I am a foot care nurse. I have been providing this care for 12 years and for the past 7 years have been working FULL TIME as a foot care provider under my own business name. I provide foot care in private homes, senior citizen apartments, and senior centers. I am contracted with my State's Mediciaid Waiver Program to provide foot care as a private duty nurse and am paid through Medicaid for service to these people; the majority of my clients pay out of pocket.
I ESPECIALLY provide foot care for people with diabetes. People who receive my care are those who suffer with pvd and other disease processes which require blood thinning medications; I provide foot care for those who have poor eyesight; suffer Parkinson's and the complications of cvas; have arthritic conditions and many, many other problems which makes self trimming of toenails dangerous- if not impossible.
I have taken what I consider to be a basic nursing procedure and made it my business to see to it that every one who is in need of it gets it. I obtain referrals from physicians, home health care nurses, Area Agencies on Aging and a whole lot of 'word of mouth'. I have never advertised my business--the care provided has spoken for itself.
I am not going to go into a long discourse about all that I do in a day--so let me give you one example that happened today at one of my foot care clinics: a gentleman presented with a description of pain on the tip of his 3rd toe, left foot. Observation and assessment noted severe hammering of the 3rd left toe and subluxation of the 2nd left toe. A necrotic ulcer at a Stage II had formed at the tip of the 3rd toe d/t pressure; a deep corn had formed between the 2nd and 3rd toes, again d/t pressure. The 3rd toe was swollen and red from the 2nd joint to the tip of the toe; the nail bed was blanched and the nail itself, having become soft and spongy was sloughing off. This indicated to me a possible osteomyalitis--
This gentleman is a type II diabetic. He has peripheral neuropathy- (I impliment the filiment test to determine neuropathy on all new clients with diabetes and symptoms of pvd.) He was not aware of the condition of his toe-only that he could "feel a bump and it really hurt". He thought it had been about 6 weeks since he'd noticed the pain--thought it was "just arthritis and it would go away".
I provided his foot care, cleansed the toe tip and padded it; I called his physician and gave report; the doctor wanted to see him right away; I put a copy of my notes into an envelope, gave it to him and sent him off to his doctor's office. When I got home there was a message for me from the physician saying that he had admitted this man to the hospital and had ordered a surgical consult. I can only hope that intervention happened soon enough to prevent a very bad situation from developing...like amputation.
I am glad that someone opened up this thread. I don't offen check out the geriatric nursing site--glad I did today. By the way, I am a veteran of LTC nursing--having had 7 years experience as a charge nurse.
If anyone has questions regarding foot care nursing services and the how's and why's of what I do, please don't hesitate to PM me.