Scope of Practice

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How is scope of practice defined for CRNAs? Is it based on training in CRNA school? Based on common usage of techniques by CRNAs?

Specializes in Vents, Telemetry, Home Care, Home infusion.

da Vinci® System Training

da Vinci System training is comprised of two parts:

(1) On-Site da Vinci Surgical System Training

Surgeons and support staff attend a half-day training session at their hospital. This program consists of didactic and practical skills sessions covering the components and proper use of the da Vinci Surgical System and EndoWrist® Instruments. On-site training highlights key da Vinci System features, System preparation and management, and includes a hands-on practicum for both surgeons and nurses.

(2) Off-Site da Vinci Surgical Skills Training*

One surgeon and his/her surgical assistant learn and practice procedural skills using the da Vinci Surgical System at one of our premier regional training centers. Offsite da Vinci System Training is a one- or two-day program combining didactic sessions and a structured, hands-on laboratory session. The curriculum emphasizes surgical team roles and responsibilities, as well as emergent techniques for optimizing robotic-assisted minimally invasive surgery.

Gee, if doctors can do robotic surgery with just 1/2 day to 2day max course, guess WE immersion course in pain mgmt for 19 hours is more than sufficient.

As with many nurses, people develop specific interest in a specific subject area that intrigies them. They purchase + read books about subject, read professional journal articles, take CE program or 2, pepper experts they work with regarding specific subject then decide to take indepth education program to strengthen and expand interest area, return to work setting performing advanced skills under another professional for first time.

It's not just taking solo course.... unless were talking robotic surgery. ;)

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Gee, if doctors can do robotic surgery with just 1/2 day to 2day max course, guess WE immersion course in pain mgmt for 19 hours is more than sufficient.

Robotic surgery is in its infancy. It's very experimental and we don't know which types of surgeries are best suited for it. Maybe in 10 years, it will prove to be an established tool. At that point, the best practices will established and anybody who wants to do it has to be certified to do it. Laproscopic surgery or any new field has to go through this evolution to become a mature field. Once a mature field, best practices for safe practice and minimal level of competence are established. Pain is such a mature field. Being certified in that field means you meet those competency levels. Why do we bother getting degrees like the CRNA? Why not just pick someone off the street and teach them how to deliver anesthesia in a few weeks?

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Actually, I like to stick with truth and state when something is my opinion. Now if you through being an SDN spokesperson, why don't you quit posting or tell us your background! That is the only pertinent thing left undiscussed on this thread.

So, if it is a weekend course and a physician goes to it...That has to mean that it is the physician's only interventional pain training by yours and Paindoc's logic.

I'm waiting along with everyone else..... for your credentials.

When backed into a corner, the red herrings and ad hominems come out. :icon_roll Stick with the debate.

You seem convinced that CRNA pain training consists of more than weekend courses. We all want you to prove it.

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Pain medicine is a medical specialty encompassing many techniques, diagnostic skill sets, therapeutic options, and research into the advancement of the field. Robotic surgery is a single technique that is merely an extension of current surgical technique. The two are not comparable in scope. Surgeons are not naive enough to think they can skip an entire residency training program to gain enough skills in a weekend to learn a specialty.

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Specializes in Anesthesia.
When backed into a corner, the red herrings and ad hominems come out. :icon_roll Stick with the debate.

You seem convinced that CRNA pain training consists of more than weekend courses. We all want you to prove it.

blah....blah...blah....again there is no proof that a FP or any other physician, that isn't board certified or didn't do a fellowship in interventional/chronic pain management, did anything other than one of these weekend courses either. So, again by yours and Paindocs logic it must be the only training these other physicians have had....just another "weekend warrior" by those standards...it doesn't matter if they have had countless OJT hours all that matters is that weekend course...

The debate didn't change. I am directly challenging the claim that anyone only does a weekend course as their only training in interventional/chronic pain management (physician or CRNA).

Again...your qualifications are?

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Here is a company who teaches Primary care physicians pain management, botox, submental liposuction and dermatology procedures and other things all in a weekend. Take the course....set up your practice to make money!

http://www.empiremedicaltraining.com/workshops.cfm

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Sweet, it appears that all you really need to practice pain is an MD and a weekend course, well yes I can see where a FP who has never performed an epidural injuection ever is qualified to perform pain after a weekend course. That clears up a lot, well I an really a believer in the MD model for pain managment, WOW my eyes are opened to the natural superiority of a physician in all things!

Hint paindoc and ng stick to your scope of practice and out of mine. It is clear that this is just a turf war over money, period not patient saftey. When I see MD's trying to drop the hammer on the MD graduates from these seminars then you will have some credability until then your crediability is about ZERO.

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Stanman and Skipaway, don't be so naive that you believe organized medicine is not outraged by fly by night organizations teaching MDs an entire medical specialty in a weekend or procedures in the same timeframe. We have and will continue to take action, and I will glady lend my expertise to plaintiffs that sue these unethical unprincipled physicians that place their pursuit of money over the safety of patients. There is no place in pain medicine for amateurs.

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If you want to do vertebroplasty, spinal cord stimulators, cervical injections add a FOUR DAY course and you will be good to go.http://www.sppm.org/PDFfiles/SPPM_Interventional_Pain_Course_SC.pdf

I think at this point we can see that there are a lot of DOCTOR weekend pain warriors. The silence on the regulation of these practitioners will be deafening.

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One day is good enough here to, I have to say I am impressed by the depth of education and training that these physicians recieve before performing these procedures, really guys backs up all those claims of higher education. Very impressive. http://www.painmts.com/index.htm

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:yawn:

If you bother to read the contents of the pain courses, it involves just injections. Just a small subset of what a board-certified pain medicine specialist does which can involve implanting pumps and stimulators. Of course, you guys didn't bother reading.

If CRNA's are suddenly allowed to cut someone open and insert foreign objects into their bodies, then during an operation the CRNA's should not only deliver the anesthesia but also do the surgery too! As I keep pointing out, the invasive procedures not only are not within the scope of CRNA's but nursing as well. Good luck convincing anyone that nurses should be allowed to cut people open. :lol2:

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Here are the arguments presented in court regarding the current case.

First, the plaintiffs emphasized the differences in education between nurse anesthetists and physicians. Second, Spine Diagnostics offered into evidence
nurse anesthetist course curricula to establish that the nurses do not receive education in the specific procedures performed in chronic interventional pain management and compared pain certification requirements of physicians and nurses
. Spine Diagnostics argued that the certification examination required of physicians exclusively tests the applicants' knowledge of pain management as opposed to the nurses' examination, which does not contain extensive questioning concerning pain management. Regarding training, plaintiffs asserted that the curricula of two weekend courses fail to demonstrate sufficient training in the field of chronic pain management procedures and offered testimony regarding the lack of requirements the profession imposes on itself to perform pain management procedures.

Pain is not harmless either.

a case involving a nurse anesthetist who performed a chronic pain management procedure, without physician oversight, which resulted in
paralysis of the patient

Like I said before, step up to the plate and convince the courts why they're wrong and you're right. Simple as that.

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