Medical Certificate for Employee Absence Act: Nurses Accountabilities

I am a nurse working in a practice setting where a client requires a medical certificate or “sick note” for absence from work. Is issuing a sick note within my scope of practice? What should I consider when issuing a sick note?

Issuing a sick note is within the professional scope of all nurses. The Medical Certificates for Employee Absence Act authorizes qualified health professionals to issue medical certificates, or sick notes to clients who are under their care. The Act defines qualified health professionals as anyone who is regulated in the province who is “providing a diagnosis, treatment or care to the employee”. This includes any nurse providing care to the client.

When requested to issue a sick note, you should consider:
  • Your competence to write a sick note. You must have the knowledge skills and judgement required to write the sick note. If you do not have the required competencies you are accountable to work with your employer to obtain any education required to attain and maintain this competency within your individual scope of practice.
  • Collaborating with the client’s authorized prescriber to determine details of the sick leave, such as the duration of the absence. Depending on the context, you may be able to independently determine the details of the sick leave.
  • Utilizing the Three Factor Framework to determine who is the most appropriate care provider to issue the sick note.
  • Employer policy with respect to issuing sick notes.

For further information on anything contained within this practice support tool, please contact an NSCN Practice Consultant at

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