bracket and you’re still working hard and not retired.

Perceived value of your service is what needs to change. Often our patients believe we are just cutting their toenails and to them it’s no big deal. How many times have you gone to visit a patient who said “I just need my toenails cut”. You assessed that patient and note she has yellow, thickened nails that are causing her pain with onychocryptosis that has caused bacterial burden and requires a significant amount of reduction with your rotary file, wound irrigation and wound dressings. At this point infection control measures and environmental considerations will have to be implemented at your cost including the fact that it will take a significantly longer amount of time to deliver your care.

Figuring these things out alone can be scary but together as a supportive group of Podortho Nurses we can empower each other and gain the confidence to value ourselves and the advanced care we provide.

We have to raise the bar. We are not a group of retired Nurses doing this as a hobby are we? I’m certainly not. This is my full time profession of choice that I have made significant investments in. I am a single independent Podortho Nurse and mother of my sweet nine year old daughter. All of us have a story. We’ve all struggled personally and professionally. It’s time to stop struggling.

When OPNA speaks about raising the bar we want to ensure we are charging what will support our careers and business goals. Much like a Registered Massage Therapist or a Registered Dental Hygienist. What do they charge? OPNA will implement a range of standard fee’s to follow to ensure there is no more undercutting in our industry. I hope we can all agree we are worth that.

I challenge you all to ask yourself is your current association dedicated to fighting the battle of recognition in your industry. If so, how are they accomplishing this? Are they contacting the claim adjudicator’s at these insurance companies to ask that Nursing Foot Care be a covered service and be added to paramedical claims in insurance plans with all insurance providers across Ontario?

Has anyone in your association contacted the Minister of Health to ask for this recognition? We need to meet with this minister.

This is OPNA’s mandate. Our vision is to gain recognition as Nurse’s who have specialized in a complex area of the body which requires a great deal of specialized training increased skill set, competencies, and knowledge through continued educational initiatives. You have done this, by obtaining training as a Foot Care Nurse.

You have likely made significant financial investments in terms of continued education in foot care and possibly beyond just basic foot care perhaps you’ve acquired training in Advanced foot care skills workshops, wound care, holistic foot treatments like Reflexology, maybe aesthetic training like nail repairs, advanced skills in nail bracing, compression therapy certified fitter training maybe even certification in laser therapy or orthotic therapy. You are a wealth of information to your clients to assist with their foot health and quality of life. Are you still questioning your worth now? I can confidently say I believe you have also made significant investments in products, instruments, machines, advertising, marketing and promotional events to grow yourself and your business. OPNA’s next step is to help do this for you. To build a marketing campaign to educate the public in your communities of what a Podortho Nurse/Foot Care Nurse is.

Many of you have been asking and wondering what is this Podortho Nurse title? Where did it come from? Many people are saying it’s a “made up name”. Podortho is the Greek meaning for foot correct and straight.

OPNA felt that as Nurses we promote health and strive for keeping our foot healthy and intact. Focusing on prevention and educating our clients. Many Podortho Nurses are also offering Orthotic therapy into their practices now which is in our scope of practice with the appropriate Continued Education Certification.  Every word or title came from somewhere and was made up at some point and time through history.

The rationale behind the title is as follows; Certified Foot Care Nurse is not a protected title. It has actually been trademarked by one company based out of Brampton, Ontario that are the only one’s permitted to use the title. (Anthony A. Peckham, Trade mark, corporate and commercial lawyer, Stewart Esten LLP, 2016).

As I understand you must also have taken their training program to use their title.

OPNA’s Podortho Nurse Title allows all its members to use it. The Podortho Nurse description is on our website at www.opnassociaiton.ca

I encourage you to take a look at it. We are not just practicing foot care. We are far more than that. I am interested to hear your feedback. I encourage you to sign up when you’re on our website and learn about all the benefits to being an OPNA member.

Let’s ask ourselves; do we want a title that is descriptive of everything we do? Do we want a title that is protected and recognized?

Podortho Nurse is now recognized as a trademarked title that is protected by our non-for profit association OPNA. OPNA is officially incooperated and has a solid set of bi-laws and policies in place. Your team of experienced Director’s are all practicing Nursing foot and lower limb care and understand the challenges you are faced with in practice.

In order to use the Podortho Nurse title you simply need to join our association and meet the required foot care training that most of you currently have.

All Nurses are mandated by our College of Nurse of Ontario and participate in Reflective practice and continued educational initiatives in order to maintain your core competencies to hold your Nursing license therefore; OPNA will not set restrictions upon you to become a member or ask you to acquire additional training or write any exams.

We have all proven our worth and are already Registered Nurses or Registered Practical Nurses and fought hard to become Nurses. This is an association that works for you and will do just that not place restrictions upon you to practice. You will have to ensure registration is up to date with CNO.

OPNA see’s value in conferences however, our goal is to hold a few mini conferences though out the year. This will allow you flexibility in attending as we know time is sometime not as flexible as we all would like. There will be a few dates to choose from so everyone is not limited to just one date every year.

Webinar’s are also on our radar to keep you informed as to any new educational events and changes occurring in our industry.

OPNA’s board of director’s supports this statement. “An association is not just about a conference”.

OPNA has an agenda and we are proud to tell you about it. It’s about doing the hard work of building a strong professional association and title with recognition accomplished though the creation of a solid description of what a Podortho Nurse is. We are creating practice standards specific to the Foot Care/Pod. Nurse. Information sharing is important and necessary to ensure consistency of care in our industry.  We will ensure documents are accessible though our website. That is our promise to you. You will be able to print off document such as; standard Nursing Foot Care Diagnoses to assist with your charting considering scope of practice, patient education handouts, referral temples to interdisciplinary health care providers when your referring your patients to another discipline, consent forms and, intake forms.

• We will lobby insurance companies and address these issues at Queen’s park if necessary.

• We will have access to specific Podortho Nursing malpractice insurance accessible and attainable in terms of fees.

• We will find affordable health insurance for members as most of us don’t have our own extended health benefits as self employed professionals.

• We will build relationships with supportive and innovative suppliers to ensure OPNA members receive special pricing for supplies with our Resource Care Partner’s Program (RCPP),

• We will create a media campaign that promotes the role of the Podortho Nurse in communities across Ontario. This will increase your patient bookings and referrals from allied health care professionals in your community.

• We will research new and innovative technologies and products and bring them to you through our website, social media, newsletters and conferences.

• We are currently working on partnering with a software company that will allow direct billing for patient care for Podortho Nurses to all Ontario Insurance Providers. Currently insurance companies are saying; there is not enough interest in Nursing Foot Care and as a result of this they have not created a porthole for direct billing.

• We will ensure your name and business and contact information will be accessible through our website for potential patients to find you as they will be directed to the OPNA website with our media campaign that promotes YOUR profession.

Podortho Nurses are the new generation of Foot and lower limb care specialist striving for best practice in our specialized field of expertise. We will pave the way to ensure our survival in this competitive health care field growing, through educational initiatives and working to our full scope of practice. “We will distil into action the maintenance and promotion of foot health through the spirit and passion of what it truly means to be a Nurse. (Erin King, OPNA President, 2016).

We’ve come this far. Let’s continue to build a strong group of Podotho Nurses and show we have what it takes to continue to be valued in the industry of foot and lower limb care.

Our team of Director’s is here to assist you with whatever you need in terms of support. Please don’t hesitate to contact us if you have questions. Our contact information including

E-mails are listed on our website @ www.opnassociation.ca

I look forward to collaborating with all of you. I am committed to being a strong voice for all of you in the coming two years as your OPNA President.

Kindly,

OPNA President/ Podortho Nurse/ Registered Practical Nurse