Abstract
Accident and emergency (A and E) work is undergoing many changes including a revision of trauma patient management, examination of medical and nursing skill mix and the introduction of health care support workers. Such changes affect all members of the A and E health care team, including nurses whose role has traditionally been in the provision of continuing care of the patient and family. A and E nurses' response to change and subsequent professionalization is poorly documented within current health literature, much of which reflects medicine's response to change within A and E departments. The following literature review illustrates that the examination of A and E related issues involves some exploration of the 'open access' policy and its perceived effects upon the A and E department.

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