Can a Registered Nurse Administer Botox?

Can a Registered Nurse Administer Botox?

Those who run med spas, dental or dermatology practices are concerned about whether a registered nurse on staff can administer Botox without their direct supervision. Allowing them to do so would free up the physician’s schedule so that he can perform other procedures that his personnel is not permitted to do.

According to the Florida Board of Medicine, there are no laws and rules that address who can and cannot administer Botox injections in the state of Florida.

However, a 2017 Board of Nursing case[1] involved a Florida licensed Registered Nurse who was alleged to have violated Florida Statutes 456 and/or 464. In March 2016, the nurse administered Botox to multiple patients on multiple occasions. The Board of Nursing found that the nurse did not perform the Botox injections pursuant to a valid physician’s order. The Board of Nursing held that performing Botox injections without a physician’s order is beyond the scope permitted by law. Further, the nurse had reason to know that she was not competent to perform the Botox injections.

The Board referenced Florida Statute 464.018(1)(h) in its decision by stating that unprofessional conduct as defined by the board is grounds for disciplinary action. The Board also referred to Florida Administrative Code Rule 64B9-8.005(13), which provides that unprofessional conduct includes practicing beyond the scope of the licensee’s license, educational preparation or nursing experience. (emphasis added). Finally, the Board stated that the nurse engaged in unprofessional conduct by practicing beyond the scope of her license, educational preparation and/or nursing experience by performing Botox injections without a valid physician’s order.

In Florida, practicing medicine without a license is considered a 2nd degree misdemeanor. Additionally, the nurse could have had the following actions taken against her:

  1. license suspended or permanently revoked;
  2. restriction of practice;
  3. imposition of an administrative fine;
  4. issuance of reprimand;
  5. probation;
  6. refund of fees billed or collected;
  7. remedial education; and/or
  8. any other relief that he Board deemed appropriate.

Two things should be taken away from the decision in this case. First, just because there isn’t a specific law on the books regarding Botox injections doesn’t make it legal for a registered nurse to administer it to patients. Second, I thought that it was interesting that the Board stated that the nurse was not performing the Botox injections pursuant to a physician’s order. Many would view this sentence as specifically allowing a nurse to administer Botox injections only in situations where the nurse is doing so pursuant to a physician’s orders (not an NP, PA, ARNP). I don’t believe that to be true because the Board went on to state that even pursuant to a physician’s orders a registered nurse does not possess the requisite educational preparation to perform the procedure and that doing so would be practicing beyond the scope of her nursing license.

[1] Department of Health v. Trisha Lorraine White, R.N. Case Number 2016-13884


It should be noted that I am not your lawyer (unless you have presently retained my services through a retainer agreement). This post is not intended as legal advice, it is purely educational and informational, and no attorney-client relationship shall result after reading it. Please consult your own attorney for legal advice. If you do not have one and would like to retain my legal services please contact me using the contact information listed above.

All of the information and references made to laws, regulations, and advisory opinions were accurate based on the law as it existed at this time, but laws are constantly evolving. Please contact me to be sure that the law which will govern your business is current. Thank you.

Jamaal Jones

This post was authored by Jamaal R. Jones, Esquire (Partner) of Jones Health Law, P.A. where we provide "On-Call Legal Services to Healthcare Professionals". For more information contact us at (305) 877-5054; email us at, or visit our website at


  • Debra
    Reply November 14, 2019 at 2:12 am

    I like the answer to this question. Long story short, if you’re going to get botox, go see a board-certified dermatologist. There’s simply too much risk involved.

  • Juliana Rego
    Reply May 11, 2021 at 1:50 am

    Here’s the response I got from the Florida board of nursing today: 


    Thank you for you contacting the Florida Board of Nursing. There is no rule or statute that specifically addresses which healthcare professions or other professionals may inject neurotoxins and dermal fillers in Florida; however, we have been advised by the Executive Director of the Board of Medicine that it is the Board of Medicine and Board of Osteopathic Medicine’s position that these  procedures are considered to be the practice of medicine and APRNs in a supervisory relationship may perform these procedures.


    The Florida Board of Nursing does not have the statutory authority to issue general position statements or white papers. Board of Nursing staff members are not authorized to offer interpretation of the regulations.


    We are unable to advise regarding specific supervision, education, training and experience requirements, nor are we able to offer business or legal advice.


    Please consult your attorney for legal and business guidance, or you may consider filing a petition for a declaratory statement. Information regarding

    Any substantially affected person (i.e. a licensee or applicant) may seek a Declaratory Statement. Declaratory statements regarding an opinion of a board, or the department when there is no board, as to the applicability of a statutory provision, or of any rule or order of the board, or department when there is no board, as it applies to the licensees particular set of circumstances, pursuant to Section 120.565, Florida Statutes. The petition seeking a declaratory statement must state with particularity the licensees set of circumstances and must specify the statutory provision, rule, or order that the licensee believes may apply to the set of circumstances.


    Please let me know if further assistance is needed.


    Warmest regards,


    Sherri Sutton-Johnson, DrPH, MSN/ED, RN, CCHW, Director of Nursing Education

    Department of Health, Division of Medical Quality Assurance

    I’m still going to contact an attorney, but it sounds like they advised it was medical practice but didn’t make it an statute. 

    As a RN I’m allowed to provide treatments and administer medications with a dr’s order. If I receive an order: administer 20 units of botulin toxin A to IM to the frontalis muscle once on patient Mary Smith. Am I to refuse that physician order?

    • Tinya
      Reply January 22, 2022 at 2:07 pm

      As an RN i find that the board has no clear answers for us, and if following an order why cant the ordered be followed by a licensed registered nurse? please let me know if you ever receive an answer.

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