Nurse practitioners in the accident and emergency department

The theoretical management of walking wounded patients by experienced nurses was compared with that of middle-grade doctors. Out of 400 patients seen, 332 were assessed by the nurses. The theoretical management by the nurses of 298 of these patients was satisfactory. The nurses mismanaged 12 of the patients according to local practice. They also requested X-rays in 22 more patients than the doctors, none of whom returned with a fracture. Out of the patients suitable to be seen by the nurses 94% said that they would use a nurse practitioner system if introduced. The theoretical waiting-time saving for the patients during the trial was 11 min. The authors recommend that if nurse practitioners are introduced in this country there should be an adequate training programme along nationally debated guidelines.