Thanks Donna
I'm glad I'm not alone. An interesting patient reported to my office today
which puts my case far stronger than I possibly could have. Two weeks ago I
saw this 75 year old lady for the first time because she could not manage her
own nails. Having cut her nails I proceeded to question and examine her a
little further and then referred her on to a specialist as I suspected an upper
motor neuron lesion or possibly a tumour. She told me today that the
specialist agrees and that she is soon to have a lumbar puncture. And all this
from a treatment modality which is beneath us? Cut the nails - treat the
patient.
Regards
Dave Cashley
Donna Shewfelt wrote:
> Well put David! I like how you think.
>
> ----- Original Message -----
> From: "David Cashley" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Thursday, March 22, 2001 8:11 AM
> Subject: Re: Service for nailcuts?
>
> > Chaps
> >
> > I just can't get my head around this train of thought at all. We are
> livid at
> > all those other professions who invade our territory by performing
> > biomechanicals and prescribing orthotics, and even more livid at the
> > un-state-registered practitioners who are "stealing our livelihood" yet we
> want
> > someone, and by the sound of it just about anyone, to take care of routine
> foot
> > maintenance. Am I missing something? I can't help feeling that we as a
> > profession need to realign our thinking as to what a nail cut actually is
> and
> > to the potential that it represents. I have no problem with supervised
> nail
> > care assistants, but at the end of the day we are the foot specialists -
> and
> > the nail specialists come to that! Lets not give our profession away, the
> > government are already doing that for us. If your clinics are so busy
> that you
> > cannot personally see to every nail cut, that's okay, but lets not demean
> its
> > position within podiatry, it will always remain a very vital function of
> > footcare as well as being a chance to educate and perform routine
> screenings /
> > check-ups on patients
> >
> >
> > Kindest regards
> >
> > Dave Cashley
> >
> > "davidjames.simpson" wrote:
> >
> > > Neil
> > >
> > > Interestingly, just thinking about it, nurses care for patients teeth
> (not
> > > dental assistants) by cleaning and the such like in a hospital
> environment,
> > > and their not dentists!! The dentists are probably quite happy for them
> to
> > > take the pressure off! I forgot that one.
> > >
> > > David
> > >
> > > ----- Original Message -----
> > > From: PodiatryPages <[log in to unmask]>
> > > To: <[log in to unmask]>
> > > Sent: Monday, March 19, 2001 9:34 PM
> > > Subject: Re: Service for nailcuts?
> > >
> > > > From: "davidjames.simpson" <[log in to unmask]>
> > > >
> > > > > Neil
> > > > >
> > > > > I can assure you that district nurse do not just dress leg ulcers, I
> > > > > found that remark quite patronising, if there is an element of
> > > > > podiatrists/chiropodists think it is below to "cut nails" them I
> cannot
> > > > see
> > > > > why such a profession as nursing ( with its own protection of title
> and
> > > > act)
> > > > > the biggest workforce in the NHS would take it quite as "having a
> nice
> > > > > break" I think you will find the scope of professional practise
> > > stretches
> > > > > rather further.
> > > > >
> > > >
> > > > David
> > > >
> > > > Sorry I should have made that remark clearer. What I meant was that
> > > dressing
> > > > leg ulcers is an extremely unpleasant job. Most people find the idea
> of
> > > > dealing with other peoples feet unpleasant so what I meant was that
> after
> > > > dressing a leg ulcer cutting nails would be a relatively pleasant job.
> So
> > > > I'm suggesting that to persuade a nurse to cut nails would be easier
> than
> > > > getting someone who normally keeps their hands clean to do it.
> > > >
> > > > It was on my mind because this afternoon (about an hour before I
> wrote) I
> > > > had two patients with large pungent leg ulcers who's compression
> bandages
> > > > had to be removed to get at their feet. Every time I have done this I
> > > wonder
> > > > at the nurses who do it every other day for those patients and many
> others
> > > > no doubt, I have nothing but respect for them. I certainly did not
> mean to
> > > > make you think that I see nurses with nothing better to do than cut
> > > patients
> > > > nails or that I have a low opinion of nurses. I do think though that
> if
> > > all
> > > > that is wrong with a patients feet is that their nails need cutting
> once
> > > > every few months and a district nurse is visiting them every few days
> it
> > > > would be nothing short of stupid if they were not doing it while they
> were
> > > > there - 5 minutes every 2-3 months - instead of a podiatrist having to
> > > visit
> > > > them separately. I always ask these patients how often they are
> visited to
> > > > get a picture of their overall care and in the case of relatively
> minor
> > > > ulcers it often turns out that by visiting a podiatrist (for more than
> > > > nails) the nurse has been able to skip a visit knowing that they will
> have
> > > > their ulcer redressed. I have no problem with doing this, I don't
> think
> > > 'not
> > > > my job' , I have no professional objection to doing this and I expect
> that
> > > > the majority of nurses would be professional enough to have no
> objection
> > > to
> > > > cutting some nails.
> > > >
> > > > As for not appreciating other health professionals scope of practice
> I'll
> > > > admit that I'm pretty ignorant on areas of practice that I haven't
> > > actually
> > > > come into contact with. How much would you know about nursing if you
> > > weren't
> > > > a nurse? Probably no more than other podiatrists. We all need to work
> on
> > > > that
> > > >
> > > > Sorry again for offending you, I hope I've explained myself properly
> this
> > > > time.
> > > >
> > > > Regards
> > > > Neil Thomson
> > > >
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