Professional Boundaries, Nurse-Client Relationships, and Privacy and Confidentiality

Nurses are accountable to develop an effective and therapeutic nurse-client relationship. In Ontario, nurses should review and adhere to the CNO (2025a) practice standard related to Professional Boundaries and Nurse-Client Relationships. One principle of this standard is related to the therapeutic nurse-client relationship in terms of “providing safe, compassionate and ethical nursing care and promotes positive health outcomes” (pg. 5). An important component of the nurse-client relationship involves engage in therapeutic communication. As per CNO, you need to recognize power imbalances in these relationships and communicate in respectful ways while protecting a client’s right to personal privacy.

In your new role as a nursing student and your future role as a registered nurse, you must adhere to the CNO (2025b) practice standard related to Confidentiality and Privacy – Personal Health Information. This practice standard outlines nurses’ ethical and legal responsibilities, the legislative acts, what personal health information is, how to apply the standard, and information related to consent and disclosure. The CNO (2025b) standard statements related to this practice standard include:

• Personal health information practices (e.g., safeguarding personal health information and maintaining confidentiality).
• Knowledgeable consent and substitute decision-makers (e.g., seeking client’s expressed consent to disclose information outside of the healthcare team).
• The client’s right to access and amend their personal health information (e.g., respecting a client’s right to review their information).
• Potential for harm (e.g., consult with the healthcare team if you learn of information that could cause harm to the client or others).
• Disclosure without consent (e.g., adhering to legislation that requires you to report information to others).

Remember, you are legally obligated to practice in accordance with the CNO standards, or nursing standards in your region.

Throughout this chapter, you will learn to apply and interpret these practice standards in the context of nursing practice and the client interview.

References

CNO (2025a). Professional boundaries and nurse-client relationships. https://cno.org/Assets/CNO/Documents/Standard-and-Learning/Practice-Standards/41033_therapeutic.pdf

CNO (2025b). Confidentiality and privacy – personal health information. https://cno.org/Assets/CNO/Documents/Standard-and-Learning/Practice-Standards/41069_privacy.pdf