Feet first: Nurse scientist jumps into area she had to fight for

Every March, the nation celebrates National Women’s History Month to honor and celebrate the undeniable contributions women have made throughout time. Look for the stories of other exceptional women at the bottom of this report.

When asked what she’d like to focus on in a story about her for Women’s History Month, College of Nursing professor Teresa Kelechi had an answer she knew might be surprising. “One of the biggest contributions in my career since I've been at MUSC is changing the practice of how nurses can help people and do – I know this sounds weird – foot care.”

Kelechi, who has a research doctorate in nursing, serves as the David and Margaret Clare Endowed Chair and the associate dean for Research and Ph.D. Studies in the College of Nursing and the director of recruitment for the South Carolina Clinical & Translational Research Institute. She said her career is grounded in the very body parts that keep most of us grounded –literally.

It's the people in danger of losing that grounding who inspired her interest. “Twenty years ago, or even maybe longer, South Carolina had one of the highest foot amputation rates in the country.”

That's in part because the state also had – and still has – one of the highest diabetes rates in the country. Diabetes can cause nerve damage and reduced blood flow, leading to injuries and blisters that either heal slowly or not at all. That can cause ulcers and gangrene, and in some cases, the need for foot amputation.

Kelechi knew something had to be done – and nurses could be a part of that. They're experts in taking care of patients. But when it came to intensive foot care, it was hands off.

“Nurses were prohibited from practicing foot care. And it was never defined what foot care really was. But it was generally assessing the feet and making sure that the integrity of people's skin and toenails were in good shape. And again, it sounds gross,” Kelechi paused to laugh. 

“But you know, if you have diabetes or neuropathy and you have problems with skin, such as thick calluses, excessively moist toe web spaces and thick, hard toenails, those can lead to wounds and other infections that can be devastating.”

She knew nurses could play a much bigger role in preventing that devastation. But it was an uphill battle. “I had to politically put myself out there. Some of the other practice people, such as podiatrists, were fighting the idea that nurses could go in and do this foot care.”

She wrote a section for the South Carolina’s Nurse Practice Act, a document that sets forth rules and regulations, and went to the state Board of Nursing and proposed that it be added. 

“They accepted it, and then it became a national standard and set the stage for nurses throughout the entire country to be able to help people take better care of their feet, teach them what's right with footwear and so on and so forth. I am so proud of that work because it had such an impact on people, not just in South Carolina but throughout the country and worldwide. It spawned a national foot-care certification for nurses.”

Kelechi has many other accomplishments on her resume. They include:

• Finding new ways to treat the symptoms of venous disease and helping patients manage it.
• Improving communication between researchers and the people who participate in their studies.
• Studying the influence of social determinants of health, such as social isolation and loneliness, on wound healing and the use of artificial intelligence methods in diagnosing inflammation in non-healing chronic wounds.
• Developing stress management help for caregivers of people with dementia.

Her work hasn’t gone unnoticed. Kelechi will be inducted into the International Nurse Researcher Hall of Fame in July.

She’s proud of all of that. But the area that really stands out for her this Women’s History Month is the impact she’s had in the field of nursing foot care. “I think at the end of the day, when I look back, I think about how many people's feet were saved or their quality of life was improved. There was an economic impact, and people were getting what they needed,” Kelechi said.

“The foot-care movement provided for hands-on training of nurses in continuing education programs, which we had here at the College of Nursing for many years. That, to me, was such an important aspect of my overall career. It also influenced my research, and it influenced how I teach in students’ clinical practice. And it influenced how I approached my career as a nurse scientist because my science rose out of that clinical practice area.”

Read about how Kelechi is empowering patients dealing with another troubling condition, in this Progress Notes report: Patients with chronic venous insufficiency can prevent leg ulcers with simple yet effective interventions