Louisiana Society of Anesthesiologists, ASA, successfully block legislative effort to expand nurse anesthetist scope of practice
Due in large part to advocacy efforts by the Louisiana Society of Anesthesiologists and ASA, another effort to expand nurse anesthetist scope of practice has been thwarted. S.B. 322 would have allowed nurse anesthetists to perform interventional pain management procedures, including but not limited to those involving the injection of local anesthetics, steroids, and analgesics for pain management purposes under the direction and supervision of a physician. The procedures for pain management purposes include, but are not limited to, peripheral nerve blocks, epidural injections, and spinal facet joint injections when the registered nurse anesthetist can document education, training, and experience in performing such procedures. S.B. 322 conflicted with the advisory opinion adopted by the Louisiana State Board of Medical Examiners in 2006, which authorizes nurse anesthetists to provide anesthetics for acute pain associated with surgery, but defines procedures for interventional pain management as the practice of medicine and can only be performed by a physician.
S.B. 322 passed the Senate last week, but it never reached the House floor for a vote. The bill died once the legislature adjourned. LSA members responded in strong number with letters, phone calls and in-person visits with legislators to ensure that the bill did not move forward.
The issue of nurse anesthetists performing interventional pain management procedures has been addressed by Louisiana's legislative, judiciary, and executive branches for nearly two years. The language of S.B. 322 mirrored an advisory opinion that had been issued by the Louisiana Nursing Board. The opinion was the subject of a lawsuit and was recently invalidated by the Louisiana Court of Appeal. The petitioner argued that the “opinion” in effect constitutes a rule and that the nursing board circumvented the rule-making process by establishing scope of practice via an advisory opinion. The Louisiana Court of Appeal agreed and held that the statement issued by the nursing board was a rule, subject to the Louisiana Administrative Procedures Act. The Louisiana Supreme Court denied the nursing board’s petition to review the lower court’s decision. ASA and the Louisiana Society of Anesthesiologists filed amicus briefs in support of the petitioner. Several unresolved issues still remain at the trial level.
Congratulations to the Louisiana Society of Anesthesiologists on their hard work!