Is this in our scope of practice? - page 2
Our nurse manager is requiring all of our unlicensed assistive personnel to document that "nail care" was done on each pt. This includes cleaning, trimming and filing. I thought I learned a long time... Read More
Sep 18, '11Occupation: OR nursing Specialty: 14 year(s) of experience in Trauma Surgery, Nursing Management ; From: US ; Joined: Jul '10; Posts: 2,897; Likes: 7,178Quote from Isabelle49I've seen some patients that need a freaking hacksaw to cut through thick yellowed talons!As an RN in Louisiana, am not allowed to cut nails, not sure about filing, but I don't do that either. Patient/family can do or they can see manicurist/pedicurist. There is just too much risk.
I had a patient once who wanted me to file his toenails with his Dremel tool, lol. I didn't.
Sep 18, '11Joined: Oct '08; Posts: 58; Likes: 95CA nurse practice act says that nurses are responsible for 'personal hygiene'; whatever you will make of that. Any restrictions about clipping nails are facility based. I strongly suggest that you read the nurse practice act, lots of people will tell you things about your scope that are just plain wrong.
Yesterday, I had a phlebotomist tell me that venipuncture is not in the RN's scope of practice. I had to laugh.
4th link down, but lots of other good things to read on that page.Last edit by missbutton on Sep 18, '11 : Reason: new thought
Sep 18, '11Specialty: 11 year(s) of experience in PeriOperative ; Joined: May '10; Posts: 336; Likes: 535It is within your scope to care for a patient's hair, nails and skin. It is not within your scope of practice to receive compensation specifically for these services.
So you could file and paint and do whatever else you wanted to the nails, but the patient could not be charged for a "manicure" or "pedicure" unless is was done by a licensed cosmetologist. Licensure for cosmetology and aesthetics exists to protect income of the professionals in the field, not to protect patients, like nursing licenses do.
Sep 18, '11Occupation: New grad RN, CNA of 5 years Specialty: 5 year(s) of experience in Cardiac ; From: US ; Joined: Mar '10; Posts: 623; Likes: 1,164Cleaning with a brush or orange stick and filing with an emery board, yes. Clipping, no....especially for diabetics!
Sep 18, '11Joined: Sep '11; Posts: 128; Likes: 73we are taught that nail care is a hygeine need. Its as important as bathing your patient. Clipping is a no-no but soaking, washing under nails, filing nails are all a part of the job just like bathing a patient is our job
like a previous poster said... you dont want to be scratched by some of the nasty nails you see. wouldnt you rather they be clean? ill bet your patient would like to have them cleaned too.
Sep 18, '11Occupation: RN, Smoking Cessation Health Coach Specialty: 28 year(s) of experience in LTC, Disease Management, smoking Cessati ; From: OH, US ; Joined: Sep '05; Posts: 304; Likes: 409Clean with nail brush soap and water, then file nicely! I would not clip ever. Oh and orange stick to clean is acceptable too...
Sep 18, '11Joined: Jan '02; Posts: 2,593; Likes: 1,419I can't wait to shout out "Can somebody go check my ventilator alarm for me? I am busy giving a mani and pedi. Thanks!"
Sep 18, '11Occupation: Staff RN Specialty: 12 year(s) of experience in Psych ; From: US ; Joined: May '11; Posts: 138; Likes: 139If the patients/residents can file their own nails they get an emery board and can get to it. Sometimes it's a great way to keep a dementia person busy. In the LTC, nail care is done on their bath day. The get an appointment with the podiatrist if they have mycotic nails or are diebetic, otherwise the LNA's file them. On the psych unit, if appropiate, the patients cut their own nails, and we always have emery boards for them to use.
When did cutting nails, on non diabetics stop happening, it's been a long time 19 yrs, since I was in nurses aid school, but nail care, cutting, filing and cleaning was part of our basic care. Even 13 years ago in LPN school that was part of our basic nursing care course.
Sep 19, '11Joined: Apr '10; Posts: 3,383; Likes: 1,924We don't carry orange wood sticks, nail files or nail clippers at my hospital...
I was always taught that nail clipping should be delegated to a podiatrist. Now, I don't mind cleaning under the nails with a soft toothbrush if they are dirty, but as others have put it, I don't have time for a mani/pedi.
Sep 19, '11Joined: Mar '11; Posts: 392; Likes: 862I'm with those who say that nail care is a part of general hygiene care. At my facility, the policy is that nurses do not cut diabetic patients' toenails but we are expected to keep them clean, and we do clean and trim fingernails as needed, and toenails unless they are so tough you'd hardly make an impression on them with a hacksaw lol, or the patient is a diabetic, as already mentioned. With apologies to any podiatrists who are reading, who'd want to be a podiatrist?? All those horny misshapen horrible toenails!
While cleaning and trimming nails isn't my favourite thing to do by any means, if they're dirty or long and the patient can't attend to it themselves, someone has to do it! Are people really saying that this isn't in our scope of practice? It seems like more and more there is less and less basic care getting done.