Advertisements can be useful when marketing a nursing business. Nurses who are considering advertising for their nursing business should ensure advertisements align with the principles outlined in the Code of Conduct. It includes the following: 

• Truthfulness – nurses must be honest and truthful and not mislead the audience or use sensational claims or statements.  The information must be verifiable. 
• Professionalism – nurses must ensure they maintain professionalism and do not erode public confidence in nurses or the nursing profession. 
• Ethical – nurses must provide all relevant information and avoid using comparative statements or guaranteeing the success of a treatment or product over another.  Nurses must identify, prevent, and ensure there is no conflict of interest. 

The Independent Practice guideline outlines the requirements for advertising nursing services.  These requirements apply to all nurses registered with CNO. Nurses are accountable for: 

• Including their name and protected title (RPN, RN, or NP) 
• Including a description of their services 
• Never using CNO’s logo or statement which implies CNO’s approval or endorsement. CNO does not approve or endorse businesses
• Not including direct references to products used or sold.
  

Yes, if you refer to the nursing services you provide or the business you own or are employed by when posting and the purpose is to gain clients or showcase the services you provide, then it is considered an advertisement. As such, your posts need to comply with CNO’s Standards and Guidelines.

When considering responding to comments on social media, it is important to continue to follow the principles outlined in the Code of Conduct, including being truthful, professional and ethical.

Before and after media may be used with the client's consent. All media must be a result of the work of the nurse associated with the advertisement and not digitally enhanced (for example, photoshopped or retouched). Please review CNO’s Consent guideline for specific guidance on client consent.

Regarding advertising products, nurses must avoid advertising that they sell products to clients.  Furthermore, the Food and Drugs Act prohibits advertising prescription drugs to consumers that include direct or indirect reference to the drug’s therapeutic use and/or benefits. For example, Health Canada identified commonly noted issues when advertising Botox including direct references to the name of the drug in videos and photos alluding to the indications of the drugs. For more information, please see Health Canada’s webpage: Illegal marketing of drugs and devices. 

Nurses must be aware of any legislation that affects their practice and are encouraged to consult with a legal professional or their professional liability protection provider for more information. 

As outlined in the Professional Conduct: Professional Misconduct Reference Document, nurses must avoid endorsing products. When a nurse endorses a product, they are suggesting that one product is better than all others regardless of the client's circumstances. Nurses must always consider the individual client’s needs to determine the best product.

It is important to remember that the nurse-client relationship is one of unequal power.  As such, nurses need to ensure they are not misusing their power and always place their professional responsibilities ahead of their personal gain, including financial or other conflicts of interest.

It is never appropriate to solicit testimonials from clients as it may negatively affect the therapeutic nurse-client relationship (TNCR). The purpose of the TNCR is to promote the health and well-being of the client, not to meet the needs of the nurse. 

Reviews on an independent third-party website are different from testimonials as nurses and their employers cannot edit, approve or easily delete reviews. As such, they are not considered to be your advertising. It is important to note that the third-party website must not have any relationship with the nurse or their employer to qualify as a review, for example, Google or Yelp reviews. 

Nurses must reflect before they interact with reviews on third-party websites to ensure they are doing so professionally. Nurses should refrain from linking reviews to their website(s), social media, or advertising.  Nurses must not manipulate reviews, for example, create fake reviews or remove negative reviews, as it has the potential to mislead the public and compromise trust.

In this situation, we understand that nurses may not have control over how their services are advertised. Nurses are accountable for advocating for responsible advertising practices to their employers to ensure that the public has relevant information and is not misled when nursing services are advertised. Nurses should document their actions for their records.

If the employer is a regulated health professional, nurses can also consult with the employer’s regulator to determine if they have any requirements for advertising. If nurses have concerns that their employer may be breaching the requirements set out in the Food and Drugs Act, please reach out to Health Canada.