Can LPNs trim a diabetics toenails in MO?

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    I am almost positive that in school we were taught that a podiatrist must trim toenails of DM patients. However, at my new in-home care job, I have several clients who are monthly visits for nail care only. I'm uncomfortable doing it, as we didn't learn anything about it in school.

    I've scanned the nursing practice act online, but the only thing I see is about IVs.

    Thanks in advance!
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    I wouldn't do it unless you have been trained in foot care, and even then I still think you have to be delegated for this task by an RN.

    Frankly, despite being an RN myself, I don't touch diabetics' feet EVER. I'm not good at nail trims, so I always refer diabetic residents/patients to a foot-care nurse or podiatrist.
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    Thanks for the reply. I will have to call 1st thing in the a.m. and see exactly what they expect in the way of "nail care," and express my concerns. On my very 1st assignment I had to trim fingernails and somehow managed to actually cut the client, even though it didn't seem like I was anywhere near the tip of his finger. His nails were so thick that it was extremely difficult. Luckily he isn't diabetic, but he IS on an anti-coagulant. Didn't bleed much, thankfully, but now my confidence in my nail-cutting ability is even lower!
  6. 0
    Quote from nurse_wannabe
    I am almost positive that in school we were taught that a podiatrist must trim toenails of DM patients. However, at my new in-home care job, I have several clients who are monthly visits for nail care only. I'm uncomfortable doing it, as we didn't learn anything about it in school.

    I've scanned the nursing practice act online, but the only thing I see is about IVs.

    Thanks in advance!
    Yes you may. I have worked in home for over 10 years. I have had foot care classes through an agency really was not a big deal. just cut them straight across an don't cut to short. Do not try to remove in grown nails. If they are to thick refer to podiatrist. nail care is an authorized task by the DOSS just make sure the agency you work for is getting authorization for that task. I always get POs for DNC but according to the agency guideline that is not even necessary, but I feel better with signed orders. Nailcare for pts w/ DM or anticoagulant TX (not including ASA) must be done by a LPN or RN. So be sure home care aides are aware.


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