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Emergency Room (ER) Nurse Career Overview

Ann Feeney, CAE
Updated September 20, 2023
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    Learn about how to become an ER nurse, what ER nurse jobs are like, and ER nurse salary prospects.
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    A mid-adult Black female nurse is checking in with one of her patients in the emergency room. She is wearing dark blue scrubs and has a stethoscope around her neck. She is leaning over the patient and smiling while checking his health vitals. The patient is a young Caucasian boy wearing a standard hospital robe while resting in bed. He is smiling back at the nurse, and is pictured with hospital equipment and a window behind him.Credit: monkeybusinessimages / iStock / Getty Images Plus / Getty Images

    Emergency Room Nurse

    how long to become

    average earning potential

    average earning potential$65,410SOURCE: PayScale

    What Does an ER Nurse Do?

    ADN or BSN required
    certification not required

    What is an ER nurse? ER nurses treat people with serious illnesses and injuries when they arrive at the hospital. Many specialize in trauma, cardiac, pediatric, or geriatric emergency medicine. Nurse practitioners or physicians provide medical care and write orders for the ER nurses, who are tasked with supervising nursing assistants.

    Key ER nurse responsibilities include the following:

    Primary Responsibilities

    • Performing triage
    • Administering nursing or medical treatments
    • Monitoring vital signs and responding to changes
    • Documenting treatments
    • Recording care plans
    • Communicating with patients and families

    Skills Learned

    • Quick thinking
    • Steadiness under pressure
    • Empathy
    • Adaptability
    • Stamina

    Credit: JGI/Tom Grill / Getty Images

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    Where Do ER Nurses Work?

    ER nurses work in a variety of settings, each of which comes with different responsibilities.

    • minusCritical Access Hospital

      ER nurses in critical access hospitals help stabilize patients for transfer and treat serious injuries. They often have fewer resources for treating patients.

    • minusUrban Hospital

      Urban hospital ER nurses often respond to a variety of illnesses and injuries and sometimes assist in violence prevention.

    • minusAcademic Medical Center/Teaching Hospital

      In academic centers, ER nurses are most likely to boast specialties, use advanced equipment, and apply experimental treatments.

    Why Become an ER Nurse?

    ER nursing jobs can be tremendously gratifying, but they can also be physically and emotionally draining. Sometimes ER nurses experience trauma and even develop PTSD from incidents with multiple casualties, such as disease outbreaks, natural disasters, mass shootings, or terrorist attacks. Like most nurses, however, ER nurses enjoy salaries above the U.S. average for all occupations.

    Advantages to Becoming an ER Nurse

    • check-circleSave lives and promote quality of life
    • check-circleGain trust and respect in community
    • check-circleOpportunities for professional advancement
    • check-circleAbove-average compensation

    Disadvantages to Becoming an ER Nurse

    • x-circleRequires deep physical and emotional stamina for long periods
    • x-circleEmotional strain of witnessing trauma and losing patients
    • x-circleFamilies may unfairly blame hospital staff, including ER nurses, for bad outcomes

    How To Become an ER Nurse

    Graduate with a bachelor of science in nursing (BSN) or associate degree in nursing (ADN).

    A four-year BSN degree will be required for more advanced nursing jobs such as nurse practitioner, but an ADN degree requires only two years of study.

    Pass the NCLEX-RN exam to receive RN licensure.

    The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is the national exam to obtain RN licensure. The exam is computer adapted and can take up to six hours. The questions cover health conditions, treatment, nursing care, and ethics.

    Gain experience in the emergency nurse specialty area.

    Two years of experience is recommended but not required to sit for the certified emergency nurse (CEN) exam. Hospitals also provide on-the-job training and mentoring under experienced clinical staff.

    Improve your job prospects by becoming a CEN.

    While CEN credentials are not required for entry-level ER nurse jobs, certification offers an advantage in the initial hiring phase, along with career advancement.

    Advance your career with a graduate degree.

    ER nurses seeking greater responsibility, autonomy, or compensation may consider entering a master of science in nursing (MSN) or doctor of nursing practice (DNP) program and becoming certified emergency nurse practitioners.

    How Much Do ER Nurses Make?

    Demand is high for ER nurses. The Bureau of Labor Statistics projects a 7% job growth rate for RNs from 2019 to 2029, making ER nursing an attractive career. ER nurse salaries are well above the average national median salary of $51,920 and the national average salary of $34,250.

    On average, nurse practitioners with ER skills earn $100,721 each year. The additional education and certification is a good investment for ER nurses seeking more compensation, responsibility, and autonomy.

    Frequently Asked Questions About ER Nurses

    How long does it take to become an ER nurse?

    It takes two years to earn an ADN or four years to earn a BSN. Candidates must hold a BSN to secure some ER nurse jobs, especially at larger hospitals. A BSN is also necessary to pursue an advanced degree such as an MSN or DNP. In addition, many hospitals will require some nursing experience when hiring someone for the ER.

    What specialties are available for emergency nurses?

    The following includes common ER nurse specialties and special credentials:

    • Trauma ER nurse: treats severe trauma cases
    • Triage ER nurse: determines priorities based on urgency
    • Flight ER nurse: treats patients during emergency air transport (certified flight registered nurse credential required)
    • Pediatric ER nurse: treats children in the ER (certified pediatric emergency nurse credential required)
    • Transport ER nurse: cares for patients during transport from one facility to another (certified transport registered nurse credential required)

    What is the difference between an ER nurse and an intensive care unit (ICU) nurse?

    ER nurses treat patients when they arrive at the hospital and focus only on immediate treatment and stabilization. ICU nurses treat patients who are in critical condition, typically in special ICUs after initial emergency treatment.

    What leadership roles are available for ER nurses?

    ER nurses seeking advancement outside of administrative roles can become emergency nurse practitioners by earning an MSN and certification. On the administrative side, ER nurses can become charge nurses, who lead the entire nursing unit in an emergency department. These positions require considerable experience and may require a graduate degree.

    Resources for ER Nurses

    • Emergency Nurses Association

      ENA provides continuing education, professional publications, and recognition awards for ER nurses. Emergency RNs in the United States and their international equivalents can become full members. Others may join without voting privileges.
    • Board of Certification for Emergency Nursing

      BCEN certifies five different emergency nurse specializations: certified emergency nurse, certified flight registered nurse, certified pediatric emergency nurse, certified transport registered nurse, and trauma certified registered nurse. The organization offers professional education and practice exams.
    • Society of Trauma Nurses

      The STN mission is to assure that the most effective trauma care is available at a local to global level. The organization publishes research, offers mentor matching, and provides education information on improving trauma care. Licensed RNs can join as voting members and others as associate members.

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    Portrait of Nicole Galan, RN, MSN

    Nicole Galan, RN, MSN

    Nicole Galan is a registered nurse who earned a master’s degree in nursing education from Capella University and currently works as a full-time freelance writer. Throughout her nursing career, Galan worked in a general medical/surgical care unit and then in infertility care. She has also worked for over 13 years as a freelance writer specializing in consumer health sites and educational materials for nursing students.

    Galan is a paid member of our Healthcare Review Partner Network. Learn more about our review partners.

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