Nurse Education
How to Become a Foot Care Nurse
Review the requirements for your state below and consider these steps:
1. Determine if your state allows nurses to perform routine foot care (a few don't allow it) and what conditions are required to perform foot care (e.g. completion of education and training, certification, working with a podiatrist, an order, etc.).
If nurses are allowed to perform foot care in your state:
2. Choose your preferred certification board based on your eligibility and values. This will determine the focus of your foot care content.
a. Wound, Ostomy, and Continence Nursing Certification Board (WOCNCB) to become a Certified Foot Care Nurse
b. American Foot Care Nurses Association (AFCNA) to become a Certified Foot Care Specialist
3. Find and successfully complete a foot care course (preferably approved by an ANCC provider/approver) that matches the exam content from your chosen certification board. (WOCNCB Exam Content / AFCNA Exam Content)
4. Find a preceptor who is a foot care professional who provides routine foot care. Complete 20-40 hours of hands-on-training. Maintain this foot care professional as a mentor for the remainder of your career.
If certification is required by your state, you want to advance the credibility of this nursing specialty, or you want to show your clients you have the knowledge and skills to perform safe, competent care:
5. Apply online for the certification exam (WOCNCB / AFCNA) and pass.
6. Purchase your tools and instruments, determine your documentation process (paper vs. electronic), and get liability insurance.
If you have any questions beyond what I've provided here and other pages, please email me (Kristen) with any questions!
Foot Care Continuing Education Hours and Hands-on-Training with Preceptors
Online Courses:
There are many options for online foot care related nursing education. Whichever source you choose, make sure the content matches the certification exam content (WOCNCB Exam Content / AFCNA Exam Content), even if you decide to not get certified. These two certification bodies are the leading experts on what knowledge and skills are required for competent and safe routine foot care.
If you prefer to follow WOCNCB standards, I recommend Emory Nursing's online Foot and Nail Care Course. The Wound, Ostomy and Continence Nurses Society® Core Curriculum: Wound Management is the core curriculum for both the Emory course and the WOCNCB exam content.
If you prefer to follow AFCNA standards, I recommend the AFCNA webinars that are currently being offered for no cost (subject to change). I've linked an old registration, but signing up should put you on an automatic mailing list for future webinars. Another option is Rainier Medical Education Programs, which offers non-credit videos so you can better understand foot care nursing, as well as videos for certification eligibility.
Additionally, the University of Wisconsin-Eau Claire offers their Foot & Nail Care Expanded Online Education course.
Always seek out the latest updates. Every so often, certification boards will survey certified foot care nurses to review new trends and needs for foot care. These reviews may change their recommendations for knowledge and skills required to perform competent and safe care. Stay up to date and informed on their recommendations by reviewing their exam content.
Hands-on-Training:
Rainier Med in Washington has offered hands-on-training in the past and (I assume) will in the future. FootCare by Nurses in Greenfield, MA offers hands-on-training. University of Wisconsin-Eau Claire offers hands-on-training (currently on hold). I highly recommend training with a podiatrist in your area who you can refer clients to if the foot care becomes advanced. Spending some hours with a wound care podiatrist is very helpful as well.
WOCNCB is currently compiling a database for CFCN preceptors, which I will link when it becomes available. CFCNs can opt in here.
Regulations regarding foot care performed by nurses:
Most states have adopted a position that follows the Scope of Nursing Practice Decision-Making Framework. After reviewing your state's Nurse Practice Act and other Rules/Regulations that may prohibit specific actions, if you have not had the education and training, it is not within your scope of practice to perform foot and nail care. Some states require certification, some states require evidence of education and training, most states use the above referenced framework (which calls for education and training), and some states have limited the foot care services that nurses can perform. Contact your state board of nursing for confirmation/clarification. Many states consider this a legal issue and refuse to give specific direction; at least one state requires an order to perform foot and nail care, while another does not allow nurses to perform routine nail care.
Most states do not declare the specifics of what a nurse can or cannot do, but will in cases where it puts the public in danger. The purpose of a state's board of nursing is to protect the public. It is our job as nurses to protect the public as well. Certification Boards have the expertise to determine what concepts nurses should know, or be skilled in, to be considered competent. Regardless of certification requirements, nurses must have education and training. Certification is verification that you are compliant with state regulations and value your clients' well-being.
Below is a list of states and a starting point for your research.
Alabama - Approved Standardized Procedures
Alaska - Advisory Opinions: Scope > Scope foot care
Arizona - Advisory Opinion
Arkansas - Nurse Practice Act and Decision Making Model
California - Understanding the Role of the Registered Nurse
Colorado - Board of Nursing > Scope of Practice Algorithm
Connecticut - Nursing Scope of Practice questions (860) 509-7555
Delaware - Board of Nursing > Scope of Practice
Florida - Petition for Declaratory Statement
Georgia - Scope of Practice Decision-Making Model
Hawaii - Scope of Practice Decision Making Framework
Idaho - Rules of the Board > 04. Practice > a. Perform Acts. (p. 17)
Illinois - State of Illinois Nursing Rules > Joint Committee on Administrative Rules > RN Scope of Practice
Indiana - Frequently Asked Questions > Statutes and Rules and Indiana Administrative Code > Article 2. Standards for the Competent Practice of Registered and Licensed Practical Nursing
Iowa - Iowa Administrative Code pending response
Kansas - NPA by Statute or Rules and Regulations > Requirements for Licensure and Standards of Practice > Standards of practice pending response
Kentucky - Advisory Opinion Statement
Louisiana - Scope of Practice > RN Scope of Practice Guidelines
Maine - Practice > Scope of Practice Decision Tree
Maryland - Proposed Concepts for Possible Regulation
Massachusetts - Advisory Ruling
Michigan - no specific nurse practice act - Public Health Code, Public Health Code (Excerpt), and Board of Nursing - General Rules
Minnesota - Scope of Nursing Practice Decision-Making Framework
Mississippi - Frequently Asked Questions (FAQs) > Wound & Foot Care > Can a RN perform nail/foot care?
Missouri - Scope of Practice Decision Making Model
Montana - Scope of Practice
Nebraska - Advisory Opinion: Safe Practice: Nursing Roles and Assignments: Competency and Nurse Licensing Scope of Practice
Nevada - Practice Decision Request and Scope of Nursing Practice Decision Making Framework
New Hampshire - Scope of Practice and Position Statement
New Jersey - Decision-Making Model Algorithms
New Mexico - Practice Acts > Nursing Practice Act
New York - Practice Information, requires an order, and restrictions apply, contact NURSEBD@nysed.gov
North Carolina - Scope of Practice Decision Tree, Practice, and Position Statement
North Dakota - Scope of Nursing Practice Decision-Making Framework
Ohio - Practice RN & LPN > RN and LPN Decision Making Model and The Nurse Practice Act - Ohio Revised Code (ORC) pending response
Oklahoma - Guidelines, Position Statements > Decision-Making Model for Scope of Nursing Practice Decisions
Oregon - Interpretive Statements, Policies, and Information Regarding Nursing Practice > All Licensed Nurses > Foot Care Provided by RNs and LPNs
Pennsylvania - Board Laws & Regulations, pending response
Rhode Island - outside nursing scope of practice
South Carolina - Advisory Opinion # 57
South Dakota - Practice and Delegation Decisioning Guides > Scope of Nursing Practice Decision-making Framework
Tennessee - Nursing Practice Code and Rules > Standards of Nursing Competence and Position Statements > Decision making Guidlines (pp. 19-20)
Texas - Decision Making for Determining Nursing Scope of Practice and Scope of Practice Decision‐Making Model
Utah - R156-31b-703b. Scope of Nursing Practice Implementation and Section 801 Practice within limits of competency
Vermont - Nurse Practice Act and APRN/RN/LPN Scope of Practice plus Decision Tree
Virginia - Nurse Practice Act and Decision Making Model
Washington - Decision Tree
West Virginia - Scope of Practice for Licensed Nurses
Wisconsin - Standards of Practice for Registered Nurses
Wyoming - Advisory Opinion RN Scope of Practice and Decision Making Model
Criteria for Qualification of Continuing Education Programs/Offerings and Mandatory Continuing Education Requirements:
The American Nurses Credentialing Center (ANCC) gives accreditation to Providers and Approvers of Continuing Nursing Education. State regulations may not require that CNE is provided or approved by these entities, however courses that are provided or approved by these entities undergo peer evaluation and have set standards for quality nursing education. Quality Matters is an additional certification body that ensures quality online education.
Determine your state's requirements for CNE so you are compliant with your practice.
Below is a list of states and a starting point for your research.
Alabama -
Alaska -
Arizona -
Arkansas -
California -
Colorado -
Connecticut -
Delaware -
Florida -
Georgia -
Hawaii -
Idaho -
Illinois -
Indiana -
Iowa -
Kansas -
Kentucky -
Louisiana -
Maine -
Maryland -
Massachusetts - Mandatory Continuing Education for nurses, 244 CMR 5.00: CONTINUING EDUCATION
Michigan -
Minnesota -
Mississippi -
Missouri -
Montana -
Nebraska -
Nevada -
New Jersey -
New Mexico -
New York -
North Carolina -
North Dakota -
Ohio -
Oklahoma -
Oregon -
Pennsylvania -
Rhode Island -
South Carolina -
South Dakota -
Tennessee -
Texas -
Utah -
Vermont - § 1624. Registered nurse license renewal
Virginia -
Washington -
West Virginia -
Wisconsin -
Wyoming -