This article explores nurse-led sedation of children in preparation for investigations such as magnetic resonance imaging or minor surgical procedures. The importance of the multidisciplinary team in setting up, implementing and evaluating this new nurse-led initiative is described. Effective planning, involvement, agreement and training are key to a successful change in practice, with responsibility being delegated to competent nursing staff. Evaluation has shown all-round benefits. Trained nurse-led sedation is safe, effective and efficient and nurses are motivated to undertake this extended role.