Details each of those limited emergency circumstances where a registered nurse and advanced practice registered nurses, may safely administer sedation, such as critical life-saving or emergency situations where there is an imminent threat to life or limb.
S0694 amends Rhode Island’s nursing laws to limit who may administer certain anesthetic and sedation agents. The bill states that registered nurses (RNs) and advanced practice registered nurses (APRNs) who are not licensed certified registered nurse anesthetists (CRNAs) may not independently administer drugs primarily used as general anesthetics, including propofol, etomidate, sodium thiopental, methohexital, and volatile gases, for minimal, moderate, deep sedation, or general anesthesia. It also prohibits non-CRNA RNs and APRNs from managing deep sedation or general anesthesia for diagnostic, therapeutic, or surgical procedures.
The bill creates narrow exceptions for emergency and critical-care settings. RNs acting as the “third hand” of a physician or licensed APRN, and APRNs trained in airway management and acting within their approved scope, may initiate, titrate, and bolus IV/IO agents in rapid sequence intubation or to maintain sedation for intubated, mechanically ventilated patients. It also allows anesthetic medications in imminent life-threatening situations, such as cardiac arrest or respiratory failure, and preserves sedation administration in emergency room and ICU settings for intubated, mechanically ventilated patients when done within scope and approved by the relevant governing body.
The bill would amend chapters 5-34 and 5-34.2 of the Rhode Island General Laws governing nurses and nurse anesthetists. Its practical effect is to clarify that elective or independent administration of certain anesthetic agents is outside the scope of practice for RNs and non-CRNA APRNs, while reserving that authority primarily to CRNAs. At the same time, it codifies limited emergency and critical-care exceptions, affecting hospitals, emergency departments, intensive care units, nurse anesthetists, physicians, APRNs, and RNs involved in sedation and airway management.
The bill appears to have received generally favorable support in the Senate, passing on June 12, 2025 by a vote of 26-10. The text and explanation frame the measure as a patient-safety and scope-of-practice clarification rather than a broad restriction on nursing practice, emphasizing that emergency care remains protected. The absence of committee transcript material limits insight into detailed debate, but the recorded vote suggests meaningful support alongside a notable minority of opposition.
The main point of contention is scope of practice: whether non-CRNA RNs and APRNs should be allowed to administer or manage certain anesthetic drugs outside of emergency or critical-care circumstances. Supporters of the bill appear to favor restricting these medications to CRNAs for elective or independent use, citing safety and professional boundaries. Opponents likely object to narrowing nursing authority, especially in settings where APRNs and RNs currently participate in sedation or airway management, though the bill preserves exceptions for emergencies, intubated patients, and critical care.