RN 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.

Essential Experience Requirement

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.

Qualified candidates must demonstrate practical experience with:

• 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.

Essential Duties and Responsibilities

• 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.

Esketamine (Spravato®) Assessment and Monitoring

• 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 care.
• Support the post-treatment clinical-stability assessment and ensure each patient meets discharge criteria before leaving the healthcare setting.

General Nursing and Team Responsibilities

• Maintain timely, accurate, and complete documentation in the electronic health record and required REMS-related forms or systems.
• Maintain readiness of infusion rooms, monitoring equipment, oxygen, emergency supplies, medication-storage areas, and IV supplies.
• Follow clinic standards related to infection prevention, controlled-substance handling, medication security, privacy, professional boundaries, and patient safety.
• Participate in onboarding, competency validation, clinical education, quality-improvement initiatives, emergency drills, and protocol updates.
• Collaborate with psychiatric leadership, nurse practitioners, treatment technicians, and operations staff to provide safe, efficient, patient-centered care.
• Deliver calm, respectful, trauma-informed care to adults experiencing depression, anxiety, OCD, trauma-related symptoms, and other psychiatric conditions.

Minimum Qualifications

• Current, active, unrestricted Registered Nurse license in the State of Ohio.
• At least five (5) years of recent hands-on RN experience with frequent peripheral IV insertion and IV medication or infusion administration.
• Demonstrated proficiency in difficult IV access, IV-site assessment, infusion-pump use, IV troubleshooting, and patient monitoring.
• Current BLS/CPR certification.
• Current ACLS certification, or ability to obtain ACLS certification within 90 days of hire.
• Strong nursing assessment skills, sound clinical judgment, and ability to recognize and elevate changes in patient condition.
• Excellent communication, organization, documentation, and patient-education skills.
• Comfort working with adults experiencing significant psychiatric symptoms and emotional distress.
• Proficiency using an electronic health record and routine clinical documentation systems.

Preferred Qualifications

Strong preference will be given to RNs with prior experience in outpatient infusion therapy, emergency department care, PACU or post‑anesthesia recovery, ambulatory surgery or procedural care, critical care, oncology infusion, high‑IV‑volume medical‑surgical nursing, behavioral health or psychiatry, ketamine infusion therapy, Spravato/esketamine treatment, TMS, or related interventional psychiatry services. Experience with REMS programs, controlled-substance handling, outpatient emergency-response protocols, and infusion-related quality and safety practices is strongly preferred.

• Annual salary of $90,000, based on a standard 40‑hour workweek.
• Full‑time benefits, including health insurance, paid time off (PTO), 401(k) plan with employer match, and paid holidays.
• Predictable outpatient schedule with no required on‑call coverage, weekends, or holidays.
• Structured onboarding, treatment‑specific education, and competency‑based training in IV ketamine infusion services and Spravato monitoring.

Physical and Work Requirements

• Ability to stand and walk for extended periods during clinical shifts and perform frequent fine‑motor tasks, including IV insertion, medication preparation, and documentation.
• Ability to assist patients with mobility or transfers when clinically appropriate, consistent with established safety procedures.
• Ability to respond promptly to urgent patient‑care needs and emergency situations.

Equal Opportunity Employer

Optimum Wellness & TMS / Metro Psychiatry, Inc. is an equal opportunity employer. We are committed to creating a respectful, inclusive workplace and delivering compassionate, high‑quality care to every patient we serve.