The role of the nurse-practitioner in a pediatric team: patient definitions.

Patient conceptions and evaluations of the nurse-practitioner role were explored in a random sample of families who attended a pediatric office team comprising a pediatrician and a nurse-practitioner. Patients do not perceive the nurse to have expertise in an exclusive domain of health problems. Thus, the majority of patients do not consider her addition to the office to have improved on the doctor services. Although many patients took advantage of the opportunity to discuss with the nurse issues they regarded unworthy of the doctor's time, they did not value time spent with the nurse as meriting dispensing with some of the doctor time or the payment of an additional fee. The low value placed by patients on the diffuse area of "care" as opposed to the application of medical science hinders the prospects of public recognition of the nurse-practitioner. This applies particularly to the nurse-practitioner as a team member, where an explicit attempt is made to articulate the unique domains and boundaries of the various professionals.