January 15, 2008

 

Louisiana Court Declares Interventional Pain Management is Solely the Practice of Medicine and Is Not within Nurse Anesthetist Scope of Practice

A Louisiana court recently held that the Louisiana State Board of Nursing’s advisory opinion substantively expanded the scope of practice of a nurse anesthetist into an area where they have not traditionally practiced (i.e. - chronic or interventional pain management).   The advisory opinion was issued in 2005 in response to a nurse anesthetist’s request for clarification on this issue.  Subsequently, Spine Diagnostics Center of Baton Rouge, Inc brought a lawsuit against the nursing board that, among other things, sought an injunction to prevent the nurse anesthetist who requested the opinion from continuing to perform pain management procedures.  Moreover, Spine Diagnostics Center sought a declaratory statement that interventional pain management procedures constitute the practice of medicine and that the nursing board exceeded its authority in authorizing nurse anesthetists to practice these procedures. 

In 2006, the Court of Appeal ruled that the “opinion” was in fact a regulation and required compliance with the Louisiana Administrative Procedures Act.  Additionally, the appellate court ordered a preliminary injunction prohibiting the nursing board from enforcing the statement.  The Louisiana Society of Anesthesiologists and ASA filed amicus briefs in support of Spine Diagnostics Center.  The Louisiana Supreme Court affirmed the court’s decision.  In November, the parties returned to the trial court concerning several remaining issues.   Last week, the court’s decision included:

• The practice of interventional pain management is not the scope of practice of a nurse anesthetist.
• The practice of interventional pain management is solely the practice of medicine.
• The advisory opinion issued by the nursing board is an effort to substantively expand nurse anesthetist scope of practice and is an improper attempt at rule making.
• A permanent injunction issue prohibiting the nursing board from enforcing the statement.

 

Click here for a copy of the judgement