Standard 12 - Professional Boundaries/Therapeutic & Professional Relationships

Standard 12 - Pressional Boundaries/Therapeutic & Professional Relationships

Respiratory Therapists (RTs) must act with honesty, integrity, and respect appropriate professional boundaries with patients/clients, healthcare team member, students, and others.

Performance Requirements

RTs:

1. Must refrain from abusing a patient/client verbally, emotionally, psychologically, electronically, physically, or sexually, or taking advantage of a patient/ client as a result of the member’s position.
2. Must refrain from abusing or taking advantage of a person with whom the member has a professional relationship or, in relation to whom the member is in a position of authority or trust.
3. Recognize how a power imbalance can impact therapeutic and professional relationships, and demonstrate integrity in all interactions, including abstaining from entering into personal relationships where professional boundaries could be compromised.
4. Must not make comments, enter into situations, and/or demonstrate behaviour that could be interpreted as abusive, harassing, discriminatory, disrespectful or of a sexual nature (e.g., suggestive/provocative gestures) and must take action to prevent similar behaviour in others by reporting to the appropriate authority.
5. Refrain from maligning the reputation of any colleague.
6. Communicate clearly with patients/clients to explain assessment and therapeutic procedures that could be interpreted as compromising professional boundaries (e.g., touching, positioning) and obtain ongoing voluntary informed consent.
7. Communicate electronically and through social media in a manner that respects therapeutic and professional relationships.
8. Understand the effect and impact of abuse on patients/clients and integrate principles of sensitive practice into care.

Treat all patients and clients equitably without discrimination on any basis, while recognizing their individual needs and levels of physical or cognitive ability.

Patient/Client Expected Outcome

Patients/clients can expect that RTs treat them with integrity while maintaining professional boundaries.

Related Standards

• Communication
• Consent
• Patient/Client Assessment & Therapeutic Procedures
• Privacy/Confidentiality
• Professional Responsibilities
• Sexual Misconduct and Sexual Abuse of Clients

Related Resources

• College of Respiratory Therapists of Ontario. (2023). Abuse Awareness and Prevention. Professional Practice Guideline. Available at: https://abuse.crto.on.ca.College of Respiratory Therapists of Ontario. (2021). Respiratory Therapists Providing Education. Professional Practice Guideline. Available at: https://education.crto.on.ca.
• National Alliance of Respiratory Therapy Regulatory Bodies. (2016). National Competency Framework for the Profession of Respiratory Therapy. Part 1. National Standards for Entry-to-Practice. Available at: https://nartrb.ca/download/ncf-part-i-entry-to-practice-2016.
• National Alliance of Respiratory Therapy Regulatory Bodies. (2024). National Competency Framework. Available at: https://nartrb.ca/national-competency-profileframework.
• Nova Scotia Regulator of Respiratory Therapy. (2008) NSRRT Code of Ethical Conduct. Available at: https://nsrrt.ca/professional-practice/code-of-ethics
• Nova Scotia Regulator of Respiratory Therapy. (2024) Sexual Misconduct and Sexual Abuse of Clients. Available at: https://nsrrt.ca/images/20250107_Approved_Sexual_Misconduct_and_Sexual_Abuse_of_Clients_Standard.pdf
• Nova Scotia Regulator of Respiratory Therapy. (2017) NSRRT Social Media Guideline. Available at: https://nsrrt.ca/images/NSRRT_Social_Media_Guideline.pdf

 Glossary

Abuse refers to “treating others in a harmful, injurious, or offensive way.”^[1]

Communicate refers to “the process of exchanging information, ideas, thoughts, feelings, or messages between individuals or groups using verbal, non-verbal, written, or visual methods”.^[2]

Healthcare team refers to “peers, colleagues, and other healthcare professionals (regulated and non-regulated).”^[3]

Informed consent means that the information relating to the treatment must be received and understood by the patient/client. Consent may be implied or expressed. Implied consent is determined by the actions of the patient/client. Implied consent may be inferred when performing a procedure with minimal risk that the patient/client has consented to previously and acts in a manner that implies their consent. Expressed consent is more official and may be written or oral.^[4]

Patient/client refers to “individual, group, community or population who is the recipient of respiratory therapy services and, where the context requires, includes a substitute decision-maker for the recipient of respiratory therapy services”.^[5]

Professional boundaries set the limitations around relationships between patients/clients, health care providers, students, and others to ensure the delivery of safe, ethical, patient/client-centred care. Professional boundaries are characterized by respectful, trusting, and ethical interactions with patients/clients that are free of abuse, sexual abuse, sexual assault, and sexual harassment.^[6]

Professional relationships refer to “the connections/interactions of RTs with service providers, students, and others.”^[7]

Sensitive practice refers to “delivering healthcare that respects the diverse backgrounds, beliefs and values of patients, and providing care with an understanding of how trauma affects health and behaviour”.^[8]

Therapeutic relationships refer to “the connections/interactions of RTs with their patients/clients.”^[9]

 ^[1] College of Respiratory Therapists of Ontario. (2023). Abuse Awareness and Prevention. Professional Practice https://abuse.crto.on.ca/definitions/#abuse

^[2] Open AI. (2025). ChatGPT (May 14 version) [Large language model]. https://chatgpt.com

^[3] College of Respiratory Therapists of Ontario. (2021). A Commitment to Ethical Practice. Available at: https://ethics.crto.on.ca. 

^[4] College of Respiratory Therapists of Ontario. (2022). Responsibilities under Consent Legislation. Professional Practice Guideline. Available at: https://responsibilities.crto.on.ca/     

^[5] Nova Scotia Government. Regulated Health Professions Act (2023). Available at:  https://nslegislature.ca/sites/default/files/legc/statutes/regulated%20health%20professions.pdf

^[6] Adapted from College of Physical Therapists of Alberta. (2024). Therapeutic Relationships Guide for Alberta Physiotherapists. Available at:  https://www.cpta.ab.ca/docs/87/Therapeutic_Relationships_Guide_2024.pdf

^[7] College of Respiratory Therapists of Ontario. (2023) Abuse Awareness and Prevention. Professional Practice Guideline. Available at: https://abuse.crto.on.ca/

^[8] Open AI. (2025). ChatGPT (May 14 version) [Large language model]. https://chatgpt.com

^[9] College of Respiratory Therapists of Ontario. (2023). Abuse Awareness and Prevention. Professional Practice Guideline. Available at: https://abuse.crto.on.ca