DIJA AYODELE, Founder, Black Skin Directory, London
My clinic—West Room Aesthetics—had been open for just 6 weeks before being closed for lockdown.
Naturally, I was devastated, but I was also optimistic because I thought that the closure would only be for a few weeks. After the initial disappointment, I looked forward to the slower pace that would allow us to make more detailed plans and strengthen our systems.
However, as the daily news briefings took a turn for the worst, I soon realised that the clinic would be closed for an indefinite period and, suddenly, that threw us into uncertainty. We had to quickly create and implement a business continuity strategy in one fell swoop! The questions we were asking were: how do we maintain momentum and stay relevant? How do we keep our patients interested? How do we attract new patients during this period? How do we keep sales up?
I knew from research that web-based skincare sales were on the rise, so we very quickly devised an online content and social media strategy. This meant many sleepless nights trying to put all this content together. Typically, you would have done this over a few months, while we were doing it in a matter of days. We ended up calling this process ‘Corona Creativity’. I am convinced that this mad period of activity is what held the business together.
» The Black Lives Matter Movement also highlighted the clinic, and we had very positive outcomes as communities came together to support Black-owned businesses «
Knowing that everyone spent those initial weeks of lockdown glued to technology, we kept front and centre of our audience with content that showcased our knowledge and clinical expertise in skin of colour. This involved producing long-form and bitesized Instagram videos, as well as collaborating with complimentary specialties, such as make-up, hair and mental health providers, on live sessions to inject some fun and bring fresh new ideas to our audience.
We created virtual skin health consultations, online webinars that clients could purchase to learn more about their skin, retailed specially curated at home skincare kits, introduced gift vouchers that clients bought as presents and introduced an online shop. The key thing we did was remaining agile and open to trying new ideas.
Importantly, we were also very honest with our clients and audience about how the lockdown was affecting us financially and emotionally, and that really resonated and clients were very sympathetic and interested in how they could help, even if it was just to leave us a Google review or share a social media post! Luckily, we were able to access some Government help, which did ease a fraction of the pressure off.
The Black Lives Matter Movement also highlighted the clinic, and we had very positive outcomes as communities came together to support Black-owned businesses.
As someone who chooses to see the silver linings in all challenging situations, I believe the honest, strong and adventurous mindset with which we approached the pandemic meant that we were able to weather the storm and shore up the business for brighter days ahead.
HARRY SINGH, Aesthetic trainer, Botulinum Toxin Club, Hertfordshire
What will you tell your grandchildren when they ask about 2020 and the COVID-19 pandemic? Will you say you binged on food and Netflix? Or, will you say it was the time that you ‘pivoted’ your business and worked on the core and foundation of your aesthetics business? I am glad to say I did the latter.
We are so busy working ‘in’ the business treating our patients and attending conferences that we have very little time to work ‘on’ the business.
Like many of my professional colleagues, I did go through the typical reaction to the pandemic and subsequent lockdown, which was fear (will all my patients go somewhere else, will we ever be able to reopen our clinic?), then learning (focus on what you can control and not what you cannot control and then grow (let's see this as an opportunity to grow myself and the business).
I concentrated on the three Vs of my business: visible, valuable and vulnerable.
I needed to be visible to my patients so they would not forget about our clinic. It was all about useful and regular communication with patients. We updated all of our patients' contact details and kept them informed as to when we could reopen and the steps we were taking to prioritise their safety and wellbeing. Regular patient updates outlined the changes we were making with the clinic, the patient journey and the seamless approach to a contactless experience, both in paperwork and payments.
We also wanted to be valuable to our patients, so we held Zoom Q&A sessions and webinars, published blogs, newsletters and videos, as well as posting live on Facebook and Instagram. Not only did we retain our patients, we were approached by new ones that heard about our mediums of communication. We covered various topics, such as injectables, skin treatments (especially concentrating on a home care regime protocol), myths about injectables, how to prolong the results and new services that we were introducing. The great thing about all this content is that we can ‘repurpose’ it into different formats and use it for new enquiries and patients.
With the combination of being visible and valuable, we were now less vulnerable to losing our patients. We are expecting even more new patients, as the public will want to look and feel good. All those events that were postponed, such as weddings, graduation ceremonies, and birthday parties will take place now and this will bring along with them additional patients requesting our services for these ‘red carpet’ occasions.
P.S. I did binge on food and Netflix for the first week of lockdown!
EMMA DAVIES, SaveFace Clinical Director, ACE Group Vice Chair
I could write a 20 000 word dissertation on my COVID-19 experiences. I'm sure everyone could say the same.
What distressed me the most was the realisation that many nurses in aesthetic medicine have a very real identity crisis.
I observed with horror the nature of the posts: the chaos, the unreliable rumours and ‘advice’, the intimidation and judging… I will simply quote partly from a post I made (on the British Association of Cosmetic Nurses forum) prior to absenting myself from further debate on the forums.
‘For decades, we have all supported the fight for this field of practice to be recognised as medical, rather than beauty. As professionals, we must distinguish ourselves from beauty therapists—and what are we doing now? We are confused because beauty salons, nail bars and spas have been included in the legislation as prohibited from opening, and are asking, does that mean us? Why are we even asking that question? My patients might come to me thinking I can beautify them, even so, they would not choose to go to a salon—they know the difference, even if you don't. Then, from their first engagement, they are in no doubt I am a nurse, that my approach follows a medical model and there is no comparison in what I do and how I do it with what happens in a salon. If trading standards come knocking, we should be ready and confident to present a slam dunk of risk assessments, policies, etc, and be able to articulate why and how we practice, that it is a medical model, not beauty therapy, and we are not in a salon. Also, the very important fact that we are regulated healthcare professionals and this legislation does not prevent us from performing our roles as nurses in medical aesthetics and our own regulators, indemnity providers and the Department of Health and Social Care only require that we follow Public Health England (PHE) guidelines and guidance from our professional bodies.
I would like to see us all excelling in professionalism at this time, and not overtly exploiting the situation. Be respectful of those choosing not to or not in a position to open yet.
Stop being confused about who you are and what you do! If you cannot operate in compliance with professional standards, PHE guidelines and your indemnity (or doubt yourself), then don't reopen.
COVID-19 has afforded nurses practicing aesthetic medicine with a real opportunity to review their practice, their business model and whether there is, in fact, any demonstrable distinction, beyond their Nursing and Midwifery Council PIN, between them and a beauty therapist in a salon. This blurring of lines can no longer be denied and must be addressed if we are to change the landscape and public perception in any meaningful way.’
YOLANDA LEE, Part-time Band 5 ITU Nurse and Aesthetic Nurse
When I first heard about the pandemic that was spreading through Asia, I was unsure how it would affect us here in the UK. Since beginning my nursing career in 2016, I had experienced the strains on our unit during the winter months with flu outbreaks and pneumonia, and contemplated this surge in admissions due to this new strain of coronavirus. As the days passed and the media portrayed the seriousness of the disease in our neighbouring countries, a feeling of anxiety and uncertainty crept into my mind.
Our first case was a pregnant lady who required an emergency C-section, and subsequently a specialist intervention called extracorporeal membrane oxygenation (ECMO) to keep her alive. The staff that cared for this lady before she tested positive for COVID-19 did so with little to no personal protective equipment (PPE), and there was an element of real fear among our unit after the positive result came back. For me, this was first case that I had personally experienced, and it confirmed that this virus did not discriminate. This young patient was in a critical condition, had never been in hospital before and was carrying an innocent child, and due to this organism, she was now fighting for her life.
The following days saw patient after patient being admitted, some with multiple co-morbidities—several who had never had any health issues in their lives—and ranging from age 40 to their 80s, all struggling to breathe. They all required over 50% oxygen and, very soon, were all intubated and ventilated.
Due to the sheer number of admissions, we had to rearrange our unit and extend to the recovery room (a large open area that could fit up to 10 beds) and a neighbouring surgical unit that held up to 20 beds, along with our 24-bedded high dependency unit (HDU) and intensive care unit (ITU). Instead of one-to-one care, the ration soon became 1:4.
It really was like entering a war zone everyday. The PPE training and fit mask testing was rushed and overwhelming. For the first couple of weeks, there was the pressure of knowing we did not have enough PPE supply, yet wanting to ensure that we were protected, so this meant that reusing some PPE was the only way forward.
» Twelve-hour shifts wearing tight-fitted masks and full plastic gowns that emit your body heat through the neck holes and caused immediate perspiration … were utterly suffocating … but the stamina and perseverance of my peers reminded me that we were strong and that our patients needed us «
Twelve-hour shifts wearing tight-fitted masks and full plastic gowns that emit your body heat through the neck holes and caused immediate perspiration, while also having your vision obscured by huge plastic visors, were utterly suffocating. The lack of PPE, the intense needs of the suffering patients and the restrictions in place to contain the virus within a contaminated area meant that doffing to have a toilet break, or simply have some water, was simply impossible. Just walking around caused me to feel like I would faint, but the stamina and perseverance of my peers reminded me that we were strong and that our patients needed us. Who else would be able to keep them alive while their bodies healed? Intensive nursing is not something that can be learnt in a day, week or even a few months! I knew that I played an important role in helping my community fight this, and my moral duty outweighed my personal fear for my family and myself.
I would return home every day and jump in the shower before greeting my partner, 8-year-old daughter and 18-month-old son. I feared for their safety, and the thought that I could possibly bring the virus home to them really played on my mind and caused some anxiety and sleepless nights. I knew I could not leave my young children and stay in accommodation while I worked, but I also knew I could not let my unit down, nor the patients who desperately needed my skills to help save their lives; it was the most confusing time.
Despite the chaos, I found peace in the fact that the whole world was going through this together, and that we as humans fight for the survival of our race. I also witnessed the selflessness of great people and the bravery that is shown in time of crisis first-hand. I love my ITU family and I am so proud of everyone for being so strong; it has brought us closer together.
I feel a great sadness for the lives lost during this period and the amount of people I saw who passed away without having the time to spend with their loved ones or to have their hand held in their last few moments because there was no one available to be with them.
This experience has changed my outlook on life, we are all only human and life should be lived to the fullest with the greatest of intentions.
CLAUDIA MCGLOIN, Clinical Director and Aesthetic Nurse Practitioner, The New You Clinic
Like so many other clinics in Ireland, mine had been closed since the beginning of March, and when it came to reopening again there was a lot of confusion.
Our Taoiseach (head of Government) at the time, Leo Varadakar, had issued a road map that set out the five phases of reopening. After reading the document, it was not entirely clear where medical aesthetics performed by doctors and nurses fitted in.
Hairdressers and beauty salons were listed in Phase 4, which commenced in July, and we were of the opinion that we could reopen in Phase 2, which was in June.
I wrote to the health minister, the minister for business enterprise and innovation, the mayor of Sligo and local politicians to seek clarification. I outlined a good case as to why medical professionals should be able to reopen safely and why we should be reopening before non-medics. Any responses I got said to follow the road map! Our governing body, the Nursing and Midwifery Board of Ireland (NMBI) said it had nothing to do with them and my insurers said to follow Government advice.
All I could do was to risk assess my clinic and, putting the public's safety first, decided to reopen the clinic in phases.
I reopened the weight management clinic first during Phase 2 in June. It was the safest option and, with new guidelines and protocols in place, would be a good starting point before gradually reintroducing medical aesthetics procedures in phases.
For me, the weeks of preparing to reopen were not stressful; after all, as a nurse with 24 years experience, I knew what to do. However, reopening post-lockdown has been an experience, a very stressful one at that.
We emailed all of our patients with the changes and new guidelines, and we informed them that, because of the lack of 2-metre distancing in the clinic, they would be required to wear face coverings.
I was horrified by the public and their laidback response to the reopening and, indeed, to COVID-19. I was met with hostility and questions as to why they should wear a face covering. What shocked me more was who was complaining. I am sad to say but the worst offenders were nurses and other healthcare professionals. We also had patients who were compromised questioning the guidelines.
I am not going to lie, I felt very anxious that first week and did not want to reopen the medical aesthetics side if this was what I was going to be up against. I reopened the aesthetic side 2 weeks later, but phased the treatments in on a basis of low-to high-risk procedures. I did not do any fillers in the first few weeks, even though other clinics were. I decided it was not safe to inject around the oral cavity due to the unknown nature of COVID-19 and our increasing cases.
Even today, 12 weeks in, we are still met with complacency and questions. I have asked everyone to sign a consent/disclaimer and sign a COVID-19 checklist. Our patients are screened at the door with temperature checks and, despite these new measures, people are starting to arrive early, sit in our closed waiting area and want to use the closed bathroom.
As we progress through the pandemic, it is getting harder to enforce some of the new guidelines. Can we really stop someone from using the toilet? I do not think we can, but I make sure to deep clean it afterwards and still keep that red ‘Closed’ sign on the door. COVID-19 is here to stay with us for a while, and, as a business, we need to learn to live with it. As I am writing this, Ireland's numbers of new cases are soaring again. We have new restrictions in place and a part-lockdown with the threat of a full lockdown. All I can do is to take each day as it comes and prepare the clinic again for another lockdown.