Clinical initiative nurses and nurse practitioners in the emergency department: what's in a name?

Background: The clinical initiative nurse in the emergency department is a role that is gaining traction nationally. For many, confusion exists related to the perceived similarities with the role of the emergency nurse practitioner and how to differentiate the clinical initiative nurse role from that of the nurse practitioner. Method: A review of available literature related to the development of the clinical initiative nurse role in Australia was undertaken. The available literature was scant in this service-driven model and literature from a variety of sources was drawn upon. Results: It would appear that the clinical initiative nurse role is valuable in reducing time to be seen key performance indicator, however, this is based on anecdotal evidence. It is clear that the nurse practitioner role better equips nurses to meet key performance indicators overall, leading to improved quality of service in the emergency department. Conclusions: Preparation for the clinical initiative nurse role is not regulated and varies widely based on the service in which the role is performed as opposed to the nurse practitioner role. The title of nurse practitioner is protected under legislation and regulated by the state nursing regularity bodies, except in Tasmania, which currently does not have the legislation to do this. The ability of the nurse practitioner to follow through care inclusive of discharge is far more effective than a role aimed at and capable of only initiation of treatment.