How to Become an ER Nurse

People with strong communication and collaboration skills, who can make decisions under pressure, and want to help save lives, may consider becoming an emergency room (ER) nurse.

Keep reading to learn about the necessary education and licensing to become an ER nurse. This guide also covers what the work is like, along with how to earn your ER nurse certification.

ER nurses provide care in emergency departments in hospitals, health systems, and standalone emergency rooms. They perform triage (determine which cases are the most urgent) , take vital signs, assist physicians and surgeons, and administer treatment and medications. ER nurse training also applies to emergencies outside traditional healthcare settings, such as battlefield medicine and disaster relief, or patient transportation to emergency care.

Working as an ER nurse is stressful but can also be rewarding. The stress comes from the pace of the work, the high stakes for patients, and sometimes from the need to communicate effectively with patients or loved ones who may be overwhelmed by emotion and fear. However, ER nurses may have satisfaction from saving lives and working as a close-knit team with other healthcare professionals.

You must first earn an RN license before working as an ER nurse by attending nursing school and passing the NCLEX-RN examination. Almost all hospitals require ER nurses to be certified in advanced cardiac life support (ACLS).

Wondering how long it takes to become an ER nurse? You can become an ER nurse in two years by earning an ADN degree or in four years with a BSN. Which one is right for you depends on your short-term and long-term goals.

You must have an RN license to become an ER nurse and maintain your license by participating in continuing professional education. Each state requires its own unique continuing education or licensing requirements. Registered nurses should check with their state’s nursing board for approved in-person or online continuing education providers.

Unlike a license, certification is not legally required to practice ER nursing, but employers may require it for employment or for higher-level positions. Even if certification is not a requirement for a position, obtaining it can boost your career.

While all ER nursing certifications focus on the knowledge and techniques of emergency treatment, these credentials vary based on the type of workplace and patient. For example, flight and transportation ER nurse certification focuses on stabilizing patients during emergency transportation, with relatively little equipment.

Available certifications include:

Most employers do not expect new graduates to have ER nurse experience beyond clinical hours. However, references from your emergency care instructors and clinical supervisors outlining your ability to make decisions under pressure and your collaboration skills will be helpful.

ER nurse responsibilities vary by setting and experience. If you work in a large ER, you may specialize in certain functions, while you may be more of a generalist in a smaller facility. In a disaster relief, battlefield, or transportation ER nursing role, you will need to know how to improvise where needed. Whereas a fully-equipped hospital will require you to know advanced equipment.

According to Payscale, the median salary for an ER nurse is $73,000 as of May 2022. However, ER nurse salaries vary widely based on education and certification, experience, and workplace setting.

It takes two years to earn an ADN degree and pass the NCLEX-RN examination. Though, some employers prefer a BSN degree, especially for advanced positions.

The best degree for ER nurses depends on your background and career goals. For example, a BSN may be more valuable for administrative roles or to earn an MSN, but an ADN program is faster and easier to get into.

There are several advancement routes for ER nurses. ER nurses can become team leaders or nurse administrators if they earn additional certifications or an MSN. They can also earn an MSN to become a certified emergency nurse practitioner.

The demand for all nurses, including ER nurses, is high. There is also great satisfaction in saving lives or helping patients with serious conditions. However, ER is also one of the most stressful and high-pressure specialties. Whether it is right for you depends on your personality and goals.