How to Become an Emergency Room Nurse

Are you the type of nurse that thrives in chaos and loves the adrenaline rush that comes with crisis situations? If so, becoming an emergency room nurse might just be the right specialty for you. Whether you are a newly graduated nurse or a veteran nurse, the emergency room offers a wealth of excitement, learning experiences, and just the right amount of pressure. If you’d like to learn more, keep reading for a comprehensive guide on how to become an emergency room nurse.

What is an ER Nurse?

The emergency room (ER) nurse specialty is essentially just what it sounds like – a nurse that works in the emergency department/room of a hospital. Because the environment is notoriously fast-paced and chaotic, an ER nurse needs to be able to keep up with constant demand and stay calm in the face of challenges. The ER is a segment of hospital health care that sees patients come in in dire situations – ideally, a true emergency. A nurse working in that emergency room should be comfortable with these types of situations. We’ll get more into what is expected of ER nurses, along with ideal characteristics of an ER nurse, but suffice it to say that an ER nurse is an extremely necessary cog in the workings of the hospital.

Duties of an ER Nurse

In the emergency department, there will be all sorts of issues that patients come in with. Everything from broken bones to heart attacks to allergic reactions are all possible circumstances that might need to be attended to, even in one single shift. Therefore, along with the interdisciplinary team of physicians and specialists, nurses who work in the emergency room will need to be familiar with a variety of traumas and treatments. Below are just a few of the major roles and responsibilities of an ER nurse:

Triage and Prioritization

One of the first things that needs to happen in the emergency room is triage. Essentially, a nurse is responsible for identifying and determining the seriousness of each patient’s issues so that more serious situations are dealt with first. Thus, a nurse needs to be very familiar with a variety of health complaints to ensure that each patient is seen in a timely manner according to their injuries.

Deal with Data

An emergency room nurse will need to observe patients and collect data about their current complaint. This data will need to be properly documented to ensure proper treatment is given.

Administer Interventions

In true emergency situations that require immediate action, nurses will need to work in a timely manner to administer interventions, whether through medication or wound care or other treatments. Following this administration, patient response is recorded and used as information to inform the next steps of care. Policies and procedures according to the facility’s best practices must be followed carefully and thoroughly.

Record New Data

As treatment is given and care is taken, the nurse must continue to update the recorded data. It should include any medication side effects present, any change (for better or worse) in the patient’s status, and physician instructions for the furthering of care.

Educate Patients

In many circumstances, nurses will need to educate patients as to the nature of their health situation as well as how to continue managing it when they are discharged from the hospital. They may need to educate patients on proper wound management, when and how to take medications, or just by simply giving more information directly related to their condition.


In such a hectic environment, it is crucial that ER nurses see themselves as part of a team with the ultimate goal of exceptional care for every patient. A nurse must communicate with the team and continually work with other members to ensure each patient is attended to.

Requirements to Become an Emergency Room Nurse

Working in the ER luckily does not require many extra qualifications, and many nurses are hired into the ER right after graduating from nursing school. Many facilities might have different requirements, but usually, there is a generic set of qualifications that you’ll need to work as a nurse in the emergency room. Some emergency departments may prefer to hire nurses that have had previous relevant experience or have completed an internship in the specialty area.

Education Requirements

As with any nursing position, the ER nurse must have completed a nursing program or degree from a community college or university. Usually, that will be a Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN). Following the successful completion of this course, the nurse will then have to take and pass their state’s NCLEX-RN exam to receive Registered Nurse Licensure. Once the RN is received as a title, the job market opens up widely.

If you have an idea of where you want to work, make sure to check out their specific requirements for hiring. Many facilities nowadays require a BSN as an absolute minimum educational requirement and won’t accept an ADN. Some hospitals may hire ADNs but require that you complete your BSN within a certain timeframe after being hired.

Additional Certifications

In order to be fully prepared to work in the emergency room, most facilities require that you take some extra certification. The nationally accepted program is the Certified Emergency Nurse course created and administered by the Emergency Nurses Association. This course will ensure that nurses have achieved a certain level of proficiency when it comes to the very complex area of emergency healthcare. This certification course includes hours of theory and practice of emergency care as well as the ethics that go into triage in the ER.

Before this examination can be taken, you must have at least 2 years of RN experience. This ensures that you will have enough experience with a wide array of health conditions so that you are more prepared to deal with them in a rushed and stressful environment.

Personal Attributes

Even if all of the educational and certification requirements are met, there are still many characteristics that an ER nurse should have if she wants to be successful at her job. They include, but are not limited to, the following:

  • Every day in the ER is different. There are different patients, different issues, different physicians. As an ER nurse, you will need to be highly adaptable to changing situations and flexible enough to make changes in your own methods of doing things. Unlike working in another department, the emergency room requires that you are able to keep up with the continual flux of the situations.
  • We mentioned earlier that ER nurses work on a team of a variety of doctors, nurses, and specialists in order to provide the right care to every patient. As such, you will need to be able to work effectively with a team. This means that you are able to both lead and follow when the situation calls for it. You should be able to have tact and empathy for your coworkers, even in difficult situations.
  • Working in the emergency room can definitely put some strain on your mental quickness. With so many things happening at once and so many different patients with different needs, you must have the confidence to make decisions very quickly without second-guessing yourself. This will come with experience, of course, but you should remember that you are educated and certified to do the job – so believe that you can do it!
  • Occasionally, things will go awry, and you’ll need to be able to bounce back quickly. If something terrible happens, even outside of your control, the nature of the ER doesn’t allow for breaks to decompress. Instead, you need to be able to bounce back quickly and continue helping people.

Emergency Room Salary and Job Outlook

The good news is that there will always be openings for qualified ER nurses. While it is possible that in the future, we will be able to cure a myriad of diseases and ensure general health for the wider population, accidents will always happen at work, at home, and while people are out and about. In turn, there will always be a need for the emergency room to be able to take in patients in need. If you’re worried about job security as an ER nurse, don’t be.

The Emergency Room Nurse average base pay is about $79k per year. However, the range is wider, from $70k to $88k in the US. How much you make as an ER nurse will depend on your location (state, city, and facility) as well as your own personal qualifications and experience. The more you have of either, the higher you can expect your pay to be, though you should be prepared to negotiate.

Final Words

Becoming an ER nurse is a wonderful career path for many registered nurses. As long as you fulfill the education and certification requirements and have the confidence to deal with the unknown every single day, you can expect to thrive in this environment.

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Dr. Jenna Liphart Rhoads is a registered nurse and a nurse educator. She earned a BSN from Saint Francis Medical Center College of Nursing and an MS in nursing education from Northern Illinois University. Jenna earned a PhD in education with a concentration in nursing education from Capella University where she researched the moderation effects of emotional intelligence on the relationship of stress and GPA in military veteran nursing students.