A day in the life of a ... cosmetic nurse

1 August 2014

Plastic Surgical Nurse Consultant ANGELA FRAZER trained at Middlemore Hospital before becoming one of the country’s most experienced cosmetic skin care specialist nurses and first botox practitioners. Follow her day of botox, skin consultations, tears, smiles, crow's feet and unfurrowed brows.

 

JOB TITLE: Plastic Surgical Nurse Consultant/ Clinic Co-Coordinator

LOCATION: Prescription Skin Care, The NZ Institute of Plastic and Cosmetic Surgery, Remuera, Auckland

5.20am  WAKE UP TO ALARM My alarm is usually set for 6.40 am. However, this morning David is flying to Queenstown. I had planned to get up too, and go for a walk …

6.40am ACTUALLY GET UP On rising, I shower, do my skin care regime, make my lunch, breakfast on egg, toast, and coffee while watching the TV breakfast news. Then it’s make-up on and out the door for the short drive to work.

8.05am ARRIVE AT WORK My official start time is 8.30. However, I often have a patient booked for then, so I always like to arrive early to be prepared.

I have been working as a cosmetic nurse and skin care specialist for nearly 18 years. My prior nursing includes working two years at the dermatology unit of London’s St Thomas’ Hospital and seven years at Middlemore Hospital’s acute plastic surgery and burns unit, where I completed a postgraduate diploma in plastic and reconstructive surgery. In 1997, I was invited to join this private practice to supervise medical skin care programmes and train as a collagen injector. Around 1999, I also became one of the first practitioners to administer botox in New Zealand.

What I love about my job is that I get to combine all my nursing experience and knowledge with the artistic/creative skills required. It is a very positive role, and I love the feedback from patients and knowing that I am making such a difference in their self-esteem and confidence, particularly when it comes to improving skin concerns such as acne and rosacea.

Today, my first patient isn’t until 8.45, so I take my iPad upstairs and spend 15 minutes with plastic surgeon Stephen Gilbert (our medical director) reviewing ‘before and after’ photos of one of my patients (who has had dermal fillers with me) and is now considering surgical options.

8.45 am FIRST PATIENT OF DAY My first patient has been coming to me for botox and dermal fillers for 14 years, but today she is having a consultation about a non-surgical, permanent fat reduction treatment (involves freezing fat cells).

My next patient is for a dermal filler top-up’ treatment. I review her previous ‘before and after’ photos, which show a significant improvement. She is very pleased with the result but would like to further soften the lines around her mouth.

10.20am CHECK MY DAD As I finished ten minutes early with my last patient, I pop upstairs (where the plastic surgeons consult) to see my dad, who is having a follow-up visit after having a skin cancer removed from his leg with a flap repair. With my background, I have been given the job of changing Dad’s dressings between appointments!

10.30am REGULARS RETURN Back downstairs to see my next patient, who is booked for botox. I have not seen her for over two years, and she explains this is due to finances. I update her medical form, and we discuss her priorities and budget. In the past, she treated her frown and the lines around her eyes, but today we treat only her frown. I notice she is very tanned, and discuss the importance of daily use of a zinc-based sunscreen and give her some samples.

My next lady has been coming to me for 15 years and is now in her late sixties. We discuss her concerns, I make treatment recommendations, and together, we decide on a treatment plan for the year ahead. She tells me that this year she is going to focus on looking after herself.

12.10pm LUNCH She was a long-term patient and one that likes to chat … as do I … so I’m now running ten minutes late and eat my salad for lunch (a little too fast!).

12.30pm BACK TO WORKMy afternoon starts with two more botox patients. I finish ten minutes ahead of schedule, giving me time to prepare a botox and dermal filler product order. Then another quick filler treatment follow-up and photos.

1.45pm NEW PATIENT I welcome a new patient. It is a very ‘full’ consult, as she wants to find out about options for skincare and pigmentation, botox, fillers, and laser treatments. The 45 minutes fly by. I don’t have time to write up her clinical notes as my next patient is waiting!

2.30pm CROW'S FEET Another follow-up and further botox treatment, as my patient would now like to treat her crow’s feet as well as her frown. She is a flight attendant, so she shares travel tips for San Francisco, where I’m attending a conference next month.

3.00pm QUICK BREAK A quick bathroom stop, and I write up my previous patient’s clinical notes.

3.15pm PATIENT CONFIDENTIALITY Another filler patient. She doesn’t tell anyone she has been having treatments with me for the past 10 years but says people always comment how great her skin looks.

4.00pm TEARS My next patient walks in and bursts into tears due to “everything going wrong” with her day. I offer to reschedule but she is definite she wants a treatment, so after 15 minutes of chat and ten minutes of actual treatments, she leaves with a smile on her face! My last patient for the day gets stuck in good old Auckland traffic and is 20 minutes late. I’m meant to finish at 5pm. However, after she leaves at 5.10pm, I finally get to turn on my laptop and catch up on emails.

6:00pm HOME I watch a bit of the news, phone my mum, and before I know it, it is 7.15 and David arrives home. I make dinner and remember that yesterday I had promised to answer some questions on the latest trends with fillers for a beauty editor, which I do before heading upstairs for a shower.

10.10pm SLEEP