The legislature is moving to make sure people involved in pain management are well-trained in the most delicate procedures, an idea that came to Senator Tom Dempsey of St. Charles when he had an epidural, an injection into nerves in or near his spinal cord to block the transmission of pain signals.

His concern is for certified registered nurse anesthetists whose work in such procedures is outside their scope of practice—meaning they lack the specific training for such a delicate procedure. Dempsey’s bill limits those procedures outside of a surgical, obstetrical, or post-operative course of care to licensed physicians.  His bill allows certified  registered nurse anesthetists or licensed anesthesiologist assistants to continue performing surgical or obstetrical anesthesia services or post-operative pain control. 

Dempsey says regular anesthesiologists who want to do these procedures go through a one-year training program. But he says hundreds of CRNAs do these procedures without that training.

Dempsey says it’s not just placement of the injection. He says the CRNAs need to be trained in the procedure and be prepared for any adverse occurrence. He says he’s told their representatives the law can change when their profession has a program to properly train them.

President-elect Don Beissel of the Missouri Association of Nurse Anesthetists complains the bill allows licesed physicians to conduct the procedures “regardless of the physician’s skills, education, training or clinical experience” while at the same time “prohibiting all other healthcare professionals, including Certified Registered Nurse Anesthetists, from performing these procedures, even if these practitioners have the skills, education, training and clinical experience to perform them.”  

The senate has sent the bill to the House.

The measure is SS/SCS/SB682

  AUDIO: debate 14:08