soon to be new nurse-need more information on Cosmetic Surgery RN

[Guest05152013]

I am going to be graduating with an ADN in May and I am currently super confused about which area of nursing I want to go into. I have worked as a nurses aid in resource pool at my local hospital for about a year now & have been trained in and work as everything including an ER tech, the ortho floor, ICU, Tele, and all the other general med/surg floors. My job responsibilities have not allowed me to go into the PACU or OR (with the exception of two or three clinical days throughout my whole 2 year program), however, even though I think I'm interested in this area of nursing. Working as an aid while in school has sufficiently burned me out for wiping butts, taking vitals, giving baths etc. and I honestly do not think I want to be stuck doing that in my career. I know teachers always say get a year of med/surg but I honestly don't want to prolong my misery any more! I am thinking about looking into being an RN in a cosmetic surgeon's office, at a hospital, or wherever. I think it is a very interesting specialty but honestly have not gotten any experience in that field whatsoever. What would I need to do to get into this field? What are the job responsibilities, hours, pay like? What are qualities that make a good nurse in this field in your opinion? I am more interested in assisting with the cosmetic surgical procedures vs. the office job position, but I honestly am open to just about anything at the moment. Any advice or info you could give me would be great! Thanks! :)

[nurseprnRN, BSN, RN]

Don't think that your student / aide experience is what you would have to look forward to as an actual nurse.

Think you could handle an emergency to RN standard of care in a free-standing facility of any kind? I would be astonished if a free-standing esthetics practice would hire you and pay out all the money it will take to train you in their toys, or a cosmetic surgery office or day surgery clinic, with no nursing experience at all. And that is exactly what you have.

Your instructors are telling you to get a year of nursing experience for a good reason. They think it would improve your employability because it will improve your skills and general nursing knowledge; this will benefit patient care and help protect you from a lot of newbie mistakes. But hey! What do they know about youth and passion? Follow your drrreeeeaaaammm!

[klone, MSN, RN]

They generally don't hire brand new RNs at cosmetic surgeon's clinics. The RN who works there is often totally on her own for the first couple hours (pre-op assessment, starting the IV, administering any pre-procedural meds) and needs to be highly independent and really know what she's doing. If you want to go into that area of nursing, I would recommend a year or two of OR and pre/post op first, in a hospital that has a comprehensive new grad orientation program.

[Guest05152013]

Thanks for your honesty- and I understand why my teachers are saying that, and why a bunch of other people are saying it, but I guess I just don't understand why it is the case. And yes you're right, I have not had any experience as an RN, however I have seen nurses in all kinds of different roles while working at the hospital I'm currently at and they just seem overworked and overstressed. I've put myself through enough of that in nursing school and working as an aide and I'm just not interested in putting myself through that just to say I've had a year of med-surg. I know that it presents you with a lot of opportunities to improve skills in time management and basic nursing care, but I know that I would be miserable and I just don't think that it's smart to put myself into a position where I know I won't be happy.

[RNperdiem, RN]

Some procedural nursing would be helpful. Skills like performing conscious sedation, IV starts are helpful.

I work in ICU where we do take a lot of patients from the plastic surgery department. These are not cosmetic surgeries (skin grafting, breast reconstruction, head and neck cancer surgeries), but there is plenty to be learned about airways, flap monitoring and how to recognise trouble ahead.

[nurseprnRN, BSN, RN]

Thanks for your honesty- and I understand why my teachers are saying that, and why a bunch of other people are saying it, but I guess I just don't understand why it is the case. And yes you're right, I have not had any experience as an RN, however I have seen nurses in all kinds of different roles while working at the hospital I'm currently at and they just seem overworked and overstressed. I've put myself through enough of that in nursing school and working as an aide and I'm just not interested in putting myself through that just to say I've had a year of med-surg. I know that it presents you with a lot of opportunities to improve skills in time management and basic nursing care, but I know that I would be miserable and I just don't think that it's smart to put myself into a position where I know I won't be happy.

OK then. For sure, your happiness would have to come first. Delayed gratification is no gratification at all. Let us know how that works out for ya.

[RNperdiem, RN]

Those overworked and overstressed nurses are often looking for a change of venue too. In many jobs you will be competing with them and will need to have something to offer potential employers.

[netglow, ASN, RN]

Here is what I've found about that - because I looked into it as well.

Many plastics guys do not use RNs in surgery eg those who have surgical suites in their own facilities as well as at hospital. They use techs for the little stuff - stuff that can be done in an outfitted exam room in office. They use PAs for the most part in the OR for the bigger stuff that includes hospital too. Here is why it's PA. PAs are simply physician's assistants they are trained to assist the MD doing whatever. Often that starts in surgery and then goes on to rounding for the doc and doing post ops in the office. PAs are liked in this role because they can train specifically for surgery. Oh, I don't mean "simple" meaning easy at all. Plastics likes to keep in the OR, they hate rounding and post op. So, an MD can basically dump a heavy load on the PA who has the scope to do the type of grind that the MD wants to be rid of.

If an RN is hired, often it's because a female is wanted in the role of educator etc. specifically if the doc is male and will be doing a lot of breast work (I'm being serious) you will be with him when he is with the patient importantly for patient comfort. You would also be there to do post op drains etc. and ALL calls from patients - often ALL pages are yours too... you to handle and decide if you want to call the surgeon and bother him with "issues" from patients. Cosmetics is a very pamper the customer kind of deal - so you will be the one to run interference with patient calls post op.

So, the best bet for you probably would be to do medsurg/oncology hospital eg breast cancer surgery patients. Plastics deals with a lot of onc patients and you need to know all that surrounds that. There are facial plastics people, but you'd have a more difficult time getting to find that avenue. It would be very much Oral and maxillofacial/plastics surgery. Yup, you need to hook up with a DMD on staff at a trauma center maybe as well. Think head trauma patients and head and neck cancer patients.

I'll edit to add: the fillers and lipo stuff are just chump change on the side. Plastics must get into the bigger procedures to make money... and so will you need to be experienced in some of that in some way.

[RNsRWe, ASN, RN]

Thanks for your honesty- and I understand why my teachers are saying that, and why a bunch of other people are saying it, but I guess I just don't understand why it is the case.

Everyone is saying this to you, but you don't understand why.....yet. Once you GET the experience that everyone is saying you must have, you will then understand the necessity.

And yes you're right, I have not had any experience as an RN, however I have seen nurses in all kinds of different roles while working at the hospital I'm currently at and they just seem overworked and overstressed.

You've SEEN them in their roles, but have not DONE the roles yourself. And therein lies the reason you do not yet understand why you would be lacking as an applicant.

I've put myself through enough of that in nursing school and working as an aide and I'm just not interested in putting myself through that just to say I've had a year of med-surg.

It is NOT "just to say you've had a year in med-surg". It's to actually have SOME modicum of experience from which to draw. Why should you "put yourself through" that? So that you might become reasonable competition for other nurses who also want the same job(s) you do. As it now stands, you are NO employer's best hiring choice. That's no reflection on you as a student, but it WILL be a reflection on you as a nurse---one who is unwilling to learn the ropes, dirty and messy though they might be.

I know that it presents you with a lot of opportunities to improve skills in time management and basic nursing care, but I know that I would be miserable and I just don't think that it's smart to put myself into a position where I know I won't be happy.

Do you believe that everyone starting out at the bottom of the hiring chain for ANY job should consider only whether they'd be happy there....or that, perhaps, they could consider the time spent "in the trenches" as making them more likely to get to that dream job?

Heck, why shouldn't someone right out of high school become the next CEO of a major corporation? Perhaps it's because he lacks the education, skills, maturity, and networking expected of someone in that class?

If you understand the answer to that scenario, you'll understand why you, too, aren't ready to be a CEO.

[Nurse SMS, MSN, RN]

The reason to put a year in acute care is not for what it does for you. It is for what it does for your patients. I truly think though that most of this discussion is moot. You are about to be a brand new ASN level RN. Job opportunities are extremely scarce these days for new grads and even moreso for two year RNs. My advice would be to apply to anything and everything and to accept whatever job you are lucky enough to get offered. All this talk about specializing when the market is the way it is really is like talking about only wanting to eat at high end steak houses when you don't have the connections to get a reservation. When you get hungry enough you'll be happy to eat wherever you find an open table.

[LightMyFire]

You might find you truly (and unexpectedly) live the area in which you find yourself. I wanted to do critical care but found that I really love med-surg!

[Good Morning, Gil]

Since you say you are burnt out on wiping butts, giving baths, do not go into any ICU setting (MICU/SICU, CCU, CVICU, NICU, PICU etc). You will do this more in ICU than you will in any other area in the hospital since the RN is responsible for total care (no CNA's at all, though there are ICUs that have a CNA or two).

Just wanted to help you narrow down your options. Cosmetic surgery RN is a pretty rare option, and will likely not be available as a new RN, but you can try if there's an opening. Doesn't hurt.

Also, this goes without saying, but you will be wiping butts in all areas of the hospital. Part of our job. Not just the CNA's job, our job to help them transfer, get the patient OOB, etc. Regardless of how you were treated as a CNA, do not be the nurse that doesn't help the CNA. That's just not right.