Carol Lesser

REI, Boston IVF
  • Boston IVF
  • United States of America

Recent Comments

Aug 07, 2019

Speaking for myself and countless IVF nurses who recognize the increasing complexity of our field, I want to wholeheartedly thank Drs. Shaia and Muasher for articulating the problem of lack of adequate sub specialty nursing training facing so many of our IVF clinics, with potentially serious consequences for both nurses and patients.

Current constructs rely heavily on IVF nurses to provide the bulk of daily patient care.  This presents a glaring problem since most IVF nurses receive no formal training, in direct contrast to REI physicians who are required to complete lengthy and intensive fellowships before entrusted to care for our patients. There is no such program for IVF nurses.  

As this recent article describes, IVF nurses are on the front line, spending disproportionately more time caring for patients compared with their physicians who are then freed to focus more on diagnosis and treatment orchestration, leaving the bulk of the day to day contact to their nurses.  As the REI field has expanded and incorporated genetic screening of both patients and embryos, our nurses often find themselves ill equipped to competently answer patient questions or to confidently offer guidance to patients who request further assistance with decision making. Similarly, with no formal training in embryology, most nurses are unable to answer other than basic questions that relate to cycle outcomes.

The lunchtime continuing education format offered by Dr. Catherino et al and referenced in this important paper illustrate both the need for and importance of physician and embryologist training for nurses to remedy this lack of basic training especially in the key areas of genetics and embryology.  The format with pre and post testing offers a constructive way to measure improvement in knowledge in these vital areas, helping nurses gain knowledge and confidence.

There is also acknowledgement of the utility of the REI nurses course offered through ASRM and the recommendation that IVF centers pay for nurse membership in ASRM. This would give access to the varied and valuable educational opportunities offered through ASRM online, including the intensive nurse’s course as well as the publication Fertility and Sterility. I would argue that the reason more nurses have not taken advantage of this course is due to the cost that most centers do not cover. Similarly most nurses cannot afford membership in ASRM and their centers do not provide this to most or any of their nurses. If centers funded and facilitated completion of this course, undoubtedly participation would be higher. Alternatively, as some of the larger centers are able to do, in-house continuing education lectures that focus on what nurses need to know to better perform their jobs could be offered.  Many smaller centers are not equipped to provide this support.  In my center many nurses complain that lectures are during lunch and they are too busy to attend or pay proper attention.

Another beneficial avenue for nursing continuing education is participation in the annual North American conference for IVF nurses called StartArt that has grown in attendance and popularity over the past few several decades. I have been both honored and gratified to be the co-chair of this meeting for more than a decade and cannot adequately express the value of bringing nurses from US and Canada together to learn from the greatest leaders in our field who recognize the value of contributing to nursing education. Unfortunately many nurses complain that they must pay their own way and the travel and lodging costs for nurses can be prohibitive even though the educational portion is covered by a generous industry sponsored grant. This is another example of how too many centers fail to take advantage of this well received and highly rated conference and the opportunity it provides to raise nurses’ understanding of the complexities and new developments of our field.

It is the hope of nurses both experienced and new to the field that the value of a well-prepared and clinically up to date nurse be recognized and then supported by each of the centers that employ IVF nurses. The attraction and retention of nurses would improve and patient satisfaction would most certainly rise and everyone would benefit.

Carol Lesser, MSN, NP-C

Boston IVF