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Ontario's College of Nurses of Ontario has decided that starting March 2027, all Botox and filler injections in med spas must be supervised by nurses if performed by staff without medical authority. The new rules also require nurse practitioners to issue specific orders for each patient after conducting an assessment. Doris Grinspun from the Registered Nurses’ Association of Ontario supports these measures as crucial for public safety, emphasizing that medical standards should apply consistently regardless of the treatment location.
Written locally by qwen2.5:14b on 2026-09-25,
using this article's own text rather than the other coverage of the
same event (that is the story summary below).
Story summary
Ontario's College of Nurses of Ontario (CNO) moved to ban unsupervised Botox and filler injections at medical spas starting March 2027, after a unanimous council vote on Thursday. Under the new rules, nurses must be present when delegating esthetic procedures like microneedling or thread lifts to unlicensed staff. This decision follows criticism of earlier guidelines that allowed for unsupervised treatments. The changes aim to improve public safety, addressing concerns raised by recent incidents where patients were harmed or died due to improper administration of treatments. One such case involved a 38-year-old woman who died after receiving lidocaine cream before microneedling in a GTA clinic while the nurse was not present. Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, emphasized that medical acts like administering Botox must adhere to strict standards regardless of location.
Written for “Ontario Med Spa Regulations” on 2026-10-05,
grounded in this article and the 1 other(s) covering the same event.
Med spa practitioners who are not regulated in Ontario will no longer be allowed to inject patients without supervision.
asserted
who → regulate → supervision
Following a unanimous decision by the council of the College of Nurses of Ontario (CNO) on Thursday, nurses will be required to be on site when they delegate medical esthetic procedures such as Botox and filler injections to a staffer who does not otherwise have authority to perform the treatments.
asserted
who → follow → treatments
The new rules will also require nurse practitioners in esthetics to issue direct, client-specific orders instead of a general directive that applies to multiple patients.
asserted
that → require → patients
They will need to complete a client assessment in person or virtually before giving the direct order.
asserted
They → need → order
These new policies will come into effect in March 2027.
asserted
policies → come → March
“We believe that is absolutely the correct decision to safeguard the public,” said Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario (RNAO), a professional association representing more than 50,000 nurses.
asserted
Grinspun → believe → nurses
When Botox or another prescription medication is administered, it is a medical act, whether it’s done in a hospital or med spa, Grinspun said.
asserted
Grinspun → administer → hospital
“The same standards of assessment, authorization, competence, safety must follow the patient wherever that care is provided.
asserted
care → follow → patient
And the college made that crystal clear today.”
asserted
that → make → ?
Unbeknownst to customers, some PDO thread lifts are being done with products that have never
The CNO’s move followed a decision in March by the College of Physicians and Surgeons of Ontario (CPSO) to require doctors who delegate procedures to be physically on site to supervise treatment.
It came two months after the CNO released sweeping guidelines for nurses in esthetic services but drew criticism for failing to fully fill the regulatory gap.
asserted
CNO → do → gap
An ongoing Star investigation has since January revealed details of four patients who were allegedly harmed after receiving esthetic treatments in GTA clinics.
uncertain
who → reveal → clinics
None of the delegating medical directors were on site at the time of the procedures.
asserted
None → delegate → procedures
One of those patients died.
asserted
One → die → patients
The gap, critics have said, had enabled a trend called “rent a licence” where some doctors and nurse practitioners acted as delegating medical directors for multiple med spas, in some cases collecting thousands of dollars a month while having little to no involvement in the day-to-day operations.
asserted
doctors → say → operations
Experts say the new rule requiring that a delegating nurse be on site should deter licence renting and limit customers’ exposure to botched procedures.
asserted
nurse → say → procedures
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