The Great Aesthetic Migration of RNs

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

For almost a year now, nurse leaders and educators have been discussing the migration of nurses from acute care positions into the fast-growing Med Spa industry. Consider the story a nursing faculty member recently told about nursing students in programs today:

For almost a decade, students have been coming into our programs with different career pathways in mind. Today, it is rare for a student to want to work in an acute care setting. Years ago, my nursing students were excited about working in Academic Medical Centers and in Trauma Units, but not today. About three years ago, I noticed a new trend. Students are now entering our programs to work in Med Spas. They see these roles not only as paying well and offering outstanding work-life balance, but also as enhancing your personal well-being. Some refer to them as princess jobs, or at least that is what they call them on TikTok. It makes me sad to see nursing talent migrating to these settings at a time when they are desperately needed in nursing. Everyone is talking about safe staffing and mandated ratios, but honestly, I can’t see how we will ever have enough nurses to make that happen. Nurses today want a completely different lifestyle, and working in a hospital is not part of it. Why are we not talking about this new reality?

This faculty member is far from alone in her concern. Managers have been telling me for several years that a percentage of nurses are shifting gears and working part-time in Med Spas until they have enough clients for full-time work. Getting anyone to work overtime or even full-time in acute care has become much more complicated. New data from the Med Spa industry suggests that what they are seeing is a growing trend. Consider the following:

Based on the most recent industry data from 2024 and 2025, here is the breakdown of Registered Nurse (RN) employment within the U.S. medical spa sector.

The industry employs approximately 100,000 people total across roughly 11,000+ locations with 1000 new Med Spas added each year.
There are likely between 10,000 and 15,000 RNs currently working in U.S. medical spas and the numbers keep increasing. This assumes an average of roughly one RN per location, though the distribution is uneven (some spas rely entirely on Nurse Practitioners or PAs, while others employ multiple RNs.
Approximately 52% of medical spas utilize nurses (RNs or LPNs) to perform cosmetic procedures.
RNs primarily serve as aesthetic injectors (Neurotoxins, Dermal Fillers) or laser specialists.

Unlike Nurse Practitioners, who can often practice independently in many states, RNs in med spas must work under the supervision of a Medical Director or valid prescriptive authority. The scope of practice in Med Spas vary by state but generally RNs function as agents of a physician or advanced provider. Even if they are highly skilled master injectors, they legally they are working under someone else’s license. Many RNs working in these practices eventually return to school for their NP so they can practice independently and own their own businesses.

The industry reports a documented trend of hospital-based RNs moving into aesthetics, often referred to as the “Great Aesthetic Migration. Nurses are leaving bedside care for med spas to escape burnout, seek better work-life balance (no night shifts/holidays), and find higher autonomy. RNs in this sector are typically compensated with a base hourly wage plus commission on services/retail. The wages are variable but can range between $80,000 and $95,000 depending on the client base the nurse is able to build.

In the most recent NCSBN licensing data report, slightly more than half (53.3%) of nurses work in hospitals. This number has seen a sharp decline over the past two decades. A critical insight from recent Bureau of Labor Statistics data is that non-hospital nursing jobs such as the Med Spa industry are growing twice as fast as hospital jobs.

The nursing faculty member who made the observations above is right. This is a trend that we are not discussing in nursing at a time when we will potentially be facing a devastating nursing shortage in the years ahead.

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