About the Foot
Bone structure of the Human Foot
(from Dorsal Perspective; top looking down view)
- The two sesamoid bones are underneath the “A” metatarsal bone.
- The green dots are the most common locations for accessory ossicles.
- The feet make up 25% of the total number of bones in the human body.
- A normal human foot is composed of 28 bones including the two sesamoid bones.
- Accessory ossicles are extra bones (in addition to the normal 28) which some people have. The typical locations for these extra bones are denoted by the green dots. These extra bones seldom cause any trouble and can thus be safely ignored in most cases.
- Anterior the forward, front, or head end (opposite of posterior)
- Deep below or the underlying layer; inner (opposite of superficial)
- Distal distant from attached end or center of body (opposite of proximal)
- Dorsal the back, top or upper side (opposite of ventral)
- Inferior lower or below (opposite of superior)
- Lateral refers to a position away from the median plane (opposite of medial)
- Longitudinal lengthwise (compare with oblique and transverse)
- Median plane is a vertical line which splits the body into two halves
- Medial refers to a position near the median plane (opposite of lateral)
- Oblique at an angle to the longitudinal direction but not at 90 degrees (compare with longitudinal and transverse)
- Plantar refers to the bottom (sole) surface of the foot
- Posterior the back, rear or tail end (opposite of anterior)
- Proximal near or toward the attached end or origin; near the center of the body (opposite of distal)
- Superficial near or on the surface; outer (opposite of deep)
- Superior higher or above (opposite of inferior)
- Transverse across; the cross section at 90 degrees to the longitudinal direction (compare with longitudinal and oblique)
- Ventral the belly, lower or under side (opposite of dorsal)
Foot Care FAQs
Excellent Foot Health is the foundation to mobility, whether you are an athlete or walking for good health. The role of today’s Foot Care Nurse is an important member of your interprofessional health Care team. Foot Care Nurses are utilized through hospitals, diabetic clinics, medical health teams, private/independent clinics, agencies and the community.
Stating that one is a “Nurse” means she/he is accountable to a provincial nursing college as a member in good standing to protect the public. In Ontario, the title ‘Nurse’ is protected through the College of Nurses of Ontario, (CNO).
Use our FIND A FOOT CARE NURSE search tool to find a Foot Care Nurse in your area.
Disclaimer: Being a member of NEFCA gives Foot Care Nurses networking and educational opportunities. NEFCA does not oversee its members’ level of training, skill, or work ethic. Nurses are charged with the lifelong responsibility while in the profession to self-assess, seek education, and meet all standards and professional guidelines as set out by applicable regulatory agencies.
Who provides Foot Care?
Many practitioners are involved in providing various levels of Foot Care based on their level of education and expertise. Providers may include Nurses, Personal Support Workers, Physicians and Chiropodist/Podiatrist.
What specialized education does a Foot Care Nurse have?
Your Foot Care Nurse may be trained in basic, advanced and diabetic foot care. To acquire this, nurses must complete continuing education courses in this specialized field, which offers theoretical and practical training in non-invasive care of the feet from a recognized community college, private educator, or private education facility. It is also recommended that nurses network with their colleagues through nursing foot care associations, conferences, and independent practice groups. The College of Nurses of Ontario requires all nurses to obtain a minimum of 8 hours of on-going education annually in their field of practice.
Many Foot Care Nurses have also continued their education in wound care and are members of CAWC (Canadian Association of Wound Care), as well as complementary therapies.
What is Complementary Therapy?
Complementary therapies aim to treat the whole person often stated as the mind, spirit and body not strictly the physical problem presented. It is known by different terms including alternative therapy, holistic therapy and traditional medicine. Some examples of complementary therapy include reflexology, acupuncture, aromatherapy, chiropractic, herbal medicine, homeopathy, naturopathy, reiki and yoga.
What type of Foot Care Nurse do I need? Basic or Advanced?
Patients are often referred by their physicians to see a Foot Care Nurse for ongoing care of their feet.
Basic foot care is usually limited to nail care (e.g., trim, file, cleanse, and massage the foot and ankle). This provider holds entry level competency.
Advanced foot care is more comprehensive and may involve completing a full assessment, creating a treatment plan (including client goals and health education), and treating ingrown nails, thickened (fungal) nails, callous & corns and other complications from diabetics, heart problems, circulatory problems, infections, and arthritis. All nurses working to their full Scope of Practice and in private practice are mandated to hold advanced nursing Knowledge, Skill and Judgment to ensure safe practice, competency and ethics.
Wound care (in conjunction with foot care) is an intervention that assists clients by facilitating and managing skin abrasions, ulcers and injuries to promote healing and prevent infection and other complications.
Do I need a referral to see a Foot Care Nurse?
You do not need a referral from a doctor to see a Foot Care Nurse, but a prescription may be required for 3rd party insurance or veteran’s coverage.
Is Foot Care covered under insurance?
Foot Care is not always covered under provincial health care systems. Reimbursement from an employee’s insurance plan may be possible.
Are Foot Care Nurses insured?
Liability insurance is mandatory. A nurse may be insured through her/his employer however, if in private practice, liability insurance is obtained through the provincial Nursing association or a personal broker.
What can a client expect on a first visit, and subsequent visits?
Your Foot Care Nurse should follow the HCCA (Health Care Consent Act) that requires consent for any treatment. The consent should include: the nature of treatment, expected benefits, material risks and side effects, alternative courses of action, and consequences of not having treatment. Treatment fees are often stated on the consent form. Any additional costs for products or services are discussed with the client during the visit.
Foot Care nurses in independent practice charge a fee directly to the client for the treatment they perform. The client can then seek to obtain a reimbursement of those fees through their employer’s insurance plan, private health care plan or Veteran’s Affairs.
Your Foot Care Nurse will complete a health history. This incorporates, your chief concerns and expectations of foot care, which includes relevant current, past, social & family history. This assists the nurse to identify risk factors that may be relevant to the outcome of the treatment. Knowledge of previous foot care treatments and/or experience information assists with what has worked or not worked in the past. You should bring a current list of prescriptions, including over-the-counter medications. It is always a great idea to take the actual bottles on first visit or have them available if having a home visit.
Your Foot Care Nurse will undertake a physical examination that will include: condition of skin and nails, range of motion, bony prominences, circulation, and sensation. The nurse will want to assess your socks, shoes and gait. It is a good idea to wear, or bring the shoes you use most of the time for a better assessment.
Documentation and Privacy
Your Foot Care Nurse is required to keep your client file confidential, current, complete and secure. Your personal information may be shared with other health team members (e.g. physician). A client has the right to view that which is documented about them and withhold or withdraw consent to the sharing of his/her personal health information at any time.
Plan of Care
Using a nursing diagnosis, (APIE – assess, plan, implement, evaluate), your Foot Care Nurse will create a plan of care with your cooperation. This may include ongoing treatments booked in monthly or 6 to 8 week intervals, client/caregiver teaching, and added complimentary therapies or products. The plan of care may include referring you to a physician, chiropodist/podiatrist, shoe specialist (pedorthist), massage or physical therapist, a diabetic nurse educator/clinic, or wound specialist.
New technology is also used by many advanced Foot Care Nurses. Lasers and light for healing/pain therapy and fungal nail treatment, peripheral neuropathy detection and treatment devices, though scientific advances and the theoretical foundation of Nursing.
Sterilization, Infection Prevention and Control
Your Foot Care Nurse must adhere to strict safety rules pertaining to their equipment use. Tools must be sterilized, preferably autoclaved and pouched prior to use for each client. Hands must be washed before and after any treatment even when gloves are used. All non-reusable items must be discarded after each client. Personal protective equipment must be used to protect the client and the nurse. All Foot care equipment and treatment areas must be disinfected between each client to reduce cross-contamination. It is highly recommended that the nurse review and record her/his reprocessing policies and procedures on an on-going basis to comply with disinfection and sterilization processes.
Disinfection processes should follow the principles of infection prevention as set out by the Public health Agency of Canada. Each province has a standard to follow (e.g., Public health Ontario/ PIDAC “Best Practice for Cleaning, Disinfection and Sterilization of Medical Equipment/Devices”, 3rd edition, and CSA standards). If your provider is qualified to give foot care treatments, don’t be afraid to ask for any of the above information including proof of memberships and/or certificates.