South Carolina answers the RN sedation question with a Board of Nursing advisory opinion — a document that is not itself a rule. Advisory Opinion #25 asks whether it is within the RN’s role and scope “to administer pharmacological agents intravenously for sedation” (p. 1). It answers yes for non-anesthetic medications. Everything below is quoted or paraphrased from the Board’s two-page PDF, with page numbers, so you can check it against the source.
South Carolina at a glance
| Board | South Carolina Board of Nursing — “the South Carolina State Board of Nursing” in its own words (p. 1); published on the LLR site, llr.sc.gov. |
| Document | Advisory Opinion #25, Sedation (RN) — its title on the Board’s advisory-opinion index — a two-page PDF, AO25.pdf; page numbers below refer to it. |
| Rule it applies | Not stated — the opinion cites no statute or regulation number and is not itself a rule. |
| Status | Advisory, in its own words: “This statement is an advisory opinion of the Board of Nursing as to what constitutes competent and safe nursing practice” (pp. 1–2). Inside it the Board’s wording varies: three conditions for moderate/procedural sedation “must be maintained” (p. 2); the competency evaluation “shall occur on a periodic basis” (p. 2); the credentialing mechanism itself is something the Board “does recommend” (p. 2); and written policies “should be developed” (p. 2). |
| Dates | Formulated May 18, 1989 · last revised January 2020 · last reviewed January 2026 (p. 1). No effective date is stated. |
| Who it covers | The RN giving non-anesthetic medications for minimal/moderate/procedural sedation on a physician’s, dentist’s or APRN’s order (p. 1); also the critical-care RN with specialized training (p. 2). |
| Who it does not cover | LPNs and other licenses are not mentioned. Analgesia/pain-management agents are outside the opinion (p. 1); anesthetic agents are outside the RN’s role — see below. |
| Settings the document names | Only “the critical care setting” (p. 2). Elsewhere: health care facilities and the bedside (p. 2). No hospitals, ASCs or other setting types are listed. |
| Re-verification interval | Periodic (p. 2) — no interval in months or years is stated; see the first question below. |
| Where the record lives | The facility’s educational credentialing mechanism — its process for evaluating and documenting each RN’s competency — plus its written policies, procedures and standing orders (p. 2). |
| CE hours | Not stated. No contact-hour count and no continuing-education requirement; the opinion lists content areas only, quoted below (p. 2). |
What the South Carolina Board of Nursing says
The opinion’s answer is yes: it is within the RN’s role and scope to give “non-anesthetic medications for minimal/moderate/procedural sedation” (p. 1) on the order of a physician, dentist or APRN. For the patient receiving moderate/procedural sedation it then sets three conditions: “The physician must remain at the bedside during and immediately after the administration of the medication, as well as throughout the procedure” (p. 2); “The RN must monitor the patient for heart rate, blood pressure, respiratory rate, oxygen saturation and end-tidal CO2 (if available)” (p. 2) — during administration, throughout the procedure and afterwards “until the patient returns to pre-procedure state of awareness” (p. 2); and “Resuscitation equipment must be readily available” (p. 2). Then comes a recommendation, in the Board’s own word, that facilities keep a documented competency record for each RN:
“The Board does recommend that the health care facilities have in place an educational credentialing mechanism which includes a process for evaluating and documenting the individual RN’s competency relative to the management of the patient receiving intravenous/intraosseous (IV/IO) sedation.”
South Carolina Board of Nursing — Advisory Opinion #25, Sedation (RN) (AO25.pdf, revised January 2020, reviewed January 2026, p. 2)
The content that mechanism covers “includes, but is not limited to, Basic Life Support (BLS), monitoring parameters, dysrhythmias, airway management, oxygen delivery, and pharmacological actions of drugs and emergency drugs administered” (p. 2), and the opinion closes by asking that “Appropriate written policies, procedures, and standing orders should be developed to ensure the safety of patients receiving sedation” (p. 2).
Three lines the opinion draws
Anesthetic agents
The line is drawn by drug class, and the Board puts NOT in capitals: “RNs who are not qualified anesthesia providers may NOT administer agents that are primarily used as anesthetics for minimal/moderate/procedural sedation, such as, but not limited to, ketamine, propofol, etomidate, sodium thiopental, and methohexital” (p. 1). Because agents change, the Board “is unable to specifically name every medication that can or cannot be used” (p. 1) and gives a test: “if the medication is indicated to be any type of anesthetic agent, the medication must be administered by the Licensed Independent Practitioner or CRNA” (p. 1), judged “According to the facilities’ vetted drug reference” (p. 1). It adds two further permissions. Where immediate airway management (intubation) is needed, “the RN may administer any intravenous/intraosseous (IV/IO) agents if a qualified provider is immediately present and available if needed to secure the airway” (p. 1). And in the critical care setting, an RN “with specialized education and training, may initiate, titrate, and bolus intravenous sedative agents with the understanding that the airway is secured and mechanically assisted” (p. 2) — a sentence about sedative agents; the opinion does not say whether it reaches propofol or ketamine.
Deep sedation and anesthesia
The opinion defines four levels — minimal sedation (anxiolysis), moderate/procedural (conscious) sedation, deep sedation and anesthesia (p. 2) — and ties the RN’s role to the level reached, not the drug used: “RNs who are not qualified anesthesia providers may not be authorized to manage deep sedation or anesthesia for short-term diagnostic, therapeutic, or surgical procedures no matter what medications are used” (p. 2).
Pain management
The opinion is about sedation, not analgesia. In capitals: “THIS ADVISORY DOES NOT APPLY TO THE ADMINISTRATION OF AGENTS FOR THE PURPOSE OF ANALGESIA/PAIN MANAGEMENT” (p. 1). It refers the reader to a separate joint advisory opinion on ketamine infusions (p. 1), so a ketamine or other analgesia protocol is outside this opinion’s scope — and outside this page.
What a South Carolina facility should be able to show
Read together, the three conditions and the recommendation translate into three records a South Carolina facility should be able to produce:
- Written sedation policies, procedures and standing orders — the opinion asks that they be developed to ensure the safety of patients receiving sedation (p. 2), and they are the natural place to write down the three conditions quoted above (p. 2).
- A per-RN competency record — the educational credentialing mechanism the Board recommends: a process for evaluating and documenting each RN’s competency in managing the IV/IO sedation patient, across the content areas quoted above (p. 2).
- Periodic re-evaluation of that record — the opinion says the evaluation and documentation are to recur on a periodic basis (p. 2), on an interval your own policy names; it sets none.
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 South Carolina facilities ask
Does South Carolina set a renewal interval for sedation competency?
Not a fixed one. Advisory Opinion #25 says “This evaluation and documentation shall occur on a periodic basis” (p. 2) and stops there — no months, no years. The interval you write into your credentialing policy is your own; a certificate with an expiry date makes it visible on the roster.
Does South Carolina require the CSRN™ course specifically?
No. The opinion names no sedation course, and no state mandates this specific one. What the Board recommends (p. 2) is a facility process for evaluating and documenting each RN’s competency across the content areas it lists. CSRN™ is designed to serve as that evidence — a named credential, assessed competency and an employer-verifiable certificate ID.
Who can order the sedation a South Carolina RN gives?
Three prescribers are named: the RN gives non-anesthetic sedation medications “as ordered by a licensed physician, dentist or Advanced Practice Registered Nurse (APRN)” (p. 1). The bedside condition on p. 2, by contrast, names only the physician; write your policy with both sentences in view.
Compliance note (last reviewed September 2026): This page is educational information about South Carolina Board of Nursing Advisory Opinion #25, not legal advice or a compliance determination. Every quotation was checked word-for-word against the Board’s AO25.pdf (revised January 2020, reviewed January 2026) on 2026-09-01; page numbers refer to that two-page PDF. The opinion’s own header shows it is revised and reviewed from time to time; confirm the current version and your own facility policy before relying on this summary. No state mandates this specific course.