Welcome to Becoming a Stress-Free Nurse Practitioner, a show for new NPs and students that want to pass their board exam the first time and make that transition from RN to NP as seamless as possible. I’m your host Sarah Michelle. Now, let’s dive into today’s episode.

Hey friends, for today’s episode we’re going to be talking to Kerri who is the brand-new owner of a medical aesthetics and IV vitamin therapy clinic in Waverly, Iowa.

I’m so excited to talk to Kerri today because number one, she’s been a nurse practitioner for 10 years and I want to show you guys that people love this profession and actually stay in it. But number two because I see so many of you in my new nurse practitioner group wanting to get into aesthetics. And so this episode is going to be your opportunity to learn all about it and see if it would be a good fit for you.

Plus there’s nothing I love more than nurse practitioners out there opening their own clinics and offering services that make our patients actually feel good about themselves. So with all that in mind, Kerri, why don’t you just give us a little introduction to you and your background as a nurse practitioner.

Kerri: Sure, thank you so much for having me. I’m very excited to share this all with you. And I feel like I really have to go back to the very beginning to get the full picture of how I got to where I am.

So I actually started in accounting in college. And then I left the area and went to be a nanny in New York. And while I was in New York I decided to volunteer on the ambulance corps, really just so I could meet some people. I didn’t know much about the medical field at all, but I just wanted to meet some people. And I was hooked as soon as I started getting on calls and just fascinated by the human body and how it works. And so that’s kind of how I got started.

Once I was done as a nanny I went back to school and thought I was going to do pre-med. So I actually got a bachelor’s in science and a chemistry minor. And then decided I didn’t really want to go to med school. And so then I started looking into nursing programs and looking at the nurse practitioner route. And here in Iowa we are fortunate that we’re a full authority practice state in Iowa, so nurse practitioners have a lot of autonomy here.

So I started as a nurse’s aide and then worked as an LPN, and then got my ADN, and just kept going to school. And so I worked in the resource pool as a nurse. So I got a lot of experience in all different areas, tried to get a feel for kind of what my passion was or maybe areas that really weren’t a good fit for me.

And then I also worked as a health supervisor at a level two trauma center and so that gave me a lot of other experience I would say. Not necessarily the clinical experience but it gave me the leadership experience, that critical decision making in high stress situations. So I feel like that gave me a different set in my toolbox as I went on to become a nurse practitioner.

So after I graduated from nurse practitioner school, and I would say there’s never a good time. I know you probably have students of all ages in your group and our kids were three and one when I decided to go back for my nurse practitioner. And so it was a really busy time of life, but at the same time they weren’t busy in activities and sports and that kind of thing. So that’s when I decided to go back.

And when I was in my last year, I feel like this is something that really served me very well. So there was a position posted for orthopedic nurse practitioner in the town that I live in. It’s a rural health critical access hospital. And I was still about a year away from graduating but I decided I need some interview experience, I’ve been at my current job for 10 years. You know, I haven’t interviewed really for anything and so I decided to apply for it.

And when I talked to the recruiter she said, “Well, you know, you still have a year left of school and we’re really kind of looking for someone right now.” And I don’t know where it came from because I was super nervous, but I said, “Well how about my last semester I can do all my clinical hours with the orthopedic surgeon? So that will fulfill my clinical hours and then plus it’s kind of like free orientation on your part.” So then she decided to bring me in for an interview and they hired me. And so it worked out so well for both of us, I think.

So I would say it’s never too early to start looking for a position. Because that worked out in our favor for both of us. And so it set us up for a really good way to get started.

So I worked with one orthopedic surgeon for nine years. And then she went back to where she came from. And I can’t do surgeries, so I needed to collaborate with another orthopedic surgeon. And I started working with one, I thought it was going to be a good fit, and it ended up being not a good fit.

It was a different culture, different expectations as far as patient volume. You know, I really felt like I wasn’t able to serve my patients in the way that I wanted to and spend the time that I felt like was important to approach their care from a holistic standpoint. And just started doing a lot of reflecting, and praying, and journaling about maybe what I wanted to do next. I mean, the nursing arena is huge as far as teaching, or different specialties, or family practice, or consulting. It’s just the options are endless in this field.

So myself, I’d always enjoyed getting medical aesthetic treatments. And we really have nothing like that around this area. And I’ve been a little bit of an entrepreneur as far as being into network marketing and that kind of thing. So I kind of looked into the option of joining like a day spa and then providing medical grade services there versus opening my own brick and mortar.

And in a roundabout way got connected with a business coach who poured more belief into me than I had into myself and really led me along that journey to opening my own brick and mortar, my own business. Being able to create my own culture, my own philosophy of how to take care of patients.

So that was a really long answer to your short question. But I feel like all the background was important about how I got to where I am now.

Sarah: Absolutely. And, you know, you really represent something that I love about the nursing realm, which there is so much flexibility for anyone of any age. Because I have students of all ages that end up on my page. I literally had someone who passed last week, 67 years old. Just became a nurse practitioner, just passed her exam, just entering into the workforce. And so I think it’s such a beautiful thing.

And I also want to point out too that I love your creativity in finding that first job and offering to do all those clinical hours and basically be trained and be ready to be out there. So your drive has probably definitely gotten you far in this profession as well.

Now to kind of look at aesthetics as a whole, you know, what do the day-to-day operations kind of look like in an aesthetics clinic? You know, what are some typical types of services that you’re able to offer? Because I think there’s a lot of people out there that don’t even really know what aesthetics truly is. I think there’s a lot of education that goes behind that.

Kerri: I would 100% agree with you. And not only do I find that in the nursing realm, but just in the community, they don’t know what medical aesthetics is. And when I started, I literally wanted to do all the things for all the people. And my business coach had to reel me in a little bit and say, “You know, that’s nice of you that you have a big heart and that’s what you’d like to do. But in reality, you’re going to have to narrow that down a little bit.”

So I really researched the industry before I got started. I’m very type A, I want to know all the things yesterday. And so I decided to start with dermaplaning, so that’s just a gentle exfoliation of the face. I do Botox and Dysport, that’s very popular in the medical aesthetics world. I do fillers. I also do HydraFacials.

And I also do PRP, I’m really passionate about PRP. So that’s platelet-rich plasma where you draw the client’s blood, centrifuge it down, and then use the part of the PRP for either SkinPen Microneedling or you can inject it into different portions of the face as kind of like a filler but you’re using your own body. And it has all the goodness of the growth factors and that kind of thing.

So I was familiar with PRP because we use it in the orthopedic specialty world as well. So that was just a natural kind of transition for me to use it here in the aesthetic world too. And then I also offer IV vitamin infusion therapies. So that’s something that’s pretty unique to this area. So a little bit of everything. But there’s so much more than that for medical grade aesthetics. That’s a very tiny little part of what can be offered in this arena for sure.

Sarah: The condensed down version.

Kerri: Right.

Sarah: I’ve never even heard about PRP. So how did you get trained to do these services? Like how do you find more information about these sorts of things.

Kerri: Sure. Yeah, so there’s a lot of training out there and I feel like you just have to be very particular about which program you decide to do. So part of it is you get what you pay for. I would definitely not just find the cheapest program and do that. I would definitely look at reviews, I would definitely contact their customer service department.

So I feel like in this industry the programs with the best value are the ones that are going to give you hands on treatment. Because you can study as much as you want on your own and you can learn all that, but in the medical aesthetics world there’s a little bit of art to it too. And so I feel like that hands on training is what’s very critical.

And then also once you get established with some of the companies, they provide some of the training too. So whether it be the Botox, or fillers, or Dysport, they do provide some of that training as well.

Sarah: I can’t even fathom not learning how to do aesthetic hands on. Like that’s almost like a red flag to me, like I can’t even remotely put that in my realm of possibility. Are there any like resources or anything like that you feel like you commonly refer to or you just have the basic training and then you’re able to implement that day to day?

Kerri: I follow particular associations like the American Medical Spa Association where they have some protocols and guidelines. And there’s some things in the medical aesthetics realm that aren’t necessarily regulated by any one body, a lot of it is very state specific.

So there are some things or some states where nurse practitioners, they can own a medical spa, but they have to have a physician medical director. And then in other states, like Iowa, you are full practice authority. So I’m my own medical director. I can be the medical director of other medical grade spas or IV infusion services that’s maybe owned by a non-provider.

So there’s a lot of resources out there but the difficulty, I think, is really just with each state being state specific. So I typically have people refer to their board of nursing if they’re looking to get into the medical aesthetics realm because that will really dictate what their scope of practice is.

Sarah: Yeah, I’m always referring my students back to their board of nursing because I get so many state specific questions and I’m like, “Guys, I would really love to help you, but I don’t know anything about Iowa, I live in Kentucky.” Like we’re not a full practice state here and so that’s something I hope is obviously coming down the pipeline and maybe one day that’s something we can implement. Have you guys been full practice as long as you’ve been a nurse practitioner?

Kerri: Yes, yeah.

Sarah: Wow, that’s awesome. Kentucky, I don’t want to say Kentucky is so far behind, but Kentucky is a little bit behind in those sorts of things, so I’ll be really excited when that day comes.

Kerri: Yeah, and I think that can be tough with traveling too, you know, because you have to learn really what you can do while you’re there. So if I’m in a full practice authority state in Iowa and then I do some traveling work in Florida let’s say, you know, you really have to know what’s within your scope wherever you’re working.

Sarah: Yeah, new rules, new regulations. And I talk about that actually a lot with students who live on the border of states and get licensed in multiple states. I’m like, “You really need to be careful because it can be totally different just a handful of miles being across the state border like that.” But to get back on topic a little bit because I got a little bit of a tangent because I’m so jealous of your full practice.

One of the questions I was most excited to ask you actually is, is there any particular service that you offer that really seems to like uplift your clients the most? Because I think that’s one of the most unique parts of being in aesthetics and being in wellness, and it’s just that ability to make your patients really feel better about themselves. So what do you think?

Kerri: Yeah, I am all about feeling better inside and out, you know, and there are some things we can do where you get instant results, instant gratification. So fillers is one of the things. You know, you fill someone’s lips day of and there is a difference right then and there.

But I would also say, you know, Dysport and Botox take a few days to kick in but once it does it’s glorious, you know, taking before and after pictures. And I can’t think of just one thing that I would say. You know, it’s really a journey.

That’s the other thing too with medical grade aesthetics. Setting realistic expectations with clients and patients that you can’t necessarily do one thing and then not either maintain it or there’s got to be some kind of maintenance taking care of yourself in more ways than just that one treatment.

Sarah: Yeah, I kind of had to shift my own beliefs about aesthetics because someone I know personally gets Botox. And so the first time I heard that he got Botox I was like, “Wait, what are you doing? Why are you doing this? Like what do you mean you’re like smoothing out your face? Like is that important?” But then I saw how much better it made him feel about himself and I’m like, “That’s just my own personal beliefs, it doesn’t even matter if it makes him feel that good.” And so I think there’s a lot of misconceptions around aesthetics too.

Kerri: I would 100% agree. And it’s not, I would say, just a vanity type treatment for people. You know, when you can help someone by giving them Botox under their arms because they’ve been excessively sweating their entire lives. And they can’t wear certain clothes because they know they’ll sweat through them or they get embarrassed. Or people who have deep acne scars, or those who have current acne that they feel like they’ve tried everything but maybe we have something else that we can offer.

And so I would agree that there’s a lot of misconceptions. And I feel like there’s just a lot of education that needs to be given about what are the things that we can help with and that it’s not just all about lips you know.

Sarah: Yeah, it’s not all a vanity thing. Because I didn’t even know until earlier when we were talking about doing Botox for excessive sweating. Like that was something I’d never heard of and obviously I’m a nurse practitioner too. So there are lots, I’m sure, of sad things along the way that go along into the health side of it too.

Kerri: Oh for sure, for sure. And, you know, Botox is used to treat migraines, it’s used to treat patients who have neurological disorders with rigidity where it can help relax their muscles. So there’s a lot of therapeutic applications for it as well that can really be life changing for people. You know, migraines can definitely be debilitating and wreak a lot of havoc on people’s lives.

And the other thing we can do is PRP for hair restoration. So not a shiny bald head but if there’s hair thinning, you know, or receding hair then doing some PRP injections right by the hair follicles can help with hair restoration.

Sarah: And I want to point out too that anybody listening, if you want to do it for vanity, do it for vanity. Like I’m all about what makes you feel good. So I don’t want anyone to think like I’m anti-Botox anti-aesthetics.

Kerri: Yes, for sure. You know, we just all want to feel good about ourselves and we want to show up as our best self. And if it just takes a little something for us to do that then there’s absolutely nothing wrong with that, you know?

Sarah: No, absolutely, I 100% agree. So nobody out there think I’m anti-Botox. So really, you know, what’s kind of been your biggest challenge in opening your own space as a nurse practitioner?

Kerri: My biggest challenge has been I didn’t know anything about opening a business, right? I mean I’ve always worked in a hospital or a clinic where we had certain rules to follow and some of it came from corporate, some of it came from joint commission. You know, everything was very structured.

And so opening my own business was kind of this whole world of options of how I wanted to do it, what I wanted it to look like. And one of the things my business coach really helped me understand is that I don’t need to know how to do all the things, I just need to know how to find my resources, right?

So even though I started in accounting I would not have been very good at that. So, you know, finding a good accountant that can help me along that journey. Finding an attorney that is well versed in what I’m doing so that they can help me along. I have a very sciencey brain, I don’t necessarily have like a social media marketing brain but there are other people who do a really good job at that so they can help me with that.

And then I feel like the other thing that’s been a shift in my mindset too, is people are coming here because they want my help in a certain area. Whereas with orthopedics, of course they need help there too but it’s just on a different level. You know, I’m not dealing with insurance, insurance isn’t dictating how I can take care of people. There’s no one else that’s kind of dictating how much time I can spend with each client or patient. Which is glorious, I just love that aspect of having that freedom and not having a quota or certain number of people I need to see.

But just using my network, and talking to other people, and reaching out to others who have done the same thing. And there’s a lot of fabulous nurse practitioners out there who own their own business and are perfectly willing to talk to other nurse practitioners who want to do the same thing.

Sarah: And I really want to make sure everyone listening hears what she said about freedom, because there is so much freedom in owning your own business. Now, along with that freedom comes wearing a lot of hats sometimes, and like you talked about figuring out your resources and how to delegate. And that just comes with being a new business owner in any capacity.

But if you’re in a nurse practitioner job right now that you don’t like, there’s always flexibility to do something different, and even possibly do something on your own, even if you’re not in a full practice state. Like you could open up your clinic, find yourself a medical director. Because I’ve seen people do it and I’ve seen people find a lot of joy in it.

And so I would much rather you guys start to investigate those types of routes than leaving the nurse practitioner profession altogether. Because the whole like hope and focus with this podcast is to show you the opportunities that are out there. So that way, if you’re kind of on the fence like, “What do I do next? Maybe this wasn’t what I expected.” Well then, you’re probably not in the job that you need to be in too.

Kerri: I absolutely agree. And like we said before there’s just endless options, there really are. And so if you know that your passion and gifts involve the medical profession as a nurse practitioner, you can find something that will still fulfill all that even if you’re in a position that’s not currently serving you.

So it takes some courage for sure. And it takes some trust that things will work out. But I can tell you, it’s not perfect right now and I don’t expect it to ever be perfect, but the hard that I have now is a very different hard than I had before. And I’m so much happier to be in this hard versus where I was.

Sarah: Yeah, it can definitely be a leap of faith. A very scary leap of faith, the doable leap of faith.

Kerri: That’s right, completely doable, yes. I never ever saw myself being in the position I’m in now. And I feel like everything we go through is part of our journey, so whether it’s the good things or it’s the bad things. You know, if I wouldn’t have had a rough couple of years in the position that I was in, I would not be where I am now because I didn’t go through that. And so even if things are a little tough, maybe look for the blessings in that and look for maybe a different door to open. There’s just always those opportunities out there.

Sarah: Yeah, I never would have imagined a year ago, and when I say never, I mean never, would have imagined having a business. And then COVID hit, and I didn’t know what I was going to do in the nurse practitioner job market, and everything was kind of chaos. And I was like, “Well, I can make like these review course videos and see how it goes.” And now everybody can see where I’ve landed at this point. So you never know what could be right around the corner too if you are kind of in a bad place or a bad opportunity or whatever that looks like.

Kerri: For sure. And I keep thinking about, you know, maybe they were available when I was getting ready to take boards and that kind of thing, but I don’t know that podcasts were really around 10 years ago. Maybe they were but maybe I just didn’t know about them. But definitely, I would have taken every review course out there.

I mean, I think boards just concern me. [Inaudible], right? I took LPN boards, thought I failed, took RN boards thought I failed. And then when I took those two boards you had to wait for a letter to come. So that letter coming was like the worst two weeks ever. And then, you know, taking the nurse practitioner boards, and at the testing center, she’s like, “Congratulations, you passed.” Like total monotone voice. Wait, where’s the confetti?

Sarah: Yeah, like the balloons.

Kerri: This is so exciting. And keep in mind I already had a job. And so the pressure was really on like, “I have to pass these boards because I already have a position and they’re waiting for me to be certified.”

Sarah: No, there’s so much pressure and anxiety that surrounds the board certification time, which is a lot of what my courses are geared towards. Like obviously, I know you haven’t done my courses, you’ve been a nurse practitioner for 10 years.

But the sole, like the true core of the courses is managing your anxiety and kind of building up that confidence a little bit. Number one, to pass your test, but number two, so that way when you’re transitioning into practice you don’t feel like it’s coming out of left field and hopefully maybe dampen down some of the imposter syndrome too. Because that’s a very common new nurse practitioner thing. And I see it over and over in my groups too.

Kerri: Yeah, and I like your approach to that because by the time we’re done with nurse practitioner school we have a really good handle on it. And [inaudible] the services we need, or we have the knowledge we need to have to pass the boards. But sometimes I feel like we get in our own way.

Sarah: Get in your own heads.

Kerri: Yeah, get in our own way, get in our own head, just making an unreal picture in our mind about what that’s going to be like. And so I love that you’re focusing so much on that, because that’s such a huge part of it.

Sarah: And people just being realistic because you’re not going to super love your first job, even in like just the first month even, because you’re uncomfortable, and you’re new, and you’re nervous. But as time goes on and you kind of grow into that role, you’ll find your love for that role, if that’s where you’re meant to be.

Now, not everybody in their first job is that going to be where they’re meant to be forever and ever. But you also got to give some time and some grace to kind of get through that uncomfortable too. So you can’t just like jump the gun and be like, “Oh, well I’m uncomfortable it’s day two, I got to go.”

Kerri: Yeah, absolutely. It is uncomfortable to begin with. You know, we have a lot of responsibility once we start practicing. And we need to take that seriously for sure. And we always need to be on alert that we’re doing the best thing for the patient all the time, and that we have our evidence base behind us when we’re making decisions. But yeah, I mean, you might not love it at first, but it might be something that really that becomes your passion. But if it’s not, there’s so many other things that you can try.

Sarah: So many opportunities.

Kerri: Yeah. And I feel like, I don’t know what the programs are like all over, but when I did my clinical hours, I got to pick who my preceptor was. And there had to be kind of a variety of hours of what you were spending your time in. But to be able to pick your own preceptor so that you know you’re going to be with a high-quality provider is super important.

And then also just making sure you’re exploring all those different opportunities of specialties or family practice so that you can really kind of get a feel if you can see yourself in that position and if it could be a good fit for you.

Sarah: And if one of those places that you’re doing a rotation doesn’t feel like a good fit, well, then you’ve already eliminated it for the future too. Or if you find something you like, you can be like, “Well, hey, I could do my clinical hours here. I could work here and be trained.”

Kerri: Yes. And I think sometimes your passion changes a little bit, you know?

Sarah: Absolutely.

Kerri: I was always thinking that I didn’t want to do the mental health nurse practitioner track. And then as I’ve spent time with patients who have chronic pain with orthopedics, or maybe they self-sabotage with eating that leads to obesity. I mean, I feel like we still do a lot of mental health, just in either family practice or specialty. In any arena that you’re in with a nurse practitioner that’s still a really important component to keep in mind there. That even if you have kind of a tunnel focus about what you’re doing, you’re still going to bring in some other parts of your knowledge and education to each individual patient.

Sarah: Yeah, it’s ironic you say that because I was just talking to my husband last week and I was like, “I almost like want to go back to school to be a psych nurse practitioner.” I was like, “Because with my courses and all this anxiety work that I do, like, I feel so called to help people with their mental health.” And I’m like, “But I can still do that as a family nurse practitioner, and I can still do that in my business. I just love school so much. It’s hard for me to not be in school.”

Kerri: Yes, I can get that for sure. And again, with my personality just wanting to know all the things about all the things, you know. But I think that’s important though, for any nurse practitioner to kind of always have that learning mindset.

You know, once you’re done with school, and you kind of feel like you’re schooled out, I get that for sure. But then always trying to broaden your knowledge and kind of staying up to date. And you’re never going to know all the things but you’re always going to have resources to look at evidence-based practice, or algorithms for what you should do for treatment but then still keeping in mind that individual patient.

Sarah: And for those of you out there listening that have never heard of having a growth mindset, that’s something I would encourage you very heavily to look up. Because I feel like having a growth mindset and that continual learning journey is such an integral part of being a nurse practitioner too. Because our care is always evolving, because the evidence is always evolving, and so our practice should always be evolving right behind that.

Now, a last little extra question, just because I did a new NP series where we looked at NPs over their first year of practice. Looking back over these last 10 years, how do you feel like you have grown in this profession? And, you know, kind of has your experience been what you hoped it would be in the beginning?

Kerri: Yeah, I mean, in 10 years there’s a lot of growth anyway, just as a person in general and with your family or with your relationships in your life. And I feel like definitely with time my confidence increased significantly.

So orthopedics, a lot of the procedures I did in orthopedics I could do in the dark. You know, just got really comfortable and confident with that. And kind of going into a completely different specialty was a little bit uncomfortable. Because like I said, I know orthopedics front to back. But it’s also exciting because there’s so much out there to be able to learn.

And I just don’t think I’d do anything differently from when I look back in the last 10 years. Like I said, I feel like there’s not really any coincidences and there’s not any waste of your time or the struggles are part of the process as well. So I don’t know if that’s really answering your question.

Sarah: No, you answered it just fine. I think a lot of it just boils down to time and giving yourself the patience and the grace to take that time to be able to learn and to be able to grow.

Kerri: Oh for sure. And never ever, ever be afraid to say you don’t know. Because if you don’t know, you don’t know. There’s nothing wrong with that. And it would be much better for you to say you don’t know and to learn it than to cause harm to a patient or miss something in a patient, you know, because you feel like you’re expected to know everything. Nobody does, nobody knows everything.

You know, even being in orthopedics for 10 years I was still learning. And so I completely agree with you about just having that growth mindset and not thinking like once you’re done with school you don’t ever have to learn a thing again because there’s always things to learn. But it’s exciting and it keeps things fresh and new, and I feel like there’s never monotony in what we do because things change all the time.

Sarah: Thank you so, so, so much for sharing your experience on the show in aesthetics because I literally cannot tell you how many people in my groups are talking about aesthetics all the time. And also, I’m really glad to be able to show, just like I said earlier, you know, somebody actually likes being a nurse practitioner, they stayed in the field, they’re continuing to grow.

And you made the perfect pivot, you know, you didn’t like what you were doing anymore so you’re like “Okay, well now I can do something else.” Which is truly like the basis of this profession anyways. You can be anything you want to be. You’ve got a degree, so you’ve got the opportunity.

Kerri: Absolutely. And I really appreciate you having me, it’s been nice to talk with you and I love the work that you’re doing. So thank you very much.

Sarah: Of course. And everybody out there listening I’ll see you next week.

Now, to celebrate the launch of the show, I’m going to be giving away a Medelita gift card which will allow you to go buy a gorgeous white coat when you’re ready. Now, I’m going to be giving away a gift card to two lucky listeners who subscribe, rate, and review the show on iTunes. It doesn’t have to be a five-star review, although I really do hope you love the show. I want your honest feedback so I can continue creating a show that provides tons of value for you guys as nurse practitioners.

Visit stressfreenp.com/podcastlaunch to learn more about the contest and how to enter. And I’ll be announcing the winners on the show in an upcoming episode.

Thanks for listening to Becoming a Stress-Free Nurse Practitioner. If you want more information about the different types of support we offer to students and new NPs, visit stressfreenp.com. See you next week.