Posted by Josh BSN RN on August 31, 2008, 9:00 pm, in reply to "Re: National shortage"
I work as a nurse in pain management in an outpatient, hospital-based interventional pain management clinic. I've seen the difference between physicians that are anesthesiologists and have done a pain fellowship perform interventional pain management, and I have seen doctors that don't have that amount of training do the same procedures.
The difference is striking.
Even if we ignore the possible complications from performing a LESI, the difference in training between a pain doc and a CRNA [or AA] performing the same procedure is going to be significant.
As nurses we can argue all day about patient advocacy and how folks that are unfortunate enough to live in BFE still should have access to pain management, and that is true. But it is difficult to stomach the patient advocacy argument if the midlevel is trying to do pain management in an area where qualified docs are performing the same procedures.
Training and expertise does directly translate into improved treatment effect while at the same time reducing the possibility of complications. If a patient's insurance only will pay for 3 epidural steroid injections per 4 month period, then as a patient advocate we should hope that those shots are done by someone that has the best chance at getting a positive outcome.
