Pursuing a Career as an Emergency Room (ER) Nurse

The ER nurse (also known as an Emergency Department nurse) must be quick thinking, collaborative, have excellent decision-making skills, and is an efficient multitasker. They treat patients of all ages and backgrounds for a variety of issues. Many ER patients are experiencing life-threatening situations and the ER nurse and associated care team must be quick to triage, stabilize, revive, or resolve these issues before getting the patient the further care that they need.  

In the article, we will explore:

• What do ER nurses do?
• Where do ER nurses work?
• How do you become an ER nurse?
• What are the additional requirements for ER nurses?
• What are the salary and job outlooks for ER nurses?

What do ER nurses do?

As mentioned, ER nurses need to think on their feet, make decisive actions, and have strong stomachs. The following is a list of possible ER nurse duties:

• Rapid patient assessment
• Ability to triage
• Wound care and management
• Blood draws and IV starts
• Insurance paperwork and care coordination
• Allergic reaction management
• Assessment of patient response to interventions
• Record and report patient status
• Trauma care/management
• Code care (respiratory/cardiac responses)
• Medication management and administration
• Minor surgical procedures
• Efficient use of medical equipment (crash carts, oxygen equipment, etc.)
• Transfusion setup and administration
• Charting
• Discharge and care coordination

Where do ER nurses work?

Nearly every hospital has an Emergency Department where patients can be triaged, stabilized, admitted, transferred, or discharged. It is important to note that while nearly every facility can handle receiving or admitting patients for an emergency, many smaller facilities transfer to larger, better-equipped facilities or other departments once a patient is stable. Should an ER nurse desire a higher level of care opportunities and experiences, they may want to pursue employment at a higher acuity facility.

Associated care team

Though ER nurses do plenty of work independently, the workflow of an Emergency Department usually means there are physicians present more often than in other areas of a hospital. The expediency of care demands excellent communication with all associated professionals. The care team may be comprised of attending physicians, anesthesiologists, lab technicians, respiratory therapists, imaging professionals, ER techs, internists, residents, social work, case managers, security, and child life specialists.

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4 steps to becoming an ER nurse

Step 1: Complete a nursing degree

Associate Degree in Nurse (ADN): To practice as a professionally licensed RN, the minimum you must achieve is an ADN. This program typically takes two years to complete (after two years of the appropriate prerequisites). ADN degrees are usually offered through community colleges and include coursework online, in the classroom, lab work, clinical rotations, and practicum experiences. If you choose this path, you should do so with the understanding you may be limited professionally. You may also be ineligible for employment in a variety of settings (particularly Magnet hospitals or hospitals seeking Magnet status).

Bachelor of Science in Nursing (BSN): To maintain a professional advantage, you may choose to begin your education with a BSN program. This program usually takes four years to complete. Much like an ADN program, they are a combination of classroom work, lecture, labor work, clinical experiences, and practicums. In general, BSN programs deliver more than what is taught in ADN programs, better equipping RNs for professional practice.  

Master of Science in Nursing (MSN): An MSN is not required for professional nursing practice. However, you may choose to obtain an MSN to This degree opens the door for teaching opportunities, higher pay, and greater responsibilities. Occasionally, some employers will reimburse or offer educational assistance for these academic pursuits.

There are many “bridge” programs available, which take anywhere from 12-24 months, that allow a student to move from an ADN to a BSN, a BSN to an MSN. If you have your RN licensure there is also an RN to MSN program. All of these programs continue to increase in popularity as the mandate continues to impact practice.

Step 2: Transition to a registered nurse (RN)

In order to become a registered nurse, you need to pass the National Council Licensing Examination (NCLEX) for Registered Nursing. Passing this exam will grant you eligibility as a registered nurse and allow you to continue on the path toward emergency nursing. 

Step 3: Obtain a nursing license

After passing the NCLEX, you must apply for a license with your state’s nursing board. The requirements vary by state and may include additional steps, such as a background check.

Step 4: Gain Relevant Experience

To become an ER nurse, it is important to gain relevant experience in the field. This will help you during the hiring process.

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What are the additional requirements for ER nurses?

There are a variety of additional certifications an ER nurse can pursue. Many of the most common are discussed below. Note that some are usually required.

Basic Life Support (BLS)

This credential teaches high-quality CPR and cardiovascular life support skills. It is usually required before hire or immediately after hire. It must be renewed every two years.

Advanced Cardiac Life Support (ACLS)

This course builds on the basic skills of BLS. It is usually required before hire or immediately after hire. It must be renewed every two years.

Pediatric Advanced Life Support (PALS)

Though many facilities may transfer these patients out, PALS is still often required for ER nurses, as they will still have to assess, treat, and stabilize. Renewal is every two years.

Trauma Nurse Core Course (TNCC)

Developed by the Emergency Nurses Association, this credential is a two-day course to present core knowledge, refine skills, and strengthen the RN foundation. It must be renewed every four years. This certificate may be required.

Certified Emergency Nurse (BCEN)

This credential is given by the Board of Certification for Emergency Nursing. Though the recommendation is two years of ED experience, there is actually no professional experience requirement before one can take the BCEN exam. Renewal is required every four years.

State-mandated continuing education (CEUs)

Each state has different continuing education requirements. You can learn more about your options and complete all your nursing CEUs for free on Incredible Health’s site.

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What are the salary and job outlooks for an ER nurse?

Though the health of the general population has shown an overall positive trend in the last few decades, there will always be a demand for highly trained Emergency Department staff to respond to life’s emergency situations. Because of this, the ER nurse outlook remains (and likely will continue to remain) strong.

The average salary for ER nurses is $91,105, according to data from Incredible Health. However, you can expect a range that is usually related to geography, nurse credentials, education, and experience.

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In 2010, the Institute of Medicine (IOM) issued a confident goal: By 2020, their desire was that 80% of registered nurses (RN) be bachelor’s prepared professionals. This desire was related to both the complexity of nursing practice and IOM studies evidencing that bachelor’s prepared RNs have better outcomes and more competent practice. Currently, the goal has not yet been achieved, but it should affect an RN’s educational choices moving forward.   

A career as an ER nurse is sure to keep one on their toes mentally, physically, and emotionally. These nurses are masters of efficient assessment and response, as well as excellent communicators, leaders, and collaborators. Are you a quick thinker and an excellent decision-maker? ER nursing may be for you if you believe you thrive in fast-paced, unpredictable environments.

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Questions from the Incredible Health Nurse Community

• What are some ER nursing hacks that you use frequently?
• What are the best written resources to prepare for being an ER nurse?
• Which is better, NIGHT or DAY SHIFT in the Emergency Department and why?

More ER threads →

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