By The Nursezone Writing Staff
The emergency room is a chaotic environment where nurses and physicians have to think on their feet and perform potentially life-saving procedures. While nursing in an emergency room is stressful, it’s also reported to be an incredibly rewarding position where the challenges and surprises each day keep the job exciting. As an added benefit, emergency room nurses
are constantly in demand
, which means they have the potential to earn higher than average incomes.
According to Advance Healthcare Network
, non-certified ER nurses earn an annual salary of $84,826
, while a certified ER nurse salary is $88,502
. These averages aren’t broken down by work experience, meaning as nurses advance in their career, they’ll have the potential to earn even higher rates. While the difference in average annual salary for registered versus non-registered ER nurses is only about 4%, becoming a certified emergency nurse is a worthwhile effort. Across all fields of nursing, having a certification increased the average wage by 23%.
How to Become an ER Nurse
To fully prepare for their career, ER nurses have to go through three steps in order to become a certified ER nurse
: education, licensure, and certification. Each step is dedicated to advancing nurses toward their desired field.
Nurses need hands-on experience working with patients, they must know the ins and outs of anatomy and disease, and they have to learn patients’ rights. Each of these subjects requires a breadth of knowledge and experience, and the process from first-year students to certified nurses can take up to six years.
Up first is traditional schooling. To become a registered nurse (RN), you must have at the minimum an associate degree in nursing (ADN). This will enable you to apply for an entry-level nursing job
and start to gain work experience. Other options that can lead to higher pay are a Bachelor of Science in Nursing (BSN), a Master of Science in Nursing (MSN), and a Doctor of Nursing Practice (DNP).
Associate Degree in Nursing
In an associate program, students will enroll in medical courses such as nursing, anatomy, nutrition, microbiology, chemistry, and other STEM field classes. It’s the fastest path to becoming an RN and can be completed in two years.
When gaining an associate degree, students will typically also have to take liberal arts classes as mandated by the college.
Bachelor of Science in Nursing
To receive a Bachelor of Science in Nursing, students must attend a four-year college or university. They would cover all the classes listed above in the associate’s program as well as a deeper dive into what a nurse can perform. This includes nursing research, care for elderly patients, bioethics, and public health.
If you’re an RN, or you already have a nursing diploma, you’re eligible to enroll in an RN-to-BSN program. These nursing programs are designed with nurses who already have some experiences but want to earn a bachelor’s degree. RN-to-BSN programs take between two to three years to complete.
Another option for earning a BSN is for graduates who have completed a Bachelor of Science program in a different field. By applying the credits from the other degree, these BSN students can finish their courses typically within a year.
One note, if you’re completing your BSN or ADN online or as a supplement to your current job, the timelines will be longer.
Master of Science in Nursing
Although not required, a Master of Science in Nursing (MSN) is the next step in your educational career. While most programs require their students to have completed a BSN program, some offer RN-to-MSN degrees.
MSN degrees take about two to three years to complete, and they are where students can hone in on specialty practices. Oncology, women’s health, nursing education, and nursing administration are a few examples.
If you’re thinking of becoming a Nurse Practitioner or an Advanced Practice Nurse, a master’s degree is a step toward that career path.
Doctor of Nursing Practice
The final step on the educational career is the Doctor of Nursing Practice (DNP). This degree builds on top of the MSN curriculum, so an MSN is usually required (although some schools provide exceptions for BSN graduates). Programs average at about three to six years of study, depending on the student’s schedule as many DNP students will be working simultaneously.
DNP focuses on areas of nursing such as system management, nurse leadership, healthcare finance, evidence-based nursing concepts, patient quality improvement, nursing philosophy, and making data-driven decisions.
Once you’ve completed either an ADN or BSN, students must enroll in and pass a nursing licensure exam before being allowed to practice. This means it’s time to familiarize yourself with NCLEX
. The National Council Licensure Examination is put on by the National Council of State Boards of Nursing (NCSBN).
To put all of the acronyms together: If you graduated with an ADN or BSN, you must take and pass NCSBN’s NCLEX to become an RN. That was fun, wasn’t it?
Certified ER nurses enjoy a bump in pay and additional responsibilities. To become certified, you must pass another exam. The Board of Certification for Emergency Nursing (BCEN
) handles certification for emergency nurses, flight registered nurses, pediatric emergency nurses, transport registered nurse, and trauma registered nurses. Each comes with a unique test that determines whether you’re qualified or not.
To be eligible, you must have an RN license, and some states require you have direct clinical experience. Check with your local board to determine what’s needed in your state.
ER Nurse Job Description
Once you’ve gone through the education process and passed the examination, you’re ready to work as an ER nurse. But what exactly does that entail? Nurses are the intermediary link between physicians and patients. As an ER nurse, you’ll be in charge of three primary roles: admissions, treatment, and discharge.
Admissions into the ER
Nurses are the gatekeepers into the ER. They have to be aware of how many beds are available, assess the condition of each patient, and determine the level of severity of each case. This assignment of urgency is known as triage.
A broken bone isn’t going to be as life-threatening as a stab wound. Nurses have to be able to assess which patient needs to be brought in first. Life-threatening situations receive immediate attention, while other patients can be kept comfortable until a physician is available.
Once a patient is admitted, the nurse will then record all their symptoms and information onto an electronic record.
Patient Care and Treatment
In an emergency room, nurses are expected to handle patient care and treatment. While a doctor is the one who orders tests and procedures, nurses do the administering. That could be putting in intravenous drips, cleaning and bandaging injuries, taking vitals, and distributing medication.
Nurses are also in charge of confirming tests, receiving results, monitoring patients, and notifying doctors of any change in patient health. While this is going on, nurses will also be in charge of communicating the condition and treatment options of the patient to the family. For this, nurses must follow all HIPAA guidelines
Once the doctor has determined whether a patient is stable enough to leave or be transferred to another wing of the hospital, the nurse will complete the discharging protocol. This includes finishing all the details on a patient’s chart, ensuring the patient has transportation, and notifying the next facility that will continue treatment.
Patients will often have questions regarding their health and care moving forward. Nurses are there to help assuage any worries and inform them of anything they should be careful about.
Typical ER Nurse Qualities
While every nurse is different, there are some qualities that many share. For example, many ER nurses are extroverted and open. This helps to manage patient care in high-stress environments. They are also able to maintain calm in chaotic situations. These two points are vital for working in a specialized area like the emergency room as there will be times when the work becomes overwhelming.
Other qualities ER nurses have include: high stamina, the ability to multitask, strong observational and assessment skills, assertiveness (to be the best advocate for their patients), the ability to switch gears, and a developed inner personal coping mechanism.
Pros and Cons of ER Nursing
When deciding whether you want to join an ER staff, consider what your typical day will be. You’ll be on the move constantly and always alert. You’ll need critical decision-making skills and the ability to cope with stress. In return, you’ll find that working in an ER is an exciting and rewarding career. To dive into the pros and cons of ER nursing, here are some things to consider.
Benefits of ER Nursing
Working in an ER will put you in a place to make life or death decisions and to care for patients coming in with critical conditions. All nurses help people recover, but only ER nurses are there when people require urgent care. It’s hard to put it any other way: saving lives is rewarding.
Incredible Learning Environment
ER nurses have to be equipped to deal with gunshot and stab wounds, foreign objects stuck in uncomfortable areas, and people brought in unconscious. Because of the sheer variety of these urgent cases, the chance to learn something new is always around the corner.
It’s impossible to survive an ER shift alone. Nurses collaborate both physically and mentally. Your coworkers become your friends, your confidants, and the people who support you on exceptionally challenging days.
Never a Dull Moment
For someone who has to be continuously engaged in their work, ER nursing is the perfect occupation. Emergency rooms may not live up to the hype of what you see on TV, but there will always be moments of high adrenaline to keep you excited and alert.
Downsides of ER Nursing
While working in an exciting, challenging environment presents many opportunities to grow, it can also become overwhelming. It’s a high-stress job that can quickly build up physically and mentally if nurses don’t learn to cope or channel their stress into other external activities.
Imagine for a moment working in an emergency room. What kind of patients are coming in? People who are in pain, possibly delusional. And they’re expecting you to fix them up. Now add the fact that you’re seven hours into your shift and there are no empty beds to put people. Your patients are going to be irritable, stressed out, and in pain. It’s an emotionally draining situation that ER nurses have to face all the time.
Constantly on the Move
ER nurses are on the go from the moment they clock in to the moment they clock out. There’s no point wearing a Fitbit around as a nurse. You’ll be getting your 10,000 steps halfway through the shift.
A result of always being on the move? Sore feet. One of the biggest complaints among nurses is the amount of foot pain that comes from all the back and forth. Some nurses even suggest having multiple pairs of comfortable shoes in your locker to swap halfway through shifts.
Traveling ER Nurse
If you’re looking to increase your average ER nurse salary, one option to consider is travel nursing
. Travel nursing is designed to help hospitals who are understaffed. Nurses will typically be on assignment anywhere from eight weeks to six months and are offered stipends to cover travel and living expenses during that time.
Travel nursing is a way to combine a love of travel and patient care. With all fifty states requiring some form of travel nursing to cover their hospitals, travel nurses are always in demand.
Is Becoming an ER Nurse Right for You?
When deciding to pursue a nursing career
or not, there are many factors to consider. While the above average pay is nice, the emergency room comes with a lot of physical and mental stress to contend with. ER nurses are expected to be alert and prepared for the chaotic environment in order to offer patients the necessary care.
As an ER nurse, you’ll find you rarely have a moment to yourself during a shift. At the same time, it’s a rewarding career for anybody who wants to work in collaborative, highly educational environments.
Bureau of labor statistics. Registered Nurses Job Outlook
Elite Learning. 2018 Nursing Salary Guide
HHS. Health Information Privacy
Board of Certification For Emergency Nursing
NCSBN. NCLEX & Other Exams