Any aesthetic nurses?

PetiteOpRN · May 29, 2010

I work in a plastic surgery center that offer both surgical and spa services.

What exactly are your goals? Nursing may or may not be the best way to meet them. In my practice, nursing and aesthetics are pretty separate.

The nurses meet with all patients who come in for medical consultations. We interview/assess the patient and give report to the physician. We do all required charting, contact insurance companies, and counsel patients about surgical options. The nursing staff is in charge of maintaining the OR (turning over instruments, cleaning/terminating the OR suite, ordering supplies, etc). We also assist as circulator/scrub/CRNFA/conscious sedation administrator in the OR, depending on the credentials of the individual RN. We do a great deal of patient teaching about surgery, medications, restrictions, post-op care, etc. We act as a patient resource as much as possible. We provide post-op care, changing dressings, pulling sutures, and assessing for complications.

The aesthetician meets with all patients who come in for aesthetic (skin/makeup) consultations. She is much more independent, and only gives report to the physician if the patient expresses interest in a service she cannot do (like Botox or fillers). She manages her inventory and is trained to do microdermabrasions, facials, more chemical peels than I can count, makeup consultations, waxing, and spray tans. As an RN, I can't do many of the things that she does.

BTW, as a nurse, I don't think I would ever be comfortable doing injections of Botox and fillers. Plastic surgeons typically have 6+ years of residency and fellowships to learn how to do that, and an "injection certification" is not quite the same thing.

mestiza79 · May 29, 2010

Thank you for your input. There's actually a few medi-spa's here where I live and in those offices the RN's administer the botox/fillers. They also do IPL/Laser treatments. These are all practices I can only do with an RN, NP, PA, or MD. I already have the esthetic background so to my knowledge I need to complete NS, then take a medical aesthetics course. So to answer your question, my main goal is to do the fillers and laser treatments. However, I wouldn't mind doing your job either. Sounds like something I'd also be interested in. My concern is the clinicals in school and the severity of them. I have a weak stomach and a soft heart so trauma would be VERY hard for me. I just would like to see how many other people are out there like me :) and hear their stories and how they made it through school. I love making people feel good and LOOK good :redpinkhe

PetiteOpRN · May 29, 2010

Clinicals can be intense. Depending on your program, the classroom portion can be just as intense, if not more so. I think I saw one code in my clinicals, and it was a slow code (pt declined for an hour with the rapid response team at her bedside before they coded her). Really, the poop was my least favorite part of nursing school (even a patient who is completely obtunded can somehow sense a clean chucks, which is going to be soiled before the patient is turned back).

Some programs will have you in the ER for a day, or in the OR for a day, very few longer than that, so it is unlikely that you will see a real trauma. Sure, they're still a trauma once we send them to the ICU, but in the ICU you're not cutting off the clothing and checking beaucoup blood product while the MDs start central lines and defibrillate the patient.

I would look around the allnurses page for current students. The struggles there are the same that every nursing student has. It will give you a good idea of what nursing school is really like.

In my experience, lasers are operated by aestheticians, not RNs. RNs do not generally have any exposure to lasers in school, and perioperative RN are the only nurses who would use them on a regular basis.

I have seen too many patients who suffered major side effects from fillers/injectables to be comfortable doing it without a 6-year plastics residency and 'MD' after my name. Some of the side effects (double vision, trouble eating/talking, and infection) are immediate and usually resolve on their own. Others take years to develop (rippling under the skin, hard areas, and noticable asymmetry), meanwhile the RN has no idea that her technique is dangerous. I see these problems exclusively with RNs and MDs who are not board certified plastic surgeons (GPs and ENTs, mainly). If a nurse came to interview with my employer and gave the impression that she wanted to do injections, she would politely be shown out. This is not the case with everyone, and it sounds like CA might be a little different (though I know of several plastic surgeons we've trained who are now working in CA).

Not every medi-spa has a plastic surgeon on staff. Here is one ( Columbia, Missouri medical spa with skin care, facials, Botox Cosmetic, message therapy, acne treatment, skin treatment and DermaQuest | Pela Cura Medical Spa ) that is run by two aestheticians and two radiologists. No RNs, no plastic surgeons, but they offer injectables and laser treatments. I don't think that having the letters "RN" after your name would necessarily be the best way to advance your career.

If you can get involved with a medi-spa as an aesthetician, I think that would be your best bet. It would get your foot in the door so that you could have a job when you graduate. Right now it is very hard for new grads to find any job, let alone a "cushy" medi-spa one.

I hope that help answer some of your questions.

mestiza79 · May 31, 2010

Well it most definitely gave me some insight! Thanks again for all of your advice. I'm currently already working at a medi-spa and am a licensed esthetician. In CA the laws are definitely different. There are tons and tons of medi-spa's here that have aesthetic RN's. And as an esthetician I am not allowed (in CA) to touch a laser or needle. The RN would allow me to do more effective and invasive treatments. There aren't too many plastic surgeons here that do the fillers/botox. Most of them have their PA or RN administer those treatments. But I will continue to do my research :) Thanks again!