Historically, nurses have participated in every aspect of patient care related to moderate sedation as allowed by their state of practice and institutional policy. The current standard requires the presence of two qualified professionals when administering moderate sedation. The role of the nurse and their scope of practice has become more defined as an increasing number of procedures are performed in outpatient settings and same-day surgical centers on an older population with increased complexity. Many professional nursing organizations have statements regarding moderate sedation including the American Nurses Association, American Association of Critical Care Nurses, and Association of Operating Room Nurses. In fact, the American Association of Moderate Sedation Nurses (AAMSN),was founded in 2008 to ensure patient safety by developing a curriculum for certification of non-anesthetist registered nurses (RNs) that promotes adherence to the American Nurses Association (ANA), American Association of Nurse Anesthetists (AANA) and American Society of Anesthesiologists (ASA) standards and guidelines for registered nurses who practice moderate sedation and are not certified registered nurse anesthetists [1]. The AAMSN provides a network of support and development that upholds high professional standards and quality care across all practice settings, including private practices, through its collaboration with other professional organizations. In this chapter, the focus will be on the training and responsibilities of nurses functioning as the monitor while caring for patients receiving moderate/procedural sedation.