RE: Nail Care Nurses
I have read with some degree of surprise the
striking vitriol surrounding the discussion
regarding nurses and nail care. In growing up
with this profession, I can understand some of
my colleagues’ fear and concern about
potentially educating nurses in nail care.
Quotes like “giving up our bread and butter”
or “training our replacements” are commonly used
when discussing this topic. I am grateful for
you allowing me an opportunity to weigh in.
By training nurses or physician extenders to do
basic nail care, we may indeed be giving up our
livelihoods. That being said, what are our
choices? I believe we have two:
1. Protectionism. We have grown up as a
paraprofessional field to the point now where we
are trained to the level of a medical and
surgical subspecialist. Much of this had to be
done in small podiatry schools, a mile away from
the big medical school. It was done in small
community hospitals and surgery centers, a mile
away from the big teaching hospital.
Periodically, we’d send ambassadors to the big
school or the big hospital, but we felt obliged
to refine our craft in the cozy confines of
small medicine. Protecting our turf by fighting
off invaders was and is our natural instinct.
This is especially true when these invaders are
less protectionist than we are. Some might say
that protectionism has got us to the point where
we are today.
2. “Inclusionism”. We have the choice of opening
our borders, as well. Some might say that if one
loves one’s profession enough, one should let
it “all hang out”. In other words, in order to
allow for the chance at seeing our profession
grow, we must take the chance of seeing it
shrink. This school of thought would dictate
that opening up and sharing knowledge is
inherently better than hoarding it. Disciples of
this school would point to our lack of
cooperation with pedorthists. In trying to
protect our place as “shoe specialists” we
largely abdicated it because of our failure to
initially share our knowledge. Now, pedorthic
trade groups largely work with non-podiatric
foot care specialty groups.
So what now to do about “foot care nurses”
or “nail care nurses”? I think our profession
can make one of the two choices above. To be
frank, I’d rather share the ball and run the
risk of going out as a “team player” than hold
on to it and languish in a protectionist
purgatory. If we share the ball, we own the ball—
and the court that it’s played on. If we hog the
ball, other “team players” will merely head to
another court to play—leaving us relegated once
again, to playing small ball in the minor
leagues.
Should we not be the principal educators—as well
as the principal providers—of foot care in the
United States (and worldwide)?
Should not the colleges educate anyone who wants
to know more about foot care?
David G. Armstrong, DPM
Professor of Surgery, Chair of Research and
Assistant Dean
Dr. William M. Scholl College of Podiatric
Medicine at Rosalind Franklin University of
Medicine and Science
