Information for nurses who perform non-surgical cosmetic procedures

In feedback received from the public consultation, it was identified that many of the requirements of the shared practice guidelines and the nurses’ guidelines were identical. Acknowledging the content similarities between the shared (multiprofession) practice guidelines and the nursing practice guidelines, a single practice guideline will apply to all registered health practitioners who perform non-surgical cosmetic procedures, with the exception of medical practitioners. This also assists the NMBA in its role of protecting the public by having consistent guidance that applies to the multiple professions practising in non-surgical cosmetic procedures.

Where there is guidance that is specific to requirements set by the Nursing and Midwifery Board of Australia for nurses, this has been included in an appendix in the guidelines.

The Medical Board of Australia’s guidelines need to remain as ‘standalone’ guidelines as they cover both cosmetic surgery and non-surgical cosmetic procedures.

Cosmetic procedures, including injectables, must only be provided by health practitioners who have appropriate education, knowledge, training, competence, authorisations (where required) and experience to safely perform the specific cosmetic procedure. It is the responsibility of the individual undertaking any cosmetic procedure to ensure they are sufficiently educated to do so safely. The guidelines provide information on the type of education required of practitioners providing non-surgical cosmetic procedures. As a minimum, this includes:

• training on the assessment for suitability for the procedure, and
• both theoretical and hands-on training in the specific procedure being offered including assessment and demonstration of competence to safely perform the procedure, and care of the person (including side effects, and short and long term complications and their management).

The Nursing and Midwifery Board of Australia does not approve training programs that are for professional development. The NMBA only approves programs of study that lead to registration as a nurse or midwife, or programs of study that leads to an endorsement. As with other areas of practice, individuals can source formal professional development opportunities to ensure that they are sufficiently educated for the nursing practice they are undertaking.

If you are currently working in the area of non-surgical cosmetic procedures and have not practised in another practice setting, you are not expected to retrospectively meet this requirement. It is important to note that should a notification be lodged relating to a nurse’s practise in the area of non-surgical cosmetic procedures, the nurse will be asked to demonstrate how they are working within their scope of practice, which is determined by their foundational education, relevant practice, training, any authorisation, their competence, qualifications and experience as outlined in the guidelines.

Registered nurses are required to undertake detailed assessment, planning and delegation of care, have complex anatomical and physiology knowledge as well as decision-making relating to pharmacodynamics and pharmacokinetics. This experience is best gained by consolidating educational foundational skills and knowledge as a graduate RN, in a general or specialist area of nursing practice (excluding non-surgical cosmetic procedures).

If you are currently practising in the area of non-surgical cosmetic procedures, you can continue to practise while meeting the requirements of the guidelines. This includes specific information for enrolled nurses in Appendix A of the guidelines.

If you are an EN intending to practise in the area of non-surgical cosmetic procedures, you are required to demonstrate the following experience and qualifications:

• practise for a minimum of one-year full-time equivalent post initial registration to consolidate the foundational skills and knowledge as an EN, and
• one year full-time equivalent experience in a related area of practice (for example, dermatology, general surgery) prior to practising in the area of non-surgical cosmetic procedures (total of two years), and
• have completed education and training that is relevant to practise in the area of non-surgical cosmetic procedures, prior to undertaking any practice.

There are aspects of non-surgical cosmetic procedures that are limited to the practice domain of registered nurses and nurse practitioners. This includes the assessment of patient suitability and additional responsibilities if providing non-surgical cosmetic procedures to persons under the age of 18.

All registered health practitioners are required to work within the limits of their skills, training and experience. The scope of practice of nurses may also be influenced by other guidance from the Nursing and Midwifery Board of Australia’s professional practice framework along with legal, workplace and regulatory requirements, such as drugs and poisons legislation as in effect in each state and territory.

Nurses must also ensure that they comply with the NMBA’s requirements for professional indemnity insurance, including that they have professional indemnity arrangements that provide appropriate cover for all aspects of their practice.