infection control

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Hi everyone

I have just completed the first year of my podiatry degree course in the uk and am treating my immediate family members - husband, mum etc. I am extremely concerned about infection control and obviously as a student with non paying patients do not have the budget for an autoclave. Does anyone have an suggestions? I currently wash all instruments in hot soapy water and then sterilise prior to use in a solution using 'pera safe powder'. Having read some of the posts I am worried now????

 

Karen3370,
And you should be worried.
Never mind the sterilisations procedure, are you insured to treat patients - I suspect you aren't?
If you have no insurance it doesn't matter if they are paying you or not you should stop treating them right now.

There is only one standard of infection control and that is what you are being taught at uni and cost doesn't come into it.
Either do it properly or don't do it at all.

CF

 

Hi catfoot

I use the term 'treat' loosely! I am not offering my limited services out!! The point I am making is that I have been cutting my childrens toe nails for years before starting uni without much of a thought for infection control. Uni has obviously opened my eyes to the risks. I spent some time shadowing a qualified pod and accompanying her on dom visits and I observed one set of instruments being 'wiped' down in between patients.

 

Karen3370,
I am not sure what you mean by "loosely" as you are either treating patients or you are not.
If you are treating patients then you need insurance, adequate training and cross infection protocols. You seem to have none of these.

The fact you cut your daughters toenails is/was irrelevent as it the instance of "wiping down between treatments" that you quote.

It is you who are training to be a healthcare professional whose prime aim is the welfare of your patients and you owe them the best treatment(s) you can give. So why not start as you mean to go on?

CF

 

Hi Karen3370,

:welcome: to the Arena!

I see no reason why you can`t treat immediate family members, with their consent. We were encouraged to do just that. If memory serves, you can apply for a `Certificate of Higher Education in Health`after completing the first year, which you can use to apply for insurance to work as a Pod assistant.

With regard to infection control, you can always use disposables?

Just my take, of course.

Cheers,
Bel

 

You know what ? :hammer:

I would make them pay !!!!!!!!!!! Charge them $500 per consult .

Suck their bank accounts dry , and go buy yourself a new Mercedes.:drinks

Well done on year 1

Hang in and keep smiling

FDC

 

Blinda,
Perhaps you would like to suggest the wording for the consent form for the OP, including a disclaimer in case of an untoward outcome?

If they cannot afford an autoclave how can they afford disposables at £5.00 a pop ( to say nothing of the RSI they create)

I find it incredulous that you are encouraging a partially-trained person to treat patients. As I recall, a pod assistant works under supervision, so, as this person wants to work solo the insurance would not cover them. Therefore I consider your advice quite inappropriate.

When I trained we were told that we could not treat patients until we were qualified as we would not be covered by any insurance, plus we did not have the underpinning knowledge to refer on if necessary.

This may all be academic as IMO the OP is not a real person but a troll - just my take on it.

regards

Catfoot

 

Calm down, Catfoot.

This is a pod student who wants to practice on her family. Not, paying patients. As I said, I see no problem with this. Many students practice on each other and family members.

With regards to Pod Assistants; who do you think do the dom visits for many trusts? I personally know of PA`s who work alone and have been `trained` in scalpel technique.....but that`s another debate

Cheers,
Bel

 

Please don't patronise me, Belinda,

It matter not a jot whether or not these "patients" pay for their services or not, there is still a Duty of Care involved.

Maybe they do, maybe they don't, but do those that do realise the implications of this?

You are comparing apples & pears.

If Trusts want to send Pod Assistants out on doms then that is their lookout. No doubt these patients will have been triaged by a pod, the Pod Assistant will be covered by the vicarious liability of the employer and will have a referral pathway accessible to them if they come across a problem. They will have been trained when and what to refer on.

This is not the situation here.

This person wants to work solo with minimal training. As we have no knowledge of this persons capabilities I maintain it is inadvisable to suggest they do that.

I think they should also check out their Uni's policy on this.

You may well have been advised to practice on your family but as I recall you were training to be an unregulated chiropodist by distance learning and not taking a full-time 3 year course.

As regards getting a job as a Podiatry Assistant, have you looked at the job market lately, Belinda?
Most NHS Trusts are cutting staff, not taking more on and all the pods I know who have large practices are dispensing with Associates and Assistants.

I maintain that your advice is unsound and also a bit naiive.

You of course are free to differ.

Yours etc CF

 

Nope, I was a second year student at uni.

Yeah, we differ.

 

Not a first-year student then ?

Exactly

CF

 

Errr, think you`ll find Karen is also classified as a second year pod student, having `completed her first year`......and as you have pointed out, I was in a different position to other students as I was already HPC registered. However, ALL students were advised that they could practice on family members from year one.

Enjoy your day CF

 

Thank you for all your comments, particularly belinda.

I didn't expect such an aggressive response but I take on board everything that you have all said. I know that I am not the only student practicing on family members and this is not discouraged at uni. Obviously standards should not be lowered regardless.

Thank you all again.

 

Yeah, but don`t take it personally. And, don`t let it prevent you from posting in future. Stick around, there`s always loads to learn (and offer) on the Arena.

Have fun with your studies :drinks

Cheers,
Bel

 

Thank you belinda.

 

Karen3370,
I'm not quite sure what response you expected?

You post on here giving excuses as to why you can't get an autoclave saying that "you can't afford one" and that a pod you shadowed "wiped down" instruments between treatments. And then you ask for advice.

You are training for what will be, arguably, one of the most responsible and skilled work you will ever undertake in your life and you want trained professionals to approve your short-cuts? Not on your life.

If you had an untoward outcome and it was found that you were not fully-qualified and yet you knew about the use of autoclaves but chose not to use one, then were would you stand ? "I couldn't afford one yer 'onour" wouldn't get you very far. Your Uni would disown you and you'd be asked to leave.

I can't help but wonder why you are not raising your concerns with your tutor(s) who know you and are in a better position to advise you? Maybe it is because they would not approve of your extra curricular activities? "Not discouraging " something is not the same as instructing someone to do something.

You still haven't told us if you have insurance or referral pathways in place for anything you can't deal with? And what is your Uni's policy on students providing podiatry treatments? Have you bothered to ask?

You may think I am being unduly harsh but it would be a shame if your career was curtailed because you did not act responsibly. I most sincerely hope you do not do anything that will come back and bite you in the bum later.

yours etc

Catfoot

 

Cat on a hot tin roof!!!!

In season? -or no reason?

 

Cat foot

I have finished uni now for the summer and am continuing with my revision for September. My experiences have given me conflicting information so far, a premier standard in uni and not so premier in private practice. I merely posed a question to experienced podiatrists who work in the real world and who were students once themselves. I have no other agenda and was under the impression that forums like this were there for less experienced people to find help and advice, I was obviously mistaken.

 

Don't think it's likely you'd be sued by your husband or your Mum, I'm sure they are greatful for your help. I am a relative newbie here and I too am shocked by the over the top response. I'd understand it if you were offering out your services to the public but for heavens sake..! I work in private practice and I have NEVER 'wiped down' instruments between patients. I do know of others who are less than scrupulous though. It's up to you, when you are practicing on the public, to ensure that your own standards are the highest possible. I also feel it's unlikely you'd get RSI from doing your Mum and your husbands feet with single use instruments, I doubt it's full time!

 

Karen 3370,
I have given advice to help you keep out of trouble and act like the AHP that we all hope you will become. Don't blame the messenger if you don't like what you hear.
You still haven't said who is insuring you to do these treatments?

Ginger.
You say

but in the real world one's husband may not always be one's husband! The courts are full of professional people who never thought they would be sued. Just take a look at the list of emminent practitioners who have been up before the HPC and then decide if you think my reaction is OTT.

Johnpod,
Maybe it is an absence of pussy not a surfeit of cat that is your problem ? Meeow !

regards

etc Catfoot.

 

They are Karen, it is.

Sometimes old battles find their way to new threads. Don´t take it personally.

I would suggest that you have a quite word with a Uni teacher you get on well with, treating family and friends re sterilization.

Good luck with your Future

ps :welcome: to Podiatry Arena I would recommend hanging around you will learn a lot and maybe teach as well.

 

Eh?!:wacko: I'm pretty sure my husband is my husband! I do understand where you are coming from BUT I still think it's all a bit ott. She's just treating her close family!!

 

Ginger,
You said

so does that mean they should have lower standards of cross infection control than paying patients ? What sort of cock-eyed logic is that?

Confused Cat

 

No it doesn't but I mean, I don't sterilise the nail clippers I use on my little boys... If I was a 2nd year student, with 1 set of instruments, as I imagine she has, I'd be doing the same as her, the best with what I have to treat my family. I just see her situation as different from a qualified professional working on the general public, surely you can see that too?!

 

Ginger,
No I don't see it.
The risk for infection and cross contamination are exactly the same with friends & family as with the paying public. The fact the OP is providing "freebies" is not the issue. :bash:
The OP is supposed to be a professional aren't they? So don't they owe it to their family to practice to the highest possible standards available?

If it was a trainee dentist who said " sorry, I can't afford a real drill so I'll fill my family's teeth after I've used a Black& Decker with a small bit" what would be your response to that? Is that acceptable? Or is it unprofessional and downright dangerous?

What you do with your kids is up to you, but if one of them had a fungal nail infection or impetigo and passed it to another would you still be so blase about it?

The only family member I treat is my husband and he gets autoclaved instruments the same as my patients do.

If we are less than stringent about cross-infection issues then we are playing a numbers game. 999 times out of 1,000 we may get away with it, but that 1 time could be the one that ends our career. (See the HPC website - complaints section)

At the end of the day we all set our own standards, so let's hope we all make appropriate choices.

regards

Catfoot.

 

I doubt many people cut their childrens nails with autoclaved instruments. As I said before I do see where you are coming from but there are ways of saying things without sounding aggressive. I treat my husband and other family members with autoclaved instruments too but that's because I am a qualified professional and have access to such things! In think we are seeing this from completely different perspectives so I'll leave it at that.

 

.....which is why I suggested disposables. If it`s good enough for Pods to train Age Concern to `cut nails` and provide each pt with their own set, without autoclaving in between treatments? Round and round we go :wacko:, waltz with me;

http://www.youtube.com/watch?v=YJnwfkrMpdc&feature=related

 

I do my fellas feet with a set of nippers that I keep in the bathroom cabinet just for that purpose. I would consider that they are our bugs to share and share alike if we want to. I just keep them socially clean. Having said that, if he or i had a verruca or fungal infection then I would not do that. It makes sense.

However, if your uni is expecting/encouraging you to do the feet of family and friends, one would imagine that they have a protocol for just that. While I cant think that they would expect you to buy an autocave if you are practising purely on an informal basis, I think they must have some guidelines about sterilisation, especially for when it extends beyond family.

If you are going to do friends feet, I would charge them, and in that way perhaps you can use disposable instruments. I dont' know how viable this would be for you. Then I guess that raises the subject of indemnity/liability?

 

Dear All,

The act of cutting and filing normal nails is an ACT OF DAILY LIVING.

In other words most normal healthy people do it for themselves and family members.

Simple.

it is no different to cutting hair, finger nails etc etc.

If as a student, who by definition is unqualified, you start to to do friends or aquaintances it starts to get a bit iffy.

People will and do sue if they suffer an injury.

If as a student you are charging a nominal fee, a court could not careless. You took a fee for service and by definition you are unqualified. So you could be taken to the cleaners in the UNLIKELY EVENT OF A PT SUSTAINING AN INJURY.

When i trained we were told Immediate Family ONLY. AS you would normally do for a family member as a lay person.

Why would you need practice as i presume you have been cutting your own nails successfully for several years, and maybe your immediate family too.

If you take a fee for service BEST PRACTICE IS THE MINIMUM STANDARD

if as a caring family person you are doing what you would do if you werent a student of Podiatry. Who Cares.

Carry On.

Enjoy your time at Uni the real world will arrive far too soon!:drinks

David

 

Davohorn,
Nail-cutting was not mentioned in the OP.

What we were told is that the OP was treating family members and had concerns about cross-infection issues.

That is the difference.

I asked what treatments the OP was insured to do, and have so far had no answer.

I also asked about the policy of the Uni concerning students giving treatments to family members and have had no reply.

That was my concern.

regards

Catfoot

 

when I was at uni, we too were encouraged to practice on family members, however we were advised to practice as we would be expected once we'd qualified. that included sterile instruments. we had it drilled into us that the omnly way to achieve sterile instruments was to heat for a minumin of 3 minutes at 134 °C (in an autoclave). we were lucky in the respect that the uni I went to would let us use thier autoclaves to sterilize, and that we had to have 2 sets of instruments for treatment while studying, so while one was being sterilized the other could be put to use.

if I was you I'd try to maintain a high level of clinical cleanliness as a student irreverent of who your treating, because once your qualified the is no other option! in saying all this, its your family, and no-one knows them better than you! treat them how best you see fit, afterall I'm sure you only have their best interests at heart. just remember that the rules are changing from those that lay people had to those of a qualified podiatrist as you advance further in your degree. all the best for uni

 

I must admit, This thread has been an entertaining read.

I wonder if the same thing exists on the colorectal surgeons forum??

Giving free treatments to family The mind boggles

 

Or the Dental Surgeons Forum, perhaps?! Eeewwwwww!

 

Dear footrookie
Suggest you get setup properly before you start. Autoclaves can be rented for as little as £15/week which includes calibration and breakdown cover:empathy:
http://www.podiatry-arena.com/images/smilies/empathy.gif