How to Become an ER Nurse
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An emergency room nurse can thrive in high-pressure situations. Are you interested in building the confidence to manage a variety of clinical problems? Think you’d do well in a chaotic Emergency Department? If you answered yes to these questions, you might want to learn how to become an ER nurse.
An ER nurse works in the emergency room, sometimes called the emergency department (ED), of a hospital. They see patients in acute care settings, where they need a broad skill set in emergency care, including critical thinking, trauma assessment, and effective communication.
What Is an ER or ED Nurse?
An emergency room nurse, sometimes called an emergency department nurse or ED nurse, sees patients with potentially life-threatening health problems that need to be addressed right away. Some patients are brought to the ER by paramedics, while others drive themselves or with a friend or family member.
Most emergency departments are connected to a hospital where they’re close to resources such as the laboratory, scanning systems, and specialists. Some EDs are separate from a hospital, sometimes called stand-alone EDs.
What Happens in an Emergency Room?
The emergency department is known for being dynamic and unpredictable — you could be applying topical antibiotics one minute and administering CPR the next. Because of this, ER and ED nurses are known for their ability to think on their feet and anticipate clinical problems as they treat patients.
As you’re taught how to become an ER nurse, you’ll be exposed to patients of all ages who exhibit a wide range of conditions and acuity. ED nurses are often the first point of contact for patients in critical conditions, helping to stabilize and treat a variety of acute health issues.
What Do ER Nurses Do?
An nurse’s job responsibilities in the ED revolve around assessing, treating, educating, and documenting patients who are experiencing emergent health problems. When you learn how to become an ER nurse, you’ll build skills that help mitigate harm and keep patients alive, including:
- Triaging patients depending on the severity of their condition (using the ABC method).
- Focused and head-to-toe assessments to understand a patient’s status.
- Assisting in emergency procedures such as CPR, intubations, and defibrillation.
- Stabilization and initial treatment for bone fractures.
- Gathering samples for blood, saliva, and stool tests.
- Point-of-care (POC) testing for GI bleeds, blood sugar levels, and more.
- Medication administration using oral, intravenous, intramuscular, rectal, and topical routes.
- Initial wound treatment, which may include assisting with suturing and stapling.
- Urinary catheterization for patients who need help urinating.
- Nasogastric tube insertion to relieve stomach pressure or empty the stomach.
- IV insertion and management for patients who need intravenous medications.
- Administering blood and IV fluids products for patients with low circulating volume.
- Continuous monitoring for patients who are at high risk for destabilization.
- Pain management, such as medication administration and cold/heat techniques.
- Documentation to ensure the electronic medical record is updated and accurate.
- Family education and support as their loved one (the patient) is treated.
How Much Do ER Nurses Make?
The average ER nurse salary is around $85,000 per year for an RN, but this number depends on your level of education, years of experience, facility, location, and other factors. If you’re just starting as a new graduate nurse, you can expect to be on the lower end of this spectrum, but with experience and certifications, your pay will likely increase. Explore ER nurse jobs to learn more about what you might earn.
The Bureau of Labor Statistics projects a 5% increase in nursing jobs in the next decade, which means an additional 189,100 jobs added to the market each year. Pursuing this field could be a stable and fulfilling career choice.
How to Become an ER Nurse: 3 Steps
How long does it take to become an ER nurse? If you don’t yet have a nursing degree, becoming an RN and entering emergency medicine can take between two and six years, depending on your academic history. Follow the steps below to join this specialty.
[GRAPHIC: How to Become an ER Nurse]
Step 1: Go to Nursing School
There are a few different ways to get started as a nurse. The shortest track, which takes about a year of training, is to become an LPN, or licensed practical nurse. If you’re looking for a higher salary and broader work settings, consider becoming an RN. If you go this route, there are two degree tracks to choose from:
- Associate Degree in Nursing (ADN): A 2-year degree from a community college or technical school.
- Bachelor of Science in Nursing (BSN): A 4-year degree from a university. Learn more about comparing ADN and BSN degrees.
You also have the option to pursue advanced education by obtaining a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP).
Nursing school is a challenging time for many students, but the long study hours and clinical experiences prepare you for a rewarding career. If you’re interested in emergency nursing, you could request hands-on experiences in the emergency department or urgent care settings. Learn more about how to get into nursing school.
Step 2: Pass the NCLEX-RN Exam
Once you graduate, you must pass the National Council Licensure Exam to receive your nursing license. This nationwide test includes multiple-choice, clinical questions, and more to judge your readiness to practice nursing at the entry level.
LPNs will take the NCLEX-PN, while RNs will take the NCLEX-RN. The updated NCLEX has been updated to reflect the newest standards, and you can prepare for exam day by studying methodically.
Step 3: Nurse Residency in the Emergency Department
Once you have your license, it’s time for your first new grad nurse job. Many hospitals and healthcare systems have acute care nurse residency programs to help you transition into life as a professional nurse. You may be able to start working in the emergency department as a new grad, or you might gain experience in another department before making this transition.
Earning specialty certifications is an optional step along the path of how to become an ER nurse. It’s one of the best ways to deepen your skills and boost your emergency room nurse resume to give you a competitive edge for nursing roles. ER nurse certifications also help you build confidence in your practice. Check out some of the best certifications for ER nurses:
- Advanced Cardiac Life Support (ACLS): This is typically the first certification that nurses working in the ED pursue, and most hospitals require it after your first year of work.
- Pediatric Advanced Life Support (PALS): Covering similar content to ACLS, this certification focuses on infants and children, and is especially relevant in pediatric ER nursing.
- Certified Emergency Nurse (CEN): A respected and recognized credential in emergency medicine, the CEN certification covers patient care, triage, and trauma.
- Trauma Nursing Core Course (TNCC): This specialized certification focuses on the knowledge and skills to treat and support patients after traumatic events.
- Emergency Nursing Pediatric Course (ENPC): A specialized credential that’s awarded to nurses who undergo advanced training in caring for critically ill pediatric patients.
- Emergency Neurological Life Support (ENLS): This training is offered by the Neurocritical Care Society (NCS) and aims to improve care and establish protocols for patients with a range of neurological issues.
- National Institute of Health Stroke Scale Certification (NIHSS): A credential for critical care providers, researchers, and students that validates their ability to assess stroke severity in patients.
- Trauma Certified Registered Nurse (TCRN): A credential awarded by the Board of Certification for Emergency Nursing (BCEN) for RNs who undergo advanced training for trauma care and pass a qualifying examination.
Emergency Department Nurse FAQ
Is it hard to become an ER nurse?
Yes, becoming an ER or ED nurse requires commitment and tenacity. Just getting into nursing school is challenging for most students. Nurses need specialized training and education to become licensed, and ER nurses may have additional experience, certifications, and more.
Do ER nurses get paid the most?
Not necessarily. Nurses may earn more or less depending on experience, specialty, certifications, location, and more. If you’re interested in earning more as a nurse, check out the highest-paying jobs for nurses. And see nursing roles in the states with the highest income for RNs and LPNs:
Highest paying states for RNs:
Highest paying states for LPNs:
ER nurse vs. ICU nurse: What’s the difference?
ER nurses and ICU nurses both support patients in critical condition. However, the ER is different from the ICU because the emergency department sees a wider range of problems, and not all of the patients there are critically ill.
Nurses in the ER often juggle several patients of varying acuity. Patients who need further support will transfer to the ICU, where nurses usually have fewer than three patients. These specialties have some of the same skills and responsibilities, but they’re also distinct. Check out the responsibilities described in ICU nurse jobs for more insight.
Which is harder, the ICU or the ER?
Neither is necessarily harder, but your personality traits may mean you’re better suited for one over the other. For example, if you’re highly organized, prefer a more calm environment, and want to focus on a few patients at once, the ICU may be a better fit. On the other hand, if you enjoy juggling tasks throughout your shift, think well on your feet, and want to see many different issues, you might do well in ER nursing.
Is becoming an ER nurse worth it?
That depends on your situation and needs. Becoming an ED nurse definitely takes work, but it’s also a role that can offer continuous learning, a competitive salary, and great opportunities. Learn more about whether becoming a nurse is worth it. The beauty of becoming a nurse is that once you’re licensed, you can work in a variety of settings, including pediatrics, long-term care, wound care, and much more.
ED nurse vs. ER nurse: What’s the difference?
While they sound different, the two terms are often used interchangeably. Emergency Department is a more common term in medical settings, because it more accurately describes an area in a hospital that typically includes multiple rooms, imaging areas, and more.
Urgent care nursing vs. ED nursing: What’s the difference?
Nurses work in urgent care and emergency rooms, but these are two very different environments. While you’ll care for patients with a wide range of conditions and various levels of acuity in both settings, the patients in urgent care typically have non-life- or non-limb-threatening conditions. As such, those centers aren’t staffed the same way an emergency department is. An ER is staffed to deliver complex critical care around the clock. Urgent care centers tend to have defined working hours and less extensive staffing.
Exploring Nursing Roles?
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