Transcranial Magnetic Stimulation Tips for Psychiatric-Mental Health Nurses

Transcranial Magnetic Stimulation (TMS) is a noninvasive, low-risk neuromodulation treatment that uses magnetic fields to depolarize neurons and affect neural pathways. A new APNA resource, created by the APNA Neuromodulation Task Force, supports psychiatric-mental health nurses with key TMS treatment considerations.

Transcranial Magnetic Stimulation tips from the New APNA TMS Treatment Considerations Checklist:

• FDA clearance shapes access to TMS
  TMS is FDA-cleared for major depressive disorder, anxious depression, obsessive-compulsive disorder, and smoking cessation in individuals 15 years and older.
• Psychiatric-Mental Health (PMH) Nurses play a critical role in TMS care
  PMH nurses’ roles include administering treatments, managing patient care, providing education, and participating in research. Continuous nursing observation to detect subtle changes in muscle activation, facial tension, distress tolerance or coil contact helps enable early intervention, the need for clinical reassessment or parameter adjustment. PMH Advanced Practice Nurses are credentialed to order treatment, set treatment parameters, and oversee administration.
• Medication stability affects treatment parameters
  Psychotropic or neurologic medication changes during a TMS course may require motor threshold reassessment or temporary treatment interruption.
• Measurement-based care guides treatment planning
  Use of standardized symptom tracking (e.g. PHQ-9, QIDS, or YBOCS) and routine suicide risk screening (e.g. C-SSRS) informs decisions related to continuation, tapering, maintenance, and rescue TMS.
• Treatment Protocol and Safety
  Standard TMS treatment typically involves 36 sessions (5 days per week) over 4–6 weeks, with tapering to reduce relapse risk. Other treatment protocols, including accelerated TMS protocols, are frequently utilized.
• Managing Expectations and Education
  Pretreatment education should cover efficacy, session duration, safety measures, and the importance of monitoring for medication changes, sleep patterns, and substance use that may affect treatment.

From scope of practice concerns to documentation to post-treatment considerations, this new checklist offers a helpful breakdown for nurses:

Explore the Resource & Find additional Transcranial Magnetic Stimulation Tips

✔️How this checklist came to be:

• A group of member experts alerted the APNA Board of Directors to a need for neuromodulation resources that spoke to psychiatric-mental heath nursing roles.
• The Board decided to form an APNA Neuromodulation Task Force and invited members to participate.
• The task force reviewed extensive evidence and practices, then collaborated to create several resources, including this checklist.
• The resource was vetted through the task force steering committee and advisory panel, then reviewed and approved by the APNA Board of Directors.
• APNA resources – including checklists – are reviewed every three years to ensure they are relevant and reflective of current evidence.

Published January 2026