Most children attending accident & emergency departments do so with minor injuries, yet can wait many hours to see a doctor. The needs of this specialist client group could be met by a paediatric nurse practitioner (PNP). But, as Gerry Linke explains, the road to autonomy and acceptance is long

Both the medical and nursing professions have recognised that many patients attending A&E do not require the services of a doctor (Howie 1992, James and Pyrgos 1989, Jones 1996). Changes in healthcare economics are appearing almost daily and many traditional concepts of service delivery and role boundaries are being challenged (Bland 1997, Tye 1997). This article discusses such changes in relation to the development of PNPs and the paediatric population in A&E, a specialist client group with needs that many trusts have not yet addressed (Audit Commission 1996).