Nurses and Ketamine

Medically Reviewed by Mark Hrymoc, M.D., Chief Medical Officer, double-board certified in General & Addiction Psychiatry

Navigating the Intersection of Ketamine Laws and Nursing Practice in California

In California, the administration of medications like ketamine, whether for therapeutic or recreational purposes, is tightly regulated. This regulation impacts not only individuals but also healthcare professionals, including registered nurses (RNs), who may encounter ketamine in their practice. Understanding both the legal landscape for ketamine and the scope of practice for RNs is crucial for ensuring compliance and delivering safe patient care.

Ketamine Laws in California

1. Legal Status and Regulations

Ketamine, a dissociative anesthetic, is categorized as a Schedule III controlled substance. This classification prohibits its use outside of specific medical contexts, making personal possession and recreational use illegal. In California, ketamine is regulated under:

Health and Safety Code 11377 HS: 

This statute criminalizes the possession of ketamine without a prescription. Being charged under this law can result in misdemeanor penalties, including up to six months in county jail and fines up to $1,000. However, those charged with simple possession might be eligible for a drug diversion program, which offers an alternative to traditional sentencing.

Health and Safety Code 11379.2 HS: 

This statute addresses the possession of ketamine with the intent to sell or distribute. It is a "wobbler," meaning it can be charged as either a misdemeanor or a felony, with potential penalties including fines up to $10,000 and up to three years in state prison.

Vehicle Code 23152(f) VC: 

This law makes it illegal to drive under the influence of ketamine, and violations can result in misdemeanor charges with various legal repercussions.

Registered Nurses and Ketamine Administration

1. Scope of Practice for RNs

Registered nurses in California have specific guidelines for administering medications, including those that induce conscious sedation, such as ketamine. According to Section 2725(b)(2) of the Nursing Practice Act (NPA), RNs are authorized to administer medications for conscious sedation if they are ordered by a licensed prescriber. This authority, however, comes with several responsibilities:

Competency and Knowledge: 

RNs must have thorough knowledge of the medications they administer, including effects, potential side effects, contraindications, and the correct dosage. Competence in administering these medications safely and effectively is crucial.

Monitoring and Safety: 

When administering medications for conscious sedation, RNs are required to monitor vital signs such as oxygen saturation, heart rate, blood pressure, respiratory rate, and consciousness level. National guidelines suggest having an emergency cart with resuscitative equipment and medications readily available.

Emergency Preparedness: 

RNs must be prepared to manage complications and emergencies that may arise during sedation. This includes having backup personnel trained in airway management and resuscitation, ensuring continuous patient monitoring, and not leaving the patient unattended.

2. Accountability and Advocacy

RNs are accountable for their actions in administering medications and must act in the best interest of the patient. They have the right to refuse to administer any medication they believe may not be beneficial or safe for the patient. Institutions are required to have processes for evaluating and documenting RNs’ competencies in managing conscious sedation, ensuring that they meet ongoing standards for patient safety and care.

Integration of Laws and Practice

The legal regulations governing ketamine in California and the professional guidelines for RNs reflect a shared commitment to safety and efficacy in both legal and medical contexts. For healthcare professionals, particularly those administering medications like ketamine, understanding and adhering to these regulations is essential. This not only ensures compliance with the law but also safeguards patient health and well-being.

By integrating knowledge of ketamine laws with nursing practice standards, RNs can navigate their responsibilities effectively, uphold high standards of care, and contribute to a safe and legally compliant healthcare environment.

Nurses at the Ketamine Therapy Center

At the Ketamine Therapy Center, highly trained registered nurses and psychiatric mental health nurse practitioners are ready to provide the best quality care to make your ketamine therapy experience a safe and enjoyable one.