How to Become an ER Nurse

Emergency nursing requires unique skills and traits, including critical thinking under pressure, remaining calm in emergencies, excellent communication, and endless compassion.

Learn about the necessary education and licensing to become an emergency room (ER) nurse and how to earn your ER nurse certification.

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What Is an ER Nurse?

ER nurses provide care in emergency departments in hospitals, health systems, and standalone ERs. They perform a wide variety of tasks and must acquire a broad skill set, including:

• Performing triage (rapidly assessing and prioritizing patients based on medical urgency)
• Taking vital signs and assisting with procedures
• Monitoring patients and collaborating with other members of the care team
• Administering medications and other treatments
• Responding to and treating medical emergencies

Working as an ER nurse is a rewarding field, but it can also be rather intense. Anxiety can be significant due to the fast pace of work, the acute nature of the care being provided, and the need to communicate effectively with overwhelmed patients and families. However, nurses who flourish in the ER setting have an opportunity to save lives and work closely with other healthcare professionals.

Emergency nursing also extends to jobs outside traditional healthcare settings too, including military medicine, disaster relief, and flight nursing.

Steps to Becoming an ER Nurse

You must earn an RN license before you can work as an ER nurse. This means attending nursing school and passing the NCLEX-RN exam. Almost all hospitals require ER nurses to be certified in basic life support (BLS), advanced cardiac life support (ACLS), and pediatric advanced life support (PALS). However, you can typically get those certifications on the job.

• Earn an ADN or BSN Degree

  To work as an ER nurse, you must first earn a nursing degree. The two most common program types are a two-year associate degree in nursing (ADN) or a four-year bachelor of science in nursing (BSN) program. While the ADN can get your nursing career started faster, some hospitals may require or strongly prefer applicants with BSN degrees.

  If you already have an ADN and want to pursue a bachelor’s degree, an RN-to-BSN program may be right for you. If you have a bachelor’s degree in another field, you can apply for an accelerated BSN program

• Pass the NCLEX Exam to Receive RN Licensure

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

• Gain Experience in Emergency Nursing

  Once you graduate, you can apply for work in an ER. Historically, hospitals required years of experience in different departments before nurses were allowed to work in the ER. However, thanks to novel programs such as nurse residencies, new graduate nurses can start their careers in higher acuity areas such as the ER, intensive care unit, and operating room.

  On-the-job training is critical for new nurses. Employers usually provide this training through a nurse residency program for recent graduates or a preceptorship for more experienced nurses. The programs typically last 3-6 months.

• Consider Becoming a Certified Emergency Nurse (CEN)

  There are several emergency nursing certification programs. One of the most widely recognized is the certified emergency nurse (CEN) credential from the Board of Certification for Emergency Nursing (BCEN). You can take the certification exam once you have an RN license and at least two years of ER nursing experience.

ER Nurse Education

Are you wondering how long it takes to become an ER nurse? You can earn an ADN degree in two years or a traditional BSN in four years. Which one is right for you depends on your short and long-term goals.

ER Nurse Licensure and Certification

To become an ER nurse, you must have an RN license and maintain it by participating in continuing professional education. Each state has different requirements. Nurses should check with their state’s nursing board for approved in-person or online continuing education providers.

Unlike a license, certification is not required to practice ER nursing. Still, employers may require it for advancement within the department. Even if certification is not required for a position, obtaining it can boost your career and knowledge after you’ve taken a few years to master ER nursing basics.

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 certifications focus on stabilizing patients during emergency transportation with minimal equipment and support.

Available certifications include:

• Certified Emergency Nurse (CEN)
• Certified Pediatric Emergency Nurse (CPEN)
• Trauma Certified Registered Nurse (TCRN)
• Certified Flight Registered Nurse (CFRN)
• Certified Transport Registered Nurse (CTRN)

Working as an ER Nurse

ER nurse responsibilities vary by setting and experience. If you work in a larger emergency department, you may be trained in advanced areas such as critical care, while in a smaller facility, you may be more of a generalist.

According to Payscale, the median salary for an ER nurse is $77,577 as of May 2024. However, ER nurses’ salaries vary widely based on education, region, experience, and workplace setting.

Frequently Asked Questions About Becoming an ER Nurse

What is the role of an ER nurse?

ER nurses treat patients from various backgrounds for different medical issues, so their roles are highly variable. Common tasks include treating and monitoring patients with medical emergencies, performing triage, taking vital signs, assisting with procedures, and collaborating with other providers to coordinate and optimize care.

What is the highest salary for an ER nurse?

The average salary for an ER nurse is $77,577 in May 2024. The highest-paid ER nurses are often travel nurses, who earn about $83,390 per year on average but can command higher salaries with experience.

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

Earning an ADN degree and passing the NCLEX-RN examination takes two years. However, some employers prefer a BSN degree, especially for more advanced positions.

What is the quickest way to become an ER nurse?

The fastest way to become an emergency nurse is to attend an ADN nursing program, pass the NCLEX-RN exam, and then apply for ER positions, ideally a nurse residency program dedicated to supporting new nurse graduates.

How hard is it to become an ER nurse?

Due to staffing shortages nationwide, it may not be that difficult to be hired as an ER nurse. Still, it can be tough to work as one. That’s due in part to the fact that ER nurses experience higher rates of violence from patients than other nursing specialties.