On December 11, 2025, the College of Nurses of Ontario (CNO) Council approved a historic shift in regulation. Effective March 1, 2026, the long-standing Therapeutic Nurse-Client Relationship standard will be retired.
In its place, the CNO is implementing the stricter Professional Boundaries practice standard.
This change, combined with the new Documentation standard taking effect February 1, 2026 explicitly targets the two biggest risks in modern nursing: Artificial Intelligence (AI) and Social Media.
The “AI” Trap (Effective Feb. 1, 2026)
The revised Documentation standard now explicitly holds nurses accountable for “the use of technology, such as artificial intelligence.”
Many nurses are using tools like ChatGPT to summarize notes or draft emails. Under the new 2026 rules, this is a dangerous game.
- The Liability: If the AI hallucinates a detail (e.g., recording a vitals check you didn’t do) and you sign the note, you are guilty of falsification. The defence “the computer did it” is no longer valid.
- The Privacy Breach: Inputting patient details into a public AI model is an immediate breach of PHIPA and professional misconduct.
The “Social Media” Hard Line (Effective March 1, 2026)
The new Professional Boundaries standard was created because the CNO believes the old rules were too vague regarding online conduct. The new standard hardens the line.
The Explicit Ban on “Connecting”: Previous guidelines warned about the risks of social media. The new 2026 Professional Boundaries standard is far more direct. It explicitly states that nurses “must refrain from connecting with clients, following clients, or accepting friend requests from clients on their personal social media accounts”.
The Scope Includes All Platforms: The CNO has updated the definition of “Social Media” to explicitly include platforms like TikTok, Instagram, and discussion forums. If you are “following” a former patient on Instagram or TikTok, you are now arguably in direct violation of the standard.
FAQ: The New 2026 CNO Standards
Q: Can I use ChatGPT to write my nursing notes if I check them afterwards? A: Proceed with extreme caution. The new Documentation standard (effective Feb. 1, 2026) explicitly mentions accountability for AI use. If the AI hallucinates a detail or omits critical data, and you sign off on it, you are liable for falsification. Additionally, inputting patient data into a public AI tool is likely a breach of PHIPA and professional misconduct regarding confidentiality.
Q: Do I really have to “unfriend” former patients on social media? A: likely yes. The CNO defines a “patient” as anyone you have cared for within the last year (and sometimes longer). The new Professional Boundaries standard (effective Mar. 1, 2026) explicitly states nurses must “refrain from connecting with clients… on their personal social media accounts.” If a former patient falls within the one-year window, maintaining a connection on Facebook or Instagram is now a documented boundary breach.
Q: Can the CNO investigate me for a post on my private Instagram account?
A: Yes. The CNO’s jurisdiction extends to “off-duty” conduct if it negatively impacts public trust. The new standard explicitly includes “discussion forums” and apps like TikTok in its definition of Social Media. Marking an account as “private” is not a legal defence if the content is shared or reported.
Q: Does the new “Professional Boundaries” standard ban me from posting in uniform?
A: The standard does not explicitly ban uniforms, but it creates a higher risk for doing so. It warns that technology use shifting to “personal communication” can blur boundaries. If you post content in uniform that mocks patients, criticizes your workplace, or is deemed “unprofessional,” the CNO can now prosecute this more easily under the expanded boundaries framework.
Q: What should I do if I receive a CNO complaint about a social media post?
A: Do not delete the post immediately (as this can be seen as destroying evidence) and do not respond to the investigator without legal counsel. Social media complaints often involve complex arguments about “freedom of expression” vs. “professional obligations.” You need a lawyer to frame your response within the new 2026 standards.
This commentary is for informational purposes only and does not constitute legal advice.
Contact Tamir Litigation Law Firm today at 416-499-1676 or visit tamirlitigation.com to learn how you can protect your licence and your reputation. You can also message us on WhatsApp for a free initial chat.