The Modern Hero TV series has been picked up by Amazon Prime Video! That’s right!!!! You can now see Dr. Scharmaine Lawson on Season 1: Episode 3 of this HOT NEW Amazon series about phenomenal women who are changing the world!! Go check it out and leave a review!!!!!! As the only nurse featured in this series, we are OVER-THE-MOON with excitement!!!
I seriously never thought being an educator was part of my career path, but I remember when the opportunity presented itself, like it was yesterday. At the time I was working as a resource nurse within a big hospital. I was caring for a patient whose mother happened to be the director of nursing. She approached me and said how impressed she was with my bedside manner and nursing skills. She asked if I ever thought about teaching nursing students. I had a blank stare because I never really thought about it. She handed me her business card and informed me to call her when I graduated from grad school. She said “you have a job”.
I learned a valuable lesson that day…..you NEVER know who is in your presence. You must remain professional at ALL times. Well…fast forward 8 years and I am still doing what I love…. teaching as adjunct faculty.
So, how do you know if teaching is right for you? Just like nursing, teaching isn’t for everyone. It requires a lot of compassion and patience, but so does nursing. You need a minimum of a master’s degree. Next, you have to be committed. You must be devoted to working with each student, and trust me when I say that you will often times encounter students that are downright CHALLENING. Flexibility is a must, particularly in the clinical setting. While, I’m thankful to have worked on great units and with great nursing staff, not all floors are conducive to the learning needs of the students.
There are multiple educator roles that range from adjunct or part-time faculty to full time educators. Working as adjunct faculty is a great way to get a small dose of where most of us started, at the bedside. It’s particularly great for me since I practice as Nurse Practitioner in an outpatient setting.
As mentioned, there are challenges. You are working with numerous students that often times have various learning needs. I’m open to constructive feedback just as much as I give it. My goal is to help individualize, if needed, the learning needs of my students….within reason of course.
Our job isn’t to discourage future nurses but to encourage and guide them along the right path. You will meet a lot of different personalities, but hey is that really that different from what we are used to day to day? I take my job very seriously. I’m there to help mold a good nurse, an excellent nurse. I support and encourage each and every one of my students.
When it comes to my students, I keep the motto “yes you can”. Yes you can get through this program, yes you can become an excellent nurse and yes you can advance your career in whatever ever direction you may choose. Believe me, it’s rewarding!
Can’t you just hear Aretha’s background singers singing “Doo Woop! The House that Jack Built!” Our Queen of Soul, may she rest in peace and love. Certainly, we all have so much respect for Aretha and the legacy she’s left behind; with an estate including property, fancy furs, cars and music royalties valued in the millions. However, frankly speaking (no pun intended) her family won’t have JACK for many years with an estate left to argue over publicly in probate as there was no will despite battling a fatal illness for many years. See Aretha is different from us in that we don’t have millions of dollars to pass on, but the same as most of us in that little forethought is given to end of life/advanced care planning (EOL/ACP) or estate planning. This occurs despite the reality there is increased communication between the patient-caregiver unit and clinicians, particularly nurses during illness and “at the heels “of an individual’s quietus.
So if there’s increased contact with clinicians, particularly nurses what are the forces/influences that play a part in the aversion to discussing EOL/ACP. Nurses Sullivan & Dickerson’s (2016) article appraised the current state of affairs of ACP in the US using theoretical analysis from a critical social theory perspective to “…understand society’s taken-for-granted beliefs that tend to empower certain groups and restrict the decision-making power of others. In their article they explore this problem from a political, economic, social and historical context. Sullivan & Dickerson (2016) note, historically we live in continuous medically advancing times which supports societal views towards life promoting treatments and laws supporting an individual’s right of self-determination. From a political context, bipartisan politicians have played on the public’s fears of doctors billing for EOL counseling during visits under the Affordable Care Act as “life-devaluing”. This misinformed argument against Obamacare tied into the “death panel” hysteria created by some Republicans. The economical context points to CMS payment models with limited EOL care coverage, federal research dollars focused on cures versus support of EOL care and disease focused payment models which primarily reimburse for life maintaining care even if futile. The societal context notes our society’s romanticism with staying young and older adults’ fear of ageism that might prevent them from sharing critical medical information. Significantly, the AMA’s physician dominance (paternalism) asserts a physician led team approach despite the fact facilitating family meetings to promote EOL discussions is within the RN and NPs scope of practice; yet it remains within the physician domain. Nurses should feel like an empowered member of the medical team and begin to spark meaningful EOL/ACP conversations.
How do you start a meaningful conversation about EOL/ACP? For starters, one has to acknowledge that talking about death is a conversation that involves coming to grips with life’s finality. If you the informant aren’t comfortable with the realities of your own mortality, you won’t be with someone else’s. Reflect on your own personal, cultural and spiritual beliefs about death. Next, ensure you have some cultural awareness of the patient you plan to have the discussion with. And if you don’t, respectfully ask. Transparency is very humbling and healing; it shows our shared humanity. Seize milestone life events to initiate the conversation such as births, marriages, divorce or surgery as suggested by the National Hospice and Palliative Care Organization. Present the information in such a way that you assure the patient you’d like to honor their preferences or their family’s/spiritual leader’s preferences in the event they would not be able to speak for themselves with regards to life saving measures and/or treatment. Take into consideration the patient may feel entrusting someone with their preferences surrounding EOL as burdensome. Allay their fears by informing them it’s more burdensome if a caregiver felt guilty not knowing if they decided as the patient would. In the case of older adults, they might also have feelings that such a discussion is a gesture of forfeiture of their autonomy. There might also be patient fears of their caregiver/family dealing with anticipatory grief in illnesses with poor prognosis. Also keep in mind, as a clinician about to initiate an EOL dialogue, first you must hash out any feelings of defeat within yourself as the treatment plan moves away from a cure and more towards maintenance and comfort.
EOL/ACP discussions are also likely to be avoided due to fear of bringing up assets, property and funeral arrangements. Like anything in life and naturally in death, it boils down to the bottom line. For minorities, particularly Blacks EOL/ACP is avoided because we are less likely to own property or leave an inheritance for family. It’s difficult to directly inform loved ones that there isn’t much to contribute to personal burial expenses and the family’s financial outlook. But with minorities slowly making socioeconomic gains, we are acquiring assets and property to contribute to generational wealth. Nurses should not give estate planning advice but should encourage patients/caregivers to seek out estate planning services as to not cause psychological stress and untoward health affects in their loved ones fighting amongst each other and with the government for what they believe you would want them to have.
Essentially, the primary factor why we don’t discuss EOL/ACP/estate planning is fear and misconceptions. Nurses need to address these fears and provide clarity to misconceptions. Be empowered to start these difficult conversations as well as serve as examples by having EOL/ACP/estate planning talks with your friends and families. Begin with checking off your driver’s license/state ID organ donor status and discussing it with family members. Choose a healthcare proxy, create a living will that specifies what medical decisions/preferences you have if you’re incapable of making them, reach out to an estate planning professional to draft a will and if you have a special needs child create a trust. Through our actions we will be prepared to assist patients or loved ones in starting an EOL conversation which is the best way of honoring a person and showing R-E-S-P-E-C-T!!!
Laura L. Gayle is a RN and Notary Public with 15 years experience in Pediatric Intensive Care units and an outpatient adult transplant clinic, coordinating care for medically complex transplant recipients. Laura enjoys writing, reading, the outdoors and trying to live life out of the comfort zone.
Medical Billing services can be quite a handful for a medical office to carry-out. In some cases, a medical office might decide to engage the services of qualified medical billers who are willing to work full time in the office, while others might decide to outsource their medical billing and management practice services.Some might decide to combine both methods, but outsourcing medical billing services seems to be the more preferred option. In this article, we would be looking at the benefits of outsourcing medical billing services for a medical office. Let’s check out some of them below;
Reduction In Cost Of Labor
Reduction in the cost of labor has always been an important factor for most small businesses, and we all know how expensive maintaining a medical billing department can be. The standard practice entails that an office should have 1.5 workers for every two doctors in practice. This is in line with the average salary package for a qualified and experienced medical billing expert which is placed at $35,000 annually, including benefits such as; Dental Insurance, Life Insurance, Health Insurance, Unemployment Insurance and many more. So, engaging the services of 1.5 workers will cost over $50,000 per year.In addition to these costs, there are other miscellaneous expenses associated with adequately providing those medical billers with the right set of equipment and supplies to enable them to carry out their job effectively. Now, we can all see how expensive it is to operate an in-house medical billing department. This is where outsourcing comes in; it helps your business save some extra cash and reduce your total overhead cost.
Reduces Billing Errors
Outsourcing your medical billing services to professional medical billers ensures that your claims are submitted accurately and quickly. The primary purpose of a medical billing company is to provide quality medical billing services, and they are solely responsible for making sure that their staffs are well trained and equipped with the know-how needed to submit medical claims properly. This helps to ensure that the number of rejected and denied medical claims due to billing errors is reduced.
Billing Compliance
The healthcare sector changes constantly, and insurance companies are partly responsible for this. One thing which makes medical billing very tasking is having to stay updated with the changes in Medicare, Medicaid, and third-party payers. Medical billing services are best seen as a full-time job, to ensure that the medical office is kept in line with the appropriate formalities required by each payer. Medical billing firms are required to stay up to date with the recent changes in protocol to enable them to maintain billing compliance.Its now very clear why outsourcing medical billing services can be of tremendous benefits to a physician, this is because medical billing services are one of the most important functions of a medical office, and a huge percentage of your income can be derived as a direct benefit of having a functional medical billing services firm to work with.
As seen on CBS Evening News with Katie Couric, Dr. Scharmaine Lawson is a nationally recognized and award-winning nurse practitioner in New Orleans, Louisiana. She is a Fellow of the American Academy of Nursing (FAAN), Fellow of the American Association of Nurse Practitioners (FAANP), winner of the 2013 Healthcare Hero award (New Orleans City Business magazine), and 2008 Entrepreneur of the Year award (ADVANCE for Nurse Practitioner magazine) where she was featured on the magazine cover.A highly sought after keynote speaker and media personality, Dr. Lawson is available for speaking engagements related to Advanced Practice Nursing, Business Concepts, and Entrepreneurship.
It only takes minutes, turn on your TV or radio and you will hear we are in the midst of an opioid crisis. It seems every professional healthcare groups in America are weighing in. Guidelines, recommendations, ideas and sometimes sensationalism is flooding the arena of healthcare. Everyone feels they have an answer to the opioid crisis.
What is always important to ask is… Is the information being reported correct? Are you really seeing the entire picture of the crisis? I really don’t think we are. The media reports that opioid overdoses have overzealous, greedy pharmaceutical companies, and overprescribing healthcare providers to blame.
Hold on.
It’s just not that easy.
Here is what we know-The current statistics about drug deaths say:
o All drug deaths (including ANY drug/medication a patient takes) account for 60,000 to 70,000 annual deaths.
o All opioid deaths (including heroin/fentanyl and prescription opioids) account for 30,000 to 40,000
Now, let’s compare to:
o Hospital-acquired infections deaths: 99,000 annually
o Tobacco, Alcohol, Guns and Traffic Accidents: >700,000 annually
It’s just important to put things into perspective.
Now let’s look at the opioid death statistics.
The number of actual prescription opioid overdose deaths are only a small percentage of the overall opioid overdose statistics.
o For instance, Fentanyl is responsible for 79% of all opioid overdose deaths. So, your first reaction might be “no one should ever prescribe fentanyl.”
o YET, only 5% of all fentanyl overdose deaths are due to pharmaceutical grade fentanyl.
For instance, in Illinois, opioid overdoses increased from 589 in 2015 to 1233 in 2016, despite significant decrease in opioid prescribing in that state. The increase appears to be almost completely driven by illicit fentanyl analogs, not legitimate fentanyl prescribed for the chronic pain patient. Schatman, Zieglar (2017) Pain Management, Prescription Opioid Mortality and the CDC.
To quote Dr Stefan Friedrichsdorf, “We do not have an “prescription opioid crisis” but really we have a polypharmacy crisis.” He cited that in New Hampshire, 72% of deaths involving oxycodone, also included alcohol, and/or benzodiazepines, cocaine, kratom, methamphetamine, and other opioids (which may not have been prescribed concurrently).
One accidental death from a prescribed opioid, illicit opioid or any other medication is one too many. But the answers are not simple. The present problem is more about illicit drugs than prescription drugs, as well as, combinations of both prescription and illicit drugs. Multiple sedating prescribed medications is also an issue. To add, more deaths are associated with illicit use of prescription opioids, than the intended prescribed reason. So many in our society, are looking for an escape and dangerously finding it through polypharmacy.
We have an epidemic of substance use disorder.
Substance Use Disorder.
THIS is what’s being ignored. That’s because there are so many factors associated: unemployment, poor education, depression, limited mental health access, mental health stigmas, availability of illicit drugs, diverted prescription opioids, genetic predisposition to substance use disorder, and psychiatric co-morbities.
Where do we go from here? More providers need to be screening for Substance Use Disorder. States need to allow more NPs and PAs to have the ability to treat Substance Use Disorder. There needs to be more education on how and when to prescribe opioids. Also, an increase in national education on appropriate disposal of medications when they are no longer needed. This act alone will help reduce the likelihood of diversion. It’s just the beginning, but it’s a start!
Reference:
Schatman, Zieglar (2017) Pain Management, Presctiption Opioid Mortality and the CDC.
Origin, as defined by Merriam-Webster’s: 1: ancestry, parentage2 a:rise, beginning, or derivation from a source b: the point at which something begins or rises or from which it derives; also: something that creates, causes, or gives rise to another 3: the more fixed, central, or larger attachment of a muscle. 4: the intersection of coordinate axes. (Merriam-Webster, 2004, p. 875).
Origins.
What is our history? What is our beginning? Are we “the muscle?” What role does a nurse play in healthcare today? There are many books and essays regarding the origins of nursing as a profession. My aim is not to bore you or review an entire history of nursing, but rather to briefly overview some relevant and often overlooked history. We are all familiar with and respect Florence Nightingale. But she is not included in this overview because she is an overused person in the conversation.
1. Ancestry, parentage
My own family includes many nurses. My mother graduated from a diploma program in 1969 and a Bachelor’s of Science in Nursing (BSN) program in 1981. She worked medical-surgical (med-surg), on a pediatric burn unit, an adolescent psych ward (unfortunately this experience did not help her much during my adolescence), home health, public health for the Tom Dooley Foundation in Nepal, rural health in Montana, and finally Hospice. She worked for Hospice starting in 1992 and recently retired from nursing in 2017.
My maternal grandmother was a flight nurse in WWII. She flew wounded troops from war zones back to England and the US. During this time there was a roster of nurses, listing which would be assigned to the next flight. After flying, the name would drop to the bottom of the list. Grandma (Helen) was up for her turn. Another nurse wanted to switch with her and go on that flight. So, Helen stayed behind. That plane crashed and everyone on the flight was killed. She was fortunate to survive. Unfortunately, Grandma Helen died when I was very young. I have so many questions to ask her. My mother still has her letters, signed “Angel in Flight.” We all have our own histories as nurses, even if we are first-generation or multiple-generation nurses. Nursing as a whole has a more utilitarian origin. In a nutshell from our nursing textbooks: Nursing has always existed in some form in all cultures. Nursing was traditionally a “lower-class” woman’s job in early Europe (Egnes, 2009). Religious organizations took over and many hospitals in the US today have roots in various Christian churches. The Civil War and other societal changes within the US demanded the need for nurses in the US and soon after training facilities were initiated (Egnes, 2009). Like I said, “in a nutshell.”
2. A rise, a beginning.
Nursing school is not easy. Characters in movies who are “going to nursing school” are cute, empty, and generally “extra” types usually played by a young, pretty white woman. Folks do not realize that nursing school is incredibly competitive, stressful, time-consuming, expensive, and challenging. Nursing school is the beginning to actually becoming a licensed professional. Many of us start in other healthcare jobs, such as Certified Nurse’s Assistants (CNAs), Emergency Medical Technicians (EMTs) or paramedics, phlebotomists, etc. but nursing school is a solid start on the path to becoming a Registered Nurse or Licensed Practical Nurse. Many nurses continue their education to become Advanced Practice Providers such as Family Nurse Practitioners (my current role in 2018), Nurse Midwives, Certified Registered Nurse Anesthetists, and others. These roles are much different from an RN or LPN role and in many states advanced nurses can practice autonomously. Your primary care provider (PCP) might be a nurse practitioner which is why “medical provider” is preferred to physician or “doctor” even though some nurse practitioners have their doctorate degree. See the American Association of Nurse Practitioners (AANP) campaign to increase awareness of these roles in healthcare. Nursing programs have dramatically changed over the years in the United States, however, incredible barriers still exist to access nursing education. This is especially true for marginalized populations, namely people of color. Mary Mahoney was the first Black woman to be admitted into a nursing school in the 1900s. She was a member of the American Nurses’ Association (ANA) and fought for equality for nurses of color. She was also very involved in women’s right to vote and various sources report she was one of the first women registered to vote in the United States in 1920. (“African-American Medical Pioneers, 2003). As a side note, we know that not all women of color (specifically Black women) were able to exercise their right to vote until The Voting Rights Act of 1965. But I digress, as racism, sexism, and homophobia/transphobia in current day still impacts who is working in healthcare roles. According to Minority Nurse, about 75.4% of RNs categorize as “white.” Only 9.1% of RNs identify as men (“Nursing Statistics”, 2014). There is limited information on the number of LGBTQ+ nurses, and many reasons why some people in this subgroup would not identify gender identity or sexual orientation publicly due to potential employer & patient discrimination. Demographic information for NPs is somewhat limited, but AANP reports their membership (which does not encompass all NPs) is as follows based on most recent data in 2010: “92% of members are female. 97% are not Hispanic or Latino. The racial distribution of membership is: American Indian/Native Alaskan 0.9%, Asian 3.7%, Black/African American 5.7%, Native Hawaiian/Pacific Islander 0.4%, White 90.3%” (AANP, 2010). The educational & healthcare systems have much work to do to decrease barriers & discrimination for those working in & receiving care within healthcare system. This is just scratching the surface of this topic. But nursing has also made huge strides since the beginning. Nursing has evolved from a “lowly” job to a profession that is largely respected although arguably misunderstood.
3. The more central, fixed attachment of a muscle.
Well. We can appreciate this “origins” definition! Think of Anatomy and Physiology nightmares. This can be an analogous to many situations.
Think about the origin of a muscle. How about the deltoid? The origin is the clavicle and scapula. Those bones are not going to move when you move the muscle. Nurse Practitioners, Physicians, and Physician Assistants have their various roles within healthcare. Nurses also have a “scope of practice” and must legally function within that scope too. If you just had the deltoid without the clavicles, you would be in serious trouble. The body simply would not work without its origins, just like a hospital simply would not work without its nurses. Sometimes nurses are referred to as doctor’s “helpers.” Nurses are not “helpers.” When non-advanced practice nurses (RNs, LPNs) follow medical provider orders, there is consideration regarding why the provider has ordered a particular medication, therapy, diagnostic test, or lab. Sometimes nurses do not know the answer, and there needs to be clarification with the provider. Much of the job needs to be done autonomously, while following orders and staying within scope of practice. In the hospital setting, a nurse is not “managed” by a physician or other APP. Nurse managers do that job. We’ve heard the cliché that “nurses are the heart of healthcare!” The heart is a muscle. But, the majority of healthcare is a business within our capitalist system, whether we like that aspect or not and that is another topic entirely with multiple layers of complexity. Sometimes the humanity of healthcare is lost in the economics and politics of that system. Of course, everyone from janitors and housekeepers to therapists and front office staff are the “human” aspect of healthcare for patients. We all have power to advocate for our patients. Nurses, especially, have incredible power as patient advocates and the same is true in the provider role. That is, of course, our job. So, the big question is: Are nurses the clavicles of healthcare or the heart?
4. Intersection of axes
Popular media has misconstrued the role of nurses. Simply blaming “the media” alone, however, is simplistic as even educational systems reinforce some of these misconceptions. This misunderstanding impacts the way regular people (er–not nurses) understand and treat nurses. Folks sometimes think a nurse’s job is to simply give bed baths, follow provider’s orders without critical thinking, and hold hands. That may be in the history of nursing, but these basic nursing care roles are no longer the role of a nurse. The advanced practice provider roles are even more often misunderstood, or assumed that the “next step” is becoming a physician when in fact that is not the end goal. Nurses (RNs specifically in this paragraph) have many roles. RNs multitask patient needs, prioritize cares, recognize signs and symptoms of declining patients, consider pathophysiology of disease, learn about new medications and procedures, change wound dressings, listen to complaints and praise, communicate with medical providers, ask questions, read nursing journals on the latest evidence-based practice, hold their bladders for far too long, walk on their feet for twelve hours, tell off-colored jokes, and drink coffee (at least, most nurses). Nurses are not angels or saints. Nurses get mad sometimes. Nurses make mistakes, just like everybody else. Sometimes nurses feel downright incompetent, so they also ask a lot of questions. Nurses are just human. There are “good” nurses and “bad” nurses, and a lot of funny ones but none are one-dimensional. One patient can take a lot of coordination. The nurse working on a hospital floor needs to communicate with therapies, the nurse’s aid, the medical provider, the housekeeper, and the family. Sometimes this role can be incredibly frustrating, especially when there are five different people and five different plans of care. But, this role is vital to the patient’s outcome. Nurses help to facilitate overall care for a patient. If any of the pieces are disjointed or missing, the patient’s care might suffer. Nurses are right in the thick of a patient’s care. Nurses really want all the pieces to fit together and for patients to receive the best care (most nurses, that is). Nurses don’t always “agree” with the patient’s choices, because we all come from different backgrounds and experiences.
Our individual origins as nurses are many. The origins of nursing are complex and ever-evolving.
So, why did I become an RN in the first place?
I started doing nurse’s aide work in high school and had various jobs as a nurse’s aide for about seven years. I always bonded with and enjoyed the geriatric population (I’ve been schooled that the correct word is “mature”). I love working with folks who have dementia, except when they are trying to punch me.
I loved anatomy and physiology (except the memorizing origins and insertions part) and chemistry, and just “how things work” overall. The body is kind of fabulous. I had the privilege of interning at a hospital in Ghana for six months (which is a separate conversation & one that I have mixed feelings about regarding international aid work). I did random housekeeping and paperwork and wrote down verbal orders from the medical provider on rounds. I ran to the pharmacy for medications. I helped with what I could when there was only one nurse in a full ward of adults and kids. Those nurses were badass. They knew how to improvise. I remember thinking, “I want to do that.” “I want to be that good.” Of course, because of my origins, I was “never” going to be a nurse because my mom was a nurse. But, my mom is a great nurse.
*This “Origins” essay was originally written in 2014 and updated in 2018. Some of the statistics, unfortunately, do not have recent updates, so older article credits remain. Since the original article was written, I have worked as an RN in many other environments outside of the hospital including assisted living, crisis mental health, and a county jail. I learned over time that I preferred some of these other healthcare settings as opposed to working on a hospital floor. I worked six years in total as an RN and while still working part-time at the jail, continued my education with a Master’s program to become a Family Nurse Practitioner (FNP). I have since graduated, obtained my licenses, and have been working as an NP in a rural clinic for nine months at the time of this writing.
Egenes, K. (2009). History of Nursing. In G. Roux (Ed.), Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow (pp. 2-8). Sudbary, MA: Jones and Bartlett.
Launching a business can be exciting as well as stressful. In August 2017, while working as a Telemetry float pool nurse, homeschooling 3 of my 5 children, being a wife, and taking care of my infant son, I founded Grace Health Scrubs. Grace Health Scrubs is a premier mobile and onsite uniform retail business located in Cincinnati, Ohio. It is one of very few uniform businesses which is owned and operated by a nurse in my area. Our company is growing steadily and we are partnering with local hospitals, doctor’s offices, and nursing programs.
We have a convenient website that allows healthcare professionals to shop 24 hours a day. As a nurse and business owner, part of purpose is to empower and share with other nurses that they have a unique advantage within the scrubs market that scrub manufacturers have yet to realize. The insight that we have based on years of wearing one specific product can really offer a lot of value to scrubs distributors and manufacturers alike.
Medical uniforms, also referred to as scrubs or nursing scrubs, are a necessity in our ever-growing economy. As long as there is a need for medical care, there will be a need for scrubs. Wearing scrubs is most often a requirement of healthcare professionals but is also expanding to other service industries such as housekeeping, massage therapy, and cosmetologists, just to name a few.
There is a global need for scrubs as well. Hospitals are one of the top employers who require medical scrubs in the world. In hospitals, there are doctors, nurses, laboratory personnel, and other personnel who are required to wear departmental colors such as all blue, grey, green, or even white uniforms.
Although scrubs are constantly in high demand, not all styles, colors, and sizes are readily available for purchase in regular stores – which is where you come in. I have heard many nurses say they only have Walmart in their local area to buy scrubs from. There may only be a handful of stores in your area, and it is guaranteed that they will still not carry every possible brand, size, or color desired by everyone needing them, so many consumers must resort to online shopping instead. As a result, why not be the bridge in your community and provide a needed service?
This article is geared towards the experienced healthcare professional wanting to start a viable business that will require in-person and online sales. So whether you are a nurse, nursing assistant, doctor, or lab technician, you likely will have a lot to bring to this business, including your insights as a consumer of scrubs, as well as your network of healthcare workers and colleagues whom you already have a relationship with. Having a solid network and relationships in this business will take you further than you can imagine. Over time, the uniform business can be lucrative and rewarding.
On my business journey, I have had many people inquire as to how to start a scrubs business. Earlier this year through my blog platform and Facebook group for moms and nurses goalsofaceomom.com, I provide support, encouragement, and tips on starting a business. As a result, I have since launched a coaching business, helping other women and nurses to start their first business. As part of an upcoming series about the scrubs business, this post will outline 7 basic steps to starting a scrubs business.
HOW TO START A SCRUBS BUSINESS IN 7 STEPS
Step 1: Create a Business Plan
A business plan can seem intimidating at first, although breaking it down into smaller pieces will help. This is the step a lot of people skip and find out later that they really needed a business plan. Outlining your business structure, budget, marketing strategies, and future plans will surely put you in a better position to obtain the necessary funding and create a more appealing business entity.
Step 2: Business Registration and Licensing Requirements
You will need to establish your business entity with the Secretary of State office within the state you reside in. Go to their website or call the office if you have any questions about registering your business.
Next, apply for a business license from your local municipality. This serves to acknowledge the existence of your business in your city. This license may have a variety of titles depending on your location, it may be “vendor’s license”, “sales tax certificate” or “business license”. Also, if your state has a sales tax, apply for a tax account with your state department of taxes as you will need to collect sales tax on items sold. Get a tax identification number too, or an employer identification number with the Internal Revenue Service. If you have a previous or current business which is related, contact a tax attorney or lawyer with regards to establishing a DBA or “doing business as” entity.
However, if you are still not sure about all the licensing requirements to become a medical scrubs and uniform retailer, you can contact the Uniform Retailers Association (URA), which is a non-profit trade association dedicated to the growth and prosperity of the independent uniform retailer. Step 3: Get Capital
Having capital is the number one thing that can make or break a business. Use your business plan for guidance. Create a budget for operating cost, expenses, etc. There are a few ways to go about this if you don’t have the cash yourself.
Get a business credit card or loan
Raise funds through events such as yard sales, GoFundMe fundraisers, etc.
Seek out an investor
Take on a partner
Take time and save up the money needed to launch your business
Step 4: Learn the needs and wants of your customers
Before you start a business, you have to be sure that you are solving a problem. Some ways to find out information is by sending out polls to your healthcare network by email or social media, conduct surveys, and research the requirements of the local hospitals, nursing homes, doctors’ offices, etc.
Find out the most common brands, colors, material preferences, etc. that the staff in your location wear. In addition, you may want to visit the hospitals and medical facilities and request their staff uniform requirements, including color and style parameters, and ask about the uniform material preferences. Just remember that knowing your customers’ desires and behaviors will help you in your marketing strategies. Step 5: Lease the best building and/or Launch Your Website
If you have decided to open a brick and mortar space, the capital you have raised will hopefully cover your first year of expenses. Brick and Mortar shops are at a minimum a 6-figure operation and it will take a lot of funding to open one with full inventory and staff for the first year. So please take the time to consult with a business strategist and accountant if this is your preferred route. So, after you have done all of that, you want to make sure that your building or storefront is in a great location, with easily visible signage, being handicapped-accessible. The location of your business should be somewhere that can be easily reached from all roads. Ideally, your location should:
Be close to medical facilities
Have a building with a front display window
Have colorful building signage which describes your medical uniform business
Launch your website
Websites are a must-have in this business. Consumers have so many options available to them, they are always comparing prices and checking the reviews. Just think of the last time you made an online purchase, did you cross-check the price? Did you check the reviews? So it is non-negotiable as to whether or not you need a website. Now, whether you will use your website solely as an e-commerce site for your business or as a convenience to a mobile scrubs business, there are a few things you need, including but not limited to:
An easy-to-search domain name
A responsive website
Excellent SEO (meta tags, keywords, analytics, speed)
Detailed product descriptions, features, and benefits
Easy navigation
Optimized images
An easy checkout process
A clear returns and shipping policy
Customer reviews
Step 5: Purchase the products
Unless you are creating your own scrubs line, then you will need to purchase inventory. So, the best way to go about this step is to research the brands you are interested in selling based on your market research in your area.
This most likely will lead you to specific wholesalers and/or manufacturers. A good wholesaler is a link between the manufacturer and the retailer (you), while the retailer is the link between the manufacturer and the customer. Now, a good wholesaler will usually give good discounts for buying in bulk, which will allow you a greater profit margin. Anything greater than 25-30% is ideal for a profit margin.
However, the better option is to contact the manufacturer directly. Please know that not all manufacturers sell their scrubs in every location in America, so be sure to check with them individually. Many of them will have an application process and different requirements, such as a minimum opening order.
Additionally, some will only sell to you if you have a physical brick and mortar store. Most of them do not agree with solely online scrub stores. The best way to find out is to call them directly. As a business owner, you have to reach out to these companies yourself in order to earn their respect. For additional help, you can check out my 10 Strategies for Buying Scrubs.
Step 6: Market your Business
For good marketing, it is necessary to recognize your target audience or demographic. In this case, we know that it is medical professionals. We have already established that these consumers are very busy, with some working off shifts and long hours. As a result, marketing to them must be adjusted in a way that they are made aware of your business both locally and online, and it must be done in a quick and efficient manner.
In today’s digital age, social media marketing is necessary. Having a strong internet presence is necessary to make an impact with consumers. An example would be to hire people to model your uniforms in promotional videos. Boost or run ads on these videos on popular social media sites like Instagram or Facebook. Even if you have a brick and mortar store, your website should be compelling and display content that introduces your business to the world. Step 7: Start selling
Before you are ready to launch, make sure you are set-up to accept payment in a variety of ways; we are in the era of CASHAPP where people are fueled by convenience and speed! Whether you are selling your merchandise in person, online, or through social media, it is a good idea to accept all types of payment. You have to be able to accept cash, purchase orders, credit, debit, PayPal, etc. if you want the sale these days.
If you are not willing to accommodate people, then you will likely miss out on the money. Starting out as a new business, you do not want to turn any customers away, so be prepared for these types of payments or at the very minimum make people aware of what you will accept when you advertise. Do you already have a scrubs business but need help with sales? Check out this free resource: 5-Ways to Make Money in Your Scrubs Business This Week.
So there you have it, the initial 7 steps to starting your scrubs business. Of course, there are many more steps in the process. It is important to note that although worthwhile, this is a serious business, not a side hustle. There is a lot of time that will need to be invested in it. It is not as straightforward as simply buying inventory, that does not make a “business”.
Buying a case of scrubs with no additional research or training will leave you discouraged and unmotivated. So before you start a scrubs business, please do the necessary research and get help from experts to diminish your learning curve. I have successfully helped several nurses start and launch their scrubs business, with the hope of helping others too. So if you need additional support or VIP coaching please email Tina Payne at Tina@goalsofaceomom.com for an application or you may check out my available programs at www.goalsofaceomom.com/programs.
Click Here to be added to the waiting list for my group coaching program:
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!!!
Personal words of advice: 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!
I am excited for your venture and hope this article was helpful. This is just an over view as there are many other in-depth items and situations to ponder that may come up. Never get discouraged and remember the goal in mind. You can do this! Please feel free to ask any questions below in the comments section or email me if you are more specific questions I can address. If you feel you are ready to move forward with starting your own CNA school, register for my next seminar HERE.
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!