How to Become an Emergency Room (ER) Nurse – Career Guide

There are many different specialties in nursing, ranging from special interests like labor and delivery to technical skills like surgical nursing. One exciting career choice for nurses is emergency room (ER) nursing. Learn more about how to become an ER nurse, what an ER nurse does and if this is the right career for you.

Steps to Become an Emergency Room (ER) Nurse

There are multiple pathways to becoming an emergency room nurse. Some common steps include:

  1. Apply to and attend an accredited and approved nursing program. Both an associate degree in nursing and a Bachelor of Science (BSN) in Nursing may qualify you to become a registered nurse, depending on state board requirements. A bachelor’s degree may lead to more opportunities as a nurse and for certification.
  2. Pass the NCLEX-RN exam. In all states, you need to pass the National Council Licensure Examination for registered nurses (NCLEX-RN) to obtain licensure as a registered nurse.
  3. Obtain state licensure as a registered nurse. Nursing licensure requirements vary by state, so be sure to check with your state’s board of nursing for specific requirements. 
  4. Obtain nursing experience. Once you obtain licensure as an RN, it could be beneficial to work in an emergency room or related environment in acute care. 
  5. Consider certification. While not required for employment, there are organizations that offer certifications for emergency room nursing. 

Pathways to Becoming an Emergency Room Nurse

There is no one path to becoming a nurse, let alone an ER nurse. Those interested in this career can consider different degree programs, formats and certifications. While one way to pursue this career is to attend an online nursing program, there are many options, including:

  • Associate Degree in Nursing (ADN): An ADN is a pathway to enter the world of nursing. ADN programs typically take two to three years to complete and may prepare you for the NCLEX-RN exam. 
  • Bachelor of Science in Nursing (BSN): A BSN is an undergraduate degree in nursing that typically takes four years to complete. In addition to the vocational training you would receive in an ADN program, you also gain additional education as you would traditionally in a bachelor’s program. 
  • RN to BSN: For registered nurses with an ADN who want to advance their education, an RN-to-BSN program may be beneficial. 
  • Master of Science in Nursing (MSN): An MSN is a graduate degree in nursing. Obtaining an MSN is a great opportunity for RNs to acquire a high level of education and qualification and prepare for licensure as an advanced practice registered nurse (APRN). There are also MSN programs online that may allow you to work while obtaining a master’s degree.

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Should I Become an Emergency Room Nurse? 

Though working as an ER nurse can be a highly rewarding career, it’s not for everyone. You may consider the following factors when deciding if this career is right for you.

Salary and Career Outlook

According to the Bureau of Labor Statistics (BLS), registered nurses earned an average of $75,300 per year in May 2020. RNs who work in hospitals earned an average of $75,030. The BLS predicts jobs for registered nurses will increase 9% from 2020 to 2030, which is faster than the average job growth for all professions. Nursing salaries do vary based on a number of factors including specialization, experience and even geographic area. The Board of Certification for Emergency Nursing (BCEN) reports that nurses with a CEN credential earn an average of $1,397 more per year (PDF, 621 KB) according to a 2017 study.

Roles and Responsibilities

According to the Emergency Nurses Association (ENA), there are several ER nurse roles: trauma, code, triage, disaster response, flight, critical-care transport, pediatric ED, burn center, geriatric ED, military, and charge nurse. Each of these has specific roles that help specific populations of patients.

In a typical day, an ER nurse might: 

  • Triage patients as they arrive at the ER
  • Assist with or perform tests like blood tests
  • Maintain patient chart notes
  • Collaborate with the rest of the ER team to provide comprehensive patient care
  • Observe and monitor patients
  • Test medical equipment and stock rooms

An ER nurse cares for patients with a variety of conditions and injuries. These patients may range from the pediatric to the geriatric. As a result, ER nurses need to have comprehensive training and be prepared for almost anything. 

Skills

ER nurses have a specialized skill set that help them succeed in this challenging environment:

  • Multitasking Skills: Things happen rapidly in the ER, and nurses need to be able to keep up. Multitasking is common, especially when nurses must assess and treat patients simultaneously. An ER nurse may focus on multiple priorities at once without forgetting or overlooking anything important. 
  • Teamwork: Many ER staff often work together to treat a patient. It can be helpful for an ER nurse to have strong collaborative and teamwork skills. Good communication skills help keep the whole team working well together. 
  • Firm and Direct Communication Skills: ER patients are often in pain, and they can be confused and overwhelmed. A nurse may need to communicate firmly and directly in these situations. 
  • Decision-Making Skills: ER nurses have to make many decisions through the course of a single shift. It’s helpful for a nurse to have the knowledge, education, and confidence to make the decisions that are best for patients.
  • Emotional Strength to Cope with Loss: Nurses will likely see some traumatic cases and, even with their best efforts, they’ll experience patient loss. It is helpful if an ER nurse possesses the emotional strength to deal with the tragic side of this career and to then go on and treat the next patient. 
  • Calmness Under Pressure: The ER is a high-stress, high-stakes environment. Nurses need to be able to triage patients and take action quickly, yet calmly. Staying calm under pressure may help patients feel more confident and calm. 
  • Flexibility: Situations in the ER can change rapidly, and working as an ER nurse requires flexibility. A nurse may need to suddenly change what they are doing with little to no notice, and immediately focus on that new priority.
  • Dedication to Lifelong Learning: ER nurses are exposed to new cases and situations. Nurses may use these opportunities as ongoing learning, applying what they’ve experienced with previous patients so they can better help future patients. This dedication to lifelong learning may help a nurse build and improve their skills.
  • Empathy: Though they may be multitasking and working under pressure, ER nurses also need to maintain empathy and compassion for patients. Taking the time to smile, speak to patients, and understand what patients are going through may help to reassure and calm frightened patients.

Emergency Room Nurse Certifications

If you want to become an ER nurse, one option is certification. Earning your nursing certification helps to validate your knowledge and expertise.

Board of Certification for Emergency Nursing (BCEN) 

BCEN offers five nursing certification programs. All require an unrestricted RN license and certifcation by exam every four years.

Information for these certifications and fees was updated as of June 2021. Be sure to check with the BCEN for the most up-to-date information.

There are benefits to becoming BCEN certified. In fact, BCEN’s white paper, 5 Compelling reasons to Get (and Keep) Your Emergency Nursing Specialty Certification, found that 92% of supervisors agreed it is important to have professional, certified emergency department (ED) nurses in their facilities. 

BCEN offers practice exams to help you prepare for the certification exam. When you take your certification exam, you’ll receive your results moments after finishing.

Emergency Room Nurse Resources

The Emergency Nurses Association (ENA) promotes excellence in emergency room nursing and is a valuable resource to ER nurses. Association members can access resources including practice and government relations information. The ENA also publishes multiple journals and magazines: 

  • ENA Connection, the ENA’s member magazine, is published monthly and highlights ER nursing trends, industry news, and nurse profiles and success stories.
  • ENA’s peer-reviewed Journal of Emergency Nursing publishes original ER nursing research, pediatric nursing reviews, editorials, and more. 
  • ENA’s NewsLine is a weekly e-newsletter sent to emails with health and nursing news.

The ENA also offers evidence-based ER nursing education and resources on an array of topics. These resources include toolkits, books, posters and more. Many of the programs feature both lessons and exams, and some qualify as continuing education credits. 

In 2004, the ENA established the Academy of Emergency Nursing to honor nurses who have made significant contributions to the field, advance the profession of ER nursing, and provide visionary leadership. To date, more than 160 nurses have been inducted into the academy.

Related Nursing Careers

Besides ER nursing, there are many other types of nursing careers that can be fast-paced and exciting. Some of these include:

  • Registered Nurse (RN) To become an RN, one must hold at minimum an ADN and pass licensure examinations. RNs are typically more general nurses than ER nurses, but they still deal with life or death every day, just like in an emergency department. 
  • Intensive Care Unit Nurse: An ICU nurse likely has specialized skills and extensive knowledge of disease pathology to provide interventions and sustain life. They should not be confused with emergency room nurses, who treat urgent patients and respond to crisis.
  • Medical Surgical Nurse: A medical surgical nurse is a registered nurse who cares for adult patients who are acutely ill dealing with medical issues and diseases or who are recovering from surgeries. 
  • Trauma Nurse: A trauma nurse is a type of emergency worker who deals with traumas. They may work with an ambulance or emergency service or an outpatient care center. They need to be able to act quickly when patients come in with life-threatening injuries or conditions.
  • Travel Nurse: A travel nurse may not have a set hospital and instead travels around a geographic area (wide or small) to fill nursing shortages or help with short-staffed facilities. Because they are in different settings, this may appeal to those interested in ER nursing for the ever-changing pace. 
  • Emergency Room Nurse Practitioner: For those who want to advance their education, a role as an emergency room nurse practitioner may be interesting. Like an ER nurse, ER nurse practitioners work in emergency departments. Nursing practitioners, however, typically have attended nurse practitioner graduate programs. 

Sponsored online nursing programs

Simmons University

info

Master of Science in Nursing (MSN)

Earn an MSN online from Simmons University. Choose from two program options — FNP or PMHNP — and prepare to raise the standard of patient care.

  • Choose from two program options — FNP or PMHNP
  • Complete in as few as 24 months
  • Full-time and part-time tracks available

Georgetown University

info

Master of Science in Nursing

Nursing@Georgetown delivers Georgetown University’s MS in Nursing program online, preparing RNs with a BSN to pursue certification in an APRN specialty. Students can earn their degree in as few as 23 months. 

  • Earn your MS in Nursing in as few as 23 months
  • Choose from one of four APRN specialty areas: AG-ACNP, FNP, NM/WHNP, or WHNP
  • Gain hands-on clinical experience in evidence-based practice

St. John Fisher University

info

Master of Science in Nursing

Earn an M.S. in Nursing online at the Wegmans School of Nursing. Bachelor’s in nursing and RN license-required. 

  • Part-time and accelerated tracks available
  • Four program options: PCFNP, PMHNP, AGACNP, AGPCNP

info SPONSORED

FAQs

If you’re just starting to explore the ER nursing field, you probably still have some questions about the roles and daily life of an ER nurse. We’ve answered some of the FAQs below. 

What is an emergency room nurse? 

An ER nurse works with patients who need immediate triage and treatment. ER nurses are registered nurses, but they may have received additional specialized training that allows them to fulfill the many responsibilities that come with working in the ER.

What does an emergency room nurse do? 

ER nurses work in a fast-paced environment. Patients in the ER can be suffering from significant trauma, injury, or illness, and nurses need to be able to act quickly to evaluate, stabilize and treat patients who are in crisis. 

When a nurse isn’t triaging patients, they’ll perform other duties in the ER. Common tasks include updating electronic health records, preparing and stocking rooms, checking medical equipment, assisting with tests like blood draws and EKGs, and more. 

Where does an emergency room nurse work? 

Most ER nurses work in hospitals or medical clinics, but ER nurses can also work in urgent care facilities, on cruise ships, as flight nurses, and on search and rescue teams.

Travel emergency nurses may work in a variety of settings. These nurses travel to emergency rooms with a need for nurses. Because the ER is a high-stress environment, it can have higher rates of burnout. Travel nurses can help by relieving staff and temporarily filling staffing vacancies. 

What’s the difference between an ER nurse vs. a trauma nurse?

ER nurses and trauma nurses perform very similar work. The main difference is in the type of injuries and conditions they handle. ER nurses may be prepared for almost anything. Patients may come into the ER because of burns, stroke or heart attack signs, fainting or loss of consciousness, broken limbs, severe stomach pain, and more. 

A trauma center is often located in the ER and sees extreme cases where a patient’s survival is in jeopardy. Patients may come into the trauma center with gunshot or stab wounds, major burns, traumatic injuries from car accidents, traumatic brain injuries, and other serious conditions that require immediate triage and treatment.

Information on this page was retrieved in January 2022.