Within scope or not

[Priscilla K Addo]

Good afternoon fellow nurses. I would like to inquire about an opportunity that was brought to me. My name is Priscilla and I have been practicing as a Nurse for 8 years now. I have received the opportunity to collaborate in the aesthetics side of nursing ie cosmetic and beauty enhancing procedures.

I was asked by the aesthetician if I could be her directive in removing warts and sun spots with the use of a electrocautery machine. Would this be a part of the controlled act because it is a form of energy? If that is the case would I be allowed to be that person to direct her?

How would I determine the amount of energy used is sufficient for patients? Wouldn't it have to be doctor to prescribe a dosage amount? If I am able get a doctor to order that will I be OK to perform this procedure if trained without a doctor and will I be able to direct the aesthetician.

Your response and support is very appreciated

[JKL33]

Doesn't sound like a very good idea. There's zero way I would become involved in this. It sounds quite a bit like she wants to perform procedures that fall squarely into the medical provider realm and either believes or wants you to believe that somehow having an RN authorize her work is going to change anything. The only thing it will change is that you will be in trouble along with her. If something is in the medical provider realm then neither one of you are qualified.

I doubt she is allowed to destroy tissue in this way and she most definitely isn't qualified to diagnose skin conditions; if you want to confirm you can check out your state's cosmetology board and related regulations.

[2BS Nurse, BSN]

I believe this would depend on your state's nurse practice act. RNs and MAs can do a lot in my state.

There are multiple treatments for warts (liquid nitrogen, canthardin/podophyllin, laser, candida antigen, wart peel, etc). The provider needs to select and order the appropriate treatment.

Did she mean use of a laser or hyfrecator? Laser removal can be done by nursing or even MAs in my state. I would hope the dermatologist would identify and mark the lesion first. You wouldn't want to be accidentally treating a melanoma! Also, remember that both of these treatments could cause scarring. You will be working with many unsatisfied, unhappy patients in Derm. They don't pay me enough to deal with that!

[JKL33]

22 hours ago, 2BS Nurse said:

I believe this would depend on your state's nurse practice act. RNs and MAs can do a lot in my state.

There are multiple treatments for warts (liquid nitrogen, canthardin/podophyllin, laser, candida antigen, wart peel, etc). The provider needs to select and order the appropriate treatment.

Did she mean use of a laser or hyfrecator? Laser removal can be done by nursing or even MAs in my state. I would hope the dermatologist would identify and mark the lesion first. You wouldn't want to be accidentally treating a melanoma! Also, remember that both of these treatments could cause scarring. You will be working with many unsatisfied, unhappy patients in Derm. They don't pay me enough to deal with that!

The OP is referencing an aesthetician; there is no medical provider involved. The aesthetician wants to employ an RN (the OP) to essentially fill that role. Scope of practice is nearly irrelevant--If it's something that isn't within the aesthetician's scope then adding in an RN but not a provider changes nothing about that. I don't see how an RN can direct/authorize an aesthetician to do anything.

[2BS Nurse, BSN]

Just now, JKL33 said:

The OP is referencing an aesthetician; there is no medical provider involved. The aesthetician wants to employ an RN (the OP) to essentially fill that role. Scope of practice is nearly irrelevant--If it's something that isn't within the aesthetician's scope then adding in an RN but not a provider changes nothing about that. I don't see how an RN can direct/authorize an aesthetician to do anything.

Oh, got it. I was thinking the aesthetician was working within a Derm practice. Yeah, I wouldn't touch that job.

[aestheticnurse7]

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