Roles and responsibilities of nurse practitioners
This page provides information to nurse practitioners and their employers on their roles and responsibilities while providing care to the public in the ACT.
Nurse practitioners work in many different areas across the public and private health sectors, including diabetes, palliative care, wound care, mental health, walk-in centres, and aged care.
As a nurse practitioner, you are responsible for the care you provide and must follow national standards and guidelines.
If you have a concern about the care a fellow nurse practitioner has provided, it is always best to first raise your concerns with the practitioner involved. If you do not feel comfortable doing so, then you can contact any of the following for assistance:
- the nurse practitioner's employer
- ACT Human Rights Commission
- Australian Health Practitioner Regulation Agency.
Roles and responsibilities in the ACT
Preparing sick certificates
Sick certificates and medical certificates are different documents.
As a nurse practitioner in the ACT, you can issue a sick certificate for employees who are unwell and cannot attend their workplace.
A sick certificate serves the purpose of a statutory declaration for the patient’s employer.
The reason why nurse practitioners cannot provide a medical certificate is because operational definitions in the Fair Work Act 2009 (Commonwealth) and Workers Compensation Act 1951 (ACT) require that medical certificates only be written by a registered medical practitioner.
If a nurse practitioner were to provide a ‘medical certificate’ it would amount to ‘holding out’, which is an offence under sections 116 and 118 of the Health Practitioner Regulation National Law 2010 (Commonwealth).
There is no limit on the number of days you can write a sick certificate as it is dependent on the patient’s disposition and employer policy.
You may also authorise attendance and carers certificates for employers of patients through the statutory declaration process described above.
These certificates are generally given when an employee misses work for a medical appointment, or who are well themselves but caring for an unwell family member.
Assessing and treating work-related injuries
Nurse practitioners in the ACT have the practice authority to assess, diagnose, and treat work-related injuries within their employed scope of practice.
However, under the Workers Compensation Act 1951 (ACT) and Work Health and Safety Act 2011 (Commonwealth) you cannot authorise workers’ compensation or Comcare certificates - they must be completed by a medical practitioner working within their scope of practice.
Medical termination of pregnancy (MToP)
Currently nurse practitioners in the ACT do not have the practice authority to prescribe a medicine for the purposes of MToP under Part 6 of the Health Act 1993 (ACT).
Any health professional, other than a medical practitioner, who prescribes a medicine for the purposes of inducing a termination of pregnancy commits an offence under ACT legislation.
Assessing a person's fitness to drive
Nurse practitioners in the ACT have the practice authority to assess a person’s fitness to drive within their employed scope of practice.
However, under the Road Transport (Driver Licensing) Act 1999 (ACT) you cannot authorise paperwork required as evidence by the ACT Road Transport Authority - it must be completed by a medical practitioner.
It is important to note there is no mandatory reporting requirement if you identify a patient is unfit to drive.
However, you should note that you are not civilly or criminally liable for assessing a patient and reporting, in good faith, a patient who may be unfit to drive.
Death certificates and declarations
Current nurse practitioners in the ACT do not have the practice authority to authorise a death certificate as required by the Births, Deaths and Marriages Registration Act 1997 (ACT).
Some registered nurses employed in the public sector may declare ‘life extinct’ in a person, but this is dependent upon local policy.
The declaration of life extinct does not have the same legal ramifications as a death certificate.
Check with your health service for further information.
Witnessing a non-written health direction
Under the Medical Treatment (Health Directions) Act 2006 (ACT), nurse practitioners and other health professionals do have the practice authority to witness non-written health directions, but one of the two witnessing professionals must be a medical practitioner.
A nurse practitioners cannot substitute for a medical practitioner for this purpose.
Requesting and/or interpreting a diagnostic examination
A nurse practitioner endorsed by the NMBA can request any diagnostic pathology or imaging examination within their scope of practice.
Like medical practitioners, you may interpret any diagnostic pathology or imaging examination within your scope of practice.
Subsidy of diagnostic pathology or imaging through the Medicare Benefits Schedule (MBS) or other funding mechanisms does not relate to your practice authority.
However, your employed scope of practice may limit which diagnostic examinations you may request and/or interpret.
Prescribing medicines
A nurse practitioner endorsed by the NMBA can prescribe any S2, S3, S4 or S8 medicine within their employed scope of practice, except medicines used for the purposes of inducing a medical termination of pregnancy, or Appendix D Medicines in the Medicines, Poisons and Therapeutic Goods Regulation 2008 (ACT).
There are Controlled Medicines Prescribing Standards for the prescribing of controlled medicines in the ACT that all prescribers must comply with.
Authority to practice on patients outside the ACT
Authorisation to practice is not required for patients living in different states or territories, as long as the care provided by the practitioner occurs within ACT borders.
In the case of telehealth services, you must adhere to legislation and policy in the jurisdictions in which the patient resides.
This is particularly important as relating to medicines, poisons and therapeutic goods acts (however named).
Reports, papers and frameworks
- Consultation Paper - Proposed legislative changes to authorise core and supplemental clinical activities performed by nurse practitioners
- (2021) Results from the Australian Capital Territory (ACT) Nurse Practitioner Workforce and Employer Survey
- (2021) Outcome Evaluation on Nurse Practitioner Policy and Legislation in the Australian Capital Territory
- Implementation Principles for Nurse Practitioner Credentialing in the ACT
- (2017) Nurse Practitioners in the Australian Capital Territory – A Review
- (2005) The Aged Care Nurse Practitioner Pilot Project
- (2002) The ACT Nurse Practitioner Project