Nursing

A coalition of nursing, physician, and related healthcare associations have endorsed the practice of allowing properly trained ED nurses to perform procedural, or conscious, sedation. There is ample evidence that trained ED nurses are qualified to perform the procedure under the supervision of a physician, said Denise King, RN, MSN, CEN, president of the Emergency Nurses Association. In addition to ENA, groups that signed a statement of support in February 2008 include the American Association of Critical-Care Nurses, the American College of Emergency Physicians, and others.

The statement is intended as a response to a move to restrict RNs from administering sedatives or dissociative agents for procedural sedation, which allows patients to tolerate medical procedures while maintaining cardiorespiratory function. The American Society of Anesthesiologists and the American Association of Nurse Anesthetists (AANA) believe that when a drug like propofol (Diprivan) is used for sedation, it should be administered only by an anesthesiologist or CRNA. AANA maintains that it isn't always possible to predict how a patient will respond, and there is potential for rapid, profound changes in sedative depth. Some state boards of nursing have advised that administration of procedural sedation is beyond the scope of a non-CRNA nursing practice.