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Emergency nurse practitioners and doctors consulting with patients in an emergency department
Emergency Medicine Journal, 05/29/09

Sandhu H et al. - The findings suggest differences between ENP and ED doctor consultations which are associated with some aspects of patient satisfaction. In contrast to previous reports, consultation length was not greater for ENPs than for doctors. There is a need for further research to test the generalisability of these findings and their impact on clinical outcome.

Exclusive Author Commentary
Dr H Sandhu, 07/24/09

There is little research examining nurse-patient communication and doctor-patient communication in an emergency department. Communication has been shown to be a key factor in influencing patient satisfaction and patient health outcomes. The current exploratory study found that Emergency Nurse Practitioners (ENPs) had shorter consultations compared to Senior House Officers (SHOs) but they spend more time giving information and counselling patients (similar to that of General Practitioners (GPs)). Informing patients is an important part of the consultation, as research shows this is associated with improved shared decision making. In the current study information giving was also associated with higher patient satisfaction for ENP consultations. The ENP is a new and developing role, with aims to substitute for doctors, reduce waiting times, and so lead to more cost-effectiveness overall. The evidence from this study suggests that they may have a different consulting style to emergency department doctors and that this may lead to higher patient satisfaction ratings. This is one of the first studies which has examined such consultations using in-depth analysis. Further research is needed to confirm whether the differences in consultation style observed here apply to ENPs working in other emergency departments. If this is found to be the case, this will have clear implications for workforce planning and communication skills training.

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