As you may or may not know, I am in school to become an advanced practice registered nurse (APRN), in the concentration of Family Nurse Practitioner. There's a bill in committee right now in the Tennessee Legislature that would limit our scope of practice. This bill would decrease competition, inflate costs, and reduce patients' access to non-narcotic pain management. Tennessee has a problem with narcotics anyway... this bill would make it worse. Contact your Senator and let him/her know you oppose SB1935.
PS. Alabama, I think, tried to make a law like this and it was struck down by the FTC for limiting competition.
Honorable Senator Stacey Campfield
301 6th Avenue North
Suite 4 Legislative Plaza
Nashville, TN 37243
Senator Campfield;
I am a registered voter in your senate district and active in the Knox County Young Republicans. I am a registered nurse and a student at the University of Tennessee, pursuing my master’s degree in nursing. I would like you to vote against SB 1935, Nurses Engaged in Interventional Pain Management (now in committee).
What if a doctorally prepared supervisor were required for every workman who nails down shingles? Small roofing businesses who could not afford a full-time supervisor would be forced to close. Costs for completing a roofing job would go up, so that people who could not afford a larger company would not get the repairs they needed. Roofing is a skill; a workman does not need a high level degree to learn how to do it correctly. Requiring an architect to supervise would drive up costs and reduce access to a needed service. Unnecessary regulation would ultimately hurt everyone, but that is precisely what some are trying to do with interventional pain management.
Interventional Pain Management is a broad term that covers several procedures. These procedures block the nerves that conduct pain but leave other nerves intact so that the affected area, i.e., an arm or hand, can still be used. Some procedures block regional nerves, such as nerves in the shoulder, or central nerves in the spine.
At this time, properly trained and qualified nurse practitioners (NPs) and physician assistants (PAs) can perform these procedures; indeed, they have been performing them for years. To this day there is no evidence that physicians conduct these interventions more safely or effectively, yet SB 1935 would prohibit NPs and PAs from helping patients control their pain through nerve blocks without direct physician supervision. The proponents argue that medical school and residency are necessary in order to properly perform nerve blocks, but is that really true?
Though great precision and accuracy are required, proper performance of a nerve block is a skill; there is no new knowledge of biology, biophysics, pharmacology, or anatomy required. Certified Registered Nurse Anesthetists (CRNAs) are specifically trained for this skill, and indeed are required to perform a certain number in order to graduate (though graduates from the UT program routinely exceed the requirements by 200%). Other NPs and PAs receive training from physicians. They are directly supervised until their training is deemed sufficient. Even after completing their training, NPs and PAs report to a supervising physician who is always available for consultation and who reviews the work they do. At this time many clinics share supervising physicians, but a requirement for direct supervision would prove too much financial strain. What makes the situation worse is that these small clinics are often in rural areas where there is no other help available.
In conclusion, there is no evidence that patients would be better off if NPs and PAs were directly supervised by a physician when performing interventional pain management. Or, to rephrase, why increase government interference and take away their freedom to practice and patients’ access to needed care? If this bill comes to debate, please vote NO.
If you have any questions or concerns, please contact me. I would also appreciate hearing your thoughts and opinions regarding this bill.
Sincerely,
Rachel Farmer
gr8brady@gmail.com
