How to Become an Emergency Room (ER) Nurse

    April 12, 2021
    How to Become an Emergency Room (ER) Nurse
    Kathleen Gaines
    By: Kathleen Gaines MSN, RN, BA, CBC

    By: Kathleen Gaines MSN, RN, CBC

    According to the Centers for Disease Control and Prevention (CDC), in 2018 there were 130 million emergency room visits in the United States. 16.2 million patients were admitted to the hospital while another 2.3 million were admitted to critical care units following an emergency room visit. 

    ER nurses are responsible for triaging, treating, and stabilizing these patients. In this guide, we’ll explain what an Emergency Room nurse does, how to become one, how much they make, and more!

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    Part One What Is an Emergency Room Nurse?

    Emergency room nurses are licensed registered nurses that work in a hospital’s emergency department, or ER. ER nurses are responsible for the stabilization of patients before transferring to the operating room, intensive care unit, and/or medical-surgical unit as well as discharging medically stable patients. 

    Patients coming through an ER can be of any age or background and they come in for a variety of reasons – trauma, injury, or acute-onset symptoms. 

    Emergency Room nurses are called a number of different names including ER Nurse, Trauma Nurse, and Critical Care Nurses. 

    Part Two What Does an Emergency Room Nurse Do?

    ER nurses work side by side with other medical professionals to ensure patients receive quality and timely care to treat immediate life-threatening medical conditions, stabilize patients requiring advanced medical therapies, and discharging stable patients. 

    ER nurses work quickly during patient exams and are comfortable using advanced equipment to monitor and treat patients. 

    A major job responsibility of ER nurses is triaging patients after the check-in process and determining if they require immediate care or are stable and can wait while other “sicker” patients are treated. 

    ER Nurse Duties & Responsibilities

    1. Administering blood products, medications and vaccinations 
    2. Assisting in the care of traumas, cardiac arrests, strokes, sexual assaults and conscious sedations
    3. Cleaning and dressing wounds
    4. Conducting cardiopulmonary resuscitation, rescue breathing, or bag-valve-mask ventilation
    5. Discharging medically stable patients
    6. Educating patients, families, and caregivers about their disease and treatment plan
    7. Performing tracheotomies and intubations
    8. Placing Intravenous lines
    9. Responding to emergency situations throughout the hospital
    10. Setting broken bones
    11. Stabilizing trauma patients
    12. Treating critical injuries, allergic reactions, and trauma
    13. Triaging patients upon arrival to emergency room
    14. Part Three Emergency Room Nurse Salary

    According to the U.S. Bureau of Labor Statistics (BLS), the median salary for a registered nurse in 2019 is $73,300 per year or $35.24 per hour, but conditions in your area may vary. The BLS does not differentiate between different specialties of nursing, but reports an average annual salary of $68,796 per year or an average hourly salary of $31.85.

    ER Nurse Salaries by Level of Experience

    Specifically, Emergency Room Nurses can earn a higher annual salary with increased years of experience.

    1. Less than 1 year of experience earn an average hourly wage of $26.79
    2. 1-4 years of experience earn an average hourly wage of $28.99
    3. 5-9 years of experience earns an average hourly wage of $32.63
    4. 10-19 years of experience earns an average hourly wage of $36.10
    5. 20 years and higher years of experience earns an average hourly wage of $39.00

    Highest Paying States for ER Nurses

    Currently, the highest average paid states for Emergency Room Nurses that have reported salaries, according to are as follows:

    1. Los Angeles, California - $47.98/hr
    2. New York, New York - $44.04/hr
    3. Houston, Texas - $37.52/hr
    4. Phoenix, Arizona - $35.76/hr

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    Part Four How to Become an Emergency Room Nurse

    Becoming an ER nurse is similar to other nursing specialties. To become an Emergency Room Nurse, you’ll need to complete the following steps:

    Step 1: Attend Nursing School

    You’ll need to earn either an ADN or a BSN from an accredited nursing program in order to take the first steps to become a registered nurse. ADN-prepared nurses can complete an additional step of completing their BSN degree if they wish. 

    Step 2: Pass the NCLEX-RN

    Become a Registered Nurse by passing the NCLEX examination.

    Step 3: Gain Experience at the Bedside

    It is possible to become an ER nurse directly out of nursing school with no experience; however, some emergency rooms will require two to three years of prior bedside nursing. This might be in a medical-surgical unit or intensive care unit. 

    Step 4: Earn Your Certification

    Advanced certification is optional but highly encouraged. The Board of Certification for Emergency Nursing offers the Certified Emergency Nurse (CEN) to eligible nurses. While not required, most nurses find this certification as a way to advance their careers. 

    CEN Eligibility Certification 

    • Current, unrestricted US, US territories, or Canadian RN licensure
    • Recommended:
      • Two years of experience in the emergency room

    CEN Exam Information

    • $370 examination fee
    • Computerized examination
    • Three hour timed exam
    • 175 items (150 scored and 25 unscored pretest items)
    • Passing: 106 correct answers

    What’s On The Test?

    • Cardiovascular Emergencies
    • Respiratory Emergencies
    • Neurological Emergencies
    • Gastrointestinal, Genitourinary, Gynecology, and Obstetrical Emergencies
    • Psychosocial and Medical Emergencies
    • Maxillofacial, Ocular, Orthopedic, and Wound Emergencies
    • Environment and Toxicology Emergencies, and Communicable Diseases
    • Professional Issues

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    Part Five Where Do Emergency Room Nurses Work?

    Generally, emergency room nurses work in hospital emergency rooms; however, they can work in a variety of other locations. These include:

    1. Academia
    2. Ambulance transport team
    3. Burn center
    4. Disaster Response and/or Emergency Preparedness 
    5. Emergency response team
    6. Flight transport team
    7. Government agency
    8. Medical clinic
    9. Poison control center
    10. Prison
    11. Trauma center
    12. Triage center
    13. Urgent care center

    ER Nurse Benefits

    Regardless of the workplace setting, full-time and part-time nurses enjoy similar benefits. While actual benefits may vary depending on the institution most include the following:

    1. Attendance at nursing conferences
    2. Bereavement leave       
    3. Certification Reimbursement      
    4. Childcare
    5. Continuing Education Reimbursement
    6. Dental Insurance
    7. Dependent health insurance coverage
    8. Discounts on extracurricular activities      
    9. Family Leave of Absence
    10. Health insurance
    11. Holiday Pay
    12. Life Insurance
    13. Maternity Leave
    14. Paid time off
    15. Relocation assistance
    16. Relocation packages
    17. Retirement Options
    18. Vision Insurance        

    Part Six What is the Career Outlook for an Emergency Room Nurse?

    According to the BLS, in 2019, there were 3,096,700 Registered Nurses in the United States. By 2029, there will be a need for additional 221,900 nurses, which is an expected growth of 7%.

    Overall, there are many jobs available for emergency room nurses due to an aging population and a greater number of uninsured individuals and families in the United States. However, there are ebbs and flows to emergency room visits. Some, depending on the location, will have periods of overwhelming needs and then others with only a handful of patients. 

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    Part Seven What are the Continuing Education Requirements for an Emergency Room Nurse?

    Generally, in order for an individual to renew their RN license, they will need to fill out an application, complete a specific number of CEU hours, and pay a nominal fee. Each state has specific requirements and it is important to check with the board of nursing prior to applying for license renewal.

    If the RN license is part of a compact nursing license, the CEU requirement will be for the state of permanent residence. Some states require CEUs related to child abuse, narcotics, and/or pain management. 

    CEN recertification requires 100 contact hours of nursing continuing education within the four-year recertification period. These continuing education hours can also be used for nursing license renewal. 

    A detailed look at Continuing Nurse Education hours can be found here

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    Part Eight Resources for Emergency Room Nurses

    Check out these additional resources for more information on emergency room nursing!

    1. Advanced Journal of Emergency Nursing
    2. American Academy of Emergency Nurse Practitioners
    3. American Association of Critical Care Nurses
    4. American Nurses Association
    5. American Trauma Society
    6. Emergency Nurses Association
    7. Journal of Emergency Medicine
    8. National Emergency Nurses Association
    9. Society of Trauma Nurses
    10. The Board of Certification for Emergency Nursing
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    Part Nine Emergency Room Nurse FAQs

    • What is an emergency room nurse called?

      • Emergency room nurses are often referred to as ER nurses but may also be referred to as trauma nurses and/or critical care nurses. 
    • How much does an RN make in an emergency room?

      • reports an average hourly salary of $33.00 for emergency room nurses.
    • What kind of nurses work in the ER?

      • Emergency room nurses must be able to think and react quickly to ever-changing situations including urgent and life-threatening situations. ER nurses must have a solid foundation of skills and the ability to learn new skills and information quickly. Typically, ER nurses should have experience in a critical care setting, such as an ICU or ER, and experience with advanced medical devices
    • ICU vs ER nurse, what’s the difference?

      • The main difference between an ICU nurse and ER nurse is the goals of care. ER nurses prioritize, stabilize, and move onto the next patient while ICU nurses plan for the long-term goals for the patients and help them move from critical illness to health. ICU nurses are also responsible for building a rapport with patients and their families including in-depth patient/family education while ER nurses rarely do significant education teaching. 

    RN $70,000 - $90,000 Associate's Bachelors ER
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