Emergency nurse practitioner: an answer to an emergency care crisis in rural hospitals.

During the last three years, a nine-month training program at the University of Virginia was designed and implemented to prepare the nurse to assume an expanded role in the emergency department. The course provides the student with sufficient knowledge and skill to diagnose and treat patients in the emergency department setting while under the supervision of a physician. Graduates of the program are certified by the State of Virginia as "emergency nurse practitioners". Qualified candidates who had identified a physician preceptor or were from an area with embryonic emergency medical systems were given priority in the selection process. The training program was divided into three-month modules which dealt first with teaching interview techniques and physical assessment skills, then clinical experiences in rural and urban emergency departments, and finally a preceptorship in the community hospital where the nurses work with the physician preceptors.