From ED to Cosmetic Dermatology
My dream specialty has always been emergency medicine. For as long as I can remember I wanted to work in the ER when I worked as a RN. I think it was the excitement of not knowing what was coming through the door. I also liked being equipped or prepared to deal with anything. It gave me a level of confidence being able to have “ control” over a situation. Although, you never do- to an extent. The great thing about the medical field is that there are so many specialties to choose from.
My nursing experience is in medical, pre/post surgical, telemetry, joint and neuro acute rehabilitation. I also have long term rehabilitation experience from when I was a licensed practical nurse during undergrad. I found it difficult to get into the ER as a nurse- at least for me. By the time I heard about a ED RN fellowship program it was always filled. And when I decided to go back to school (at the time I was considering medical school- another story for another day) I decided to stay in my unit and not transfer. I figured I was comfortable with my manager and schedule and did not want to shake up things at a time where my stress level would already be high.
Its no surprise when I completed the PA program I entered the specialty of emergency medicine. How did I pull that off? Well contacts are definitely a thing. It worked out perfectly that I had a good friend who was already a PA in the ER and who put in a good word for me; with my nursing experience, my reference, and a great interview I was hired into the specialty of my dreams. As a matter of fact I had the job before I took my PA board exam.
I loved the ER, it felt like I was a perfect fit. What I liked most about the ER was doing procedures, specifically laceration repairs. I liked “fixing” a problem with minimal pain or discomfort. It was a goal of mine to help the patient relax by the time I introduced myself to them. I succeeded, most of the time. I got to see and treat multiple populations, from pediatric to geriatric and had chief complaints across the board of body systems. It was very satisfying calming the fears of the patient/ family, answering their questions and educating them on their health and ways to care for themselves. I did have some days where the stress of the hospital was overwhelming, but over time I had become seasoned enough that I knew how to manage my time appropriately so that I could sneak time for my lunch, and bathroom breaks in between seeing patients or waiting for test results.
2020- the pandemic. It changed everything for me. At the time of the pandemic I had been an ER PA for 4 years. There was nothing else to do except work so I did. I worked full time in the ER, part time in telemedicine and then eventually part time in urgent care. I quickly started to see that I could not continue in this specialty forever or for much longer. What made it worse was the workload, it became unbearable. Even with my time management skills I could not get a moment to eat or use the bathroom. My anxiety level was out of control, and I was losing control of what I call my “ER self control”. I became irritable, and so I started looking for specialties in an area that had already sparked my interest.
Aesthetics was on my radar since 2019. My face was a complete mess during and after PA school ( I graduated 7/2016) so after several failed attempts with different dermatologists I found a black plastic surgeon who was also a board certified dermatologist who changed my life. This is when I began to consider working in the dermatology specialty. The next push was when another friend of mine who was also a PA had a botox training course. I signed up for her course and I immediately realized that I needed to try and get into this specialty as soon as possible. It took me a year to get a job in aesthetics after spending thousands of dollars in trainings, several calls to dermatologists, plastic surgeons and medical spas. I flew out of state for trainings, I mean the dedication was there for sure and I am glad that I did not give up.
Why aesthetics? There are not enough black providers in this specialty- plain and simple. I wanted to be a representative for minorities because maybe they would feel more comfortable seeing me in this space and not shy away from these services that work so well. Another reason was because I myself wanted to learn more about skin care. I saw how Dr. Garries (the plastic surgeon, Very Pretty Skin) took great care of me and I wanted to be able to maintain my skin on my own and help others do the same. And finally I loved the procedural aspect of aesthetics, working with injectables, being an artist, etc.
What are the benefits of working in aesthetics? You get to look nice- sorry but that can also be a con because you have to look nice (well you don’t have to but you should). Once upon a time I never thought I could make it in this industry because I thought I did not have “the look” and I quickly realized how wrong I was. You just have to be competent, confident and honest. But you definitely have to put yourself out there and be “about it” (the products, the services, etc). Another benefit is I no longer had to be around sick people, and everyone who came to see me, wanted to be there. And it was not an emergency so that pressure was removed from the interaction. So majority of the time my clients (no longer patients) are pleasant. You also build relationships- funny- that it one of the reasons I loved the ER because, I did NOT WANT to build relationships. Our desires change as our lives change.
Is it always sweet? No, but what job is? It’s a wonderful change from the hustle of emergency and urgent care medicine. But it can be stressful trying to satisfy certain clients. Also like all specialties, there are some shady things that go on. So it is imperative to remain neutral in such a small field where “everyone knows everyone” and leave situations where you do not feel comfortable.
I do not regret my decision to leave the ER but I do miss it sometimes so I plan to do some shift work in the hospital or urgent care to maintain my clinical skills and knowledge.
I’ve been in aesthetics for two years now and there is always something to learn. A new technique, a new product. I am always excited to see my client’s before and after photos and the satisfaction of exceeding someones expectations is priceless. Restoring someone’s confidence is empowering to say the least.
If you want me to discuss more about my new career in cosmetic dermatology please let me know in the comments. Thank you for reading!