PMHNPgomez

Hey there. First time ever responding to a post but I felt compelled to share my experience. I did clinical rotations at a ketamine clinic in Washington where (like CO) rules are not defined and there are several clinics popping up. To be honest (in my specific experience) - it was a very unsafe environment and I ended up quitting clinicals due to fear of eventual repercussions. To outline my experience - the shipments of ketamine (they did IM injections based off of weight) - were stored in a closet with no real “count”, the patients had VS taken but there were frequent episodes of apnea which the other providers called “holding their breath in the ketamine experience”, the ketamine was prescribed for at home use in the form of sublingual tabs with zero education on the potential addictive nature, and any questions I had regarding safety were thought of as a naysayer. I’m all for integrative psychiatry - but let’s just be real here for a a moment regarding our education, our practice role, and our knowledge of ethical research - ketamine in the context of psychedelic medicine for the treatment of psychiatric illness has almost no scientific emperical evidence, ketamine as a treatment for treatment resistant depression in the form of es ketamine and some IV use has evidence but only in that context, and really the safe use and integration of these medications should on those with specific training on using anesthetics - which is not a PMHNP scope of practice. Sure, we can risk it - but if someone stops breathing in an outpatient clinic and you’re the only one around - who’s neck is on the line. Again, I’m all for integrative psychiatry and psychedelic science - but doing it in an informed and safe way - which I don’t think we are there yet with ketamine. There’s not enough research or evidence and ultimately I think the ketamine clínics of today (from what I’ve seen in WA) fall short of the great responsibility we have to our patients when entrusted with their care and their lives.