As nurses, the COVID-19 pandemic has led us to scrutinise our practice even further. It is obvious now more than ever that we must keep ourselves and our patients safe during these unprecedented times. While some practitioners have returned to clinics, the variety of treatments offered has been reduced due to the increased risk of transmission and Indemnity insurers adding further restrictions to our practise, including the need for a medical reason to perform an aesthetic procedure.
Mask-wearing will bring new challenges regarding communication and being able to read emotions
The British Association of Cosmetic Nurses (BACN) is aware of the ongoing debate regarding which services can reopen and, in particular, what the difference is between cosmetic and medical aesthetic procedures.
Lengthy debates on our Facebook page have highlighted the confusion surrounding returning to work, and the lack of transparency from the Government in this area. The aesthetic treatments we deliver to the public as nurses (e.g. injectable fillers and neuromodulators) are medical treatments and should only be carried out by qualified medical professionals.
Developing a medical model
The BACN is in the process of developing a medical model for aesthetic treatments to help in daily clinical practice, spearheaded by one of our highly experienced nurse members.
Along with a medical model, the BACN is also updating its Code of Conduct. This will align with the Career Framework for Aesthetic Nurses; however, due to the pandemic, it will not be available until early 2021. The BACN board hopes that its members will use this template to map their professional development.
The BACN is also looking at how it can further develop continuing professional development (CPD) content online, offered to us by sponsors and stakeholders. Admin team members Tara Glover and Gareth Lewis have returned to work and are putting together a new virtual regional programme to be rolled out in the near future. With social distancing guidelines in place, maintaining training, networking and meeting peers is harder than usual, so we believe this is the best option going forward.
Putting patients' safety first
The BACN is happy to announce that members will be able to complete their annual basic life support (BLS), automated external defibrillator (AED) and anaphylaxis training in a digital format. This will be offered at a discounted price from ECG Training, which is a very reputable company.
Working together
With many of us self-isolating (or even being furloughed) and some restarting work, it is safe to say that work life has changed significantly since the COVID-19 pandemic began. However, as members of the BACN, it is important to remember that, while we might be working in isolation, we are not isolated.
With even more members joining the BACN during the pandemic (we now have over 850 members), who wanted to be part of an organisation, lockdown has highlighted the issues of working as a lone practitioner when not able to practice. Given the additional complications and mitigating the risks of working in a COVID-19 world, the safety net of a large organisation has been a positive reason to join. With that in mind, the BACN would like to better understand our members' reasoning for joining, reasons for staying a member and how we can support the diversity of membership.
In addition to January's annual survey, we will be sending out a short survey soon to help capture this feedback. Please do take the time to complete this, as the results will help us focus on the issues that are most important to you.
A new normal
COVID-19 has touched all of us in different ways over the past 6 months. Whether reassigned to the NHS frontline or personally affected by the virus, everyone will feel the impact of the pandemic and the challenges of the physical, mental and practical recovery will be felt for many months to come. How we practice has changed; more importance has been placed on assessment and patient selection, and there may be patients who will have vulnerabilities due to age or co-morbidities that are contraindicated at this time. While the pandemic is one of the few things that has hit everyone on a global scale, each single experience is different. As practitioners, we need to be more aware of the individual physical and mental impact when carrying out wellness checks and risk assessments.
The impact of the pandemic on mental health
On 18 August 2020, The Office of National Statistics (ONS) released data about depression during the pandemic, stating that one-fifth of British adults are likely to have experienced some form of depression during the pandemic. At least 19.2% of British adults have suffered from some form of depression in June, with some 13% developing moderate to severe depressive symptoms during lockdown.
Reduced patient contact and wearing personal protective equipment (PPE) could potentially exacerbate symptoms or be missed by the practitioner. Nestor et al (2020) discusses how wearing a mask will bring new challenges regarding communication and being able to read emotions: only seeing half of a patient's face – and therefore expression – could possibly reduce the ability to empathise. They hypothesise that neuromodulators may offer a positive solution to diminishing negative emotions by targeting the glabella, promoting wellbeing for the mask-wearers and who they interact with. In conclusion, they add that this would have an important therapeutic psychosocial function.
Statutory and voluntary domestic abuse agencies across the UK noted that calls relating to domestic abuse, along with online requests, increased by 25% since the lockdown began in March 2020. The risks were not unique to the UK, and the increase has been reported globally (Taub, 2020). Organisations have agreed that lockdown increased household tensions due to forced coexistence, economic stress and anxieties about the virus. Isolation due to shielding, quarantine or lockdown regulations could create an escalation of abuse for those living with an abusive partner or family member. They also observed that the victim would be less likely to ask for help in that situation, and with no visitors or fewer visitors to a household, it might mean evidence of physical abuse could go unnoticed. We must remember that coercive control is easier to carry out with lockdown rules in place.
This year will also be remembered as the year that acknowledged racial inequalities on a global stage and how those inequalities have woven themselves into the very fabric of society. One such way is how the COVID-19 pandemic seems to have had a greater impact on those from a Black, Asian and minority ethnic (BAME) background. With that in mind, I am going to recommend an article I recently read in The Guardian by Neil Singh: Decolonising dermatology: why black and brown skin need better treatment.