anhedonia

I went back to school to become a nurse when I was in my late 30's. There were NO jobs for us when we graduated except in nursing homes, as that was the period of all the cutbacks in nursing. I believe that is why we have such a shortage now. Two years ago I took a nursing refresher course; many of the students were in their 40's and a number of them graduated when I did and had to work in other fields. After finishing the program, I went looking for a clinical nursing position; most hospitals would not even grant me an interview because I had not worked clinically. The one hospital that did only offered day/night rotation; by then I was 50; there was a shortage. I said I'd take permanent evenings or days, but just couldn't rotate. I was shown the door. I guess if you are 20 something today you can get hired and are more willing to take any shift and lower pay. There are few office nurses in my area, Massachusetts, and the pay is horrible; medical assistants work for less, of course, and are very popular here. I know lots of nurses who have left the field in their 40's because they can't take it anymore. It's a profession in trouble, and, by the way, is listed tenth highest in occupational injuries.

It is not possible here in MA to get this type of insurance. I do not think it exists. You can get insurance to do permanent cosmetics; I use Marine Midland Insurance. As for the botox, etc., we need a medical director here but right now we don't have to work in that person's physical location. Nor do we have to be on their payroll. It isn't easy to find someone to be a medical director. If you can maintain your own location but need a director, start calling plastic surgeons, derms and even internists you know. Call spas and see if they do the proecedures and ask who is their director. If you aren't geographically close, maybe that person will act as your director. If your state has a law stating that you have to be employed by an MD, you may be able to maintain your own location but you would be paid by that person. The laws are not clear in this area or aren't even in existence, so check with the state to make sure you understand and see in writing what they require, if they require it. If they don't have laws governing it, then try my suggestions. With a medical director, you work under that person's license. This is one way in which states are seeking to keep us from making a good living on our own. There is legislation here that would make it harder for us to practice, but I am hoping the bill will be changed to something more reasonable before it is passed. Here, once you find someone as a director, you have certain procedures to follow, need policies and procedures, and then you work out a split arrangement with the doc. As for peels, etc., you should check and see if your nursing insurance would cover you for those; my assumption is that it should. Let us know if you find out anything more. Those of us trying to enter this field are having a hard time doing so; don't give up, though.

So far here most docs still do their own; many are in groups and you'll find there's one in the group who does the botox and fillers. Plastics should be too busy, but even one I met who told me he'd be looking to hire someone isn't as yet; he even got himself into a beauty salon and does patients there. I, too, do permanent make-up; not very popular here right now, but I did try to break into it to do areola repigmentation and started with a major cancer center and large hospital based PS center. I was told since it is part of the reconstruction fee the docs do themselves. We are in a tough medical climate here; many docs leave the state due to low reimbursements, high malpractice and whopping housing costs. You can't see a neurologist in under 4-5 months. I'll just have to keep plugging along. Today I have a meeting with an esthetician who would like to add botox to her menu of services. That's where I'm looking for business for now; I'm still trying docs and have good contacts but nothing yet.

I have done a great deal of research on the legalities of doing this in my state. I did secure a medical director, but he is not a derm or PS so I have decided to confine my service to Botox only, as there is much less chance of having a problem. I can get a PS for fillers, however, he wants too large a percentage for someone so small and without my own place to offer enough services to offset the costs. The bigger problem we face her is legislation that would require that nurses work in a physician's office and only inject while the physician is in the office. I find this absurd, as nurses work in many settings without a doctor in the building. We are organized and trying to fight it, but eventually the sponsors will probably win. It is very hard to find a job injecting with a derm or PS as they keep the work for themselves. And some of us would rather be self employed entrepreneurs rather than hourly employees. Nurses still do not get the respect they deserve; I'm not sure we ever will I learned from a nurse who has done this for many years. I know a couple of nurses who went to one day classes, very expensive, had to travel, and they only injected two or three people; I'm not sure it's worth all that money, particularly in the climate (political) I'm in.

I started with an ADN. It's fine if you want to stay in clinical nursing, but eventually you might want to change career paths. I am 2 courses shy of my BSN, which I only want to say I have it. I don't work in a clinical situation. Spent a number of years working on research projects; when the grant funding ended, I was without work and not desiring a return to a hospital. All the jobs I know I'm qualified to do I cannot get because around here (Boston) you need a Master's, although not necessarily in nursing, to get any type of administrative position at a major hospital. Just something to think about. I did a course a semester towards my BSN; you'll get there eventually. There are also RN-BSN and other programs of that type. If I had it to do again I'm get a master's degree in clinical psych and gone into counseling. But that's water under the bridge for me.

I would love to talk with you. I'm trying to get going in this field as well; let's compare notes.

Check out the website for AMEN. QUOTE=NancyRN]I have been getting acid peels and permanant makeup at a plastic surgeon's office. The nurse who does them has been trained by the doctor. She was just in the right place at the right time; she had no prior plastic surgery experience. She's told me how much she loves her work. I've noticed quite a growth spurt of day spas offering acid peels (Although I would only get a peel from someone operating under the supervision of an MD). The day spa where I get my hair done has plans for offering botox injections soon. Does anyone know where I can get training in medical esthetics? I've looked online and all I find are very expensive schools out of state which seem to be set up in the manner of a vocational school. As an RN I don't need anatomy classes. I just want to learn to give peels and botox. Thanks for any input you might have!

I have recently learned how to inject botox and dermal fillers. I am looking for a Medical Director but really do not know what they are required to do to be one. I also don't know what I would need, although I have been told I need liability insurance but cannot find a company that will write a policy in Massachusetts. I would be off-site at my own location. I would like to put together a proposal to present to the doctor I want to approach. If anyone can give me some information on what I need to know here in MA I would be most appreciative. Thanks in advance for your help.