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American Nursing: An Introduction to the Past

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Professional nursing holds a unique place in the American health care system. As members of the largest health care profession, the nation's 3.1 million nurses work in diverse settings and fields and are frontline providers of health care services. While most nurses work in acute-care settings such as hospitals, nurses' expertise and skills extend well beyond hospital walls.

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Have you ever stopped and realized how nursing has changed over the years?

Let's face it-all professions undergo evolution, but the field of nursing now involves completely different roles and expectations for those working in it. Let's delve into how nursing has changed over time, as well as exciting current and future trends.

After all, we must learn from our history to better understand what's next, right?

Nursing in History

According to Advanced Medical Certification, a job description of nursing in 1887 cites some duties as:

Daily sweep and mop the floors of your ward, dust the patient's furniture and window sills.

Maintain an even temperature in your ward by bringing in a scuttle of coal for the day's business.

Each nurse on day duty will report every day at 7 a.m. and leave at 8 p.m., except on the Sabbath, on which day she will be off from 12 noon to 2 p.m.

The nurse who performs her labors and serves her patients and doctors faithfully and without fault for a period of 5 years will be given an increase by the hospital administration of 5 cents per day.

The list goes on to cite restrictions about nurses using liquor or smoking and being given two evenings off each week if regularly attending church. As you can see, nursing in the 1800s was limited mostly to performing domestic duties in a medical environment. Hospitals trained nurses directly as opposed to universities doing so today. Keeping an orderly space, taking clear notes for physicians, and being in general good standing in the community were of utmost importance.

Nurses were expected to act respectfully and deferentially, particularly to the male patients.

In the 20 th century, nurses were viewed with more admiration during World War I and World War II, tending to soldiers injured in combat. Their primary place of work was in hospitals or near battlefields. As in the 1800s, they continued to maintain brutal working schedules and conditions without adequate compensation. It wasn't until the latter half of the 20 th century that new opportunities began to open up for nurses and new careers became available.

Important Ways Nursing Has Changed

Nursing has evolved from basic caretaking and domestic work to requiring real clinical experience and medical knowledge. Additionally, nursing work environments have changed. Whereas they used to be limited to battlefields and hospitals, nowadays you will find nurses in doctors' offices, schools, facilities, military bases, in patients' homes, and offering help via telehealth services-just to name a few.

Nurses have far more responsibility now, which is also why it's such an expanding field in healthcare. A nurse from 70 years ago would be shocked and impressed at the duties and tasks modern-day nurses take on.

Current Nursing Specializations & Career Advancement

While it used to be nurses remained mostly hospital nurses and were restricted to that role and environment, we are looking at a totally new landscape-and for the better!

Nowadays, nurses are afforded many exciting career opportunities, whether in a hospital, clinic, or private practice. For example, according to the Bureau of Labor Statistics, a nurse anesthetist's average annual salary is $181,000 or roughly $87 per hour. A neonatal nurse practitioner can make up to $125,000 annually or about $50 per hour caring for newborn babies during their first 28 days of life. Another lucrative nursing career is that of a cardiac nurse practitioner, a job pays an average of $114,00 per year.

Additional career opportunities include a variety of nurse practitioners, varying from orthopedic to oncology to general and family. Nurse midwives, clinical nurse specialists, pain management nurses, as well as nurse educators are also included. The list goes on and on and is expanding every day.

As you embark on your nursing journey, it's important to ask yourself-which specific pathway interests you?

The Future of Nursing: New Trends

In a field like nursing that has grown to include so many career options, it's important to look ahead. If this role in the medical field has changed so drastically in just the last few decades, what's coming next down the pipeline?

First and foremost, the job market will be the best it's ever been for most nurses, as the Bureau of Labor Statistics predicts a 12% increase in demand through 2028. Additionally, Global Health Education predicts there will be a sharp additional demand for nurse practitioners, specifically family nurse practitioners. There's a shortage of doctors in the U.S. and since nurse practitioners can write prescriptions and perform doctor-like duties, they can serve as primary physicians to many communities. (This need will only increase, as experts predict a physician shortage of almost 122,000 by 2032!)

Additional trends expected will be enrollment in online programs and a keen interest in nurses who have a BSN. Nurses without this type of four-year degree may want to heavily consider going back to school to obtain it. Furthermore, obtaining a master's degree in nursing will also be important-a requirement for many nurse practitioners-and holding a doctorate in nursing even more so for nurse educators.

Men will continue to enter the nursing profession, which was once dominated by women, and geriatrics specialists will be in high demand with an aging Baby Boomer population.

The Takeaway

There are few jobs and careers that have displayed such a breadth of change over the years as nursing. Take advantage of its evolution and its highly rewarding opportunities. The nurses of yesterday may not look much like the nurses tomorrow, but one thing's for sure-in this career, the future is bright.

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Have you ever stopped and realized how nursing has changed over the years? Let's face it-all professions undergo evolution, but the field of nursing now involves completely different roles and expectations for those working in it. Let's delve into how nursing has changed over time, as well as exciting current and future trends.

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Implementation of a postgraduate dermatology fellowship... : Journal of the American Association of Nurse Practitioners

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wait times and inadequate patient access to care, has led to more NPs practicing dermatology to help meet the demand for care. New graduate NPs may struggle in their transition to practice, and fellowship programs have been shown to support NPs as they transition from novice to expert. In this article, the University of Rochester Medical Center shares its experience in developing, implementing, and managing a postgraduate dermatology fellowship program for NPs.…

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"My absolute favorite part of being an aesthetic nurse practitioner is seeing the transformation in my patients' confidence."

Venessia Norvil, MSN, Owner of Pretty Perfect You

Aesthetics has become a very popular specialty for NPs in recent years. Aesthetic NPs specialize in cosmetic medical procedures that improve patients' appearances. It can be a competitive specialty requiring devotion, experience, and networking. Being an aesthetic NP is less stressful than working in other specialties, and it offers a generous salary and regular working hours. There are also plenty of opportunities for aesthetic NPs to practice autonomously and own their medical aesthetics practice.

Aesthetic NPs focus on refining patients' physical appearances and confidence. They examine and evaluate patients, educate them on their procedure options, answer their questions, perform those procedures, and monitor them for adverse reactions. Cosmetic procedures can make a huge difference in how patients feel about themselves.

Meet the Expert: Venessia Norvil, MSN

Venessia Norvil is a nurse practitioner who specializes in aesthetics. She owns her own medical spa, Pretty Perfect You. She obtained her MSN APRN from Chamberlain University and her MSN in education from Western Governors University.

At Norvil's practice, she offers a wide range of aesthetic services to help patients look and feel their best. These include Botox and dermal fillers, rejuvenating chemical peels, laser treatments for smooth skin and hair removal, micro needling for a fresh, youthful glow, PRP (Platelet-Rich Plasma) therapy, and personalized skin care consultations. She also specializes in non-surgical facelifts, using the latest techniques to enhance a patient's natural beauty without the need for surgery.

The Role of Aesthetic NPs

Aesthetic NPs work in outpatient settings such as medical spas or private practice clinics. They can perform several clinical procedures. They inject dermal fillers or Botox to improve the appearance of wrinkles and crow's feet. These injections can also make lips look fuller and counter the effects of aging. Some fillers help patients have a more pronounced jaw line or chin. While other injectables are used as fat reducers such as Kybella, which breaks down double chin fat. Injectables can also be used to treat TMJ or chronic jaw pain.

"My absolute favorite part of being an aesthetic nurse practitioner is seeing the transformation in my patients' confidence," says Norvil. "There is nothing like the moment when a patient looks in the mirror and smiles because they feel great about themselves."

Aesthetic NPs perform laser therapy such as tattoo removal and laser hair removal. They also provide skin treatments such as facials, microdermabrasion, and chemical peels. They offer sclerotherapy treatments which eliminate varicose veins through the injection of a solution in the veins. They may also offer cool sculpting which helps patients lose weight and breaks down fat tissue.

Additionally, NPs may work collaboratively with dermatologists or plastic surgeons and assist in performing surgeries, administering procedures, and/or manage patient education and recovery. They consult with patients to perform medical screenings and prepare them for the procedure. They provide education and explain what to expect from the procedure. Another benefit is that aesthetic NPs have the opportunity to build relationships with repeat patients.

"I also love the creative aspect of the job-it's like being an artist, but with the human face and body as my canvas," says Norvil. "Plus, I get to stay on the cutting edge of beauty and wellness trends, which is endlessly fascinating."

Aesthetic NP Training

To become an aesthetic NP, nurses need to continue their education and earn a master's of science in nursing or a doctorate in nursing practice degree with an FNP or other NP specialization. Afterwards, NPs should work with dermatologists or plastic surgeons to gain new skills. NPs can take courses on Botox and other injections to learn how to provide these services. Some programs offer live patient injector training to learn proper dosing and delivery.

"The best way to become an aesthetic NP is to start with a solid nursing background and then dive into specialized training in aesthetics," says Norvil. "This means attending workshops, getting certifications from reputable organizations, and gaining hands-on experience under the guidance of seasoned practitioners."

Aesthetic NPs should demonstrate proficiency in administering injectables such as Botox and fillers. They should be able to communicate effectively to convey treatment details with their patients. They should have a desire for continuous learning to stay up to date on evolving medical processes.

"Networking with other professionals and staying current with industry trends through conferences and professional groups is also key to your growth and success," says Norvil.

Norvil recommends the following tips for NPs interested in working in aesthetics:

"Seek out experience in dermatology or plastic surgery settings to build a strong foundation."

"Invest in top-notch training programs and earn your certifications."

"Start by mastering a couple of procedures before branching out to others."

"Cultivate a robust professional network-relationships in this field are invaluable."

"Educate your patients thoroughly and set clear, realistic expectations."

"Always prioritize safety and ethical practice in your work."

"Keep your passion for learning alive; the industry is always evolving, and so should you."

Career Outlook

Prospects and careers as an aesthetic NP are rising rapidly as medical spas and facial procedures continue to gain popularity. According to Incredible Health, the aesthetics injectable market will continue to grow at least 12 percent per year for the next five years. Both men and women are looking to counter the effect of aging on their appearance, and the use of Botox and filler has become widely accepted.

"The future for aesthetic NPs is incredibly bright," Norvil says. "With the increasing demand for non-surgical cosmetic procedures, there are endless opportunities for growth and specialization. Technological advancements will continue to introduce exciting new treatments, offering even more ways to help patients achieve their aesthetic goals."

Currently there are no NP programs dedicated specifically to becoming an aesthetic NP. Those interested in this specialty can earn their family NP or adult NP degree and then train with an experienced aesthetics NP or physician. Many medical spa owners are interested in training new hires and helping them learn the skills needed to succeed.

"As the field expands, aesthetic NPs will gain more recognition and autonomy, opening doors for professional development and innovation," Norvil says. "It is an exciting time to be in this specialty!"

Challenges in Aesthetics

Being an aesthetic NP can have its own set of challenges. Opening a new practice can be difficult as NPs try to build up their client base and reputation. NPs should focus on marketing initially to grow their business. Practicing in aesthetic medicine can be isolating due to NPs often practicing solo.NPs should try to network with peers and attend training courses with like-minded medical staff.

"One of the biggest challenges as an aesthetic NP is managing patient expectation," says Norvil. "It is crucial to ensure they understand the realistic outcomes and potential risks of their chosen treatments. On top of that, navigating the business and regulatory aspects of the practice requires careful attention to detail and continuous education."

NPs should spend time thinking about the patient's mindset and goals. They should understand what patients are trying to achieve. Then they should be honest about what kind of results the patient can expect.

Resources for Aesthetic NPs

To learn more about education, practice, and advocacy of aesthetic NPs, check out some of the resources below:

The American Academy of Aesthetic Medicine (AAAM): Founded in 1999, AAAM is the first global leader in Aesthetic Medicine. It is devoted to teaching providers how to develop or expand their aesthetic medicine practice. AAAM provides education and hands-on training to its members and updates them with the latest scientific knowledge.

The American Association of Aesthetic Medicine and Surgery (AAAMS): The AAAMS is dedicated to training NPs and other medical professionals in the art of aesthetics. NPs can enroll in their program to learn necessary aesthetic skills. They teach medical and surgical aesthetics using a hybrid learning method, by combining online learning and hands-on training.

American Med Spa Association (AmSpa): AmSpa is an association for nurse practitioners, physicians, and registered nurses interested in the medical aesthetic industry. It consists of a safety council that guides practices in making sure their medical spas are legally compliant and safe for patients. It also offers medspa owners insight and feedback on their practices.

International Association for Physicians in Aesthetic Medicine (IAPAM): Organizations such as IAPAM train nurse practitioners in aesthetic medicine. This includes Botox, dermal filler, microdermabrasion, chemical peel, and laser training.

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How to Become an Aesthetic Nurse Practitioner (NP)

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Aesthetic NPs evaluate and educate patients on cosmetic procedures such as Botox injections and fillers, designed to improve appearances.

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Nurse Anesthetist (CRNA): What They Do & Training

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A CRNA (certified registered nurse anesthetist) is an advanced practice registered nurse (APRN) who administers anesthesia for procedures and surgeries.

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Implementation of a postgraduate dermatology fellowship program for nurse practitioners - PubMed

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Transition to practice programs (also referred to as fellowship, residency, or postgraduate training programs) for nurse practitioners (NPs) are becoming more popular, especially in specialties such as dermatology. A nationwide shortage of dermatology clinicians, which had led to long appointment wa …