Men are more likely to put off routine health care appointments for screenings which often leads to a less healthy lifestyle. Men are also more likely to delay seeing a health care provider for symptoms of a health problem that could lead to conditions affecting men such as heart disease, prostate, testicular, and colon cancer along with osteoporosis and nutrition issues.
With the glaring issues of Men’s health, Mr. Graham has recently started his clinic that focuses on primary care and men’s health. NP-VIP Concierge Medical clinic provides comprehensive health care in your home, over your phone or home computer with the use of a HIPAA-approved telemedicine app. Telemedicine is the use of telecommunication and information technology to provide clinical health care from a distance. It has been used to overcome distance barriers and to improve access to medical services that would often not be consistently available in distant rural communities or busy lifestyles.
Mr. Graham started his medical career of as a medical assistant 26 years ago when he joined the United States Army and served a total of 22 years of active duty service. During his tenure in the Army, he became a Registered Nurse, graduating from Alcorn State University in 2006 with his BSN and Walden University in 2015 with an MSN as a Nurse Practitioner and is currently pursuing his DNP. Mr. Graham is also a Duke-Johnson & Johnson Nurse Leadership Fellow at Duke University. As an Advanced Practice Nurse, Mr. Graham has worked in areas such as Primary Care, Urgent Care, and Critical Care. With the variety of experience, Mr. Graham has focused on Primary Care with a focus on Men’s health. Research has shown that men, their health has for the most, has taken a back seat to women’s health. Mr. Graham’s focus is on prevention and early detection.
Long before I had the inkling to become a nurse entrepreneur myself, I was helping other nurses cultivate their entrepreneurial ideas. I was good at coming up with business ideas for others who wanted to start a business using their nursing education. For as long as I can remember colleagues always seemed to ask me about doing something outside of the bedside.
After awhile, I decided to write a book about being a nurse entrepreneur without actually being an entrepreneur. In 2013, I published my first book, So You’re a Nurse and Want to Start Your Own Business? The Complete Guide for nurses who wanted to move from the bedside. My business, ReNursing Edu (Formally known as ReNursing Career Consulting), was modeled after this book. Unbeknownst to me, my book was just the beginning.
Not long after publishing my book, I was contacted by an editor for Minority Nurse magazine to write blog posts and articles for their magazine. I was thrilled! I wrote regularly for Minority Nurse about nursing topics I had experience in—starting a business and being a nurse practitioner.
Fast-forward to today and I am the published author of more than 20 titles that mostly focus on business and nurse practitioner education. My focus is on nurse practitioners because while in school I noticed a gap in our education that left us at a disadvantage after graduating. This gap encompasses not only clinical education, but also business education and personal finance when dealing with the cost of going to school and the aftermath of student loan debt.
My books have branched out into other educational products for nurse practitioners that will assist them in clinical practice. My most recent product is the NP H&P ™ clinical journal that helps students log their clinical encounters while in school for easy access when it comes time to enter them in their schools clinical tracking system. The journal also contains prompts on what to ask when taking a patient history so as not to forget the important points.
Other products in the ReNursing Edu line include NP Clinical Cheatsheets™ that provide a quick reference guide for everyday clinical practice. The cheatsheets have a lot of information in a single page such as charting tips, common measurements, fracture types and more. They are available in both laminated and digital versions depending on preference. A second cheatsheet will be coming out later this year that focuses on issues seen more in an urgent or emergent type setting.
When I wrote my first book I never imagined where it would take me, especially since I didn’t plan on writing another. Since starting ReNursing Edu, I’ve come to realize that as an entrepreneur your business may not look like you imagined it would be when you first started. It’s important to go with the flow and change direction if your business ends up taking you elsewhere.
Nachole Johnson, MSN, FNP-BC
https://www.renursing.com
For more information on ReNursing Edu or ReNursing Edu products please visit www.renursingedu.com
Many NPs who want to start a business are looking for a niche. While I started a primary care practice for women in 1985, I was ready for a change. I was looking for a niche that could provide me with a part time practice that would allow me flexibility, low stress and a healthy income. I wanted to be free of the ever increasing, administrative burdens of managing a traditional fee for service practice. Those tasks that were taking me away from face to face delivery of patient care that was so important to me.
In my waiting room I had a digital picture frame with photos from my trips. Patients would see it and ask me for advice about their upcoming trips. What shots do I need? How can I prevent traveler’s diarrhea? Should I take malaria pills? It occurred to me that there was a need for this type of service in my community and it could be a practice I could do part time.
In 2008 I opened Travel Health of New Hampshire, PLLC (www.travelhealthnh.com). I operated it on a limited basis side by side to my primary care practice until 2015 when I retired from primary care and now I operate the travel clinic part time.
Why do I think travel health is perfect practice model for an NP owned business?
1. Low cost to start – you can easily open a travel clinic for less than $15,000.
2. Perfect model for a cash only practice since most insurances wont cover travel health anyways.
3. Low overhead- you don’t need a lot of space or fancy equipment.
4. Low need for staff- I actually don’t have any. A full -time travel clinic could run with an NP and one staff person.
5. It’s easy to learn what you need to gain expertise in travel health online. Great for new grads. (www.BeaconCEU.com “The Comprehensive Course in Travel Health”.
6. You don’t need sophisticated business skills to run it successfully.
7. There is an online program that teaches you step by step how to start and run a travel clinic (www.BeaconCEU.com “Owning, Opening, & Operating a Travel Clinic”).
8. Great add on – you can add travel health as another revenue stream to an existing practice.
9. Flexibility – see patients when you want, no call, and you can do this part time while you work for someone else. Ideal for someone who wants time with their family or as a semi-retirement business.
10. And it’s fun! Patients are happy to come see you. You can spend 45 minutes to an hour with your patients and really get to know them.
Travel health is an exciting field in health care that is a perfect practice for an NP owned business. What are you waiting for?
For more information contact Nancy Dirubbo, DNP, FNP, FAANP, Certificate in Travel Health at ndirubbo@BeaconCEU.com
Medical house call practices by nurse practitioners are beginning to gain a lot of attention, as more nurse practitioners are making house calls to provide medical aid to patients who cannot visit a health facility. A Housecall practice by nurse practitioners enables advanced practice nurses to build a private practice with less overhead, and ultimately, earn more revenue. It also offers some flexibility in work schedule, as well as some degree of freedom. If you are a advanced practice registered nurse (APRN), you too can start a house call practice today.
Key Steps for Starting a House Call Practice
Starting a house call practice can be a tumultuous process for many nurse practitioners, as most are confused about where and how to start. However, like many small businesses, a nursing house call practice also requires certain steps and processes you have to take to make it a success. To help you build a successful house call practice, highlighted below are some crucial things you need to do.
· Get Your Credentials
The first thing you need to do before setting up your practice is go through the credentialing process. This is required, especially, if you will be accepting payments from patients with government or private insurance. You will be asked by insurers about your medical background, as well as all the necessary licenses and permits. The entire process can take several months, so you might want to start early, to get it over and done with, as soon as possible.
· Get Licensed
Next, you need to follow some important regulations set up by your state and the federal government. You will need to get licensed by the APRN licensing department in your state. Depending on the state where you hope to have your practice set up, you might want to visit the Board of Nursing for your state to get the requirements. There may be other requirements you might have to provide, including DEA registration if you will be administering medication to your patients. You might also need to provide a national provider identifier number (NPI). If you do not have one, you can apply on the National Plan and Provider Enumeration System website.
· Establish a Legal Structure
Your house call practice will also need a legal business structure, which will help determine how you will be paying your taxes, as well as the extent to which you will be liable for losses, debts, and lawsuits. Thus, you might want to hire an attorney that will help you make the right legal decisions. Your attorney will oversee the entire legal aspect of your practice, by drafting legal documents like articles of incorporation/organization, partnership agreements, etc.
· Fund Your Practice
You may also require a small business loan or some other form of capital, to fund your house call practice. You will need to consider the cost of equipment, an accountant, attorney and other costs. Other expenses to add to your start-up cost, include the cost of medical records software, computers, medical supplies like gloves, bandages, syringes, etc. To get funding for your practice, you will need to find the right lender for you, as well as make sure that you have all the requirements they need.
These are just some key steps you need to take when planning to start a house call practice. for more in-depth information on how to start a house call practice as a nurse practitioner, You should Order Housecalls 101. And, if you would like to learn, first hand, the essential skills, and tools needed to run a successful house call practice, Book the House Call Course by Dr. Lawson today!
The power of Nursing Leadership: Difference between a leader and a boss The buzz word these days seems to be “I am a BOSS” as well as other catchy phrases as it relates to being in charge, autonomous, independent and the like thereof. I wanted to delve a bit deeper into the word Boss and how it does not make you a leader. As I was researching the word boss and leader, I came across these definitions from the Merriam-Webster dictionary. Boss- a person who exercises control or authority union bosses a mafia boss; specifically: one who directs or supervises workers. Leader- a person who leads: such as a guide and/or conductor. A person who directs a military force or unit leaders of the army. A person who has commanding authority or influence.
What stood out as a difference were the words influence, lead, guide to describe leader while a boss used words like control, authority, direct and supervise. I have 22 years of leadership experience of being a leader in the Army. The Army has afforded me the opportunity as a very junior Soldier to be placed in leadership positions above my grade level. Years later becoming a nurse, I’ve gained experience to be a nursing leader through developing both my bedside and administrative skills. I have been stationed in remote areas of the world where I was the only public health nurse and had the privilege to serve as the Garrison health consultant and be instrumental as a site surveyor in the grand opening of the child development center in Daegu, Korea. The military has taught me about peer leadership and how to successfully earn respect based on character and not just position. The military has helped me to strive to be a compassionate, hardworking and strong nurse whether it’s in the Medical surgical department, pediatric unit or disaster preparedness for family and servicemembers who staged in South Korea from the Japan Tsunami of 2011. Leadership is not defined by title, rank, degree or stature. It is born and bred and exists within. It is a desire. It is advocating and taking care of others. It’s acknowledging weakness as well as strength. It is the empowered, empowering others to be leaders. I’ve been fortunate to attend leadership courses that helped hone and define my leadership skills. Leadership has taught me that one should never compromise their moral compass to get to the top but should always carry themselves with honesty and integrity. The late Dwight.D.Eisenhower, 34th President of United States, once said, “The supreme quality of leadership is unquestionably integrity.
When discussing Nursing Leadership, it is safe to say that it is the driving force in advocating and delivering the quality of care and the patient care outcome that is essential in today’s complex healthcare system. It is my belief that from the moment you become a nurse, you become a leader. From the bedside, to the administrative role, you are a leader. As nurses, we have to take on the role of a leader, be that change agent who will leave a legacy that influences not only our healthcare system, but the next generation of nurses. The profession of nursing must find a way to afford opportunities to the most exceptional individuals, even if their journey of success was not like their own. This is an act of selfless service, to be able to embrace the entire young professional nurse in an effort to produce the greatest outcome.
I want to share with you six leadership nuggets that have guided my everyday actions and have influenced my approach to nursing:
1. Always display integrity and allow no one, no organization to get in the way of that.
2. Loyalty to yourself, your organization, colleagues and those entrusted in your care.
3. Compassion- Its ok to be firm, fair and assertive but do not lose sight of extending compassion.
4. Professionalism- Nursing is a profession, act accordingly.
5. Always put yourself in position to learn new things-Continued education is key to future success.
6. Never forget your Why.
Dr. Estacy Porter NP
Dr. Estacy Porter is a wife, mother of 4 kids and a retired Army Nurse Captain of over 22 years with her last job as Chief of Preventive Medicine Department. She is a Board Certified Advance Public Health Nurse and licensed Nurse Practitioner in Community Health. Dr. Porter is the founder and CEO of Jewel in His Eyes, a Holistic Health Empowerment program for girls and women to live and be the healthiest version of themselves as well as founder of Garifuna Nurses United, is a membership-based organization with a mission to gather Garifuna Nurses from across the diaspora together to foster a positive environment of growth, professional development and address health disparities amongst the Garifuna people. Her Doctoral Project focused on developing an executive level leadership and mentorship toolkit for Army Public Health Nurses.
Imagine, it’s that “time of the month” and your homeless! For a homeless woman of menstruating age, menses brings a week of struggling, not only to find a way to handle the physical and emotional symptoms, but to also contain the flow of blood, as tampons and pads are expensive and for most homeless women, completely out of reach. Many times, this means relying on fashioning makeshift “pads” of sorts, made from toilet paper or paper towels scrounged from public restrooms and even resorting at times to socks, rags or brown paper bags.
When you are homeless, there is no comfort to be had from a warm shower, no retreat into your private bedroom where you can relax with a heating pad and certainly no visit to your personal physician to get a prescription for pain relieving medication if needed. Then there’s the issue of simple cleanliness to think about, as there is also no relief from the constant threat of disease associated with the repeated use of unsanitary materials, such as yeast infections, urinary tract infections, vulvar dermatitis or worse death, not to mention an unpleasant odor, which can occur when the genital area is not cleaned daily.
Forget for a moment the comfort a warm bath would bring and just focus on how you would feel if you had your menses and couldn’t bathe, except maybe to hurriedly wipe yourself with a wad of cold wet paper towels in the stall of a public restroom. For a homeless woman and for the approximately 169,000 homeless women like her who are living on the streets on any given night in the United States, this miserable scenario is relentlessly repeated each and every month, twelve times throughout the year.
A box of tampons costs about five to seven dollars and for the woman who is homeless, the choice is all too often between buying them and having something to eat. To make matters worse, in forty states, menstrual supplies such as pads and tampons are classified as non-essential “luxury” items, further adding to their cost, while Viagra, a medication that treats erectile dysfunction, is taxed in only one state! Plus, even if a woman has access to food stamps (SNAP), feminine hygiene products cannot be purchased with this money.
That’s why in 2017, I started Her Padded Truth, a nonprofit organization geared toward providing women who are homeless, in transition, and living in impoverished conditions with menstrual hygiene products. We are geared to ending menstrual shaming and educating communities and government on the unfair “pink tax” that women are subjected to in many states. We are a grassroots movement making a huge impact in the state of Virginia. Since starting we have donated over 10,000 menstrual hygiene products to women across the Hampton Roads area and abroad. The goal is to bring awareness and remove the shame of the stain.
Deciding to become an entrepreneur can be a scary task to tackle, especially if you lack a mentor or support. You ask your self “ Where do I start? Which way do I go? Who can I trust?” It can all seem so overwhelming that you may give up before you even get started. However, with determination, perseverance, and a strong support team, it can be done! Remember, no one determines your fate but you!
In my practice as an RN, I saw a decline in the quality of CNA’s. I felt this stemmed from multiple issues. One big issue was a lack of nurse support for CNA’s thus causing a lack of pride in their work. I also noticed that many schools seemed so fly by night, “Become a CNA in 10 days!” Are these students really getting the exposure and sense of pride that they need for the job? That’s when I decided someone has to take action and that someone would be me!
I had no idea where to start and figured lots of things out along the way. I must say I did some major head bumping along the way. I met people who were very helpful, people who donated time and money in my vision and then there where those who of course just wanted my money and gave me only half of what I needed. Unfortunately we can’t always see those people coming. Nevertheless it took me two years to get my CNA program up and running. I would like to share with you the steps to get moving in the right path. I happen to be in the state of Georgia so much of this will be Georgia based, however other states are very similar.
Identify your authorizing body for the CNA program in your state. Each state is different. The CNA program may be governed by the Health Department, the State Board of Nursing, or a separate branch that is specific to nurse aids only. In the state of Georgia the certifying body is the later mentioned. The nurse aid-training program certifying body is the Georgia Medical Care Foundation (GMCF). Please click here for more info GMCF Nurse Aid info. In the state of Georgia you must attend a FREE two day workshop offered by the state called “ Train the Trainer” in order to become a CNA instructor and/or start a CNA school. Dates for this workshop can also be found at the link above. Please note this workshop fills up FAST and is offered once a month so have the site booked marked and check it religiously every day to catch an open spot. I would also like to note you do not have to be a nurse to own a CNA school, however you must have a nurse (RN) be on staff to coordinate the program.
In many states you are responsible for writing your own curriculum and submitting it for approval. This affords you the ability to expound upon certain aspects you may feel are important to teach and can help you create a unique set of CNA graduates that facilities will seek out. The state of Georgia requires that your curriculum be at least 85 hours of instruction, lab and facility time. You can choose more hours if you wish. Choosing a book and writing a curriculum is VERY time consuming. It took me a year to write my own. Many states are open to which book you can use but be sure to check with your state to ensure you choose an approved book. In Georgia they discuss how to write your curriculum and which books are approved at the Train the Trainer workshop. If you still feel stuck or overwhelmed, feel free to consults someone like myself who has been there and done that. I will be happy to provide a consult to help you with your curriculum. Just email me at thesecretcocktail@gmail.com
Find a nursing home that is willing to contract with you. It is a state requirement that you have a contractual agreement with a facility to bring your students to so that they may gain hands on learning. Depending on where you live and the number of schools in your area, this process can take a while. Many facilities already have contractual agreements with other CNA schools or nursing schools and may be at capacity. Also some facilities insurance do not allow them to have students in their facility. Make a list of nursing homes far and near, find out who the DON is and make contact with them. Sell your vision and school to them. Why should they let your students practice there? Will you offer their employees a discount to attend your school? Can you promise them future staff members out of your graduates? Can the two of you partner to help fill their CNA shortage?
Submitting your curriculum and waiting for approval can take up to three months in Georgia. If you are lacking any documents or something needs to be corrected in your first submission, you have two additional chances to re-submit in a one-year period. If your curriculum fails all three times, you must try again in a year so you must be diligent! In the event your curriculum passes (which it will because you will be diligent) you are contacted for a site visit by the state and the site visit can occur up to 3 months after the curriculum has been approved. It is imperative you have a site identified and all required items ready at the site for inspection. An equipment list can also be found at the link above. For more info on curriculum help join my email list HERE. I give out free tips to help you along the way.
WHAT SOMEONE NEVER TOLD ME!! There are additional items that need to be submitted with your curriculum. In the state of Georgia, there are a multitude of forms you have to craft such as: Clinical sign in sheet, Class sign in sheet, instructor evaluation form, student evaluation form etc. If these are missing, you must resubmit, even though it is not part of the curriculum. Also the entire curriculum and all these forms MUST be printed out and hand delivered to GMCF for approval. All additional documents must be resubmitted the same way so have plenty of paper and ink handy because you will become a self made Kinkos! If you would like more tips on the SECRETS behind starting your own CNA school, visit my YouTube channel The Secret Cocktail. There you will find videos to answer your questions and give you insight on topics of interest.
Once your curriculum has been approved and you pass the dreaded site visit, they will let you know right then and there if you are approved to start, however you cannot open the doors of the facility until you received an actual letter in the mail. Being completely approved is the best felling in the world!!!
PLEASE! PLEASE! PLEASE! Have a business plan written. Ensure you have a solid marketing plan and be sure to have a strong partner (this was my failure). There is no way you can do this on your own. You need someone who is just as vested as yourself in the endeavor. Of course you will need an instructor to help teach and secretary to secure those students when they call, but you certainly need someone to help you in the background. Ordering supplies, marketing, accounting, building community partnerships, preparing for annual state inspections, cleaning the building, I mean the list goes on!!! I promise you, you cannot do it all alone. Both of you must understand this is not an instant cash business and you will initially be working for free just as you would with any other entrepreneur endeavor. However, with determination and perseverance you will strive for success and you will succeed!
Today was magnificent for so many reasons. First, I had the opportunity to meet two pretty amazing nurse practitioners from Woodlands, Texas. Seree Reynolds (L) and Watchara Silo (R) are both family nurse practitioners who are originally from Bangkok, Thailand. I had the honor of teaching them the nuts and bolts of how to start a Housecall practice in their community. They are now equipped to go out and provide Primary Care to many who would otherwise not receive healthcare.
Second, I thoroughly enjoyed working with them because I got to learn about Thailand and how advanced practice nursing is approached there. We also shared our hopes and dreams regarding family, business building, and cooking habits. Guess what? You think you are different from the next person, but you’re really not. You actually have more in common than you would ever imagine.
The Housecall Course REMAINS the ONLY course in America training clinicians on how to open and maintain a successful Housecall medical practice.
This has been a keynote speaking experience like none other. I never imagined falling madly in love with a community of clinicians, future midwives, and soon to be nurse practitioners.
It all began when Dr. Julie Marfell, the Dean of Nursing picked me up from Bluegrass Airport. I was still in awe of the endless blades of green grass when I was cordially treated to an incredible organic meal at the local CoOp. Let me just say, ” I was licking my fingers.” I truly believe that I am a total foodie because well, I’m from New Orleans. This makes me a certified foodie. When I lick my fingers after eating, it’s good. Real good.
Anyway, we were then off for a 2.5 hr drive through the most majestic mountain terrain I had ever seen outside of the Great Smokey Mountains and the fabulous snow-topped mountains of AK. I hardly noticed that for about 30 minutes my phone was quietly registering and reporting , “NO SERVICE.” I didn’t notice because of the glorious scenery and the incredible fascinating stories about the founder of the Frontier Nursing School, Ms. Mary Carson Breckinridge . All I can say is, “WOW!” She was an incredible visionary that saw a need and filled it. I am so honored to have been the keynote speaker at the 5th Annual PRIDE Diversity Impact weekend.I’m really kinda glad that I didn’t do a lot of research on Frontier Nursing School before I arrived because that made everything a little more raw for me. More than ever, I have been overwhelmed with the spirit of compassion, community, diversity, and giving since arriving. I feel Ms. Breckinridge’s spirit all around me. I know she’s here. The home she lived in and the trails she took to deliver babies as a midwife for women in her community are still here. There is even a brick from THE Florence Nightingale here!!!!!!!!! It just doesn’t get any better. I rubbed it. I was in the room with it.
My Speaker bag with all kinds of neat gifts about Ms. Breckinridge and two sweet little FSN ponies for my babies.
As my journey draws to a close, I will relish in the noises from a cricket-filled night and maybe take one more hike through the mountains because I’m always trying to get more steps!
by Victoria Randle NP-C 
