North Carolina says yes, then attaches conditions. Its Board of Nursing position statement says administering sedative, analgesic and anesthetic agents for moderate or deep procedural sedation to non-intubated clients “is within the non-anesthetist Registered Nurse (RN) scope of practice” (p. 1) — and that doing so “requires all of the following” (p. 1): employing-agency policy authorising it; an RN with the knowledge and validated competencies the statement describes; an RN who does not assume other responsibilities “which would leave the client unattended” (p. 1); and the ordering practitioner present — procedure area for moderate, bedside for deep. Everything below is quoted or paraphrased from that PDF, with page numbers.
North Carolina at a glance
| Board | North Carolina Board of Nursing, Raleigh (p. 1) |
| Document | Procedural Sedation/Analgesia Position Statement for RN Practice — a 9-page PDF (“Page 1 of 9”, p. 1). Page numbers here refer to it. |
| Rule it applies | No operative rule quoted — the statement is issued under none and interprets none. Its References list two Board rules and nothing else from the Administrative Code: 21 NCAC 36.0224 and 36.0225 (p. 8). |
| Status | Advisory. “A Position does not carry the force and effect of law and rules but is adopted by the Board as a means of providing direction to licensees who seek to engage in safe nursing practice” (p. 1) — though it is written in mandatory vocabulary: sedation “requires all of the following” (p. 1). |
| Dates | “Origin: 1/2015” · “Revised: 4/2015, 9/2018, 9/2022” (p. 9). No effective date, review date or expiry is printed; positions are “reviewed regularly” (p. 1). |
| Who it covers | The non-anesthetist RN administering or monitoring moderate or deep procedural sedation/analgesia for “non-intubated clients undergoing therapeutic, diagnostic, and surgical procedures” (p. 1), adult and pediatric (p. 7). |
| Who it does not cover | Four exclusions (p. 2): APRN-CRNAs, whose scope “exceeds and is not limited by the constraints of this Position Statement”; sedation for intubation, including RSI, handled instead “as detailed in the NCBON RSI Position Statement” (not summarised here); “moderate to deep sedation/analgesia of already-intubated, critically ill clients”; and four things within both RN and LPN scope — analgesia without sedatives, minimal sedation/anxiolysis, topical or local anesthesia, and sedation “solely for the purpose of managing altered mental status”. General anesthesia is “limited solely to anesthesia providers, including CRNAs”. LPNs are excluded from procedural sedation itself — “beyond LPN scope of practice” (p. 8), because nursing care of these clients “exceeds Licensed Practical Nurse (LPN) scope of practice” (p. 1). |
| Settings the document names | Not stated — no setting type is named anywhere; the words hospital, ambulatory, office and endoscopy do not appear. It locates people rather than places: “immediately available” means “present on site in the unit of care and not otherwise engaged in any other uninterruptible procedure or task” (p. 3). |
| Re-verification interval | None set by the Board — delegated explicitly: “Employing agency determines frequency with which ongoing competencies are re-validated” (p. 4). Agency policy is then asked to address documentation “in the manner and at the frequency specified by agency policy” (p. 5). |
| Where the record lives | Not stated as a location. Education, training, experience and competency validation “must be documented and maintained” (p. 4), inside the employing agency’s written policies and procedures (p. 5). Who holds it, in what form, for how long: not stated. |
| CE hours | Not stated: no contact-hour count anywhere, and continuing education is not mentioned. The one certification named in its competency list is “Advanced Cardiac Life Support (ACLS) and/or Pediatric Advanced Life Support (PALS) certification” (p. 4, item A.4), scoped “appropriate to the status of the client/population” (p. 4). |
What the North Carolina Board of Nursing says
On the nurse’s side, the RN “must possess in-depth knowledge of and validated competency to apply the following in practice” (p. 4): anatomy and physiology, including oxygen delivery and dysrhythmia recognition; the “Pharmacology of sedation, analgesia, and anesthetic agent(s) administered singly or in combination”, including reversal agents; “Airway management skills required to rescue a patient from sedation/analgesia level deeper than intended and to manage a compromised airway or hypoventilation”; and ACLS and/or PALS certification (p. 4). Five validated practice competencies follow (pp. 4–5), ending in recovery assessment “including the use of a standardized discharge scoring system” (p. 5).
On the agency’s side, “each employing agency determines IF the administration of moderate and/or deep procedural sedation/analgesia by non-anesthetist RNs is authorized in their setting” (p. 5). Where it is, written policies and procedures must address eleven items — “including but not limited to” that list (p. 5), a floor and not a ceiling — from credentialing and the documentation requirement to the presence and dedicated-nurse rules, approved medications and dose limits, emergency protocols and age- and size-appropriate equipment (pp. 5–6). It closes by warning that “Pulse oximetry measures oxygenation, not ventilation.” (p. 6).
“Education, training, experience, and validation of initial and ongoing competencies appropriate to RN responsibilities, procedures performed, and the client/population must be documented and maintained.”
North Carolina Board of Nursing — Procedural Sedation/Analgesia Position Statement for RN Practice, revised 9/2022, p. 4
What a North Carolina facility should be able to show
That translates into three per-nurse records. The statement writes them for moderate and deep procedural sedation together (p. 4); the list below is scoped to the moderate-sedation roster, and nothing on it should be read as evidence for deep sedation.
- ACLS and/or PALS certification appropriate to the status of the client population — the certification named in the statement’s competency list (p. 4, item A.4). It attaches no currency wording to it, and no CE hours to anything.
- Per-nurse evidence of initial education and training covering the knowledge areas it lists — anatomy and physiology, the pharmacology of the agents including reversal agents, and airway management to the rescue standard (p. 4).
- Per-nurse evidence of validated ongoing competency for the five practice competencies (pp. 4–5), re-validated at the frequency your agency policy names (p. 5) — the Board sets none (p. 4).
The CSRN™ course — 10 CE contact hours developed and delivered by Capt. M. Ron Eslinger, CRNA, with module exams, case studies and a certificate ID your credentialing office can verify — is built to be records 2 and 3 on that list. Facility seats and roster tracking →
Questions North Carolina facilities ask
How often does North Carolina say sedation competency must be re-validated?
It does not say. The Board delegates the interval outright: “Employing agency determines frequency with which ongoing competencies are re-validated” (p. 4). Annual, biennial, per-population: none of those words appears in the document. The interval you write into your policy is your own, and a certificate with an expiry date makes it visible on the roster.
Does North Carolina require the CSRN™ course specifically?
No. The statement requires no named sedation course; the certification named in its competency list is ACLS and/or PALS (p. 4, item A.4), and no state mandates this specific course. It asks instead for the record in the block quote above, written for moderate and deep procedural sedation together (p. 4). Its References page does list the American Association of Moderate Sedation Nurses, noting that its “Resources section provides information on Certified Sedation Registered Nurses (CSRN)” (p. 9). That is a listing — the Board neither approves, endorses nor mandates any course in this document, and validated competency is met by your assessment of the nurse’s practice, not by a certificate alone. CSRN™ is built to be the moderate-sedation education-and-assessment half of that.
Can a North Carolina RN administer propofol for procedural sedation?
The Board’s position is that it is not prohibited, which is not the same as authorised. Propofol is named among the medications that, “if ordered by Physician, CRNA, NP, PA, or” another credentialed practitioner “and allowed by agency policy, is not prohibited provided the appropriate indications and precautions are in place.” (pp. 7–8). Every one of those conditions is doing work: the order, your own agency policy, the practitioner’s presence, and an RN who meets the education and competency requirements in full. General anesthesia stays outside it, and nitrous oxide is “the ONLY agent that can be administered by non-anesthetist RNs via the inhalation route” (p. 2).
Compliance note (last reviewed September 2026): This page is educational information about the North Carolina Board of Nursing’s Procedural Sedation/Analgesia Position Statement for RN Practice, not legal advice or a compliance determination. Every quotation was checked word-for-word against the nine-page PDF on the Board’s server on 2026-09-02; page numbers refer to that PDF, whose printed history reads Origin 1/2015, revised 4/2015, 9/2018 and 9/2022. A Board position statement does not carry the force of law, and the Board reviews its positions regularly; confirm the current text and your own facility policy before relying on this summary. No state mandates this specific course.