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A Nurse in a Podiatry Clinic
POLÍVKOVÁ, Hana
Podiatric centre is a specialized clinic for diabetics which is focused on comprehensive care, diagnosis and treatment of patients with diabetic foot syndrome and on those ones at risk of diabetic foot syndrome. Currently there are 32 podiatric centres in the Czech Republic.Diabetic foot syndrome can be defined as ulceration or destruction of feet tissue mostly in diabetic patients, accompanied by neurological abnormalities and various degrees of peripheral artery disease. It is a disease that can be prevented by proper and thorough education in the area of foot care. The key task of a podiatric nurse is thorough and repeated education. a nurse informs patients about prevention and about proper foot and wound care, and instructs them on appropriate footwear. Furthermore, a nurse treats foot defects, does debridement, treats the limb with appropriate local medication, provides screening and sampling of biological material and finally, she provides patients with psychological support.In the research part we set two goals. The first one was to find out the specifics of a nurse´s activities in a podiatric clinic. a research question has been assigned to this aim - What are the specifics of nursing in a podiatric clinic? The second goal was to learn what information is provided by a nurse in the prevention of diabetic foot. This goal was investigated by asking the research question: What information about the prevention of diabetic foot do nurses provide? After processing the interviews the received material was divided into six categories. The first category focused on nurses´ education and extended by a subcategory of "Nurses´ self-education". Two nurses have completed the course for Certified Podiatric nurses, one is registered to it and the last one has no education in the context of podiatry. Nurses are educated primarily through the Internet and they attend some lectures.The second category describes what information is given by nurses in the prevention of diabetic foot syndrome. This category was divided into two subcategories, namely foot care and footwear. Most nurses agreed that the main principle of the prevention is daily foot inspection, no barefoot walk and especially thorough foot care as well as wearing appropriate footwear. As far as the foot care is concerned, the nurses agreed only on removing calluses and treating defects. The other answers were different. The nurses mentioned feet showering, thorough drying and lubrication. Diabetic footwear is recommended by all the nurses. They emphasize the importance of proper examination of footwear before putting it on and wearing suitable socks. In the third category we have dealt with the question of what it means to work as a podiatric nurse. All the nurses clearly agreed that their main activity is repeated and consistent education. We were pleasantly surprised to find out that some nurses use a practical demonstrations and give clients information leaflets and brochures. Furthermore, the nurses carry out administrative activities, treat defects, assist doctors and conduct basic podiatric examination. In the fourth category we dealt with basic podiatric examinations. All the nurses agreed that they perform physical examination and sampling of biological material. Most nurses also provide neurological and vascular examination. Two nurses mentioned that they send clients to an X-ray. In the fifth category we investigated which clients´ mistakes are the most common. It is definitely a bad foot care; this assertion is agreed by all respondents. Furthermore it is wearing inappropriate footwear and socks. In the sixth category, we evaluated what clients with diabetic foot syndrome are most interested in.According to the nurses´ answers podiatric patients are interested in healing their defect, they ask what the cause of diabetic foot syndrome is and newly diagnosed diabetics require the information about diabetes mellitus.
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