Careers in Nursing: What is an ER nurse?

If you’re thinking about becoming a nurse, you’re likely considering all of the potential career options within the nursing field. The nursing profession has no shortage of opportunities, with specialties in pediatrics, women’s health, and more. One area that is appealing to people who enjoy lifelong learning and want to work in a fast-paced environment is emergency room (ER) nursing. ER nurses work under intense stress, but the work can be exciting, and they can, of course, play an important role in a patient’s urgent medical needs. 

Are you thinking about becoming an ER nurse? If so, it will help if you already possess an innate ability to remain calm during high-pressure events and handle patient care with a high degree of empathy. Understanding what ER nurses do, the education required, and the important skills necessary for success can help you head in the right direction for achieving your career goals in this field. 

What does an ER nurse do? 

ER nurses work in hospital emergency rooms, triage centers, urgent care centers and trauma centers to treat patients experiencing a variety of illnesses, including everything from mild injury to serious critical illness states like heart attack or strokes as well as trauma. 

ER nurses work in crisis conditions, so they must be able to work seamlessly with physicians and other members of the interdisciplinary team to quickly assess, identify priorities and provide quality care. Some of the most common conditions treated in the ER involve upper respiratory infections, strains and sprains, chest pain, and injuries of all types including falls and motor vehicle accidents. 

Beyond initial injury, ER nurses are responsible for: 

• Complete physical assessments to identify health issues and prioritize needed interventions 
• Administering medications. The nurse is responsible for administering medications needed to help manage psychological illness and control pain.. 
• Monitoring vital signs. Regardless of the injury, a nurse will need to continually monitor the patient’s vital signs to ensure they remain in stable condition. 
• Assisting with minor procedures. Patients may need minor procedures, such as receiving sutures to close a wound. Nurses may be asked to assist health care providers with these types of procedures. 
• Coordinating diagnostic tests. Many patients require diagnostic testing in order to further evaluate their current illness or injury. Nurses play an important role in prioritizing needed diagnostic tests and often provide needed patient education about such testing.
• Provide interventions needed for care management. Whether managing intravenous access (IVs), conducting wound care, or monitoring output with urinary catheters, nurses implement numerous interventions necessary for providing quality care.

Many of these responsibilities are similar, if not the same as, those of a registered nurse working with patients admitted to other medical settings, however, these duties are performed at a much faster pace and on a more compressed schedule in an emergency setting. In fact, ER nurses often help evaluate a patient’s condition and provide treatment at the same time. Additionally, ER nurses must routinely conduct protocols to ensure that ER equipment, space and resources are ready to go for any emergency.

Where do ER nurses work? 

Most ER nurses work at hospitals or free-standing ERs, but there are plenty of opportunities in other areas that require the skills of an ER nurse. For example, a nurse may serve on a rescue team or work for a film production crew, where access to medical care is needed in case of an emergency. An ER nurse is also commonly sought after on cruise ships because they are experienced treating patients with many different medical issues. 

ER nurses may also serve in less serious settings, such as walk-in urgent clinics, where patients have emergencies that aren’t as serious as those that require an ER visit. Additionally, ER nurses are often qualified to work in emergency response units, state and federal prisons, and position control centers. 

Qualities required for a successful ER nurse 

ER nurses are skilled at remaining calm during stressful and demanding situations. A nurse’s ability to handle an urgent situation with a high degree of confidence can impact the quality of treatment and how comfortable the patient and their family feel. 

As an ER nurse, it’s also important to have an interest in ongoing learning. While you’ll see many of the same cases on a weekly basis, there will also be more unusual cases that arise. Additionally, life saving and critical illness treatments are often improving based on new evidence, which makes continued learning on the job a priority for successful ER nurses.

A willingness to stay flexible is also important because an ER nurse must be able to pivot fast and adjust as a situation changes, and do so without missing a beat. But perhaps one of the most important qualities of an ER nurse is a strong sense of compassion and empathy. Patients visiting the ER are often stressed, worried, and sometimes experiencing intense levels of pain. When an ER nurse has a high level of empathy, it can help the patient feel more comfortable and improve their experience and care. 

Steps to becoming an ER nurse

If you're interested in learning how to become an ER nurse, you’ve come to the right place. 

The amount of education needed will vary based on your current level of education and your future career ambitions. Nurses must receive their RN accreditation to apply for state licensure. You can work toward an ER nursing career by doing the following: 

• Get your nursing degree. ER nurses must be registered nurses, so the first step is to complete an accredited nursing program. Common options include an associate degree in nursing (ADN), a bachelor of science in nursing (BSN), or a direct-entry master of science in nursing (MSN). The ADN program typically takes two years or less to complete, and the BSN takes four years to complete. If you have a bachelor's degree in a field outside nursing, an accelerated second degree BSN takes much less time. During your nursing program, you’ll cover a variety of areas, including pathophysiology, pharmacology, care of acute and chronic illnesses, research and evidence based practice as well as critical thinking. 

• Pass the NCLEX-RN exam. Nurses obtain licensure through their state board of nursing. Every board has different requirements, but all will require that you pass the National Council Licensure Examination, also known as the NCLEX-RN. This is an exam that covers all the important content areas of the nursing practice. This test is taken on a computer and you will answer as few as 75 questions or as many as 265 questions, depending on your answers. Many nursing programs offer a preparation course to help you get ready to take and pass the exam. 

• Seek a job working in the ER. Entry-level new graduate nursing jobs are available in emergency rooms. Some nursing programs will offer ER clinical rotations or internship opportunities while you’re in school, giving you additional knowledge and skills to transition into a career as an ER nurse. 

Beyond this, you can also apply for emergency nurse certification (CEN). While you need at least two years of experience prior to applying for the emergency nurse certification credential, this optional certification can be a competitive differentiator when you apply for an ER nursing position or for advancement. 

Potential pay scale and job opportunities 

The average pay of an ER nurse is $31.97 an hour, or $51,000 to $97,000 annually, according to Payscale.com. A 2019 study found that the median salary for emergency, trauma, and transport nurses was roughly $77,500. Job growth as a whole for the nursing industry is expected to be faster than average through 2029, which will provide many potential career opportunities. This is especially true for ER nurses. With an aging population, many people require urgent care and visit ERs or urgent care facilities for unexpected medical issues. 

The amount that you earn will vary based on where you live, type of employer, and your prior nursing experience. For example, the highest-paying states for registered nurses are California and Hawaii, with the District of Columbia also paying well. 

Charting your path forward 

If you enjoy working in a fast-paced, challenging environment, the ER nurse position may be a good fit. ER nurses should possess the ability to think fast, have strong critical thinking skills, and be able to act decisively about a patient’s course of treatment. They need collaborative skills to work seamlessly with other members of the care team such as doctors, medical assistants, and other healthcare professionals. 

If you possess these skills and mindset, consider getting started today with an online ABSN program.The rewards of this career path are worth the effort as you provide care and comfort to patients during difficult times. ER nurses can also expect career opportunities and compensation to remain strong into the future, with many opportunities to choose how and where they work. 

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 November 1, 2021.

Sources:

Statistical Brief #227. Healthcare Cost and Utilization Project (HCUP). September 2017. Agency for Healthcare Research and Quality, Rockville, MD. hcup-us.ahrq.gov

Board of Certification for Emergency Nursing. About the CEN Exam. bcen.org

Payscale. Average Registered Nurse (RN), Emergency Room Hourly Pay. payscale.com

HumRRO. Emergency/Trauma/Transport Nursing Workforce Study. medevacfoundation.org

Nurse.org. Highest Paying States For Registered Nurses in 2021. nurse.org