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fingernail cutting

Discussion in 'United Kingdom' started by alvin, Nov 22, 2010.

  1. alvin

    alvin Member


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    I was just wondering how other members deal with this subject. As a domiciliary chiropodist I am getting more and more patients asking for they're fingernails trimmed. I will do this service, but wonder whether I should start charging for it. After all it takes up more of my time, and as I have already said the requests are increasing.
     
  2. Catfoot

    Catfoot Well-Known Member

    Hi Alvin,
    I would definitely charge for it - I do.
    It takes up more time and I use a smaller pair of clippers for this purpose which also need to be decontaminated and sterilised. As pods, treating hand conditions is within our Scope of Practice and we should be paid accordingly. You don't need to charge a lot extra, just a token amount to show that you are a professional that expects to be paid for your time.

    regards

    CF
     
  3. naoglesby

    naoglesby Welcome New Poster

    One of my contemporaries was recently put in the corner, having been asked to trim her patient's nasal hair.. we have got to draw the line! :S
     
  4. Hi

    You know what, as a fully qualified foot care nurse I too get plagued by this request and yes it does take up my valuable time especially if they have not booked the appt. along with there foot care appt., it still takes up time. I DO charge for it now but didn't for awhile. I consider it "hand care" I don't want to put here what I charge for it but if you need to know please feel free to send me an email. I would love to hear from you.

    travelingsoles.....:dizzy:
     
  5. Tuckersm

    Tuckersm Well-Known Member

    In Australia, it is not considered to be within a podiatrists scope of practice, as it is not included as a core competancy nor taught at an undergraduate level.
     
  6. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    This sounds like post modern ALP Rudd-speak, seeking to dress up a triviality in legalese.

    My mum taught me how to cut (my) fingernails when I was a little boy. I cut the fingernails of my small three children (I guess I don't charge them - unless cleaning up toys is payment-in-kind). Will the dental board get me if I help them brush their teeth?

    This is a bureaucratic nonsense that should have been resolved many years ago in this country. Whatever happened to professional judgement and inferred competency, let along commonsense. How is the structure and function of nail tissue any different between the hand and foot? Can a nephrologist only treat the left kidney, if they don't have a core competency in right kidney treatment? Is the callus on a foot somehow different to that on the hand of a tradesman?

    We all know undergraduates aren't taught the specifics of every known pathology affecting the foot. It is inferred that by completing a university degree that health professionals have the ability to discern that where they may be inexperienced or uncertain, that they should seek out reliable information to base their decisions, or refer on. That is the nature of a professional.

    I would love to see this issue tested in court. It would be an amusing debate.

    LL
     
  7. patentheels

    patentheels Welcome New Poster

    I work in an aged care facility, and often find myself being asked to trim fingernails. I was under the impression that, legally, we were unable to treat anything above the knee, and perhaps our indemnity insurance wouldn't cover us if there was an issue. It is frustrating though to see gryphotic type fingernails that are inappropriately treated by nursing staff with unsterile nail scissors.
     
  8. NeedingMassage

    NeedingMassage Active Member

    Hi,
    Isn't the profession called PODiatry and which part of POD = hand?
    If you justify hand callouses and finger nails to yourself then you're half way to justifying prescribing hand orthoses. That should double business overnight i.e. two feet + two hands = $ x 2.
    Hope this helps,
    Owen.
     
  9. Tuckersm

    Tuckersm Well-Known Member

    And I treat pressure ulcers on the foot and heel. Would it be OK to treat the ones on the sacrum?
     
  10. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Stephen

    Can I quote from my favourite article on this subject (Safriet BJ: Closing the Gap Between Can and May: A Primer for Policymakers, Yale Journal of Regulation, 19:301, 202)

    Sound familiar?

    I would rather have you treat my sacral ulcer than 95% of the other health professionals in this country. You would know what to do.

    LL
     
  11. cornmerchant

    cornmerchant Well-Known Member

    All

    I do the occasional nail cut, add a couple of pounds on to the fee and patient is very happy and comfortable. We are more than competent to deal with fingernails and the SCP have agreed that it is within our scope as nails are nails! In fact I have performed nail avulsion on a thumb for a patient with great success.

    A little compassion goes a very long way.

    Cornmerchant
     
  12. msepod

    msepod Member

    Who, then in Australia is legally covered for nail cutting?
     
  13. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Probably anyone who is not a registered health practitioner.
    ie beauty therapist, parent, neighbour, friend.

    Go figure.

    LL
     
  14. msepod

    msepod Member

    Hmm, its interesting that the longer one studies often the more legalities involved. Don't personal care assistants do fingernails? I definitely think it would complement a Podiatry clinic.
     
  15. twirly

    twirly Well-Known Member

    I also am willing to cut finger nails if requested by the patient or care team. I have no issues regarding this. I charge an additional nominal fee.

    Kind regards

    Mandy.

    PS.
     
  16. Kyrret

    Kyrret Active Member

    I also cut fingernails if asked and charge a nominal £2.00.
     
  17. George Brandy

    George Brandy Active Member

    So how do Podiatrists feel about treating finger nails that have been injured?

    I ask this as a patient attending for Podiatry trapped her finger in a car door fracturing the distal phalanx. I didn't see the original injury but 3 months on, the patient attended for further treatment with the finger still bandaged and quite desperate about its condition given the fact that she had been discharged by the primary care team with advice that "it would take a long time to heal and she'd to be patient".

    Being nosy I asked if I could have a look and would redress it for her.

    What a mess.

    The damaged nail was being pushed upwards by the new nail growth so that 3/4 of it had separated from the nail bed and yet it was firmly attached towards the free edge. Hypergranulation tissue was protruding from the medial aspect of the nail sulcus and dried exudate was crusted around the proximal edge of the loose, damaged nail. So with the patient's confidence at an all time low due to length of time this injury has taken to heal, I offered to treat it for her after giving her full explanation of what was happening in terms she could appreciate.

    The patient was none too keen to have a local anaesthetic to remove the remaining nail but I felt competent enough to treat as I would an injured toenail when a LA has been refused. In the UK this is the criteria for treating finger nails - competency. I also still believe in common sense.

    So one week on the loose and damaged nail has been removed to reveal a peduncle of hypergranulation tissue approximately 3mm in diameter and standing 2mm proud of the nail bed. I suggested that I refer the patient back to the primary care team so they can help resolve this problem. The patient declined as she had worked out with my careful explanations of how I was treating the nail and what changes had taken place on the nail bed that the wound would not have healed with the damaged nail intact. She'd also worked out that with the condition of the nail bed there was an increased risk of infection and that the primary care team had failed to recognise these ongoing problems.

    I have not ruled out that we may need to involve a wound care team based on cost dependent on how the hypergranulation tissue responds to treatment.

    The notes have been written in long hand and yes I need to invest in a digital camera for the practice.

    So my Australian colleagues, would you have not offered treatment because of an alleged lack of competency and with the decision that Podiatrists only treat feet?

    GB
     
  18. I often get asked if I would cut someone's fingernails - usually that person being on their own and very often post CVA. Simple nail care takes less tha a minute - and no I don't charge "extra" - they pay for their consultation time same as everyone. If additional work was required - as in George's case above, then bill accordingly, if that's all they present with. Commonsense and a little compassion go a long way - unless you're a regulator it seems!
     
  19. David Smith

    David Smith Well-Known Member

    Exactly :good:

    Dave
     
  20. mburton

    mburton Active Member

    As an NHS podiatrist I have more than enough feet to cope with without taking on any hands as well (though I have avulsed and phenolised a troublesome fingernail some years ago - an exceptional case).
    Have often wondered why there appears to be no takers for this obvious gap in the market though...
     
  21. susiesue

    susiesue Member

    what he said
     
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