When you begin researching ketamine therapy, the first questions are usually about the treatment itself. How does it work? What does it feel like? How many sessions will I need?
Those are important questions. But there is another one that deserves just as much attention: Who is in the room with you during your infusion?
Ketamine is an anesthetic medication. It affects your blood pressure, heart rate, breathing, and consciousness. The training and experience of the person managing your session directly impacts your safety and the quality of your care. Understanding what a CRNA is, and how that training differs from other provider models, can help you make a more informed decision about where to receive treatment.
What Is a CRNA?
CRNA stands for Certified Registered Nurse Anesthetist. CRNAs are advanced practice registered nurses who specialize in the administration of anesthesia. They are among the most highly trained providers in the nursing profession, and they deliver anesthesia for a wide range of surgical and medical procedures every day across the country.
The path to becoming a CRNA is rigorous. It requires:
- A four-year Bachelor of Science in Nursing (BSN) from an accredited program
- Critical care nursing experience, typically one to two years minimum in an intensive care unit
- A doctoral-level nurse anesthesia program (DNP or DNAP), which includes advanced coursework in pharmacology, physiology, pathophysiology, and anesthesia principles
- Thousands of hours of supervised clinical anesthesia cases across diverse surgical settings
- National board certification and ongoing continuing education requirements
In total, a CRNA completes a minimum of eight years of education and clinical training before ever practicing independently. This training is specifically designed around one thing: safely managing patients who are under sedation or anesthesia.
CRNAs are the same professionals who manage your airway during surgery, adjust your medications during complex procedures, and monitor your vital signs when you are at your most vulnerable. They do this work in operating rooms, labor and delivery units, trauma centers, and pain management clinics across the country.
Why Does Provider Training Matter for Ketamine Therapy?
Ketamine is not a simple oral medication. When delivered intravenously, it enters the bloodstream directly and affects multiple physiological systems simultaneously. This is what makes IV ketamine so effective, but it is also why the person managing your session needs a specific set of skills.
Here is what anesthesia-trained providers bring to a ketamine session that other provider types may not:
Hemodynamic Monitoring
Ketamine can cause temporary increases in blood pressure and heart rate. For most patients, these changes are mild and manageable. But for patients with cardiovascular risk factors, hypertension, or other underlying conditions, these changes need to be recognized and addressed in real time. CRNAs are trained to read hemodynamic trends continuously, not just check a blood pressure reading at the beginning and end of a session.
Airway Management
At the subanesthetic doses used for mood and pain treatment, airway complications are rare. But "rare" is not "impossible." Anesthesia providers are trained to recognize early signs of airway compromise, including changes in respiratory rate, oxygen saturation, and airway tone, and to intervene immediately. This is a core competency of anesthesia training. It is not part of most other advanced practice nursing or physician assistant curricula.
Drug Interactions and Pharmacology
Many patients seeking ketamine therapy are already taking other medications: antidepressants, benzodiazepines, blood pressure medications, or pain drugs. CRNAs are trained in advanced pharmacology with a specific focus on how anesthetic agents interact with other drugs. This knowledge allows them to adjust dosing, anticipate interactions, and modify protocols on the fly.
Emergency Response
Anesthesia training includes extensive preparation for rare but serious events: anaphylaxis, laryngospasm, cardiovascular emergencies, and adverse drug reactions. CRNAs practice managing these scenarios regularly as part of their clinical training and continuing education. If something unexpected happens during your infusion, the difference between a provider who has managed hundreds of emergencies and one who has managed none is significant.
What Is the Difference Between a CRNA and Other Ketamine Providers?
Across the country, ketamine clinics are staffed by a range of provider types. Understanding the differences is not about criticizing any profession. Every clinician mentioned below brings valuable skills to patient care. The question is whether those specific skills align with the demands of managing an IV anesthetic medication.
| Provider | Anesthesia Training | Airway Management | IV Sedation Experience |
|---|---|---|---|
| CRNA | Doctorate-level, thousands of clinical hours | Core competency | Daily practice across surgical settings |
| Anesthesiologist (MD/DO) | Medical degree + anesthesia residency | Core competency | Daily practice across surgical settings |
| Nurse Practitioner (NP) | Not typically included in NP programs | Not a standard part of training | Limited unless sought independently |
| Physician Assistant (PA) | Not typically included in PA programs | Not a standard part of training | Limited unless sought independently |
Some clinics operate with an NP or PA administering ketamine under the supervision of a physician who may or may not be onsite. Others have a physician present but without anesthesia-specific training. These models can be legally compliant, but they represent fundamentally different levels of clinical preparedness for managing an IV anesthetic agent.
The point is not that other providers are unqualified for their own areas of practice. It is that IV anesthesia has its own skill set, and the providers trained specifically in that skill set are CRNAs and anesthesiologists.
We encourage you to learn more about our clinical team and approach and to compare it with what other clinics offer.
What Does CRNA-Supervised Care Look Like at Music City Ketamine?
At Music City Ketamine, your infusion is supervised by Marla Peterson, CRNA, from start to finish. Marla brings more than 20 years of anesthesia experience to every session. Before joining MCK, she spent her career managing anesthesia in operating rooms, where the demands are high and the margins for error are slim.
Here is what that means for your experience:
Hospital-Grade Monitoring, Every Session
- Continuous pulse oximetry (oxygen levels)
- Blood pressure monitoring at regular intervals throughout infusion
- Heart rate and rhythm tracking
- Capnography (CO2 monitoring) when clinically indicated
- Real-time assessment of sedation depth and patient comfort
One patient at a time. Unlike clinics that run multiple patients simultaneously with a single provider circulating between rooms, we focus on one person per session. Marla is in the room with you, not down the hall monitoring someone else. If your blood pressure trends upward, she sees it immediately. If you need a dosing adjustment, it happens in real time. If you simply need reassurance, she is right there.
Before your infusion begins, Marla reviews your medical history, current medications, and any previous anesthesia experiences. She develops a personalized protocol based on your specific clinical picture, not a one-size-fits-all dosing template.
You may also meet Walter White and Wilma, our therapy dogs, who help set a calm and comfortable tone before your session begins. Their presence is entirely optional, but many of our patients find it grounding.
To understand more about how we structure each session, visit our how it works page.
Questions to Ask Any Ketamine Clinic Before Booking
We believe informed patients make the best decisions for their own care. Whether you choose Music City Ketamine or another clinic, we encourage you to ask the following questions before scheduling your first infusion:
- What are the credentials of the person who will be in the room during my infusion? Ask specifically about anesthesia training, not just their title or degree.
- Will the same provider be present for my entire session, or will they be monitoring multiple patients? This affects how quickly they can respond if something needs attention.
- What monitoring equipment do you use? At minimum, you should expect continuous pulse oximetry and regular blood pressure monitoring. Ask whether they use capnography or cardiac monitoring.
- How do you handle adverse reactions or emergencies? Ask about their emergency protocols, what medications and equipment are available, and whether the provider has hands-on experience managing anesthesia-related emergencies.
- How do you adjust dosing during the infusion? A skilled provider adjusts based on real-time physiological data. Ask whether your protocol will be personalized or if the clinic uses a standardized dose for every patient.
- What is your provider's experience with IV sedation specifically? Years of clinical experience matter, but experience with IV sedation and anesthetic agents matters most in this context.
These questions are not designed to put any clinic on the spot. They are designed to help you understand the level of care you will receive. A clinic that takes safety seriously will welcome these questions and answer them openly.
If you have questions about our approach, the safest step is a conversation. Schedule one here or text us at (615) 988-4600.