RN chronic pain article

[Deanmonster]

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http://online.wsj.com/article/SB10000872396390443862604578032842310254744.html

At least we should know by Nov. 1. It boggles my mind how loose regulations are on RNs.

 

[DrAwsome]

http://online.wsj.com/article/SB10000872396390443862604578032842310254744.html

At least we should know by Nov. 1. It boggles my mind how loose regulations are on RNs.

Don't anesthesiologists have to have a fellowship to do pain procedures? Why would nurses with no fellowship get to do pain? That doesn't make sense. If that's the case, why not just have pain training during anesthesia residency and have all anesthesiologists do pain procedures?

I guess I don't understand what the goal is here. It seems it's a 2 tiered system, where one group is over educated and the other group is under educated. I agree with you, it boggles the mind.

 

[medking]

Don't anesthesiologists have to have a fellowship to do pain procedures? Why would nurses with no fellowship get to do pain? That doesn't make sense. If that's the case, why not just have pain training during anesthesia residency and have all anesthesiologists do pain procedures?

I guess I don't understand what the goal is here. It seems it's a 2 tiered system, where one group is over educated and the other group is under educated. I agree with you, it boggles the mind.

...to the point where they don't even realize when they're causing harm. People that don't know their own limits are very "strong", and by "strong", I mean scary and dangerous to the rest of us.

And yes....blows my mind.

 

[leaverus]

Don't anesthesiologists have to have a fellowship to do pain procedures? Why would nurses with no fellowship get to do pain? That doesn't make sense. If that's the case, why not just have pain training during anesthesia residency and have all anesthesiologists do pain procedures?

I guess I don't understand what the goal is here. It seems it's a 2 tiered system, where one group is over educated and the other group is under educated. .

The goal is $$$ - what else? I wouldn't say fellowship-trained pain docs are over-educated. They are trained to manage chronic pain and do invasive SURGICAL procedures so their training is appropriate; perhaps even insufficient at just a year. But anesthesiologists do not absolutely have to have done a fellowship in order to treat chronic pain patients or do pain procedures; and many haven't. RNs OTOH are unquestionably under-educated for it. Even after a 4-year anesthesia residency I wouldn't consider myself qualified for it so we're talking about people with fragile but over-inflated egos.

BTW, can't access original article linked - need subscription? Is there another link?

 

[DrAwsome]

The goal is $$$ - what else? I wouldn't say fellowship-trained pain docs are over-educated. They are trained to manage chronic pain and do invasive SURGICAL procedures so their training is appropriate; perhaps even insufficient at just a year. But anesthesiologists do not absolutely have to have done a fellowship in order to treat chronic pain patients or do pain procedures; and many haven't. RNs OTOH are unquestionably under-educated for it. Even after a 4-year anesthesia residency I wouldn't consider myself qualified for it so we're talking about people with fragile but over-inflated egos.

BTW, can't access original article linked - need subscription? Is there another link?

I know their goal is $$. But is the proposition for them to do this without supervision? And why would anyone go to a nurse when they can go to a physician? I also don't get how they would make more $$ with pain vs what they currently do. And again, why would the licensing bodies allow nurses to do something that attendings many times don't do? If I were an anesthesiologist I would take these matters all the way to the supreme court. It makes no sense that this keeps happening. Why don't we let nurses do neurosurgery too then? Why not do urologic or ENT procedures, and take the place of rad oncs as well? It's absolutely insane.

 

[MD Dreams]

I know their goal is $$. But is the proposition for them to do this without supervision? And why would anyone go to a nurse when they can go to a physician? I also don't get how they would make more $$ with pain vs what they currently do. And again, why would the licensing bodies allow nurses to do something that attendings many times don't do? If I were an anesthesiologist I would take these matters all the way to the supreme court. It makes no sense that this keeps happening. Why don't we let nurses do neurosurgery too then? Why not do urologic or ENT procedures, and take the place of rad oncs as well? It's absolutely insane.

I said the same exact words in another thread not too long ago. You are absolutely right. The ASA needs to pick this issue up and take it all the way to the Supreme Court and make anesthesia a medical specialty and not a medical and nursing specialty. I have no problems with CRNAs. I do have a problem with CRNAs practicing independently to any degree. This is getting out of hand and its time for a paradigm shift! Maybe we can draft a petition letter with signatures and send it to the ASA to motivate them to act. The money we send the ASA should be used to make legislative change.

 

[jwk]

I said the same exact words in another thread not too long ago. You are absolutely right. The ASA needs to pick this issue up and take it all the way to the Supreme Court and make anesthesia a medical specialty and not a medical and nursing specialty. I have no problems with CRNAs. I do have a problem with CRNAs practicing independently to any degree. This is getting out of hand and its time for a paradigm shift! Maybe we can draft a petition letter with signatures and send it to the ASA to motivate them to act. The money we send the ASA should be used to make legislative change.

You don't really think the ASA is unaware of this, do you?

Licensing is a state issue, not a federal one. There are no federal licenses to practice medicine, nursing, or any other profession. Licenses to practice for physicians, nurses, CRNA's, AA's, and myriad others are issued by various state boards and licensing agencies. Likewise, the federal government does not regulate what procedures constitute the practice of medicine and which are the practice of nursing. They may not pay for them if not done by an appropriate practitioner, but they don't say who may or may not actually perform a procedure.

So, if you're trying to prohibit CRNA's from practicing pain management, or from practicing independently (however you define that), it has to be done at the state level, either through the courts (litigating what crosses the line into the practice of medicine) or through the legislature (defining scope of practice within the law). Neither one is cheap.

 

[leaverus]

And why would anyone go to a nurse when they can go to a physician?

You think the nurse introduces themself as nurse? And you think the patient knows or cares enough to question it when all they want is pain relief? I know of one CRNA practicing pain - maybe he has a PhD, i wouldn't know - but his patients address him as "doctor" and he doesn't bother correcting them.

Why don't we let nurses do neurosurgery too then? Why not do urologic or ENT procedures, and take the place of rad oncs as well? It's absolutely insane.

I don't believe that's too far in the future.

 

[TeamZissou]

I said the same exact words in another thread not too long ago. You are absolutely right. The ASA needs to pick this issue up and take it all the way to the Supreme Court and make anesthesia a medical specialty and not a medical and nursing specialty.

Agreed, since the supreme court doesn't determine scope of practice; why not address Medicare/Medicaid and let that have it's affect nationwide?

I don't subscribe to WSJ, anyone wanna share what the article said?

 

[Deanmonster]

if you google "Nurses Seek Expanded Role" and click the WSJ article you can get it free.

It is just an overview of CRNA's doing chronic pain and that the Centers for Medicare and Medicaid Services are expected to decide whether to reimburse them by Nov. 1.

As for who would visit a CRNA over a chronic pain doctor... maybe... someone who wants opiates.

 

[likeaboss]

So what's the gameplan?

Is the ASA all over this or what!?