Int J Emerg Med (2010) 3:271–278 DOI 10.1007/s12245-010-0214-8 ORIGINAL RESEARCH ARTICLE Perceptions of nurse practitioners by emergency department doctors in Australia Tracey J. Weiland & Claire Mackinlay & George A. Jelinek Received: 22 December 2009 / Accepted: 24 June 2010 / Published online: 26 August 2010 # Springer-Verlag London Ltd 2010 Abstract Background The Australian Medical Association is strong- ly opposed to the nurse practitioner (NP) role with concerns that NPs may become doctor substitutes without the requisite training and education that the medical role demands. Despite this, NPs have been heralded by some as a potential solution to the access block, workforce shortage and increased demand affecting emergency depart- ments (EDs). Aims The purpose of this study was to determine the perception of NPs by medical staff working in Australian EDs. Methods Semi-structured telephone interviews were con- ducted with closed and open-ended questions. Participants were drawn from a representative stratified sample of two city, two metropolitan and two provincial hospitals of each State/Territory. Results A total of 95 doctors from 35 EDs participated in this study including 36 Departmental Directors; 36% of participating Directors indicated having an NP on staff. The views expressed in this paper are those of the author(s) and not those of the editors, editorial board or publisher. Electronic supplementary material The online version of this article (doi:10.1007/s12245-010-0214-8) contains supplementary material, which is available to authorized users. T. J. Weiland (*) : C. Mackinlay : G. A. Jelinek Emergency Practice Innovation Centre, St. Vincent’s Hospital Melbourne, P.O. Box 2900, Fitzroy, Melbourne, Australia e-mail: Tracey.Weiland@svhm.or.au T. J. Weiland : G. A. Jelinek Department of Medicine, The University of Melbourne, Melbourne, Australia Doctors were strongly opposed to the statement that NPs could replace either nurses or other prevocational doctors; 71 interviewees commented on the role of NPs in the ED. Thematic analyses revealed polarised views held by doctors. Eight major themes were identified, the most common being that there is a lack of clarity of the NP role definition, their scope of practice and differentiation from the medical role. Conclusion Although ED NPs represent a highly skilled professional group their role is poorly understood by ED doctors. Opposition to the NP role is a significant barrier to the introduction of great numbers of ED NPs as a strategy to overcome the medical workforce shortage. Keywords Nurse practitioner . Intern . Emergency medicine . Supervision Introduction The Australian Medical Association is strongly opposed to the nurse practitioner (NP) role with concerns that NPs may become doctor substitutes without the requisite training and education that the medical role demands [1, 2]. Despite this, NPs have been heralded by some as a potential solution to the access block, workforce shortage and increased demand affecting emergency departments (EDs) [3]. This view is reflected in government with increased funding for NPs at Federal [4] and State levels, with some Australian State Governments releasing funding to increase NP numbers within EDs [5, 6]. Further support for NPs has come though the recent introduction of independent prescribing rights [7]. Data regarding the impact of NPs within emergency medicine (EM) suggest a positive benefit on key perfor-