How to Become an ER Nurse

Updated November 29, 2022

Interested in emergency healthcare? Learn how to become an ER nurse, including information on the necessary education, licensing, and certification.
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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.

What is an ER Nurse?

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.

Steps to Becoming an ER Nurse

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).

  1. 1

    Earn a ADN or BSN Degree

    You must earn either a two-year associate degree in nursing (ADN) or a four-year bachelor of science in nursing (BSN). While the ADN can get you started as a nurse faster, some emergency rooms may require or strongly prefer applicants with a BSN degree. A BSN also positions graduates to earn an MSN to become an advanced practice nurse (APRN).

  2. 2

    Pass the NCLEX Exam to Receive RN Licensure

    The NCLEX-RN examination is a multi-hour multiple choice examination covering all aspects of nursing. It is graded as a pass or fail. NCLEX-RN first-time pass rates are a strong indicator of nursing school quality.

  3. 3

    Gain Experience in Emergency Nursing

    Once you graduate, you can work in an emergency department. While your nursing school work will include clinical hours, on-the-job training is critical for new nurses. Your employer will provide you with this training.

  4. 4

    Consider Becoming a Certified Emergency Nurse (CEN)

    There are several emergency nursing certifications, but a valuable one is the certified emergency nurse (CEN) credential from the Board of Certification for Emergency Nursing (BCEN). You can take the certification examination once you have an RN license, but the BCEN recommends at least two years of ER nursing experience.

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ER Nurse Education

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.

ADN Degree

If your question is how to become an ER nurse as quickly as possible, an ADN may be your answer. This degree takes two years, compared to four years for a BSN. If you earn your ADN and eventually decide to pursue a four-year degree, you can enroll in an RN-to-BSN or RN-to-MSN program. Some employers require or give preference to nurses with BSNs, especially for leadership roles.

  1. 1

    Admission Requirements

    High school diploma or GED certificate with science and math courses

  2. 2

    Program Curriculum

    Practical nursing skills, such as using medical equipment and monitoring patients; how to maintain a hygienic healthcare environment; how healthcare organizations work; communications; legal and ethical concerns

  3. 3

    Time to Complete

    2 years

  4. 4

    Skills Learned

    Administering medication and other prescribed treatments; wound care; performing medical testing; safely using medical equipment; understanding and updating medical records

BSN Degree

The four-year BSN takes longer than an ADN and features more stringent admission requirements and an in-depth curriculum. This is why employers may prefer or require a BSN for certain roles. A BSN also prepares you to earn an MSN to become an advanced practice nurse (APRN), nurse educator, or nurse administrator. Individuals with a bachelor's degree in a non-nursing field can complete an accelerated BSN program in 12 to 18 months.

  1. 1

    Admission Requirements

    High school diploma or GED certificate with math and science classes; minimum 3.0 GPA

  2. 2

    Program Curriculum

    Nursing skills; public health and population health; nurse leadership; research and statistics; understanding and applying evidence-based nursing practices

  3. 3

    Time to Complete

    Four years

  4. 4

    Skills Learned

    Performing nursing tasks; patient communications; leadership; strategies for improving patient care

ER Nurse Licensure and Certification

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:

Working as an ER Nurse

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.

Frequently Asked Questions About Becoming an ER Nurse


How many years does it take to be an ER nurse?

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.

What is the best degree for ER nurses?

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.

What career advancement opportunities are available for ER nurses?

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.

Is becoming an ER nurse worth it?

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.


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