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Nurses–Make Your Hands Happy!

DRY, CRACKED HANDS – A NURSE’S TRIBULATIONS

The primary cause for deeply dehydrated hands comes from washing and the immediate application of alcohol-based sanitizers. This is part of the job, BUT you can take steps to help alleviate the worst conditions.

ON THE JOB

While some facilities/practices prohibit the application of emollients (lotions or creams) on the floor, taking a moment to rehydrate your skin on your personal breaks will help tremendously. Choose products that will 1) add moisture (water) back 2) prevent moisture loss (see ingredient list below.)

According to OSHA, employees must be allowed to wear protective equipment such as glove liners to prevent injury. Look for cotton glove liners to slip on under your exam glove. They will absorb excess perspiration, part of the reason, the skin leaches natural oils.

HOME CARE

Give your hands a deeply hydrating slather of a good water-based cream or lotion, then slip on a pair of gloves or mitts designed to penetrate the moisture. These can be heated. There are soy-based mitts that can be warmed just for this treatment available in your drug store.

Purchase a small paraffin bath – on your clean hands, apply your moisture cream, then dip your hands into the paraffin bath three times to build up a light coating of the paraffin, then slip your hands into plastic bags to keep the paraffin from getting on everything. Allow the wax to fully cool—by which time the lotion will have penetrated your skin and given a nice hydration treatment. (Note if you share the paraffin bath with others, we suggest dipping out a portion with a small paper cup, rather dipping.)

PRODUCT KNOWLEDGE

Rather than listing a product, here are some ingredients to look for. If your hands are dry…they are dehydrated…they need water, not oils. So look for moisturizers with a first ingredient of WATER….not an oil or petroleum-based product.

Other ingredients that will help are: Urea or uric acid – helps bind moisture to the cells in the epidermal layer. Another “binding” agent is hyaluronic acid (HA) which has the miraculous chemistry of being able to bind up to 1000 x its own molecular weight in water.

Also look for exfoliative ingredients such as AHAs – alpha hydroxy acids–good ones are lactic acid or malic acid; or BHAs – beta hydroxy acids such as citric acid or salicylic acid.

You also need an occlusive ingredient to lock it all in place – a botanical-based emollient such as shea butter, coconut oil or any distilled oils that sound like they’d be good on a salad will be good for your skin: safflower oil, avocado oil, wheat germ oil, etc.

Mixing your own products is a shot-gun approach—better to get properly formulated products, avoiding non-essential ingredients such as fragrance, dyes, and unneeded waxes.

The biggest repair you can invoke – is to avoid over-immersion in water and its leaching effects in the first place.

FCNs Must Test for PAD

Foot-care-trained nurses are quick to spot troubling symptoms in their patients’ lower limbs and feet

Peripheral artery disease (PAD), sometimes called Peripheral Vascular Disease (PVD), is a disease in which plaque may build up in the arteries outside the heart that carry blood to the head, organs, and limbs. This plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. When it builds up in the arteries, the condition is called atherosclerosis. Unless prevented or treated, plaque can narrow the flow of blood in the arteries.

This limits the flow of oxygen to organs and other parts of the body which can ultimately lead to death of a patient. It can happen in any organ but is more often in the legs. (PAD can also be from other causes than atherosclerosis.)

According to the CDC, PAD can be asymptomatic, causing a dangerous situation for sufferers as it can lead to coronary artery disease and cerebrovascular disease, which could lead to a heart attack or stroke. For this reason, patients with risk factors should be tested for PAD to allow early diagnosis of the disease, if it is present.

Risk Factors for PAD are:    

Foot exams reveal symptoms of PAD

 Smoking
 High blood pressure
 Atherosclerosis
 Diabetes
 High cholesterol
 Older than age 60

Foot Care Nurses must be fully educated about this disease. Studies show that about half the cases remain unrecognized, allowing a high risk of ischemic events in the future of these patients. Therefore, if a patient has pain, numbness, aching, or heaviness in the leg muscles (possibly claudication) with exertion which is relieved with rest, it’s time for a complete exam and to test of PAD.

Check for these symptoms:
 Weak or absent pulses in the legs or feet
 Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all
 A pale or bluish color to the skin
 A lower temperature in one leg compared to the other leg
 Poor nail growth on the toes and decreased hair growth on the legs
 Erectile dysfunction, especially among men who have diabetes
 Muscle atrophy
 Hair loss and smooth shiny skin

Diagnosis of PAD
In patients with these symptoms, the ankle-brachial index (ABI) is indicated. It’s a simple and quick, non-invasive test that measures the blood pressure in the ankles and compares it with the blood pressure in the arms at rest and after exercise. If the ABI is <0.9, the patient must be immediately referred to a vascular specialist. This physician will prescribe imaging tests such as a Doppler ultrasound, magnetic resonance angiography (MRA), and computed tomographic (CT) angiography. These tests provide additional information in diagnosing PAD.

Conclusion: Foot Care Nurses with knowledge of PAD can save lives through responsible practices. If a patient 1) has symptoms that indicate PAD or 2) has the risk factors for PAD, the FCN must conduct an ABI. This test will determine potentials for the presence of PAD and whether he or she should be referred to a specialist.

September is Pain Awareness Month

Did you know…

Gout is one of the fastest growing arthritic illnesses in the United States.

It is very painful and is difficult to treat. Caused by the imbalance of uric acid in the joints, one of the most affected joints in Gout is the hallux. Foot Care Nurses will see patients who have this form of arthritis. In many cases it can be successfully managed through dietary changes.

FCNs must know the dietary changes that will manage this disease and then educate their gout-suffering patients on these tactics. The most effective dietary change is reducing the amount of uric acid levels; this will reduce the number of attacks.

The Arthritic Foundation has an excellent blog titled “What Role Does Diet Play in Gout Management”

A second great informational blog is titled “Making Smart Meat Choices if you have Gout”

These blogs are written for the consumer but are excellent education for Foot Care Nurses to pass on to their suffering patients.

 

SEN Module 5 – Resources for Entrepreneurial Nurses

To begin, click on the “Play” button at the bottom left corner of the view screen.

This concludes your studies of “Strategies for Entrepreneurial Nurses.”

To proceed with obtaining your Certificate of Completion, please complete and submit the following Survey:

Survey for Strategies for Entrepreneurial Nurses

This Survey is necessary in order to complete the Certification process in order to claim your CE Contact hours with your state.

SURVEY QUESTIONS - BEST PRACTICES IN FOOT CARE FOR RNs

Where relevant, please mark 1-4, with 1 as low, 4 as excellent.
For others, mark yes or no or write in where necessary.

I acknowledge that it is my responsibility to utilize the information provided in this course within my appropriate Nurse Practice Guidelines and/or Scope of Practice in accordance with the relevant regulations of my professional licensure.

Thank you for your interest in our program,
PROFESSIONAL EDUCATION, LLC
©Professional Education, LLC. All rights reserved.

Click on the links below to access the downloadable materials mentioned in the module above.

Check Lists

Supplies & Equipment Checklist

Start Up Check List and Timeline

Forms

New Client Questionnaire – pdf

New Client Questionnaire – Word

Physician Authorization Form for Pedicure – pdf

Physician Authorization Form for Pedicure – Word

Brochures

Because We Care – Word

Doctor to Patients – CFCN referral – Word

Postcards

Postcard 2 per page – Word

Salon Signage

Because we care – Word

Because we care – no autoclave – Word

Letters

Letter to Local Media Intro MNT & Safe Foot Care

Letter to Local Media Intro Medi-Pedi

Press Releases

Press Release – Intro FCN

Press Release – Intro New Tech

LINKS & RESOURCES

 Click the links shown here for:

Footlogix

Restorative skin and foot care – follow the link for special pricing for our students on their initial order

Erica’s ATA

Electric files, evacuation systems and bits. Use Coupon Code: ERICA20FEET to get 20% off all bits and implements

LCN-Light Concept Nails, USA

Nail enhancement products, skin care lotions, creams and treatments and Barefoot gel nail line. Use Coupon Code: NCA10 to take 10% off your initial order

SEN Module 4 – Growing Your Business

To begin, click on the “Play” button at the bottom left corner of the view screen.

SEN Module 3 – New Marketing Strategies

To begin, click on the “Play” button at the bottom left corner of the view screen.

SEN Module 2 – Setting Up Your Practice

To begin, click on the “Play” button at the bottom left corner of the view screen.

Click on the following link to access a Time Line for your planning:

Start Up Check List and Timeline

SEN Module 1 – A New World for Entrepreneurial Nurses

To begin, click on the “Play” button at the bottom left corner of the view screen.

Strategies for Entrepreneurial Nurses

Strategies for Entrepreneurial Nurses

Online Training in Business Development

This program is chock-full of ideas, tools and topics to think about if you are considering a change in your nursing career.

  • It discusses a unique entrepreneurial opportunity for nurses to create a stand-alone practice
  • It gives you the justifications and the methods for obtaining the training needed for this new specialty
  • It’s available entirely online
  • It can be taken at your convenience–time or any place a computer and internet access are available
  • It provides 5 hours of CE Contact Hours (California – check your state for reciprocity)

***Bonus *** Includes 2 hours of Practice Development Consultation to help you develop your new practice plans.

Nurses can be Entrepreneurs

Nurses can take advantage of changing demographics to create a new, interesting career choice – opening their own practice as a Foot Care Specialist

Private or Mobile Foot Care

Some states allow nurses to develop their own treatment practices in Routine Foot Care. The legal parameters are mapped out in the state’s practice guidelines and can provide the freedom and opportunities never before enjoyed in the nurses’ professional lives.

Foot Care of the Elderly

Americans are living longer and the numbers of elderly and diabetics are increasing quickly. Many will be suffering from chronic conditions, such as diabetes and others that require special care of their feet, and the med-surg nurse can be the one providing it.

Bed-bound Patients

Ulcers can occur on pressure point areas, including the heels of the feet, which can progress from no symptoms to an ulcer needing acute care within 48 hours. Patients benefit from a nurse’s assessment, prevention and care of these conditions on the feet.

Long Term Care Patients

Foot care in this setting is critical as poor foot care may allow the development of severe lesions on the feet and legs of patients, with potentials for amputation and death. It is imperative nurses in this setting know foot care to reduce the suffering and morbidity of patients.

Podiatry Offices and Diabetic Foot Care Clinics

Trained nurses can lighten the load for podiatrists and physicians by performing Routine Foot Care and dramatically increasing patient treatment numbers. Many physicians and podiatrists are looking for relief from RFC so they can concentrate on more critical care.

Home Care Nurses

Nurses can perform foot care for home-bound patients. No, or poor, foot care can cause ulcers and other serious infections on the feet. A nurse trained in assessment and Routine Foot Care is providing important prevention and treatment care to these patients.

Foot Care with Electric Files

To begin, click on the “Play” button at the bottom left corner of the view screen.