A Day In The Life: Mary Nielsen, Esthetician - Skin Treatments - Skin - MiladyPro
A Day In The Life: Mary Nielsen, Esthetician
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Apr 19, 2017
day in the life
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A Day In The Life: Mary Nielsen, Esthetician
Welcome to A Day In The Life, where we follow a beauty professional for one day. This time we get a peek into the life of Mary Nielsen, an esthetician in Oregon.
: The alarm chimes. I hit ‘SNOOZE’. No gym today. Fifteen minutes later I'm up. Coffee. I am not a morning talker or a morning breakfast eater. I review my emails, reading info from Skin Inc, Day Spa, Dermascope, LinkedIn groups and other sources of skin-related information. If I find something that I think is important to research or learn more about, I take a screen shot as a reminder to look at it later.
: I shower and go through my skincare, hair care, and other personal hygiene regimens
Make my "swamp water," as my hubby calls it. Kale, spinach, frozen fruit, banana, and powder smoothie. I also pack up my lunch. I typically cook a little extra the night before so I can eat leftovers for lunch the next day. Today’s lunch is leftover jelly glazed salmon, green peas, and riced cauliflower. I smooch my hubby & am off to work, coffee in hand.
I like to listen to morning news radio to keep in touch with current events. While I’m driving I also use my NuFace microcurrent device and my Conture, a skin tightening technology. It seems like the only time I can fit it into my day. I can charge these through the USB charger in my car.
Business cash deposit through the drive-through of the bank. I’m responsible for taking the cash and checks from the previous day to the bank. It needs to be deposited before the bank opens today.
Arrive at the clinic. I like to arrive early so I can see the schedule and prepare for the day. I put my lunch in the refrigerator in the break room and stow my purse under the sink in my esthetic room. I fix myself a second cup of coffee.
I double check that my equipment is functioning. I fill and turn on the steamer. I check the microderm machine and the Silk Peel, looking to make sure I’ve got enough tips to last the day. I turn on the devices that I’m going to use so I know they’re working and have been sanitized since the last use. I restock my linens. I double-check and restock my supplies of sponges, cotton rounds, disinfectant, and other one-time use items like gloves and micro needling tips. I check my supply of small tools like extractors to be sure I have enough. I add towels to the hot towel cabby. I turn on the photo-analysis device and make sure the printer for that device is stocked with photo-paper.
I go to the reception area to see who’s on the schedule for the day and to help the front desk manager pull client charts and prepare the charts with the necessary paperwork before treatment. One of the important details is verifying the client has signed a consent. Often times a client will sign a consent for a service at the first visit. Once the client completes that series of treatments, she often returns for a different service. When clients add services, it’s important to make sure to have a signed consent for each service. Other staff arrive and I have the chance to check in with them and socialize before the day begins. We’re all excited about attending the esthetic show in Vegas and are making plans to travel together.
My first client arrives. I grab her chart and walk her back to the treatment room. I have her sit while I review her records. I look at the list of medications on her medical history form and verify that she’s not had any changes in her health since her last appointment. I also review the notes from her last visit to reacquaint myself with her skin. I leave the room so she can change into a spa gown. While they change, I use the restroom.
I return to the treatment room and let myself in after a quick knock. I dim the lights. As I’m doing that, I usually say, “Now you’ve got my undivided attention for the next 50 minutes.” It’s a reminder I use to reinforce my desire to be focused on the needs of my client. I turn on the steamer so it's ready by the time I need it in the facial. I begin with a cleansing and a comprehensive skin analysis with a mag lamp. I cover my client’s eyes with gauze. As I look at the skin, I will verbalize what I’m seeing. “You’ve got a few clogged pores, so I’m going to work on extracting those today…..I know you’re here to work on fine lines and anti-aging today but I’m seeing some broken capillaries and superficial redness. If that ever bothers you, we have a treatment that can help.” I’m not trying to hard sell but inform the client of additional services we offer. I tell her about the eye cream that I’m using on her today, describing the benefits and recommend she get some for home use. I’m also looking for suspicious lesions. If I see anything I describe it to her and ask how long it has been there. I will recommend the client seek out a medical professional opinion on what is concerning me. Sometimes I’ve even used the client’s phone to take a photo so she can show it to her doc. I tweeze brows to shape them but offer a brow wax if excess hair is more than tweezable. I also let the client know that it’s just another $15 when added to the service. I keep my water bottle in the room and try to drink between clients to stay hydrated during the day.
I perform an anti-aging facial, using steam, an enzyme exfoliant, light extractions, facial massage, application of a growth factor serum and mask. At the beginning of the treatment, the client is talkative and wants to tell me about her upcoming class reunion. As the treatment progresses, she becomes less talkative. I’ve got to really tune into the vibe so I know when to quit asking questions and let her relax. While the mask is on, I do a light hand and wrist massage. I remove the mask with warm steamed towels. I apply eye cream with a special warm infusion device that clients love. I apply an antioxidant, a moisturizer, and an SPF. At the end of the service, I raise the head of the bed slightly and adjust the lights. “Thank you for giving me your time today. Take your time getting dressed. I’ll meet you outside.” I leave the room, further brightening the lights as I go. While the client is dressing, I get a brochure or information about the service I’ve recommended for her facial redness as well as the eye cream I recommended. I bring it to the front desk and have a quick conversation with the front desk manager. She understands and is worth her weight in gold. She’s a big part of the success of our team.
I return to the room and escort the client to the reception area. I verbalize post-treatment instructions while we are walking. “Remember to wear your sunscreen, avoid harsh chemicals on your skin for the next few days.” I reintroduce her to the front desk manager who greets her warmly and says, “You look refreshed! Mary recommends you use this eye cream to help with your crow’s feet. I can add that to your ticket for today’s service.”
: I greet my next client who is just walking in the door for her treatment. “I’m preparing the room for you now and I’ll be back to get you soon.” I then document the first client’s notes on the treatment, being sure to note any observations, her response to treatment and recommendations, including a suggestion that she go for a medical evaluation of a rough scaly spot near her left eyebrow.
I buzz back to my room and flip it for the next client. I replace the sheet and towel, put used tools in the sanitizer and wipe down everything with disinfectant after I don gloves. I grab the micro needling kit from the cupboard. I also grab a long pull on my water bottle and return to the front desk to walk my client back. She is excited about her first collagen induction therapy session.
My client sits in the treatment room while I review her medical history and determine if she is appropriate for a micro needling session. She scheduled the treatment via our office online scheduling program but I need to verify that she is a candidate. She’s done her research and micro needling is a great option for improving acne scarring. I review the procedure with her, explaining what I’m going to do and what she can expect. I also double check her allergies to make sure she’s not sensitive to the topical numbing cream I’m going to apply before the treatment. I then have my client lie back on the treatment bed and I double cleanse her face. After the cleanse, I escort my client to the photo room, a room that is dedicated to recording our clients’ before and after photos. In our skin studio, we always get photos when we start a series of treatments. We also get photos at the midway point thru the series and at the end. I’ve found that documenting the progress is really important. Clients forget what they look like and will claim to have not had significant results over the course of a 3 to6-monthh series. Whoever said a picture is worth a thousand words was right.
Photos completed, I escort the client back to the treatment room. Now I do a thorough skin analysis, again pointing out areas on her face where I see concerns and also offer options available to treat those areas if she’s interested. I apply a topical numbing solution to my client’s face, thoroughly rubbing it in. I explain that I’m going to leave her to numb for 30 minutes. I offer to leave the lights on and give her magazine to peruse or offer to dim the lights and let her relax. She opts to play a game on her cell phone. I grab another drink from my water bottle.
I rush to the waxing room in our office and do a quick check that the wax pot is on. I forgot to turn it on this morning! But a co-worker has come to my rescue and has already prepped the room for me. I’m back at the front desk escorting my third client back to the waxing room. As she settles into the treatment chair, I double check her medications and skin care regimen. I don’t want to lift tissue so I need to make sure she hasn’t used any Vitamin A based products in the last 5 days. I cleanse her face, this time being careful to leave her eye makeup (Her request). I do a skin analysis with the mag lamp and tell her about our chemical peel special this month. I then move on to her brows, waxing and tweezing stray hairs.
I escort my client to the front desk and tell the front desk manager that my client might be interested in learning more about the chemical peel special when she checks out. I hustle back to the waxing room and replace the linen, clean the wax pot, disinfect the tweezers and scissors so the room is ready for the next client.I re-enter my treatment room with a quick knock. I double-check that I’ve got a blood borne pathogen disposal bag ready along with the rest of my supplies. I grab a quick swig of water. I cleanse the numbing cream off my client’s skin. As I perform the treatment, she tells me all about her wedding plans. She’s getting married in 5 months. We’ve got time to have her looking great for those wedding photos.
I apply cold compresses to my client’s face to help with the erythema after micro needling while I give her post-treatment instructions. I escort my client to the front desk and get her rescheduled for her next session in 4 weeks. I document my treatment on my brow wax client and on my micro needling client. I return to the treatment room and flip it for my next client. I sanitize my equipment and tools, put fresh linen on the bed and prepare to do an acne treatment after lunch.
Lunch. I head to the kitchen with my water bottle that needs refilling and I wait while another staff member uses the microwave. We discuss our busy mornings but are careful that we don’t violate clients’ confidentiality. We speak in generalities like, “I had a new client who is getting married and I think her treatments are going to really help her look great in her wedding photos.” I usually use my lunch time to connect with co-workers or check my email and social media. Our office rotates responsibilities for posting on the clinic’s Facebook page. It's not my week because otherwise, it’s something I try to squeeze in during lunch.
I’m at the front desk ready to escort my next client back. I chat with the front desk manager who tells me that the brow wax client that I had this morning will be coming back in for a chemical peel next week. My client is late. He arrives apologetic and I explain I’ll have to cut his service a little short because I have another client right after him. Thankfully he is understanding.
I walk my client back to the treatment room. He settles onto the treatment bed while I turn on the steamer. I review his medical history and ask him about any changes since his last treatment. I ask him about his water intake, his diet, and his lifestyle so I can better understand how to treat his outbreaks. I ask how his skin responded to his treatment and ask him to describe his skin care routine. I rarely make diet recommendations, although I do explain that some people notice an improvement in their acne breakouts if they eliminate dairy. I also recommend he bring a package of unscented face wipes in his gym bag and use them to cleanse his face when he finishes his bi-weekly community soccer club matches before he heads to the brew pub to socialize with the team. In a previous appointment, I’ve recommended he discontinue washing his face with the same deodorant soap he uses on his body when he showers and he’s switched to a 10% benzoyl peroxide with noticeable improvement in his acne. I’ve got him using a physical barrier sunblock during the day and a salicylic acid-retinol blend at night. He needs reinforcement and accountability so it takes me a little longer to review everything with him.
I cleanse his skin and do a skin analysis with the mag lamp. I note that the number of comedones is much less and his skin overall appears healthier. I apply steam. While the steam is doing its magic, I document my findings in the interview and skin analysis. I perform extractions, being very careful to not injure his skin. The retinol product has thinned his epidermis and I risk tearing his skin if I’m too aggressive with an extractor tool. Sometimes I use my gloved fingers and tissue or a gauze square. I’ve also used a cotton-tipped applicator to get underneath the plug and push it up. I offer to move my client to the waxing room and have him spend a session under the LED light now that I’ve done the extractions. We are out of time. I explain the benefits of blue light and the additional charge. He agrees. I grab a swallow of my water. I escort the client to the waxing room. I wheel in the LED light panel. I apply goggles to his face and ensure he is comfortable. I apply the panel and set the timer for 30 minutes.
I am running behind. I hustle to the front desk. I apologize to my waiting client. I inform the front desk manager that the previous client is under the LED Light. I hustle to flip my room, grabbing another drink of water. I’m back at the front desk, escorting my client back. As my client settles into the treatment bed, I review her medical history. She is in for a chemical peel treatment. I note that she is allergic to aspirin so I have to check the peel to make sure salicylic acid is not one of the ingredients. I flip on the steamer. I cleanse her face and do a skin analysis with the mag lamp. I note her melasma and let her know that the chemical peel will help even out her pigmentation but she needs to consider adding a melanocyte inhibitor to her home skin care regimen. I also remind her that a series of chemical peels is suggested and we are offering a special this month as well as an additional discount if she purchases a package of three. I place my client in a comfortable position and apply distant steam.
I leave the room and go to my client under the LED light therapy. I turn it off. I apply sunscreen and escort him to the front desk. I remind the front desk manager that he had an added service as she checks him out and reschedules his next appointment. I return to the treatment room and turn off the steam. I prep my client’s skin for the chemical peel, deliberately moving a little slowly so her skin can cool from the effects of the steam. I give her a hand held battery powered fan to use to help with the head sensation. When I feel her skin is cool, I apply the peel, watching for a clinical endpoint of moderate erythema. I’ve added a booster to this peel that will specifically target melanin and help with the melasma. I’ve also got a large syringe of distilled water handy. If the client happens to get any chemical peel solution in her eye, I can use the syringe to flush out her eye. I’ve only had it happen once during a treatment, but I was glad to have it available. I also know the pH scale so I can tell the client that I’m using a peel that has the same pH as lemon juice, not battery acid on her skin. I am constantly asking my client for feedback during a chemical peel. How uncomfortable are you feeling on a scale of one to ten? I don’t’ want her to ever feel she is above a six or a seven. I end up applying three layers of the peel. If an area frosts, I avoid it when applying the next layer. The frosting means the peel is penetrating and reacting with the proteins in the skin. I’ve used a peel that is self-neutralizing. Chemical peels have come a long way and the new cocktailed ingredients make them a great option for a beautiful outcome. I explain to her what to expect in the next few days. I escort my client to the front desk. I give her a written post treatment instruction sheet and a post treatment skin care kit to help her manage her peel and get the best results.
I flip my room, new sheets, towels, sanitizing and disinfecting. I also grab a swig of water and take a bathroom break. I’m at the front desk for my next client. I escort her to the treatment room. She is new. I ask her to sit while I review her medical history, paying attention to her medications, her allergies, and treatments at other facilities. I’m anticipating cleansing her face and then the photo room for pictures as we formulate a plan for treatment. I move her to the treatment bed and cleanse her face. After cleansing, I sit her up and give her a hand mirror. I ask her what bothers her most. I’ve learned that there are times when what I see and think the client is wanting treatment for, is not what they see and want treatment for. So, this particular client is concerned about general aging concerns. She has considerable laxity in her jowls. She wants the more vibrant looking skin. She grabs her cheeks with her hands and pulls the skin back to her ears. “I want to look like this.” This is a red flag for me. That and the indications on the medical history form that she’s had injections at another clinic 10 days ago and numerous other treatments at other clinics. I do a thorough skin analysis with the mag lamp, noting things that I believe we can treat successfully. I sit her up and tell her that I’m not sure we can make her happy. She’s wanting to look like this and I demonstrate by pulling my own cheeks back to my ears. That means surgery. We can give her healthier, younger looking skin and can do treatments that provide some tightening but she would most likely be disappointed by the outcome. I can give her names of several physicians that we have relationships with and who are reputable if she’d like. And, I offer to provide other skin care services, if she’s interested. I end the consultation by standing up and moving toward the door. I escort the client to the front desk. I give her brochures and information about the treatments and skin care options I’ve suggested.
I chart on my acne client, my chemical peel client, and my last client. I drink my water. I head to the front desk where I great my next client warmly. We’ve been seeing each other for years. I leave the room so my client can undress and don a spa wrap. I hit the restroom. I enter the room after a light knock. While I’m reviewing the medical history, she fills me in on the latest news that she’s going to become a grandmother. She reclines and I cleanse her face. I do a skin analysis and commend her for keeping up her home skin care routine. I can tell she’s been faithful. I perform an infused microdermabrasion, using an anti-aging serum with hyaluronic acid.I complete the treatment and apply sunscreen. I escort my client to the front desk. We hug and I tell her I’ll see her soon, re-congratulating her on her good news.
I head back to my room. I remove the linen to the hamper and take the hamper to the dirty utility room, transferring it to the bin where the commercial laundry service picks up once a week. I return to my room to disinfect equipment and put reusable tools in the sanitizer. I document my last client’s notes in the record. I grab my purse and water bottle. I turn off the light to the treatment room. I drop the client’s charts at the front desk. I grab my lunch from the break room and say good night to my co-workers.
Photos: Courtesy of the author
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About Michelle Campbell
Michelle Campbell is the Content Marketing Specialist for MiladyPro.