Continuity of care: the orthopaedic nurse practitioner in tertiary care.

Since 1965 registered nurses have been educated to perform expanded functions in primary health care. The nurse provider role evolved from a shortage of primary health care providers. "Nurse practitioners" were needed to increase access to health care in urban and rural areas of the country that lacked the necessary number of providers to give quality patient care. Until recently, the majority of nurse practitioners have continued in the traditional primary care role, practicing in clinics, private physician offices, and on an independent basis. However, many factors now provide the impetus to have nurse practitioners develop tertiary care practices within the nation's acute care hospitals. This article describes the development and implementation of an orthopaedic collaborative practice in tertiary care.