How to Become an ER Nurse

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Written by Marie Hasty, BSN, RN Content Writer, IntelyCare
An ER nurse prepares for his shift.

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 make a great ER nurse. These clinicians develop a broad skill set in emergency care, including critical thinking, trauma assessment, and effective communication.

ER nurses work in the emergency room, sometimes called the emergency department, of a hospital. They’re often the first point of contact for patients in critical conditions, helping to stabilize and treat a variety of acute health issues, such as:

  • Chest pain
  • Trouble breathing
  • Allergic reactions
  • Poison ingestion
  • Physical trauma
  • Infectious diseases
  • Psychiatric emergencies
  • Obstetric and gynecological emergencies
  • Endocrine imbalances
  • Urological problems
  • Circulation problems

What Is an ER Nurse?

An emergency room nurse, sometimes called an emergency department nurse or ED nurse, sees patients who come to the hospital with health problems that need to be addressed right away. This department is known for being dynamic and unpredictable — you could be administering 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.

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 Do ER Nurses Do?

ER nurse responsibilities revolve around assessing, treating, educating, and documenting patients who are experiencing emergent health problems. These nurses 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.

How Much Do ER Nurses Make?

The average ER nurse salaryis $77,238 per year. Salaries in this specialty typically range from $69,143 to $85,943. 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.

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? Attending a four-year bachelor of science program or a two-year associate program is the first step to becoming a nurse. 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 take the National Council Licensure Exam to become an RN. 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 submit your ER nurse resume and start working as a new graduate nurse. 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.

Obtaining specialty certifications is one of the best ways to deepen your skills and increase your competitiveness for nursing roles. ER nurse certifications 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.
  • Pediatric Advanced Life Support (PALS): Covering similar content to ACLS, this certification focuses on infants and children.
  • Certified Emergency Nurse (CEN): A respected and recognized credential in emergency medicine, this 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.

Exploring Nursing Roles?

Now that you know the skills and qualifications to become an ER nurse, you might be curious about other nursing opportunities. Sign up for job notifications to get tailored opportunities sent directly to your inbox.