The Form That Saved My Business: Legal Lessons for Footcare Nurses

One missing signature can change everything. In this episode of EmpowerHer Entrepreneur, CEO and Footcare Business Mentor Janis Boudreau pulls back the curtain on real-world lessons about legal protection in Footcare Nursing. Learn what she wishes every nurse knew before their first client and how a few well-written forms can protect your reputation, your license, and your peace of mind. 

Transcript

SPEAKER_00: 0:35

Hi, everybody, and welcome back. Welcome to Empower Her Entrepreneur, the podcast for women building health-focused businesses that make an impact. Today's episode is featuring myself as a CEO, educator, and mentor to hundreds of footcare nurses across Canada. Today I'm going to help walk us through one of the most critical yet very often overlooked parts of running a footcare business: legal forms and consents. So thank everybody so much for joining me today. Whether you're in your car driving, perhaps you are getting in between time in your clinic between clients or on mobile practice. I'm thrilled to be here speaking to all my fellow footcare nurses across Canada. And today we're going to dive into something every nurse needs. Even if it's not the most glamorous part of our business, paperwork that protects you. So forms and consents aren't just red tape. They're your first line of defense in professional practice. It's one of the things that I see highlighted when I attend every single conference, when I'm meeting people, mentoring them online for an hour. I cannot begin to explain how not okay it is to simply take very easy templates online or not have the proper documentation. And I see it over and over again. So I'm, and I've even spoke, I remember speaking quite a few years ago at the CPC conference in London where I talked very clearly. Um, as I have had a legal issue myself, got out of it one, did amazing because we had absolutely everything in place. So, why legal documentation matters? When we transition from being employees to entrepreneurs, one of the biggest mindset shifts is you're gonna have to realize that we are now responsible for our own legal protection. Hospitals and agencies used to handle that, but in private practice, that's on us. Our proper documentation is gonna protect you, the practitioner, your business legally and professionally, and your clients by setting clear expectation. Think of your business forms as part of your care plan, but for or kind of as part of that, but for your practice itself. They're not just admin work, they are risk management tools. Without them, you open yourself up to potential complaints, misunderstandings, or even legal action. And none of that supports the compassionate ethical care you want to provide. And why legal documentation matters? As somebody who opened the mail one day and I had an unfortunate situation where a client tried to sue us. They had been through five of our nurses. We decided to end care with them. And uh five months after our last appointment, they still hadn't had anybody. They developed an infection. Um, it was such an unfortunate situation, but the person was just so, so upset, um, they went after us. This is a person who has sued many people. Um, so we were just, you know, another person being attacked and sued. And it uh really helped that our documentation from one end to the other, I'm talking about being able to provide the charting notes, uh, providing when we said, hey, you know, you know, we we just do not have anybody to take care of you at this time. Um, to be honest with you, we actually ended care. Not so much we ran out of um a nurse to go there, it just we just were not practicing. We didn't have anyone in that area. And all of us know that any moment that can happen. Maybe you have practicing in three areas and decide, you know what, it's just not for me. I'm gonna go down to one. Can you imagine you remove a client and then they come after you um legally? So having documentation that, hey, you know, we're giving we did your feet fresh, we're giving you six weeks' notice. We have documentation of who we, you know, here are three other places that you can go see. Um, we keep all of our records extensively long. Um, we had to have our reprocessing records, um, records on how we train our nurses, teach our nurses, even though they're contracted. So all of this stuff really matters. And my end result was that a lot of times clients, they're already going through something on a on a healthcare issue basis. But if you have all that to defend yourself and protect yourself, you're gonna be that much better. Um, you know, for me it was a long haul going through that, but I was very happy when the lawyer's like, actually, Janice, you don't have anything to perfect in your business. I did, however, um have a health law team, an employment law team. These are lawyers specifically to help me in my business. And that's where you will notice at AFC and Learning Institute, we do sell a large number of forms, policies, procedures. We have uh legal teams that either draw them up or help us draft them up. So they are meeting. And it was after I went through such a big legal issue, uh, and this is many, many years ago now, that they they basically edited and recreated ours. We learned what was missing. We learned where there were a couple holes. And so if you ever look at our um intake, our consents, all those, those are dynamite. They are done by lawyers, and sometimes if you don't want to recreate it, purchase it from us. It's the easiest thing you will do. So let's talk about the essential forms you need. What forms should every foot care nurse have in place? And let's go through the absolute must-haves, everybody. First, your client intake form. This is where you're gonna collect basic demographics, medical history, allergies, and consent for treatment. It's your clinical foundation. I'm going to mention all these and just give a little bit of tidbit. So, client intake form. Um, if you ever had a client who states, well, you know, you cut it this way and then I got an ingrown now, but perhaps on their client intake form, they've had a 20-year history of problems with ingrowns and you captured that. That's where you're helping to protect yourself. Again, um, it's far and few between that really you may never get sued, or you may, but capturing information, especially the history of issues with their feet, or imagine being faced with an issue where a client says, after care with you, two of my toes hurt. But realistically, we had the client intake form that you came to us already in pain and issues with those toes. We didn't cause those. So everything you're gathering, and also on a friendly note, it's really just having that baseline so we totally understand what's going on with our clients. Number two, the treatment consent form. This is crucial. It confirms that your client understands that what you're going to be doing, the potential risks, and gives you permission to proceed. I will never forget, starting out about 15 years ago, and I don't know where the heck I got it, but it was definitely a template online. I think even the first original program I took uh gave that to me to be able to use. And wow, when it was redone by a you know, a health lawyer, it ended up to be a couple pages long. It ended up to be extremely informed consent. It had everything it needed in it now to uh be able to protect me. So be very cautious and careful what you're using as a consent form that you could be leaving yourself open to liability issues. And this is to be done before you perform care. You can utilize this whether you're doing a hard copy as in paper, or like us, we use um Clinico, and I know there's like Jane, and I think there's quite a few company on. There's lots of different ways. You can also capture it electronically. You're just making sure that you're not completing care before that's performed. I want to tell you too, we do consent audits in our clinics and in our home care division just to make sure we're not missing anything. Three, privacy and confidentiality agreement is required under privacy laws by PIPA, PHIPA in Ontario, and I know this is nationwide, it's gonna be something a bit different for you. Another Provincial Health Information Acts. We have provided this as a section within our treatment consent form. Have I seen it done separately? We also have this for all of our contracted workers as well as staff. Uh, this is the same thing, something that was done up and just included with our lawyer, but it's really, really important. We also have this on all of our booking software, all of our emails that go out. There is a statement that we utilize for absolutely everything. And it does protect us for a financial and cancellation policy. Clearly state your payment terms, cancellation fees, and refund policies to prevent disputes. We have a separate form we use for financial. Um, when a client books their appointment online with us, or the secretary at one of the locations is booking it, or one of the nurses doing it herself, everyone automatically gets a confirmation email and text, or both, and also a reminder. And within this, we have a very strict cancellation policy. And we put a link in there so they may cancel it. This is also reiterated with them on their first day of care, as well as this is on a, we keep like a financial sheet, like a form that they sign. Because there's some of our clients that are getting billed, they're um utilizing, we have a system for credit cards through QuickBooks Online that we're gonna do uh billing. So often we have a fine uh financial form that's gathering that information and then also reiterating our cancellation policy because you do not want an issue, and again, you you can gauge. I mean, of course, we've got people who've missed an appointment, somebody's gone in the hospital, they're sick, but this comes to play, Lord. You know that client, you know they've already missed the appointment three times. This is also a reason if you've got this in place, if you needed to remove a client from under your care by having that in play. Our going now to the financial policy is ours needs to be paid for, our care. If we provided care, it must be provided immediately after. The only windows is that as long as they're saying example, sign their Green Shield sheet and we sent it in, we consider that payment. They've cut a check, they've paid by the square, they're giving the nurse the cash. That's considered paid. What we have an issue with is when clients say, Oh, I'm out of money today, just bill it, and it's 30 days later. So again, you have to have that financial policy. And for us, you don't get to be seen by us again until it's been paid from the previous time. Unless, of course, there's an issue with insurance, but we won't even get into that on this podcast because, well, it can be delayed. Five, a COVID or infection uh control consent if it's applicable. So through the pandemic, it shifted everything. Infection control documentation still demonstrates very much due diligence. So while we're not in those COVID times anymore, we actually did have a consent that they had to sign in regard, everyone will remember this in guides to signs and symptoms, and were they all clear? Um, we also, for us, um, under infection control, we don't have a consent, we have a policy, and that is for all of our documentation when we're reprocessing our tools. So under five for COVID or infection control, consent slash policy, I'll talk about that. Um, COVID, yes, if God forbid um another pandemic happened, we'd pull up the policy. But infection control is huge for us. So we do weekly, monthly, and yearly maintenance. We have logs for each one of them. And of course, we're using, we're from Ontario, so we're using the public health documentation sheets to gather um every single load, when it's been done, who it's been done by, what time, did it pass? Um, everything is kind of under that umbrella, what you need legally. It's huge. Um, when I ran into a legal issue before, like I said, many years ago, one of the first things I had to provide was copies of those reprocessing logs, and then copies of the maintenance on the machines. So make sure you're those are forms that are very much important in your business. Number six, before and after photo consent. So if you're gonna use photos for charting or marketing, this is an absolute must. Always get explicit written permission. For us, what we do is to keep things contained. At the bottom of our treatment consent form, there's like basically another section. And people may not want to have it, and that's fine. Do we love having before and afters? Yes, we do, especially if there's an issue with what was done, how it was done, um, if it's improving. A lot of times it's just really fabulous. We get those consents, and families of loved ones that might be at facilities can get a hold of us and say, Hey, how's mom doing? We're like, look at the first photo, look at photo number 10. And they're just totally wowed. There can be so many reasons to have those photos. Sometimes also for us, especially when we're visiting at long-term care facilities, if we go in and we're like, okay, I've not touched these toes yet, and that, you know, there's been an injury. They've, you know, a toe got either banged on a wheelchair, the floor. I'm walking into something, I'm visually inspecting and seeing something. We always grab a photo, we upload that to the client's file, we label it before care was completed, where often gives us the opportunity to even notify family if needed. And that is all about protecting ourselves. And you know what? A rec uh number seven is a record retention policy. You need a system for how long you're keeping your records, and usually it's 10 years after the last visit or even longer for minors. So for myself, this was really crucial when we went from I mean, 10 years ago, we were paper-based with files. Oh my gosh, I remember having to pull all those files for each nurse and who was seeing who. So our retention policy is for 10 years. And I think the more harder thing to do is we've got our reprocessing logs and our maintenance logs, and I literally have a closet upstairs with boxes and boxes and boxes. And I even think they're in the shed at the office. We keep those because, again, in a legal issue, they really scour over those and they look through them. So every one of these forms is going to protect both your professional license and your reputation. It also communicates professionalism to your clients, and you're showing them you run a compliant, ethical, and a trustworthy business. Okay. Legal language and professional protection. Let's talk about the legal language inside these forms. So many nurses are totally intimidated by legaleese, right? But here's the truth: your forms don't need to sound exactly like a lawyer wrote them. They just have to be like a uh lawyer wrote them. Our lawyers designed them that they were for, you know, anyone, because the people who are signing them often, you know, they want to make it easy as possible. So just be in they need to be clear, comprehensive, and totally legally valid. I just want to quit because I have definitely seen some contracts out there. I've seen some consents and some forms where there are things put in. I'm like, oh no, no, no, no, no. You can't even add that. That's not even legal to the document. Example, are you aware when you're hiring somebody that there is it is against the law as of October to do a non-compete and instead it's a non-solicit. So, what this means, example, if a nurse leaves me and then decides to, you know, inconspicuously let those clients know she's on her own and where she is and and whatnot, that that is not um allowed. That is not that's I mean, I call my lawyer. Um, we keep a very close eye on things like that. But that's the thing is so there's tons of things I see in there, and even in regards to consent forms that are just like really not covering you. So make sure every consent form includes a statement of understanding that the client has read, understood, and had the chance to ask you questions because then it's informed, which is what we need. A statement of voluntary participation confirming the client is choosing to proceed. And you need a signature and a date from both you and the client. You can absolutely consult a lawyer familiar with healthcare law to help review your forms once you've uh drafted them. It's a small investment that could save you thousands down the road. I remember, like I said, we had our forms redone. It did cost me$8,000. Um, they were actually just audited recently, and those are the ones you see for sale on the AAFC and Learning Institute. All of those forms are reviewed quite regularly. So remember, if it's not written down, it didn't happen. Documentation is your professional shield. So, real world, ladies, let's give some scenarios here. A client develops an infection after a visit and claims you didn't warn them about post-treatment care. If you had a signed consent and after care instructions, you're covered. Scenario two, a client refuses to pay for a late cancellation. If your financial policy was signed and reviewed, you have written proof. And you have even more reason if you have to remove them as a client on your list. Scenario three, you're asked to share client photos for marketing without consent, and that's a privacy violation. But with a proper photo consent form, you're totally legally safe. These are everyday realities. Forms don't just keep you compliant, they keep your business sustainable. Empowerment, and here are some next steps. Here's my takeaway for every foot care nurse out there listening. You've worked so hard to build your skills, your business, and your brand. Don't let a missing signature or an unclear policy put it at risk. Start with One form at a time. Review your current documents. Update the language for clarity and compliance. Keep copies organized and accessible. And finally, educate your clients about why you use these forms. It's going to build trust and confidence. And if you're unsure where to start, check with your nursing college, your professional association, a health call lawyer, or reach out to mentors like me. We've been through it, and oh boy, we can help guide you. Because protecting your business isn't about fear, it's about empowerment. And when your paperwork is in order, you can focus on what you need to do best. You're going to provide compassionate and high-quality care. So thank you everyone to being here today and learning about protecting themselves and their businesses. So for more resources, templates, and mentorship, definitely visit us online. Thank you everyone for listening. And remember, good documentation isn't just about paperwork, it's professional protection.