Module 1

Under Construction

Introduction to Foot and Nail Care

Learning Objective 1: Explain the principles of being a foot care nurse.

 

Case Study 1

Sally is a registered nurse (RN) in a state that allows qualified nurses to perform foot care. She has worked in a long term care facility for 6 months after her initial licensure. She has an associate degree in nursing and is applying to a BSN program in the Fall. While searching for career options, she sees that WOCNCB has a foot care certification. Sally is troubled by the condition of her residents’ toes and feels a calling towards foot care. She searches online for more information, including state regulations, certification board requirements, and some information about foot care. Sally reads that there are additional options for certification and reviews the exam content. She questions why so many topics have to be covered to trim toenails. Sally would like to become certified so that clients will be able to trust her skills, but she’s unclear about additional reasons.

 

1. To become eligible to perform foot care, the state will require Sally to additionally have:
 

     A. a bachelor degree in nursing.
 

     B. at least one year of experience in long term care.
 

     C. a well standing, active RN license only.
 

     D. professional education and training in foot care.
 

 

2. Right now, Sally’s foot and nail care options include:
 

     A. Pursue certification by the AFCNA as a Certified Foot Care Specialist.
 

     B. Pursue certification by the WOCNCB as a Certified Foot Care Nurse.
 

     C. Start work in 6 months when she has enough long term care experience.
 

     D. Wait to complete her BSN program before she starts foot and nail care.

 

3. Foot and nail care includes:
 

     A. Assessing wounds for type, infection, and referral.
 

     B. Delegating nail care to personal care attendants.
 

     C. Educating family members how to safely trim toenails.
 

     D. Sizing and fitting clients for compression stockings.
 

 

4.  Additional reasons to become certified include:
 

     A. A registry that guarantees at least two new clients every month.
 

     B. Certification examinations that ensure comprehension of required content.
 

     C. Discounts on foot care tools that assist new individuals with setting up.
 

     D. One time certification that provides verification for nursing competency.
 

Answers to Case Study 1:

1. To become eligible to perform foot care, the state will require Sally to additionally have:
 

     A. a bachelor degree in nursing.
 

     B. at least one year of experience in long term care.
 

     C. a well standing, active RN license only.
 

     D. professional education and training in foot care.
 

Answer: D

 

All states have a Nurse Practice Act or adopted statute that determines scope of practice and may allow for use of the Decision Making Model. All states that allow nurses to perform foot care require professional continuing education and training by a foot care professional.

 

2. Right now, Sally’s foot and nail care options include:
 

     A. Pursue certification by the AFCNA as a Certified Foot Care Specialist.
 

     B. Pursue certification by the WOCNCB as a Certified Foot Care Nurse.
 

     C. Start work in 6 months when she has enough long term care experience.
 

     D. Wait to complete her BSN program before she starts foot and nail care.
 

Answer: A.

 

Nurses with associate degrees in nursing are eligible to become certified by AFCNA after professional continuing education and training by a foot care professional. WOCNCB requires a bachelor degree. Experience must be with a foot care professional. Education must be foot and nail care specific from an accredited continuing education course.

 

3. Foot and nail care includes:
 

     A. Assessing wounds for type, infection, and referral.
 

     B. Delegating nail care to personal care attendants.
 

     C. Educating family members how to safely trim toenails.
 

     D. Sizing and fitting clients for compression stockings.
 

Answer: A.

 

Wounds (arterial, venous, pressure/sheer, friction, trauma, etc.) may be found during foot and nail care. Certain conditions may keep clients from identifying wounds. Referrals a primary care physician or wound care center will address wound issues and hopefully stop progression of infection. Nail care must be performed by a foot care professional. Intact skin care may be delegated. For individuals with compromised conditions (i.e. vascular insufficiency and diabetes), it is not recommended that non-professionals trim toenails. Compression stocking fitting requires specific training that is not included in foot and nail care competencies. Due to complicated health conditions (e.g. a mix of venous insufficiency with arterial insufficiency), stockings should be prescribed by the client’s physician and fitted by a professional fitter.

 

4.  Additional reasons to become certified include:
 

     A. A registry that guarantees at least two new clients every month.
 

     B. Certification examinations that ensure comprehension of required content.
 

     C. Discounts on foot care tools that assist new individuals with setting up.
 

     D. One time certification that provides verification for nursing competency.
 

Answer: B.

Certification eligibility does not require education from specific sources and allows the nurse to determine which courses to complete as long as there is a specific number of continuing education hours. The chosen courses may not reflect the same content on the certification exams, which is what determines content comprehension to claim foot and nail care competency. There is no registry to guarantee new clients, no discounts are given, and recertification is every five years.

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