The use of intraoperative neuromonitoring (IONM) is becoming increasingly mainstream. A 2018 study in the Journal of Spine Surgery reported the use of IONM in spine surgery increased 296 percent from 2008 to 2014.

Lauren Feltz

Because of this, an increasing number of neurodiagnostic technologists are pursuing certification in this arena.

Still, the demand for techs far exceeds the supply, according to Lauren Feltz, an IONM tech for the last 13 years and the owner of IntraOp Solutions. Her company helps connect hospitals with with short-term IONM services to fill staffing shortages.

We spoke with Feltz to gain a better understanding of how neurodiagnostic technologists can pursue IONM certification and what institutions can do to adjust to an increasing demand for certified staff.

Demand Outweighs Supply

Like many clinicians trained in IONM, Feltz has a background in something else — she is a certified anesthesiologist assistant (CAA). Her husband, who runs IntraOp Solutions with her, comes from audiology, a field with some overlap in testing with IONM.

IONM is very niche, Feltz said, and it’s hard to learn about. This may be due to a very small number of training programs — the University of Michigan and Labouré College in Massachusetts are two of note for her.

“I think very few people know about it,” Feltz said. “I just found out through applying to a ad.”

With such a small funnel into IONM for neurodiagnostic technologists, the field has become open to those from other disciplines already working in the operating room, like Feltz and her husband.

Other challenges include a difficult work-life balance. Working in an operating room can be stressful, and it can require long hours, Feltz said.

“You work when cases start until they end,” she said. “It’s very difficult to have a family and create a routine around that. It can be very difficult to staff and to not create burnout.”

Filling Staff Holes

Because it can be difficult to find already-trained techs, some hospitals do their own training and develop an in-house team. This can take a long time, so the quantity of cases should be enough to invest in training, Feltz said. Most in-house programs are at very large institutions that require IONM daily, she added.

But, even outsourcing companies like hers can struggle to find qualified techs.

“I know myself looking at hiring people that it’s hard to find people who are certified who can jump into any kind of situation,” she said. “Companies tend to hire people and then train them. But training can take three to six months, sometimes longer.”

Because Feltz and her husband do most of the staffing provided by her company, they focus on short-term, temporary help because staffing is usually “in flux in the neuromonitoring world.”

“It could be that you just need help on Mondays,” said Feltz. “It could be that somebody is out for two weeks. Now, with the COVID quarantines, somebody is out for two to three weeks. We’re trying to fill that gap.”

Feltz loves her work and she encourages people to enter the field whether by attending a school or seeking work through a staffing agency. The value of IONM continues to be proven and with it job opportunities will continue to grow. If neurodiagnostic techs don’t jump on this opportunity, others will.

You can learn more about IONM from the American Society of Neurophysiological Monitoring or about getting a certification in intraoperative neuromonitoring (CNIM) from ABRET, a neurodiagnostic credentialing body.

Special thanks to Lauren Feltz, CNIM, CAA, MHS, owner of IntraOp Solutions, a neuromonitoring company that provides short-term service for groups that do neuromonitoring. You can connect with her on LinkedIn.