Nurse practitioners offer late-night options.

Byline: David Wenner

Mar. 19--Jennifer Shearer thought her baby might be sick. She asked the day care staff to call her if they noticed anything wrong.

But she didn't find out until the end of the day that the 4-month-old had vomited several times. It was too late for an appointment with a pediatrician.

So Shearer called GoodNights After Hours Pediatric Urgent Care, a type of medical practice that's common in some states but unusual in Pennsylvania. She was given a 5:30 p.m. appointment, and her baby received intravenous fluids to avert dehydration.

GoodNights exemplifies an approach Gov. Ed Rendell wants to use to improve health care across Pennsylvania and make it more affordable.

It's open after regular business hours -- from 4 p.m. until midnight every day, including weekends and holidays. And all of the medical care is provided by nurse practitioners, not doctors.

Nurse practitioners have more training than regular nurses. They can perform many of the medical tasks …