In the world of aesthetic practice, it is common for nurses to work in isolation within their clinical environments. This is proven to be a challenge, as it can often act as a hurdle for building relationships and accessing peer support
It has been a busy and productive start to 2020 for the British Association of Cosmetic Nurses (BACN), as we continue to develop a number of exciting projects for the membership, such as the work being undertaken by the Education and Training Committee. The major project for this year is the development of a ‘Career Framework’ for Aesthetic Nurses and as part of this work, we are updating the aesthetic nurse competencies. A strong theme throughout these competencies is the focus on instilling best practice against defined standards, through adopting a safe approach, underpinned by evidence, which are key factors for aesthetic nurses to aspire to.
Working in isolation
Within aesthetic medicine, one of the challenges facing many practitioners is that numerous individuals are working in isolation within their clinical settings, with some working in dual clinical roles (NHS-based). The importance of peer support is increasingly acknowledged, as well as the need to build relationships with colleagues of allied disciplines, as patient need and safety must override any commercial interest(s). It can be a challenging shift in practice from working in a multi-disciplinary environment, to one of independent practice, which many nurses may initially embark on when entering the aesthetic speciality.
Traditionally, nurses working in isolation have been viewed as community based and conducting home visits; however, this notion is currently considered more broadly. Guidance around lone working for NHS employees is available from a number of organisations, such as the Royal College of Nursing (2016), among others. The Health and Safety Executive define loan working as ‘those who work by themselves without close or direct supervision’ (Health and Safety Executive, 2013). Within the aesthetic speciality, there is a paucity of guidance for aesthetic professionals working remotely.
Conferences and networking events are a great way to meet like-minded aesthetic nurses and relieve some of the autonomy of lone working
Lone practice in aesthetic medicine
It is realistic for aesthetic nurses to practice autonomously with appropriate measures in place. Lone working may not mean that aesthetic nurses are working in complete isolation, and will depend upon the context. For example, many aesthetic nurses occupy spaces within established clinics, where an existing team is working alongside them. Aesthetic nurses should be encouraged to conduct their own risk assessments to identify any areas of concern, which can include the cleanliness of the premises, suitability of the space/environment to perform aesthetic treatments and the appropriate disposal of sharps. Contemporaneous and secure note-keeping is paramount, which should include procedures in place for handling complaints, among others.
Lone practice and prescribing
There are challenges associated with practice for aesthetic nurses, both with and without prescribing privileges. Aesthetic nurse prescribers carry significant accountability in demonstrating responsible prescribing decisions for their patients. It can be limiting for aesthetic nurse prescribers to access continuing professional development (CPD) and ongoing learning to update knowledge, owing to a shortage of specialist educational opportunities. The Association for Prescribers is an excellent resource, which hosts an annual conference and also offers a variety of medically orientated generic CPD prescribing modules. By comparison, non-prescribing aesthetic nurses face a number of challenges working remotely and must rely on the support and supervision of a prescribing nurse or doctor practising within the aesthetic speciality. Prescribing for non-prescribing aesthetic nurses arguably carries significant responsibility and accountability regarding the administration of the drug, as well as the support and supervision required in managing potential complications.
Patient-centricity and forming networks
The patient at the centre of the management must remain the focus, and should the prescriber choose to take on the responsibility of prescribing for a colleague, then they must comprehend the scope of the support required with demonstrable competencies to provide the necessary clinical input. There is potential that working in isolation may facilitate prescribing decisions made outside of scope of competence in the absence of peer support. Forming a network of aesthetic professional colleagues is an invaluable line of support and allows a dialogue to share experience, discuss questions, treatments, as well as referral if a complication is outside of scope of experience.
The role of BACN
Attending the forthcoming BACN regional meetings and annual conference are a great way to meet like-minded professionals within your locality, receive overviews from companies and gain CPD and CPR updates. Details can be found on the newly updated BACN website at: www.bacn.org.uk.