There is currently a lack of a single consensus statement on Registered Nurse (RN) sedation core competencies or a consistent way in which RN sedation practice is regulated in the United States. This is despite the fact that the administration of procedural sedation during imaging is a regular practice among nurses. Variation in Board of Nursing regulation, a lack of research on RN sedation practice, and the absence of a national standard for RN sedation are the three key controversies that are associated with the practice of RN sedation. In order to offer regulators and nurse educators with information regarding the existing standards and knowledge gaps as they pertain to sedation treatment, recommendations are provided to address each of these areas. The discussion also includes methods that can be utilized to enhance sedation research in order to increase practice in this particular field.