LeaRN627

I work in a very large dermatology practice (about 30 doctors) and our turnover is very slow, but part of that is due to we are a university setting and we get great state worker benefits. Our salaries are poor, but the benefits are too good to quit on. Private practice can vary. I know one dermatologist who helped his medical assistant go through RN school with her promise to work for him for a number of years. I think that time has long passed but she still works for him. I know others who pay very, very poorly, only hire part-time so they don't have to supply benefits, and are stingy to a fault. Being associated with a group that is university or hospital based is probably the best way to go if you are near such a facility.

I have been a nurse for 40 year. I have been working in dermatology for 8 year now, in Mohs surgery for 7 of those years. It is very complex and rewarding work. You must be able to multi-task and move fast. It is not a sit at your desk job, you are on your feet and running most of the day (I work 4-ten hour days). If you want an easy going job, this is not it. It is hard work but it is never boring. People often think dermatology equates cosmetic, but since the skin is the largest organ of the body, it is the first to give signs and symptoms of injury and literally multi-thousands illnesses. A rash is not just a rash, but may be the first sign of a deadly illness. Melanoma is the deadliest skin cancer and it is an honor to be part of ridding people of this cancer since the rise in young people is happening so frequently (please use sunscreen and do not use tanning beds). There is much to do in education and soothing people who have disorders that can scar them permanently. Dermatology is not for the faint of heart, but it is very rewarding. My previous experience was in the operating room with plastic surgery being a specialty. Also very hard work. Not everything is breast augmentation or tummy tucks, but often it is a tummy tuck secondary to using that skin and fat to reconstruct breasts after mastectomy, a surgery that will have you on your feet for 6-10 hours. But if you get to be part of that, you feel good for quite awhile! Hope this helps.

I have been a nurse for 40 years. I am a certified OR nurse and a certified dermatology nurse. I have worked in dermatology for 8 years, 7 of those years in Mohs surgery. The skin is the largest organ of the body and is often the first to show signs of internal injury and illness. It is about as far from boring as possible. It is, in fact, very complicated and interesting. Please let me know if I can answer any specific questions.

I have been a surgical RN for 36 years and have practiced in GA, NJ, SC, CA, TX, NE, and CT. I have always removed various drains and tubes and retention sutures. All of those places had policies in place. However, I think you were right to question and should not have been criticized in front of others or made to feel as you were for questioning. It is a smart nurse who questions when in doubt and if you are uncomfortable with an unfamiliar procedure it is the responsibility of the supervisor to get you training. That being said, I also would not condone telling the patient you were not familiar if nurses can do that procedure. You have now compromised the nurse who is familiar with that technique, but now the patient will be fearful of allowing a nurse to do any procedure. I would suggest that you simply tell the patient you need to check on the order before proceeding, then contact your supervisor and tell him/her that you have not done this and you are not clear if this is an allowed RN task. You have every right to refuse to do a skill set you have not been properly trained in, but you should be careful to not undermine the skills of nurses in general when the doubt may simply be in your mind, not in other nurses already skilled in this technique. Once a patient hears you say you are not sure about something, the patient is going to be wary of all the nurses in your agency. Just my humble opinion. Good job of seeking answers and poo to your supervisor for making you feel bad asking questions!