SPRAVATO REMS Clinic Coordinator / Monitoring Registered Nurse

About the role

Nuestra Esperanza Health, PLLC is seeking a registered nurse to help launch and operate a specialized outpatient SPRAVATO treatment service. The position combines direct patient monitoring with clinical operations, REMS documentation, emergency readiness, and quality oversight.

You will monitor patients before, during, and for at least two hours after SPRAVATO administration — pulse oximetry, respiratory assessment, blood pressure monitoring, sedation and dissociation assessment, fall-risk precautions, clinical documentation, discharge-readiness support, and escalation of adverse events to the on-site prescriber.

What you will do

Patient preparation and treatment

• Verify patient identity, active REMS enrollment, treatment order, dose, and transportation plan.
• Review interval symptoms, medications, adverse events, and pretreatment instructions.
• Obtain and document baseline blood pressure, pulse, respiratory rate, oxygen saturation, alertness, and dissociation status.
• Observe patient self-administration under the direction of the on-site prescriber.
• Maintain a calm, private, low-stimulation treatment environment.

Post-dose monitoring

• Monitor each patient for at least two hours and until discharge criteria are met.
• Monitor respiratory status using pulse oximetry and direct clinical assessment.
• Measure and document blood pressure at approximately 40 minutes after administration, and at additional points as ordered or clinically indicated.
• Assess and document sedation, dissociation, anxiety, dizziness, nausea, fall risk, and overall clinical stability.
• Continue observation beyond two hours when a patient has not returned to an acceptable clinical baseline.
• Promptly report abnormal findings to the on-site prescriber.

Emergency response

• Recognize respiratory depression, reduced consciousness, severe blood pressure elevation, and neurologic warning signs.
• Initiate approved airway positioning, oxygen, suction, bag-mask ventilation, basic life support, and AED procedures within training and scope.
• Activate emergency medical services when required and prepare a complete clinical handoff.
• Document emergency events, interventions, responses, and disposition.

Documentation and REMS coordination

• Complete treatment records accurately and contemporaneously.
• Prepare or complete the Patient Monitoring Form after every treatment session.
• Track submission and confirmation within the required seven-calendar-day window.
• Maintain patient enrollment, training, treatment, and audit-support records.
• Reconcile completed sessions against submitted REMS forms.
• Escalate missing, rejected, or late documentation immediately.

Medication and clinic operations

• Support secure receipt, storage, dispensing documentation, device tracking, and inventory reconciliation.
• Confirm that SPRAVATO is never released for home use.
• Perform and document daily monitoring and emergency equipment checks.
• Maintain treatment-room readiness, infection-control supplies, and fall precautions.
• Coordinate treatment-day scheduling, transportation confirmation, and patient instructions.
• Participate in mock sessions, emergency drills, audits, incident reviews, and corrective actions.

Program development and quality

• Help refine workflows, checklists, documentation templates, and patient education.
• Monitor operational measures and identify workflow gaps.
• Train and support backup monitoring staff after demonstrating competency.
• Participate in annual and change-driven REMS refresher training.

Required qualifications

• Active, unrestricted registered nurse license in Wisconsin.
• Registered nurse experience in at least one of the following settings: critical care or intensive care, emergency department, or internal medicine.
• Current Basic Life Support certification.
• Demonstrated competency in vital-sign assessment, pulse oximetry, medication-related monitoring, and clinical escalation.
• Ability to recognize changes in respiratory status, blood pressure, consciousness, and behavior.
• Ability to provide calm, respectful care to patients experiencing psychiatric symptoms, anxiety, sedation, or dissociation.
• Strong documentation, organization, and time-management skills.
• Comfort following detailed protocols and maintaining audit-ready records.
• Ability to work on-site for the entire scheduled treatment and monitoring period.
• Ability to maintain patient privacy and comply with HIPAA and organizational confidentiality requirements.

Preferred qualifications

• Psychiatric, behavioral health, infusion, post-anesthesia, or procedural nursing experience in addition to the required background.
• Advanced Cardiovascular Life Support certification.
• Experience with REMS programs, controlled-substance workflows, regulated medications, or clinical research.
• Experience responding to respiratory compromise or blood pressure emergencies.
• Experience with electronic health records, medication inventory, quality improvement, or compliance audits.
• Experience helping launch a new clinical service.
• Bilingual English and Spanish communication skills.

Physical and environmental requirements

• Remain on-site and attentive during extended monitoring periods.
• Assist a patient with safe positioning, standing, or ambulation.
• Respond quickly to a patient emergency.
• Operate blood pressure, pulse-oximetry, oxygen, suction, bag-mask ventilation, and AED equipment.
• Move or position clinical supplies and equipment.
• Work in proximity to patients experiencing nausea, vomiting, anxiety, altered perception, sedation, or acute clinical deterioration.

Reasonable accommodations will be considered in accordance with applicable law.

How to apply

Please submit a current résumé, active nursing-license information, Basic Life Support certification status, and a brief statement describing relevant psychiatric, procedural, infusion, recovery, emergency, or program-launch experience.

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