The evolution of the role of the Emergency Nurse Practitioner in Scotland: a longitudinal study

Aims and objectives. To examine how the role of the Emergency Nurse Practitioner has evolved in Scotland. Background. In 2001, Cooper and colleagues published a report on their survey (carried out in 1998) which described the extent and nature of Emergency Nurse Practitioner services in Scotland. They described a nascent nursing role and service that existed in almost half of Emergency Departments and that concentrated its activity on the management of minor distal limb trauma and wound management. Since that date, several relevant and important political, professional and local issues have combined to accelerate the development of this role. Design. Longitudinal survey of Scottish Emergency Departments (n = 97 in 1998, n = 93 in 2009). Method. Census survey of all Scottish Emergency Departments identified by NHS National Services Scotland’s Information and Statistics Division Accident and Emergency Waiting Times dataset 2006‐07. Results. Emergency Nurse Practitioners are now practising in the majority (89%) of Emergency Departments and Minor Injury Units compared with 47% in 1998. Most departments (78%) use Emergency Nurse Practitioners in dual roles, and most departments (67%) differentiate their Emergency Nurse Practitioners from other nursing staff by use of a title. Wide variations in pay, role and scope of practice still exist. Conclusions. The role of the Emergency Nurse Practitioner has increasingly become part of mainstream health care delivery in Emergency Departments across Scotland and can now be considered to be common place. This study demonstrates that ‘Advanced Nursing Practitioners’ and ‘Nurse Practitioners’ cannot necessarily be considered to be synonymous, and nursing roles that are allowed to evolve naturally adopt a non‐uniform level of practice. Relevance to clinical practice. This paper is of interest to Nurse Practitioners and workforce planners.