We are pleased to announce that on Dec. 11, 2025, CNO’s Council approved the new Professional Boundaries and Nurse-Client Relationships practice standard. This standard will replace Therapeutic Nurse-Client Relationship. The new standard reflects CNO’s ongoing work of modernizing its standards to better reflect current nursing practice realities, and changes in the health care landscape and public expectations.
The new practice standard will take effect on March 1, 2026, but is available to review now. The transition period allows us to consult and develop supporting resources, and gives nurses, educators, employers and system partners time to familiarize themselves with the content and incorporate it into materials, such as curricula and policies.
The value of practice standards
Practice standards support CNO’s mandate to protect the public by promoting safe nursing practice. They are widely used by nurses, academic institutions, and employers, and inform nurses of their accountabilities and the public of what to expect of nurses.
CNO practice standards are broad and principle based, so they can be applied to all nurses regardless of their role, job description or area of practice. Every standard is created to be accessible (clear and easy-to-understand), defensible (evidence-informed and measurable), and relevant (reflect contemporary practice, meeting the needs of the public and system partners).
Revision process
To ensure relevance and responsiveness to changes in the practice environment or legislation, CNO’s standards are part of a cyclical review process.
“Our goal for every revision is to ensure standards of practice are informed by the latest evidence, reflect the realities of current nursing practice environments, and remain responsive to the rapidly evolving health care landscape,” said Maya Nikoloski, CNO’s Director of Professional Practice. “Every practice standard is a result of thoughtful collaboration and provide a strong foundation for care that is safe, effective and inclusive.”
The development of the Professional Boundaries and Nurse-Client Relationships practice standard was informed by an extensive review process that included:
- a jurisdictional scan and literature reviews
- analysis of professional conduct data
- review of practice inquiries
- feedback from nurses through CNO’s Nurse Advisory Group
- input from CNO’s Employer and Academic Reference Groups
- input from system partners, including a consultation survey sent to a random selection of CNO registrants
- external legal counsel input
What’s new?
- New title
The title was updated to include professional boundaries to emphasize this important component as highlighted by evidence reviews and nurse feedback.
- Streamlined content
We removed duplication across the standard for clarity and efficiency.
- Dedicated sections
New sections were added to provide clear guidance on professional boundaries and abuse prevention as our evidence review, and nurse input, revealed this was a gap in the previous practice standard.
- Integrated diversity, equity and inclusion expectations
We added DEI expectations to reinforce our commitment to diversity, equity and inclusion in nursing practice.
- Expanded technology and social media guidelines
We added additional expectations for safe use of technology and social media in relation to maintaining professional boundaries.
Supporting nurses
To support nurses in applying the practice standard, we are developing a range of resources, including educational webinars, Q&As, scenario-based and reflection content. These resources will be available starting in early 2026 and can be found on the Standards & Guidelines page.