Meet an ER Nurse

NurseJournal Staff
Updated May 11, 2022
    Emergency nursing is a demanding and rewarding career. Learn from a real ER nurse what it's like to serve in the role.
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    Emergency nurses help triage emergency room patients and provide care for patients with serious injuries or illnesses. They experience the triumphs of saving patients’ lives, along with the desolation of losing patients and communicating with their loved ones.

    Find out directly from an ER nurse what emergency room nursing is really like with the following Q&A. As a health and wellness influencer, Rastisha Smikle has worked as a registered nurse (RN) for over 10 years. She currently works in one of the nation’s top hospital systems and owns a CPR training company.

    Q&A With an ER Nurse

    Portrait of Rastisha Smikle

    Rastisha Smikle

    Rastisha Smikle, also known as Nurse Stisha, is a health and wellness influencer based in Orlando, Florida. She educates and motivates her audience in an entertaining way. Having worked as an RN for more than a decade, she delivers expertise in wellness, ER care, and maternal/baby care. Smikle currently holds a position with one of the nation’s top hospital systems. She also owns a CPR training company to teach business owners and individuals.

    Q: Why did you choose to become a nurse?

    As a young girl, I always played doctor, and I’ve always known that I wanted to help people. My dad is a retired firefighter/EMT, so I got to witness his work in the field. I always liked hearing the action-packed stories he told and watching medical shows on TV. My mom has always said that I’m a really good caregiver.

    But, what really triggered me into realizing that nursing was my calling was when I watched “Patch Adams”. I love that movie. Robin Williams’ character inspired me. I wanted to be able to make a difference like that. As a result, I set my sights on becoming a doctor. Later on, in middle school, I met a good friend’s mom who was a nurse.

    When I told her about the movie, and I made her watch it, she said, “Honey, that’s more of what a nurse does.” I then knew it was my goal to become a nurse and get the opportunity to change lives. I wanted to be that person to make a difference in someone’s life, even if it is for a short duration.

    Q: What led you to ER care specifically?

    My original motivation to pursue a position in the ER was to challenge myself and grow and develop my nursing skills. My first love in nursing was working with oncology/cancer patients. After six years, I started to see the effect that it had on me emotionally. Dealing with the losses became emotionally strenuous. I was excited to transition and learn new skills, be in a face-paced environment, and impact patients’ lives.

    Q: What’s it like working in such a fast-paced environment?

    Sometimes it feels like organized chaos, and it’s often nonstop. Patients often ask, “How do you do this job without roller skates on?” I do my best to control as many elements in the environment as possible because it helps to keep me focused on caring for the patients rather than tasks.

    Q: Do you think ER nurses experience higher levels of burnout?

    I think that the ER is one of the settings that encounters high levels of burnout and turnaround. We see and deal with any and everything. Any scenario — good or bad — that you can think of, we’ve been through it. Pre-COVID-19, I think that the burnout took much longer to set in; however, the uncertainty of the virus brought with it a lot of fear to us frontline workers.

    Q: What does patient care look like in an ER setting?

    Patient care is focused on meeting the critical needs of each patient. It can be very challenging because patients sometimes think that the care that they will receive in the ER is a “fix-all.” Patients sometimes leave the ER with the same issue/condition that brought them in.

    As a result, patients are referred to other doctors for follow-ups, more diagnostic testing, and care. In the ER, we rule out all of the life-threatening conditions and either admit the patient to the hospital or discharge them to continue their care with the necessary follow-up.

    Q: What’s something people might not realize about working in an ER setting?

    Our role as nurses and healthcare providers is a selfless one. We often choose to place the needs of others above our own. Because the nurses are providing most of the hands-on care, a lot of frustrations are also taken out on us. We are often yelled at, complained about, and mistreated for things that are outside of our control.

    One message that I feel is important is that gratitude goes a long way. Your gratitude and appreciation can continue to fuel and ground us. Because kindness comes so few and far between, sometimes a thank you is a small gesture that reminds us why we continue to do our job.

    Q: What are some of the greatest challenges and rewards of being an ER nurse?

    One of the greatest challenges of my job is losing a patient. It is something that you never get used to. Having to console a family member through the initial shock and grief doesn’t get easier over time. I often think of the moments they will miss and how their families will cope without them. Unfortunately, no training can prepare you for those moments.

    My greatest rewards have been seeing how the nursing and healthcare community banded together during the most challenging times these past few years. The support from our community members was also very inspiring. We often came into work with goodies from companies that wanted to encourage and thank us for our continued work.

    Q: What advice would you give to nurses or future nurses considering ER care?

    My advice to other nurses that want to pursue ER nursing would be to try not to doubt yourself. The ER is a challenging place to work. There will be a learning curve and culture shock. In order to tap into your greatness, you have to navigate through both.

    And ultimately, because there are so many options in nursing, if the ER ends up not being a good fit, there’s always other options. Hospitals often don’t want to fire you. They want to find a place that fits you, so you can thrive. I think people are fearful of failing, but it’s not really failure. It’s growth.

    What Does an ER Nurse Do?

    Emergency nursing requires professionals to identify the critical needs of each patient and work with clinical teams to direct the patient to the appropriate level of care. For those in immediate danger, it means admitting the patient to the hospital, while for others, it means referring them to other care providers for testing and follow-up care.

    Emergency nurses work with the patient’s loved ones, along with the patient and the rest of the healthcare team. They must possess strong communication skills and the ability to ensure that patients and their families understand the steps they need to take.

    Key Skills and Responsibilities

    • check-circleTriage patients
    • check-circleTake vital signs and conduct testing under a physician’s or nurse practitioner‘s directions
    • check-circleUpdate the patient’s medical records
    • check-circleKeep the patient’s loved ones informed
    • check-circleEducate the patient and family on their diagnosis and condition
    • check-circleProvide emotional support to the family, especially in the case of death

    How to Become an ER Nurse

    To become an emergency room nurse, you must earn a nursing degree from an accredited school. While you can become an ER nurse with a two-year associate degree in nursing, many hospitals require or prefer candidates with a four-year bachelor of science in nursing degree. After graduation, you must take the National Council Licensure Examination and apply for a nursing license.

    Once you’ve gained experience, you may want to become a certified emergency nurse. Certification demonstrates your commitment to emergency nursing and indicates that you’ve mastered the required body of knowledge.

    While it’s not mandatory, the Board of Certification for Emergency Nursing recommends at least two years of experience as an ER nurse before pursuing certification. This also ensures that you don’t invest time and energy in certification if you become more interested in another specialization.

    How Much Do ER Nurses Make?

    According to PayScale data from July 2021, the average annual salary for an ER nurse is $70,000. The Bureau of Labor Statistics’ (BLS) projects an above-average 7% growth rate in nursing jobs from 2019-2029. Hourly emergency room nurses earn an average of $32.00/hour. Experience and education can increase salary figures even further.


    Average Hourly Salary

    Source: PayScale (July 2021)


    Average Annual Salary

    Source: PayScale (July 2021)