Botox

dishes, BSN, RN · May 6, 2016

If you are unclear if you can administer a substance by injection without a physician's order or proper delegation from a physician or a medical directive, I suggest you review the Nursing Act. Also, look up CNO's disciplinary hearings regarding Botox injections and professional misconduct.

CaffeinePOQ4HPRN, BSN, MSN, LPN, RN · May 8, 2016

If you are unclear if you can administer a substance by injection without a physician's order or proper delegation from a physician or a medical directive, I suggest you review the Nursing Act. Also, look up CNO's disciplinary hearings regarding Botox injections and professional misconduct.

I have a friend, not a Nurse by any designation, who finished an aesthetic certificate at George Brown college. She is opening her own business (with the help of family money) and asked me if i knew any RNs who she could hire to work in her spa to do Botox and demal filler injections. She is adamantly under the impression that so long as someone is an RN they can administer Botox and demal fillers without an MD order or delegation. I tried to explain to her that I was fairly certain an MD's order is required to which her response was, "my instructor said all that was required was that the person needs to be an RN and have their own Liability Insurance". I contacted the College for clarification and I am staying far far away from this situation.

It's amazing to me that anyone would think otherwise or attempt to do things outside the law. SMH!

dishes, BSN, RN · May 8, 2016

It's not really a surprise to me that an aesthetic course instructor and/or an aesthetics business owner do not have a clear understanding of the law. Based on the aestheticians I have met, I don't expect strong analytical reasoning from people who work in the beauty field. I am however surprised when a nurse does not know the law and that they are not legally permitted to diagnose, prescribe or administer drugs by injection without a doctor's order. I am also surprised when a nurse does not understand that the Botox must be obtained by prescription through a pharmacy.

CaffeinePOQ4HPRN, BSN, MSN, LPN, RN · May 8, 2016

It's not really a surprise to me that an aesthetic course instructor and/or an aesthetics business owner do not have a clear understanding of the law. Based on the aestheticians I have met, I don't expect strong analytical reasoning from people who work in the beauty field. I am however surprised when a nurse does not know the law and that they are not legally permitted to diagnose, prescribe or administer drugs by injection without a doctor's order. I am also surprised when a nurse does not understand that the Botox must be obtained by prescription through a pharmacy.

Exactly! She was arguing with me and had the nerve to say that because I'm "just an RPN" that perhaps I didn't understand the role of an RN. I bit my tongue after she said this... Because, I realized that no matter how I tried to help educate this person, in her eyes I'm just a dumb diploma Nurse who knows less than she does.

It's scary to know that businesses like this exist and that people don't bother to fact check.

savotinaRN · May 8, 2016

I just want to clarify that as RN I do know and it's checked that to administer Botox or filler it's needs to be assessed by Doctor and than you as nurse injector inject the client. My question wasn't about do I need a doctor my question is about does medical spa have one or not and do they have insurance or not for me to work under. Because doctors from my research want 2000 dollars a month and they give you medical directive to work under but it's too much money to pay for me. That's why I asked if some one knows if spa provides them?

CaffeinePOQ4HPRN, BSN, MSN, LPN, RN · May 8, 2016

I just want to clarify that as RN I do know and it's checked that to administer Botox or filler it's needs to be assessed by Doctor and than you as nurse injector inject the client. My question wasn't about do I need a doctor my question is about does medical spa have one or not and do they have insurance or not for me to work under. Because doctors from my research want 2000 dollars a month and they give you medical directive to work under but it's too much money to pay for me. That's why I asked if some one knows if spa provides them?

As a Registered Nurse in Ontario, I am surprised and concerned that YOU are not aware of CNO's policies or relevant provincial legislation. When and where did you acquire your BScN and registration with the College? I ask because these are things new and seasoned nurses are aware of. You are required to have your own Liability Insurance, regardless. And I quote:

"All members of the General, Extended, Temporary, Emergency Assignment and Special Assignment classes are required to hold PLP. Members in those classes are accountable for ensuring they hold PLP that meets the requirements set out in By-Law 44.4 ."

CNO website source: Professional Liability Protection

At this point, I think it would be most beneficial to you to contact the College of Nurses of Ontario directly and brush up on the Nursing Act, 1991, source: (Law Document English View | Ontario.ca). As a Nurse, it is YOUR responsibility to stay abreast current and changing legislation.

Wanting to earn extra money is one thing, but looking for a "work-around" is an entirely different and unsettling reality. You need a physician, full stop! You cannot administer Botox autonomously... engaging in controlled acts requiring appropriate authorization, but doing so without appropriate authorization is NOT ok. It is also NOT not tolerated by the College.

Here's some reading for you to consider from CNO's website r/t a Registered Nurse who did what you are seemingly trying to do. If you don't care about the implications your actions might have on the public, at the very least care enough about your overall reputation and/or license:

Barbara Cecilioni 6836613.

FYI - The nurse cited in that disciplinary action is: "Not Entitled To Practise" anymore. Do you want that for your future?

dishes, BSN, RN · May 8, 2016

Have you asked the spas who their diagnosing, ordering physician is and if they assess the patient prior to the botox injection? Anytime you work for a non-unionized organization you should obtain your own malpractice insurance.

savotinaRN · May 9, 2016

Thank you very much for the information. But i think you understand my question completely wrong. As a nurse I am aware of policies of administering medications. Never in my practice that I hurtled a patient in any way! And I am fully aware that I need a doctor. My question was about medical spa environment!

dishes, BSN, RN · May 9, 2016

It's more clear now, than in your original post that you understand that you need a doctor, are you looking to work in a physician owned clinic?

Silverdragon102, BSN · May 9, 2016

I would say that the results are still the same... In a spa environment will you have a doctor prescribing the Botox injections? You will still need a prescription to give the drug

CaffeinePOQ4HPRN, BSN, MSN, LPN, RN · May 9, 2016

...
Because doctors from my research want 2000 dollars a month and they give you medical directive to work under but it's too much money to pay for me. That's why I asked if some one knows if spa provides them?

The truth, which is very clear and evident from your statement quoted above, is that you are looking for a workaround to avoid working under an MD (and paying whatever fees would be required for you to do so as a cosmetic Nurse injector). The reality is you need your own PLP and you have to work with an MD. End of story. These are the standards in Canada. If you don't like it, go work somewhere where money is valued over patient safety; a place with loose regulations, poor standards and a bad reputation, like in Tijuana, Mexico... With all the gruesome and deadly plastic surgery nightmares. If you can live with yourself practising that way. If you weren't fishing you would stop asking the same question in varying ways.

Practising without your own PLP and performing controlled acts without proper authorization are not acceptable in Canada.

The only get rich quick or fast money strategies are ones that put the public at risk, and have real potential to hurt people.