Case Study: Cosmetic Nursing

Taylor was a Registered Nurse for over 30 years at their neighborhood hospital but retired recently to spend more time with their recently born grandson.

Taylor gets a call from their old friend from nursing school, Sam, who has recently opened a clinic after acquiring their Nurse Practitioner designation. This clinic offers several services such as dermal fillers, sclerotherapy, neuromodulator injections such as Botox®, and chemical peels. Taylor is offered a job with the title of “Cosmetic Injector” at the clinic and is told they can make their own schedule. As Taylor and Sam are old friends, they agree that a written contract is not required.

Taylor is overjoyed to have found a position where they will still have a source of income and the flexibility to work whenever they want. Sam also informs Taylor that as a Cosmetic Injector, they are not required to hold a nursing license, so Taylor decides not to renew their licensure. To prepare for the new role, Taylor reviews the clinic’s policies and consults Sam’s clinic’s website. Sam has published several advertisements and testimonials, such as the following:

• “We are the best clinic in the area; we promise you won’t be disappointed!”
• “If you pay for 3 fillers up front, the fourth one is free!”
• “BEST cosmetic care clinic in the region!” – Client
• “I guarantee that the dermal fillers Sam sells are the best you will ever get!” – Client

They also note that the clinic offers various other promotions, such as 2 for 1 fillers, discounts for referrals, and unlimited yearly neuromodulator injections for a fixed cost. They also feature before and after pictures of some of their clients.

Taylor sees a few clients during their first week at the clinic, including a neuromodulator face injection to counter wrinkles. After getting acquainted with the client, they start chatting about common interests and Taylor forgets to obtain informed consent prior to completing the procedure in accordance with the clinic’s policy, nor do they mention the potential side effects of the treatment.

The next day, the same client calls the clinic and speaks to the receptionist to report some side effects from the procedure. The client is concerned over muscle weakness near the site of the injection, blurred vision, and trouble swallowing. The client is very upset because they were not aware of the potential risks and side effects and says that they would not have gone through with the procedure if they had known. Taylor is on vacation for the next three days when the office receives the call. There is no other cosmetic injector available for the client to speak with. The receptionist is able to calm and reassure the client and therefore does not feel the need to inform Taylor of the call.

Taylor works at the clinic for a few months with no further issues and has many happy clients who return for various procedures. One day, after chatting with some of the other staff members, Taylor learns that their nursing regulator is investigating Sam for professional misconduct. Taylor is unsure of what could have happened and worries that they may be investigated as well due to the procedure they completed without obtaining informed consent.

Quiz

Resources

1. College of Registered Nurses of Manitoba, Scope of Practice for Registered Nurse (Nurse Practitioner)s/RN(NP)s, May 2018, online: https://www.crnm.mb.ca/uploads/ck/files/RN(NP)%20Scope%20of%20Practice%20with%20watermark.pdf ; Nurses Association of New Brunswick, Fact sheet: Medical Aesthetics, June 2021, http://www.nanb.nb.ca/media/resource/NANB-FactSheet-MedicalAesthetics-June21-E.pdf
2. BCCNM, Scope of Practice for Nurse Practitioners, April 2021 , online: https://www.bccnm.ca/Documents/standards_practice/np/NP_ScopeofPractice.pdf
3. For more information, please consult our InfoLAW on Considerations for Providing Cosmetic Services.

Please keep in mind that names, characters and locations in these case studies are fictitious. Any resemblance to actual persons, living or dead, or actual events is purely coincidental.

THIS PUBLICATION IS FOR INFORMATION PURPOSES ONLY. NOTHING IN THIS PUBLICATION SHOULD BE CONSTRUED AS LEGAL ADVICE FROM ANY LAWYER, CONTRIBUTOR OR THE CNPS. READERS SHOULD CONSULT LEGAL COUNSEL FOR SPECIFIC ADVICE.