John Beales advises on the practicalities of establishing emergency nurse practitioner services

A&E nursing has been one of the most fervent supporters of the development of nurse practitioners, with some 98 A&E departments in the UK (36 per cent of the total number) claiming to offer such a service in a survey carried out in 1996 (Tye 1998). These services are wide ranging in terms of scope of practice, location, staffing, service objectives and development rationale. It is clear that no one ‘pathway’ has developed and that a significant amount of ‘re-inventing the wheel’ has occurred in A&Es across the country. This is compounded by the failure to establish any agreed common usage of the term ‘emergency nurse practitioner’ to define the scope of practice undertaken, despite the issuing of advisory documents (Tye 1997 Royal College of Nursing 1997).