Foot care 'not being recognized as the need it is': Sask. nurse

Health-care advocates are sounding the alarm on foot-care coverage in Saskatchewan, and launching several initiatives to raise awareness and provide services to those in need.

A petition by the Advanced Foot Care Nurses of Saskatchewan, a group that offers advanced foot-care services, is calling for increased funding.

The petition was launched by Bree Wright, a registered nurse and operator of a foot clinic in Moose Jaw. She teaches an advanced foot-care course for registered nurses and licensed practical nurses.

"We see that there's not enough accessibility for foot care across the board," Wright said. "There's not enough funding for foot-care nurses, there's not enough funding for the podiatrists. Foot health in general and lower limb health in general is just not being recognized as the need it is. And so where do we start?"

While the petition addresses insurance coverage, it is only the first step in changing how foot care is treated in the province, she said. 

"We can see the impact on high-risk individuals unable to access or afford proper care," said Wright. "We're asking for a call to action from other professionals who do know the ins and outs of changing health care and insurance coverage policies."

Coverage challenges

Foot-care services by nurses are not covered by the government.

Podiatry services — typically more advanced foot-care services administered by doctors — are covered by private health-care providers.

According to Dr. Ata Stationwala, the president of the Saskatchewan College of Podiatrists, there are only 22 registered podiatrists in Saskatchewan, making access to insured foot-care services a challenge. He agreed that lack of access is what leads so many people to seek the services of foot-care nurses instead.

"We've been trying to lobby the government to try to attract podiatrists to the province. We're often recruiting from the United Kingdom and the U.S.," he said.

Stationwala is in favour of making foot-care coverage more accessible by putting more of that demand into the hands of nurses, but said training for foot-care nurses should be more comprehensive before those services are covered by insurance. 

"I see a definite need for nurses with advanced foot-care nurse training," said. "I think it's a great thing, but the training isn't adequate to provide the care that they're wanting to provide."

Wright agreed that podiatrists and nurses can work together to solve the issue, but said the advanced foot-care course she offers is adequate to merit insurance coverage. 

"I want us working together. Absolutely. The training is so vastly different. You know, the podiatrist, they're the experts, they're the specialists. They are doing like the wound care that patients can't receive from general practitioners," she said. "We are applying all of the core competencies of our nursing training and then taking foot-care training on top of that to specialize." 

If left untreated, foot issues can develop into a variety of more serious ailments, like foot ulcers and fungal infections. People with diabetes are especially at risk.

Lisa Fletcher is a foot-care nurse at the Saskatoon Community Clinic and runs a separate clinic of her own. She's seen many patients come in after neglecting foot issues for months due to lack of money. 

"With the winter months coming, and we're already in it right now, frostbite happens within seconds sometimes depending on the wind chill and the weather conditions," she said. "So sometimes we have people that don't even know they've got frostbite because they've already had altered sensation to these digits.

"And so then they'll end up in the hospital and sometimes it's almost too late for us to intervene, and they'll also have to end up with surgery and having amputations."

Fletcher will be hosting a fundraiser on Friday evening in Saskatoon to raise money for foot-care services for people experiencing homelessness. She has also signed Wright's petition.