Foot Care and Wear for Nurses
Supporting your feet so they can sustain you through a busy shift
Take a look at the footwear of your fellow nurses. What do you see — besides dirty shoes? My hospital experience has shown me that many nurses wear shoes that should have been tossed long ago.
Todd Phillips, an ED RN, estimates 25 percent of his fellow nurses wear worn-out shoes. He says, “nurses are aware of their feet from being on them all the time and having limited moments to rest or ‘prop them up’ during a shift.”
RN Margaret Silebi echoes, “I can say for certain that nurses don’t pay attention to footwear. Some ED nurses still wear the first pair they bought. There seems to be pride in the bloodstains and battle scars — the stories the shoes tell.”
With each step you walk, your feet are subjected to a force of two to three times your body weight. Each foot hits the ground around 800 times with every mile walked. No matter how long your shift, good, comfortable shoes and proper foot care will make that time on your feet easier.
Tips for Shoe Care
The variety of footwear worn by nurses includes walking shoes, running shoes and clogs. Buy shoes based on comfort and usability. This means slip-proof outersoles that are resistant to chemicals and acids, and leather or fabric that can be cleaned of blood and other fluids. Slip-on styles eliminate laces that come untied and can catch on stools, gurneys and IV poles. Clogs may be comfortable, but the addition of a sling back-strap makes them safer.
It’s easy to keep your feet and shoes fresh by sprinkling a small amount of powder or baking soda on your feet or into your shoes to control odor. A spray of Lysol into each shoe is another option. This is especially important if you do not wear socks. If your shoes get stinky, wash them with soap and water and let them dry naturally. After they have dried, give each shoe a couple of shots of Lysol. Do not put your shoes in the dryer.
Check your shoes occasionally for a loss of structure and support, and general wear and tear. The most common breakdown is in the mid-soles, which results in your foot rolling to one side or the other. This indicates it’s time for new shoes.
It's All in the Fit
Without properly fitting shoes, your feet will encounter many problems. Too loose, and your feet will slide around creating friction. Too tight causes excessive pressure. Both can change the biomechanics of your foot strike, which in turn affects gait and throws off stride and balance. This stresses tendons and ligaments. If feet and toes are pinched in too-tight shoes, blood circulation is reduced and you’ll endure aches or pain. When trying on shoes, walk in them for a while to be sure they are comfortable and do not have any pressure points. Shoes should conform to the shape of your feet. Make sure the shoes flex comfortably in the forefoot and there are no irritating seams inside.
When Did You Last Replace Your Insoles?
Insoles provide extra support and/or cushioning. The typical insoles that come with shoes are of little value. If in doubt, take them out, and if they easily fold in half and are thin, replace them. Replacement insoles offer better heel support, shock absorption, and reduced friction. Some have a better arch support that helps those with flat feet.
The right insoles can make a big difference in the overall fit and comfort of our footwear. But insoles are not made to last forever. Check them occasionally for breakdown and replace them when necessary. There are two common types of insoles available: viscous polymer and foam. The polymers are a great choice for those wanting additional cushioning. Foam insoles are lightweight and inexpensive but offer less shock absorption.
Do you need orthotics? Their purpose is to maintain the foot in a functionally correct position and cure lower extremity ailments. Typically prescribed by a podiatrist or orthopedist, orthotics are medical devices custom made from cast impressions of your feet. A properly fit orthotic will support the body’s natural movements and reduce the demands placed on the muscles when the body is out of alignment. The result is less work by the muscles, meaning less fatigue and fewer injuries.
The Joy of Socks
Socks perform four basic functions: cushioning, protection, warmth and absorption of moisture off the skin. The fabric and weave will determine how well they do. Most socks come in three fabrics or blends — cotton, wool and synthetics. Cotton provides no wicking or insulating properties and should be avoided. Wool blends are comfortably warm in winter and cool in summer. Synthetic fabrics, such as CoolMax and Olefin, wick moisture away from the skin.
Hose do not breathe well. Support socks or hose promote circulation and can relieve tired aching legs and swelling. If you usually go sockless or wear hose, give socks a try. The cushioning and warmth on a long busy shift will help your feet survive. Several times a year, check your socks for threadbare areas under the heels and forefoot and for holes in the toes. If you find these, toss the socks and buy new ones.
Socks should fit snugly without sagging or being stretched too tight. If they are too large, they’ll bunch up and cause skin irritation while socks too small can constrict circulation.
Foot Massage — You Can Do it Yourself!
Massage helps increase circulation, reduce swelling and release tight, overworked muscles back to their optimum condition. When muscles are relaxed and receiving better circulation, they are stronger and tolerate higher levels of abuse with less pain and breakdown. Tight muscles lead to strains and soft-tissue injury. Chronic tightness can cause muscle and connective tissue injury and inflammation, resulting in biomechanical imbalances, back pain, Achilles tendonitis and plantar fasciitis. This is where massage can help.
To do a self-massage of your feet, start by warming your feet in a bath or with warm, moist towels. Cross one leg over the other with the sole facing you. Use both thumbs to massage in a deep, circular motion, working small areas at a time. Work from toes toward your heel, and then to your ankle. Use various movements and pressure to find what feels best. All movement, and pressure, should be toward the heart — moving the old “stagnated” blood back to your heart. The use of massage oil or creams helps with the kneading of the skin and softens dry heels and calluses at the same time. If possible, have a partner massage your feet. For additional tips on massage see the sidebar below, Foot Self-Massage.
Don't Forget to Moisturize
Because of never-ending hand washings, nurses learn to care for theirs with a good moisturizer. The same goes for feet. Whether wearing hose, socks or going sockless, your feet need care, too. Use creams or lotions to improve the skin’s texture and tone by exfoliating dry and dead skin and allowing newly rejuvenated skin to emerge. The use of a deep-penetrating hydrating cream twice a day will help your feet stay soft and supple by restoring their natural oils.
Pay close attention to your heels and the balls of your feet, two of the places where fissures and calluses typically form. To help the cream work its magic, at bedtime rub in the cream and place plastic wrap over your feet. The wrap seals in the cream to enhance the moisturizing effect. In the morning after showering, use a pumice stone or callus file to buff the skin and reduce calluses. After this buffing, rub in a small amount of cream to keep them soft during the day.
Our Feet are Overworked and Under-appreciated
If you have chronic foot problems, or are uncertain what your feet are trying to tell you through their pain, consider consulting a podiatrist or orthopedic surgeon. Listen to your whole body and especially your feet. Be attentive to when the pain begins and what makes it hurt more or less, and be prepared to tell the specialist about the problem, its history, and what you have done to correct it.
Let’s face it, your feet are overworked and under-appreciated. Denise Nash, RN, who works on an extremely unforgiving floor surface reminds us, “Our feet beg us to pay attention to them regularly.” With a good understanding of footwear and feet care, you can make it through your shift feeling good.
• Bottom of the foot — Place your thumbs on the ball of the foot. Apply pressure to the underside of the foot and slowly move toward the heel.
• Heels — Massage the bottom and sides, applying gentle pressure with your thumbs.
• Toes — Stroke between the toes upward toward the heart.
• Top of the foot — Using your fingers, massage the top of the foot, focusing on the soft points between the bones of the forefoot upward toward the ankle.
• Stroking the foot — Using both hands, place your fingers on the top of the foot and the thumbs underneath. One hand at a time, stroke by sliding your hands upward toward the heart.
This article is from workingnurse.com.