Care of the patient receiving continuous infusion neuromuscular blocking agents can be optimized when a peripheral nerve stimulator is used to monitor the depth of neuromuscular block. A protocol using a peripheral nerve stimulator, supramaximal stimulation, and train-of-four monitoring allows the critical care nurse to maintain patients with the least amount of drug for the desired effect. This practice decreases the risk of adverse effects associated with overdosing, thereby increasing the quality of patient care and outcome within the critical care setting.