How to Become an ER Nurse
Patients entering an emergency room are often under intense stress due to medical illness, trauma, or other critical situations. They are often worried and require quick and effective treatment, along with emotional and psychosocial support from healthcare staff.
An emergency room (ER) nurse is essential to providing this care and often serves as a primary source of communication to emergency department patients and their families. Despite intense working conditions, many nurses find life as an ER nurse tremendously rewarding.
If you're considering this nursing career path, it helps to better understand the required education, certification options, job outlook, and how to best secure a position in the field.
What do ER nurses do?
Emergency room nurses are registered nurses (RNs) that typically work in emergency settings — hospitals, triage centers, or otherwise — as a part of the emergency care team, which includes physicians, nurse practitioners, physician assistants, medical assistants or nurse techs, office staff, and more. As an ER nurse, you will encounter patients with many different conditions. You will see everything from broken bones to serious illnesses and acute cardiac events.
ER nurses must be quick thinkers, make critical decisions under pressure, and have an innate ability to multitask. The ER nurse is skilled at assessing emergency patients quickly and accurately and working with a team to provide effective and safe patient care.
Examples of an ER nurse's responsibilities include physical assessment, administering medications, monitoring hemodynamics, performing diagnostic tests, and implementing interventions such as intravenous access, wound care, and oxygen management. ER nurses continuously communicate with the patient and his or her family about their health, diagnosis, treatment plans, and more.
While ER nurses may see trauma patients, there is a difference between ER nurses and trauma nurses. ER nurses typically work with patients struggling with serious illness (heart attack or stroke) or injury and triage patients to make sure those with urgent needs are met first; trauma nurses typically serve patients who have suffered major injuries as a result of an accident or other event and often must be ready to act quickly to save the lives of their patients. Trauma nurses work in trauma ERs or ICUs within hospitals that are designated to receive trauma patients. Not all ERs are trauma centers, as a result some ERs will have more or less trauma patients compared to others (often less if they are not a trauma center).
How to Prepare to be an ER Nurse
Step #1: Earn your nursing degree
Earning your nursing degree from an accredited nursing program is the first step to becoming an ER nurse. You can earn your associate degree in nursing (ADN), a Bachelor of Science in Nursing (BSN), or complete a direct-entry Master's in Nursing program.
The ADN is a popular path for students who want to complete a nursing degree quickly and enter the workforce, with these programs taking as little as 18 months to finish. A bachelor's degree can take about four years to complete; however, completing a bachelor's program can better prepare you for your role and future career success as well as support positive patient outcomes. As noted by the AACN, a 2019 study found that BSN-prepared RNs were significantly more prepared than ADN-prepared nurses on 12 out of 16 areas related to quality and safety, while a 2014 study found that a 10% increase in the number of BSN-prepared nurses in hospital units was correlated with a 10.9% reduction in patient mortality.
Additionally, distance BSN programs are a popular option for students who want to complete their nursing degree and maintain existing personal commitments. These programs typically are completed asynchronously without mandatory login times and allow most work to be completed online. Accelerated second degree BSN (ABSN) programs are also an option for individuals who already hold a bachelor's in a different field and are looking to change careers. An ABSN program is commonly completed in 12-16 months time because students enter after they have completed all the necessary prerequisites.
Step #2: Seek licensure in your state
After completing your nursing degree program, you must take the licensing test required to become a licensed registered nurse in your state. The National Council Licensure Examination (NCLEX-RN) is a test that covers a variety of nursing topics. There are at least 75 questions on the exam, but you could be asked over 200 (depending on your answers) to ensure entry-level competency in the nursing profession. Many schools offer preparation courses to help prepare to take the exam.
To initiate this process, you must first apply to your state's licensing agency. From there, you'll be authorized to take the NCLEX-RN exam. It's important to note that some states may have requirements in addition to passing the exam, such as completing a background check or providing letters of recommendation.
Step #3: Explore certification opportunities
Emergency rooms are often willing to hire ER nurses right after they graduate from an accredited nursing program and have earned their license. Hospitals offer new graduate nurses robust residency (or orientation) programs to expand their training and education in the area of nursing in which the individual will be working under the mentorship of nurse educators and RN preceptors. Alternatively, a nurse may work in a different department within the hospital system and apply for a transfer to an emergency nursing position after gaining experience. Such transition would also necessitate the support of an extensive ER orientation program.
In addition to being a licensed RN, you may become a certified emergency nurse (CEN) by taking and passing the CEN exam. This certification, which is nationally recognized, is for nurses in emergency settings who are looking to improve their knowledge, career, and patient care. It requires that you obtain a certain level of expertise in emergency patient care, and you must have at least two years of RN experience to take the exam.
Earning potential and job outlook
Registered nurses earn salaries anywhere from $50,000 to $90,000 annually. While ER nurses are RNs, they have an opportunity to earn slightly more, with salaries ranging from $51,000 to $97,000 annually. Specific salary potential will vary based on where you live, the setting in which you work, your experience, and your level of education.
ER nurses can expect job prospects to continue to grow in the future. The job outlook for registered nurses is expected to rise faster than average over the next decade. Understanding the job responsibilities of an ER nurse, what education to pursue, and the licensing requirements will help get you on the path to becoming an ER nurse faster.
If you're interested in becoming an ER nurse, you have many options for receiving your education. Consider these online ABSN programs as a way to kick start your career.
The content published on our blog is reviewed by credentialed healthcare professionals to give you the most up-to-date and professionally accurate information. This particular article was professionally reviewed by Colleen Sanders, RN, FNP-BC on March 7, 2022.