To do or not to do: use of the scope of professional practice in accident and emergency work

The Scope of Professional Practice has the potential to revolutionise the practice of Accident and Emergency nursing. However, for such a revolution to take place re-evaluation of the thinking and doing of Accident and Emergency nursing is needed. In particular, many organisational approaches to work such as team-building and multidisciplinary work need to be recognised and the place of the nurse within them formalised. The make-up of nurses' work in Accident and Emergency needs to be understood, so that expansion of the role can encompass a wide range of 'caring' work as well as easily identify tasks. In addition the use of the Scope of Professional Practice should be based upon clarification and recognition of dilemmas which may lead to informed risk taking by Accident and Emergency nurses. Once nurses' work in Accident and Emergency is understood, the short- and long-term effects on the continuity of patient and family care of nurses' actions and non-action can be explored. Communication is seen as underpinning all professional and care development in relation to the use of the Scope of Professional Practice in Accident and Emergency. The art of listening as well as talking to colleagues, patients and families is important if the revolution is to take place.