Nursing Foot Care: a wholistic approach

At McDermott Footcare, the first visit with a new client includes a concise assessment of pre-existing medical conditions. The reason is because pre-existing medical conditions are reflected in the health of the feet. It is important to consider what is happening to the entire body and not just the feet.

  • arthritis affects the joints in the feet resulting in pain, inflammation, swelling, calluses, and corns
  • a weakened immune system results in fungal and bacterial infections of the feet and toenails that are difficult to treat
  • steroids such as prednisone may cause brittle, thickened toenails
  • poor circulation to the extremities from conditions such as peripheral vascular disease and diabetes may result in pain, numbness, neuropathy, swelling, changes in the colour of the skin, bacterial and fungal infections of the feet and toenails, thickening of toenails, amputation

In nursing foot care, as in all medically-related care, a wholistic approach is best. Since care at McDermott Footcare is provided by a registered nurse, counselling and health teaching is provided as needed. Clients sometimes have health-related questions and they find the knowledge and advice of a registered nurse reassuring and helpful; this gives clients peace of mind.

A wholistic approach to nursing foot care must also recognize the importance of spiritual care. Honouring the person’s spiritual dimension, irregardless of their religious beliefs, is accomplished by treating clients with respect, being nonjudgmental, and actively listening to them.

In healthcare-related professions, it is easy to focus on the procedure that must be performed, the disease that must be treated, the diagnosis that must be addressed. But the persons we care for are so much more than the diagnosis with which they present. In order to give the best care, we must always take a wholistic approach and consider each person’s mind, body, and spirit connection.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

 

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Nursing Foot Care: Frequently Asked Questions

Recently, McDermott Footcare was a guest expert at a community home care information seminar.  Here are some of the questions asked by the audience as well as frequently asked questions:

How do I know that a foot care nurse is properly trained?  Anyone claiming to be a foot care nurse should be able to show you a Certificate of Completion of an Advanced Nursing  Foot Care course.  In addition, the RN or RPN should have a current Licence to Practice nursing from a nursing regulatory/disciplinary body.  In Ontario, Canada, the College of Nurses of Ontario will be able to verify if the RN or RPN is a professional nurse in good standing with no disciplinary actions against him/her.   Only a RN or RPN can take courses leading to certification in Advanced Nursing Foot Care.

Why does the nurse have to take a nursing history/assessment?  As RNs and RPNs, we understand that there is a connection between the health of the feet and the health of the body as a whole.  Poor circulation and nerve function in the feet affect skin condition, and the ability of the feet to recover from open wounds and infection.  Certain medications affect the condition of the nails and skin, causing them to become brittle, fungal, thickened, discoloured, difficult to cut.   In addition, some medications decrease the body’s ability to fight infection resulting in fungal infections of the feet.  A properly trained certified foot care nurse will be able to satisfactorily explain the correlation between health, medications and feet.

Initial nursing assessment of a diabetic client.

How do I prepare for a home visit from a foot care nurse?  Choose a comfortable chair that you would like to sit in for the duration of the treatment.  A recliner works best as does a chair with a footstool.  If neither is available, the certified foot care nurse can improvise, creating a suitable area to place the feet.  One or two fresh towels are useful also.  There is no need to soak your feet just before or during the visit.

Using the client’s bed as a suitable work surface.

How long is a visit?  The first visit is usually a little bit longer since an initial assessment has to be obtained.  Typically, the first visit is about an hour, depending on the foot care needed.  Subesequent visits are shorter.

Will you teach me how to care for my feet between visits?  An important part  of quality professional nursing care  includes thorough health teaching.  A properly trained, certified foot care nurse should be able to provide appropriate guidelines for self-care of nails and skin between visits.  The RN or RPN will also be able to determine if further medical treatment is needed and advise seeing your doctor.

How much does nursing foot care cost?   Prices vary between nurses and in different jurisdictions.  The nurse may charge a distance fee.  Ask the nurse for their fee.

Can I claim this?  In Ontario, Canada, nursing foot care is an allowable income tax expense.  Some private insurance companies will reimburse up to 80% of cost.  Depending on the fee charged, the Department of Veterans Affairs will reimburse all or part of the cost.  Always ask the certified foot care nurse for a receipt.  Make sure the RN or RPN registration licence is included in the receipt since this is necessary for reimbursement.

Can I have a one-time only appointment?  Certainly.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author