Alex Dinovich, Nurse Practitioner and Medical Director at Bradford Skin Clinic and Medical Spa, acts as medical director for Registered Nurses and Registered Practical Nurses injecting in Brampton, Caledon and Bolton. An Ontario nurse's authority to inject comes from a directive or direct order issued by an authorized provider, and that mechanism is provincial rather than local.
Written and reviewed by Alex Dinovich, NP, Nurse Practitioner and Medical Director at Bradford Skin Clinic & Medical Spa.
College of Nurses of Ontario registration 13564840, verifiable on the
public Find a Nurse register.
Last reviewed .
At a glance
The short version.
InvestmentQuoted per arrangement. Scope, number of nurses and case review volume all move the figure
What the arrangement includes
Included in the arrangement
Directives written to the scope you actually holdWhich is a different question for an RPN than for an RN, and is treated as one.
Competence established individuallyPer nurse, rather than a name added to somebody else's document.
Prescribing for neuromodulatorsWhere that applies to what you do.
Case review with a stated route and response expectationFor the clients a directive was never going to cover.
A complications plan naming your local escalationPeel routes, agreed before you need them.
Reissue when the College's expectations moveThe Aesthetic Services guideline is recent and the College has said its review continues.
Not included: training. Directorship gives you authority, not technique.
Who you would be working with
A person, not a signature.
Directorship is a professional relationship rather than a
location. You are choosing the person who authors your mechanism, reviews it as
your practice changes, and picks up when a client does not fit it.
Alex Dinovich is Nurse Practitioner and Medical Director here. She is registered with the College
of Nurses of Ontario as 13564840, verifiable on the
public register.
What a directive gives you
Authority to perform the controlled act it names.
A written mechanism you can show.
A named provider accountable for authoring it.
What it does not cover
Anything the directive does not say.
Competence, which comes from training and practice.
Your own accountability to the College for your own decisions.
A directive covers what it says it covers.
Accountability under an authorizing mechanism is specific and bounded.
You remain accountable to the College of Nurses of Ontario for your own practice.
Alex Dinovich, NP. The authorising provider, not a name on a certificate.
What you are actually arranging
Not a supervisor, and not a signature. A medical director for a nurse injector is the authorized provider who issues the mechanism that lets you initiate a controlled act, keeps that mechanism current, prescribes where prescribing is required, and is reachable when a client does not fit it.
Everything else people attach to the title is marketing. The document and the availability are the service.
Because the authority comes from the Nursing Act, 1991 and from the College of Nurses of Ontario, it is provincial. A Nurse Practitioner in Bradford can author directives for a nurse injecting in Brampton exactly as one in Peel could. What matters is whether the document fits your practice and whether you can reach the person who signed it.
The scope conversation, done properly
Brampton has a large and growing population of Registered Practical Nurses moving into aesthetics, and the RPN scope question gets handled badly in both directions.
Some directors refuse RPNs outright, which is not what the regulation says. Others authorize RPNs on exactly the same document they use for RNs, which skips the analysis entirely.
The real position sits in between and depends on your individual competence and on the complexity and predictability of the clients the mechanism covers. That is the analysis the College expects, and it is specific to you rather than to your designation. We have written it out in full on directorship for Registered Practical Nurses, including what an RPN should expect to be asked before anybody authorizes anything.
If you are an RN, the equivalent page covers the same ground for your designation.
If you are early in this
A directive is not the first step and a course is not authority. The order is: registration, then genuine competence at the specific injections you intend to perform, then an authorizing mechanism from an authorized provider.
Nurses who come to us having completed a weekend course and nothing else usually need supervised practice before independent initiation makes sense. That is not a sales position, it is where the risk sits. Shadowing in a working clinic exists for that gap, and how to become a nurse injector in Ontario sets out the whole sequence with nothing invented.
Home visits and non clinical settings
Peel has a lot of mobile injecting, so this deserves a straight answer.
A mobile practice can be covered, and the drafting gets tighter rather than looser. What you carry, what you will not treat outside a clinical setting, how prescription product is stored and transported, the equipment you must have with you, and precisely what you do if something goes wrong in a house thirty minutes from the nearest hospital.
Some settings cannot meet conditions a safe directive would have to impose. When that is the case, the answer is that the setting should not be covered rather than that the document should be vaguer. A directive that is quiet about the hard parts is not protecting you.
The drive, if you want it
Brampton is about an hour north: the 410 to Highway 10, across on Highway 9 to the 400, then north to Exit 64. From Bolton or Caledon it is closer to forty five minutes up Highway 50 or Highway 27.
Most of the arrangement never needs it. Authorship, revision and case review run on documents, phone and video. The drive is worth it once, at the start, if you want to see the clinic and meet the person before their registration number goes on your paperwork.
Who you would be working with
Alex Dinovich, FNP-PHC, Nurse Practitioner and Medical Director at Bradford Skin Clinic and Medical Spa, College of Nurses of Ontario registration 13564840. Check it on the public register. She assesses, diagnoses, prescribes, issues direct orders and authors directives in her own right, and injects daily here.
Tell us your designation, what you inject, where you inject it, and what you are competent to manage yourself. We will tell you what the documents would need to cover and what the arrangement costs, or that you are not ready for one yet.
Call 647-333-6805. Bradford Skin Clinic and Medical Spa, 444 Holland Street West, Unit 2, Bradford, Ontario.
Asked by nurses
Asked and answered.
How far is Bradford from Brampton?
About an hour. Most people take Highway 410 north to Highway 10, across on Highway 9 to the 400 and north to Exit 64, or the 407 east to the 400 if the timing suits. Bolton and Caledon are closer, around forty five minutes up Highway 50 or Highway 27.
I am an RPN. Does that change what can be authorized?
It changes the analysis, not the possibility. An RPN can be authorized to perform these controlled acts under an appropriate mechanism, and the question a director has to answer is about your competence and the complexity and predictability of the clients covered. Any director who treats RN and RPN scope as interchangeable, or who refuses outright without looking at your practice, is not doing the analysis.
Can you authorize me to inject at home visits?
Possibly, and it is drafted more tightly rather than more loosely. The document has to name what you carry, what you decline to treat away from a clinical setting, how product is stored and transported, and exactly what you do if something goes wrong where help is not down the corridor. If a setting cannot meet those conditions, the honest answer is that it should not be covered.
My clinic owner is not a nurse. Does that matter?
It matters for who holds what. A business owner can run a clinic, but they cannot authorize a controlled act, and they are not the person accountable for your practice. You are, to the College of Nurses of Ontario. So the mechanism has to name you, you have to be able to read it, and you have to be able to reach the author without going through your employer.
Do you take on nurses who are just starting out?
Yes, with the order kept straight: competence first, authority second. If you have completed training but have never injected under supervision, the sensible route is supervised practice before a directive covering independent initiation. We would rather say that than authorize somebody who is not ready, and we offer shadowing for exactly this gap.
How is this different from the clinic down the road offering directives for a flat monthly fee?
It may not be, and you should compare properly rather than take our word for it. Ask both of us the same questions: who authors the documents, who revises them and how fast, what case review includes, how you reach the provider, what the complications arrangement is, and what happens to your booked clients if it ends. The fee only means something once those answers exist.
Sources
Where this comes from.
Everything on this page is drawn from the regulator, not from a
competitor's marketing. Read the originals rather than taking our word for any of it.
General information about Ontario regulatory requirements. Not
legal or regulatory advice. Nurses remain accountable to the College of Nurses of Ontario
for their own practice decisions.
Talk to us
Ask before you commit to anything.
Leave four details and Alex will come back to you directly. If what
you need is not something we do, we will say so and point you at whoever does.
Written and reviewed by Alex Dinovich, NP, Nurse Practitioner and Medical Director at Bradford Skin Clinic & Medical Spa.
College of Nurses of Ontario registration 13564840, verifiable on the
public Find a Nurse register.
Last reviewed . 
