Ketamine Registered Nurse

Compensation: $90,000 annually | Full-time benefits | No call | No weekends | No holidays Position Summary

Optimum Wellness & TMS is seeking an experienced, highly skilled Registered Nurse (RN) to join our outpatient interventional psychiatry and infusion-services team. This role supports the safe delivery of provider-ordered IV ketamine infusions and the assessment, direct observation, monitoring, education, and discharge support of patients receiving self-administered esketamine (Spravato®) in a REMS-certified healthcare setting.

This is not an entry-level nursing position. The successful candidate will bring extensive hands-on IV expertise, excellent clinical judgment, a calm and compassionate bedside manner, and the ability to recognize and promptly escalate changes in patient condition.

Applicants must have a minimum of five (5) years of recent, direct RN experience involving frequent peripheral IV placement and IV medication or infusion administration. Applicants whose experience does not include substantial, routine IV initiation and infusion administration will not meet the minimum qualifications for this role.

• Successful peripheral IV placement, including difficult-access patients; vein assessment, site selection, equipment selection, and securement.
• IV medication and infusion administration under authorized prescriber orders; infusion-pump operation; IV-site surveillance; and maintenance of IV patency.
• Identification and response to infiltration, phlebitis, occlusion, bleeding, vasovagal symptoms, and medication-related adverse effects.
• Ongoing clinical assessment, vital-sign monitoring, clear documentation, and prompt escalation of concerning findings.
• Safe discontinuation of IV access and post-treatment patient education.

• Complete and document pre-treatment nursing assessments, including relevant clinical updates, medication reconciliation, patient-reported symptoms, baseline vital signs, and readiness for treatment.
• Establish peripheral IV access; verify patency before treatment; and monitor and maintain IV-site integrity throughout the infusion.
• Prepare and administer IV ketamine under an authorized provider order, established clinic protocols, and applicable legal and professional standards.
• Operate infusion pumps and monitoring equipment safely and accurately; monitor and document blood pressure, heart rate, respiratory status, oxygen saturation, level of consciousness, comfort, and treatment-related symptoms.
• Recognize and respond promptly to elevated blood pressure, nausea, anxiety, dissociation, excessive sedation, vasovagal symptoms, IV complications, or changes in consciousness or respiratory status.
• Immediately notify and elevate clinical concerns to the supervising psychiatric provider, psychiatrist, or Medical Director according to clinic protocol and emergency-response procedures.
• Safely discontinue IV access after treatment and participate in the clinical assessment confirming the patient meets established discharge criteria.

• Perform and document pre-treatment assessment and required baseline vital signs, including blood-pressure evaluation.
• Support REMS-compliant treatment processes for patients who self-administer Spravato under direct observation in the certified healthcare setting.
• Observe and monitor patients throughout the required post-administration observation period; obtain and document required blood-pressure assessments, including the approximately 40-minute post-dose measurement and additional assessments as clinically indicated.
• Monitor for sedation, dissociation, respiratory depression, dizziness, nausea, anxiety, confusion, falls risk, blood-pressure elevation, and other treatment-related concerns.
• Perform pulse-oximetry monitoring and document required clinical observations in accordance with clinic protocol and REMS requirements.
• Provide clear education regarding treatment expectations, transportation requirements, driving and safety restrictions, and when to seek urgent or emergency…