How to Become an ER Nurse

Do you thrive in high-pressure situations? Are you interested in building the confidence to manage a variety of clinical problems? If you answered yes to these questions, you might want to learn how to become an ER nurse.

ER nurses work in the emergency room, sometimes called the emergency department, of a hospital. These clinicians develop a broad skill set in emergency care, including critical thinking, trauma assessment, and effective communication.

What Is an ER Nurse?

An emergency room nurse, sometimes called an emergency department nurse or ED nurse, sees patients with 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 nurses are known for their ability to think on their feet and anticipate clinical problems.

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. ER 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 ER nurse’s job responsibilities 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.
• Focused and head-to-toe assessments to understand a patient’s status.
• Emergency procedures such as CPR, intubations, and defibrillation.
• Stabilization and initial treatment for bone fractures.
• Point-of-care (POC) testing for infection disease, 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.
• Blood draws to check for infection problems and lab abnormalities.
• Administering blood 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.

ER Nurse vs. ICU Nurse

ER nurses and ICU nurses both support patients in critical condition. However, the ER is different from the ICU because ER nurses see a wider range of problems, and not all of their patients 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.

Nursing in Urgent Care vs. Emergency Room

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 not as extensive staffing.

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.

Step 1: Go to Nursing School

Ready to get started earning your nursing degree? First you must complete a four-year bachelor of science in nursing (BSN) program or a two-year associate degree in nursing (ADN). You’ll take courses in assessments, psychiatric medicine, pharmacology, and more.

Nursing school is a challenging time for many students, but the long study hours and clinical experiences prepare you for a rewarding career. Learn more about how to get into nursing school.

Step 2: Pass the NCLEX-RN Exam

Once you graduate, you’ll must pass the National Council Licensure Exam to receive your RN license. This nationwide test includes multiple choice, clinical questions, and more to judge your readiness to practice nursing at the entry level. The NCLEX has been updated to reflect the newest standards, and you can prepare for exam day by studying methodically. Learn more about the new NCLEX.

Step 3: Nurse Residency in the Emergency Department

Once you have your license, congratulations! You can start applying to new grad nurse jobs. 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 ER 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 ER nurses pursue, and most hospitals require it after your first year of work.
• Certified Board for Sterile Processing and Distribution (CBSP): Surgical techs, scrub nurses, and related roles can seek out these credentials, which demonstrate that you are trained in the highest standards of medical instrument hygiene and safety.
• 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.
• 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.

How Much Do ER Nurses Make?

The average ER nurse salary is $77,000 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 6% increase in nursing jobs in the next decade, which means an additional 193,100 jobs added to the market each year. Pursuing this field could be a stable and fulfilling career choice.

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