A decision of the Victorian Civil and Administrative Tribunal (VCAT) has overturned a refusal of nurse practitioner endorsement for an aesthetic nurse, with the Aesthetic Beauty Industry Council (ABIC) describing the outcome as ‘the decision that reopened the door for aesthetic nurses’.
The ruling in Tzimas v Nursing and Midwifery Board of Australia [2026] VCAT 60 sets aside a 2022 decision of the Nursing and Midwifery Board of Australia (NMBA) and determines the applicant’s entitlement to endorsement under the approved Nurse Practitioner Registration Standard.
In a detailed public response authored by ABIC CEO and Director Stefanie Milla, the organisation framed the outcome as significant not only for the individual applicant, but for the profession more broadly.
‘A landmark decision has been handed down in Victoria that makes one thing unmistakably clear: if an aesthetic nurse has done the work, built the capability, and meets the approved standard, their field of practice does not automatically disqualify them from becoming an endorsed Nurse Practitioner,’ says Milla.
‘This matters for one nurse, yes. But it matters far more for the profession.’
The legal question before VCAT
The proceeding concerned an application for review of the NMBA’s refusal to endorse an experienced aesthetic nurse as a nurse practitioner.
Under the Health Practitioner Regulation National Law, endorsement requires demonstration of advanced nursing practice at an autonomous and accountable level, within a defined scope, supported by appropriate education and experience.
VCAT set out the proper inquiry in clear terms. The Tribunal stated:
‘The relevant inquiry is not whether the practice area is described as ‘cosmetic’, but whether the nurse’s role demonstrates the requisite level of advanced, autonomous and accountable practice within a defined scope.’
It further observed:
‘There is no express exclusion of cosmetic or aesthetic practice from the concept of advanced nursing practice. The assessment must focus on the nature, complexity and accountability of the work performed.’
Those passages go to the core of the dispute. The Tribunal rejected any suggestion that cosmetic practice is inherently incapable of meeting the approved standard. Instead, the focus must remain on evidence of capability within scope.
Guidance versus the approved standard
The proceedings took place against the background of the NMBA’s Position Statement on nurses and cosmetic medical procedures, which indicated that nurses working solely in cosmetic procedures were unlikely to meet the requirements for endorsement.
VCAT accepted that the Board may provide guidance. However, it made clear that such guidance must remain consistent with the legislative scheme and the approved Registration Standard.
The Tribunal stated:
‘While it is appropriate for the Board to provide guidance to the nursing profession that the routine practice of cosmetic medical procedures is ‘unlikely’ to meet the requirements of advanced nursing practice, we consider it goes too far in stating that practice in that area ‘is not working at the advanced practice level’ (emphasis added).’
The Tribunal warned that it ‘could fall into error if it was to inflexibly follow the line set out in the Position Statement’.
In effect, endorsement must be assessed against the approved Registration Standard and the evidence of the applicant’s practice, and cannot be refused by applying an inflexible policy to an entire field based solely on its label.
Advanced practice and the ‘impossible task’
One issue explored in the proceedings was the idea that advanced practice must be demonstrated as a constant, discrete category of work.
VCAT rejected that framing. In addressing the notion that every hour of practice must independently satisfy an ‘advanced’ threshold, the Tribunal described that as ‘an impossible task’.
The reasons recognise that advanced practice is integrated. It may include routine and complex elements within the same consultation, provided the practitioner demonstrates the requisite judgement, accountability and capability across their scope.
The Tribunal examined detailed evidence, including case studies, supervisor notes and clinical examples involving post-procedure complications, suspected vascular occlusion and complex comorbidities. It assessed how risk was identified, escalated and managed, and how prescribing accountability operated in practice.
Ultimately, VCAT was satisfied that the applicant met the approved standard and set aside the refusal.
Consideration of conditions
VCAT expressly considered whether conditions should be imposed on the endorsement to reflect the applicant’s specialist field of practice.
Under sections 95(2)(b) and 103 of the National Law, the Tribunal has power to impose conditions if appropriate. It observed that conceivable conditions could include limiting practice to non-surgical cosmetic procedures or restricting prescribing to medicines used in those procedures and their common complications.
However, the Tribunal declined to impose any conditions in this case.
The matter had been argued on a binary basis – either the applicant met the Registration Standard or she did not. Neither party sought conditional endorsement, and the Tribunal determined that, having found the standard satisfied, no conditions were warranted on the evidence before it.
What the judgment establishes
The decision establishes that:
• Cosmetic or aesthetic practice is not automatically excluded from advanced nursing recognition
• The correct inquiry is functional and evidence based, not label based
• Guidance cannot replace the approved Registration Standard
• Advanced practice may be demonstrated through integrated clinical work, with hour by hour demonstration described as an ‘impossible task’
As VCAT made clear, the determinative question is whether the applicant has established advanced practice within a clearly articulated scope, supported by evidence of experience and education.
The ruling does not create a shortcut to endorsement. It does, however, confirm that cosmetic nurses are entitled to have their applications assessed on the same statutory criteria as any other practitioner under the National Law.
For a profession that has long debated whether aesthetic practice would be recognised at advanced levels, the Tribunal’s answer is unambiguous: the label does not decide the outcome.
What happens next
‘For years, too many highly trained aesthetic nurses have felt a quiet but persistent message in the background: your work isn’t ‘serious enough’, your complexity isn’t recognised, and your discipline won’t be judged on its evidence, it will be judged on its label,’ says Milla. ‘This decision challenges that.’
ABIC emphasised that the ruling does not lower standards. Rather, it confirms that endorsement must be assessed according to the approved registration standard and the evidence presented.
The organisation also announced the launch of a National Aesthetic Nurses Committee, stating that it will not allow ‘this moment to fade into a headline’. ABIC is currently seeking senior advisors to join the committee. For more information or to apply, visit ABIC.
