Working life: Jan Cumiskey, senior community podiatrist

9am: Morning clinic where I work in Tralee runs from 9am-1pm and I see my first patient around 9.30.

Before that, I check voice messages in case there are any urgent calls. We see urgent referrals within 48 hours. An example of an urgent referral is someone who presents to the clinic with an active foot ulcer. We recently treated someone who was referred to us by their GP with a foot ulcer. He had dead (necrotic) tissue and his bone was visible. His GP faxed a referral to the Specialist Diabetic podiatry department in CUH. So did I, as per national guidelines. During his assessment, I checked the blood pressure readings in his legs as his blood flow was quite slow. I also took a swab for microbiology to see what bacteria were present in the wound. I contacted his GP to request a referral to a vascular clinic. We work very closely with GPs and we have a good rapport.

11am: All the patients we treat are high risk. About 70% have diabetes. Poor blood sugar control can lead to neuropathy, or nerve damage. Patients with severe neuropathy need to check their feet and inside their shoes every day. They could step on a nail and not feel it, or have a little piece of glass under their skin and not realise it. This can leave the foot red and swollen. Part of my role is sharp debridement, which is a surgical procedure using a scalpel to reduce the level of infected tissue.

1pm: By lunchtime, we’ve usually seen about nine patients. I usually eat in the canteen or I might go for a walk.

2pm: I see seven to nine patients in the afternoon, including any urgent referrals. We also work very closely with the other healthcare professionals in the community. Good communication is paramount to good patient care. Our service commenced in Jun 2011 and there are two podiatrists based here in Tralee. We teach new patients how to check their feet and we give footwear advice. If they are high risk and have a lot of swelling and have an ulcer we can fit them for medical footwear. Our patients include people with rheumatoid arthritis and vascular complications.

5pm: The clinic finishes and I head home. I like to relax by walking Banna beach with my two dogs.