Below, you'll see:
- Who benefits from my nursing foot care service.
- Who should see a podiatrist.
- Protocol of my nursing foot care service:
- Preventive assessment of your skin, nails, circulation, and nerve status.
- Physical care of your nails and skin.
- Education on foot health and body health.
- My limitations as a foot care nurse
Who benefits from my nursing foot care service:
Any person, diabetic or not, who needs help clipping their toe nails and have corns and/or calluses removed, will benefit from my nursing foot care services. This includes:
- Elderly who can't bend and reach their toe nails.
- People with poor vision who can't see their feet or toe nails.
- People with arthritis or other muscle or nerve disease that leaves their hands too weak to manipulate the tools.
- People with poor arterial circulation who are at risk for wounds and arterial ulcers.
- People with poor venous circulation who are at risk for wounds and venous ulcers.
- People with peripheral neuropathy who have lost the protective sensation in their feet.
- People with corns and/or calluses that need to be removed.
- People with thick fungal nails that need to be thinned.
- People with ingrown nails who are willing and able to have the ingrown corner(-s) rounded with each foot care service.
- People with nails that are difficult to clip.
- People with edema of their feet and toes that makes toe nail clipping difficult.
- Diabetics who often suffer from many of the above conditions. Diabetics develop physical problems with both their nerves and circulation. They are often at much higher risk for foot complications than the average population. A thorough foot care exam; a careful nail trimming; careful removal of corns and calluses; as well as teaching, comprehension, and compliance are all important factors in preventing amputations; or at least, delaying amputations.
Who should see a podiatrist:
Medicare and other medical insurance sometimes cover routine foot care for diabetics and other people, who are considered "high-risk;" usually due to poor circulation and/or nerve damage.
I highly recommend that you see a podiatrist if you have wounds that need treatment; if you're diabetic and need an evaluation and prescription for diabetic shoes and/or orthotics covered by Medicare; if you're diabetic, or otherwise at high-risk, and your routine foot care is covered by a podiatrist; and if you're simply too-high of a risk to be seen by a foot care nurse.
The following comprehensive, preventive, and affordable nursing foot care service is the protocol that I follow for my clients:
- Preventive assessment of your skin, nails, circulation, and nerve status:
- Visual inspection of your skin to determine the health of the skin; circulatory status; signs of athlete's foot; signs of dermatitis; signs of pre-ulcers; signs of actual ulcers and/or wounds; signs of infections; and signs of corns and/or calluses.
- Visual inspection of the nails to determine the health of the nails; signs of fungal nails; signs of incurvated nails; signs of thickened nails; signs of ingrown nails; and signs of other nail abnormalities.
- Palpating temperature of the skin with my hands to determine if an infection may be present or if the arterial circulation is poor.
- Visual inspection and palpation with my fingers to see if edema is present; to determine which kind of edema is present; and to possibly determine the reason for the edema.
- Testing the patency of your sensory nerves with a monofilament to determine if you can feel touch and pain in your feet.
- Brief evaluation of your shoes to see if they have a good fit and the quality meets your needs.
- Brief evaluation of your feet and gait to see if a custom-made orthotic may be needed for correction of your gait.
- Physical care of your nails and skin:
- Clipping, cleaning, thinning, and filing of your nails. Your nails will be clipped according to your wishes, as long as your safety is not compromised. Your ingrown nail corners will be rounded to buy you more time before they dig into your tissue and cause an infection. The thickness of your thick nails will be thinned to make the nails more comfortable and less painful in your shoes. The free edge of your nails will be smoothed to avoid tears in your socks. Debris will be cleaned away from your cuticles and from under your nails. Stainless steel clippers and courettes are used for the clipping and cleaning, and an emery board or dremel tool are used for the thinning and filing.
- Calluses and dry skin will be removed with an emery board or a dremel tool. Corns will be removed with a scalpel, or softened and teased away with a courette.
- Your skin and nails will be cleansed with a no-rinse skin foam cleanser; dried with a soft towel, and moisturized with a good-quality lotion.
- A brief massage of your feet and lower legs will be done as the lotion is applied. If you suffer from dependent edema, a massage that pushes the extra fluids up towards the core of your body is beneficial, and can be done at home, as well.
- Small cushioning devices will be provided to protect your toes against pressure to minimize the risk of pain, calluses, corns, and ulcers.
- Education on foot health and body health:
- Any new or abnormal findings will be brought to your attention. Suggestions will be made if you need to see a podiatrist or other specialist; or if you can take the "wait-and-see" approach and try to "doctor" the finding at home first. The choice depends on the severity of the finding(-s) and your general health status.
- You are encouraged to take a look at the hand-outs from my website with guidelines for body health and foot health.
The following are my limitations as a foot care nurse, working independently:
- I may do "routine" foot care; but not "treatments."
- I can't work on wounds; but, I'll let you know if you have a wound that needs treatment.
- I can't prescribe medications; but, I can suggest OTC products.
- I can't prescribe specialty shoes or specialty orthotics; but I'll let you know if I feel that you might need an evaluation.
- I don't have expensive equipment to perform evaluations of circulation and nerve status; but, I can use my eyes, hands, simple equipment, and my knowledge to make a nursing evaluation.
- I can't order x-rays or lab work; but, I can suggest that you see your PCP or a podiatrist, etc.
- I can't do surgeries; but, I can suggest that you see a surgical podiatrist, orthopedic surgeon, vascular surgeon, etc. for a problem that needs surgery.
- I'm not able to contract with medical insurance due to not being a podiatrist; however, my fees are reasonable and often equal to or less than a co-pay.