Emergency room nurse with colleagues

Emergency room nurses are experts in acute and urgent care. They work in emergency rooms and provide immediate support to patients in need. ER or emergency nurses work in hospitals, level 1 trauma centers, or medical clinics. 

Being an ER nurse requires constant focus and engagement. You work hands-on with patients of all ages and backgrounds, and you’ll need to be able to provide comfort and support along with impeccable medical care. 

Most ER nurses undergo special training to work with patients in emergency settings. They must know how to perform all the duties of a regular RN, along with advanced life support techniques and emergency interventions. 

What does ER mean?

ER stands for “emergency room.” Nurses in the ER are called ER nurses or emergency room nurses. The emergency room provides direct, acute care for patients who enter on their own or arrive by ambulance. 

There are four levels of emergency care, and patients are seen based on the assigned level.

  • Level 1: Immediate. Patients who fall under Level 1 have life-threatening injuries or conditions. Therefore, they are always given top priority. The ER nurse focuses on providing life support and medical interventions until the patient is stabilized.

  • Level 2: Emergency. Level 2 patients also require immediate care, and their conditions risk becoming life-threatening. Examples of level 2 patients include people who have suffered major injuries and show signs of respiratory distress.

  • Level 3: Urgent. Urgent patients may present with severe headaches or abdominal pain. They could also require diagnostics, X-rays, CAT scans, or MRIs.

  • Level 4: Non-urgent. The lowest level of emergency room priority is level 4. Patients experience the most extended wait times because their conditions do not place them in immediate danger. 

Emergency room nurses are constantly tasked with something new with many levels and patients coming into the hospital daily. As a result, they’ll often have to switch gears at the drop of a hat and work with various patients in different conditions throughout their shifts. 

Note that some ERs use an upcoding system where the levels of emergency care are reversed. In these hospitals, level 4 or 5 is considered the highest priority.

What is the difference between an ER nurse and a registered nurse?

ER nurses are RNs who specialize in emergency care. Some also hold certification as CENs or certified emergency nurses. However, many nurses in the ER are just RNs who have chosen to work in an acute care setting.

Because of its diverse range of patients and healthcare demands, many hospitals require at least one to two years of working in a hospital before hiring a new nurse to work in the ER.

What qualifications does an ER nurse need?

At the minimum, an ER nurse must hold a valid RN license and certifications in cardiac life support. Most employers also require ER nurses to be CENs (certified emergency nurses) and have certification in advanced life support for adults, children, and infants.

What work does an ER nurse do day to day?

That’s a question almost impossible to answer! ER nurses have some of the most dynamic, fast-paced jobs in healthcare. Every day is different, even if you have worked in the emergency room for years. 

Some of the critical responsibilities ER nurses have include:

  • Assessing patients upon intake to determine their emergency level

  • Stabilizing new patients until a doctor can see them

  • Performing minor medical procedures, like setting broken bones, applying bandages and sutures to wounds

  • Taking vital signs and ensuring patients remain stable

  • Drawing blood, inserting intravenous lines, and giving medications prescribed by doctors

  • Answering patients’ questions about their health and medical care

  • Offering assurance to upset patients and family members

  • Responding to life-threatening cases, including people with heart attacks, victims of car crashes, and other severe injuries 

Where do ER nurses work?

As their name implies, ER nurses work in the ER of hospitals. Emergency room nurses can also work in acute care or ambulatory centers. They can also work in the military, in sports areas, as flight nurses, or even in the movie industry. In entertainment, emergency nurses may be hired to stand on set and offer immediate medical assistance if something goes wrong. 

Schools and walk-in health clinics are also an option for those who want emergency training but prefer a more relaxed environment. Here, patients are generally in less severe conditions, but having emergency skills makes you a valuable job prospect. You can also provide life-saving care if someone experiences an emergency injury.

What is it like to be an ER nurse?

Being an ER nurse is exciting, but it is also stressful. You are on your feet for 12 hours at a time, and there is rarely a moment to slow down. Busy emergency rooms have a carousel of patients, so you’ll always be moving from one to another. You can also go from treating a patient with minor problems to providing life support to someone in cardiac arrest in a matter of minutes.

If you enjoy a challenge, love working with people, and want to make a difference in people’s lives, then you might like being an ER nurse. But you need to be aware of the job's stress factors and physical demands. Nurses usually manage multiple patients at one time, so it’s essential to understand the stress level you might experience during your shift. 

If you work in critical care or are part of a crash team, you must accept that you may witness adverse medical outcomes, even when you initiate resuscitative measures.

How much do ER nurses make?

Salaries vary across the United States, but ER nurses get paid well. The median salary for an ER nurse is $76,944.90. Your earning potential will be impacted by factors like certifications, education level, experience, and location.

Recommended Reading - How much do Emergency Room Nurses (ER Nurses) make?

Advantages and disadvantages of a career as an ER nurse

Below are some of the pros and cons of being an emergency nurse. 

Advantages of choosing a career as an ER nurse

1) Fast-paced work environment

The emergency room is rarely slow, and you’ll always have something to do during your shift. Patients can range from small children to older adults. With so much on your plate, you’ll need to be an expert at shifting attention rapidly without losing focus. 

Because anything can happen at a moment’s notice, you’ll need to be a quick-thinker and ready for anything. 

2) You’ll always learn something

ER nurses often reach a point where they think they’ve seen it all…until a new patient comes in with something they never imagined treating. Emergency nursing is an excellent field if you’re a passionate learner who wants to improve your practice continually. You will always learn something from your patients, fellow nurses, and physicians. 

ER nurses need a well-rounded skill set to handle various healthcare problems without skipping a beat. They don’t have time to look things up or ask about an issue. They must be committed to furthering their education, both on the job and independently. 

3) Earn a high salary

According to Glassdoor, the average ER nurse’s base salary is $89,762. However, experienced nurses, or nurses in high-demand areas, can earn over six figures annually. 

The opportunity to earn a salary is more significant because of your unique emergency skills. With a higher degree level and certification (CEN), you may be able to earn even more.

4) Save lives regularly

ER nurses save lives around the world every single day. You may make the difference between someone dying from an accident and surviving to tell their story. And even in non-life-threatening situations, you have the opportunity to make a serious or traumatic event in someone’s life easier through empathy.

Offering genuine care, compassion, and understanding to your patients is one of the most valuable things you can do. 

Disadvantages of choosing a career as an ER nurse

1) Stressful work environment

It’s no surprise that ER nurses are often stressed. With such a demanding job, they’re more prone to experiencing burnout and compassion fatigue. So it’s essential to have outside support and resources that help you rest and rejuvenate on your off-days. 

2) Risk of trauma

Some ER nurses aren’t prepared for what they’ll encounter on the job, which can have lasting psychological effects. You’ll witness victims of violent crime, children in life-threatening situations, and sometimes struggle to save people who die under your hands. Although the job can be gratifying when things go well, the truth is that not every patient recovers. 

You must know what you may encounter and be sure you can handle distressing situations. When you are impacted by traumatic cases, having the right resources to process and cope is crucial. 

3) Physically demanding

You will have to stand for 12 hours at a time, lift and move patients, and possibly run from one part of the ER to another. The constant demand can be exhausting, so ER nurses need to develop stamina and endurance to stay active and engaged in their jobs. 

How to become an ER nurse

Your first step to becoming an ER nurse is completing an accredited nursing degree program. You can earn a 2-year associate’s degree (ADN) or a 4-year bachelor’s degree (BSN). If you aspire to get a job in emergency care right after nursing school, then a bachelor’s degree is your best option.

After completing your degree, you’ll need to pass the NCLEX exam. Then, you can get your nursing license and start training to earn your CEN certification. 

Recommended Reading - How to become an ER Nurse

Frequently asked questions about ER nurses

How long does it take to become an ER nurse?

It takes between 2 and 6 years to become an ER nurse. So, on average, expect to spend at least four years becoming fully qualified and certified as an emergency nurse. 

Is being an ER nurse worth it?

Being an ER nurse is worth it when you focus on the difference you make in patients’ lives. Unfortunately, not every patient’s story has a happy ending. But if you focus on the difference you can make in the moment, you can find fulfillment in the job.

And, of course, there are cases where you may directly save someone’s life, and that feeling is indescribable. 

Is being an ER nurse hard?

Working in the emergency room is demanding, stressful, and traumatic. Not everyone can be a successful ER nurse, but it’s rewarding.