How to Become an Emergency Room Registered Nurse: Pros, Cons, Careers Paths, and More

Americans pay more than 145.6 million visits to the emergency room every year, according to the Centers for Disease Control and Prevention. Often the first person they see is an emergency room nurse, who might be tasked with:

• Performing CPR
• Conducting the triage (i.e., patient assessment)
• Stitching wounds
• Administering IV and medication
• Monitoring vital signs
• Collecting data
• Maintaining medical records
• Educating patients and their families
• Collaborating with doctors and specialists to provide the necessary care

Because ER treatment is so often urgent and critical, ER nursing is unquestionably a high-stress profession. If you’re looking for a low-key job with a predictable routine, you should probably look elsewhere. If, however, you thrive on challenges and excitement, the ER could be the place for you. ER work isn’t exactly as action-packed as it appears to be on television dramas, but it’s rarely boring.

In this guide to becoming an emergency room registered nurse, we’ll discuss:

• The pros and cons of becoming an emergency room registered nurse
• Kinds of emergency room registered nurse careers
• Educational commitment to become an emergency room registered nurse
• Licensure and accreditation for becoming an emergency room registered nurse
• Resources for becoming an emergency room registered nurse
• Typical advancement path for an emergency room registered nurse
• Further accreditation or education for an emergency room registered nurse

Pros and cons of becoming an emergency room registered nurse

Emergency room nursing can be extremely challenging, but there are positives.

Pros of becoming an emergency room registered nurse:

• Job outlook: The field of nursing is expected to grow by 12 percent through 2028. That’s more than twice the growth rate of the overall job market.
• Saving lives: Registered ER nurses help people survive serious trauma, disease, and injury.
• Never boring: ER nurses regularly have the opportunity to perform numerous vital tasks.
• Pay: Emergency room nurses earn an average of $66,292 a year, but that number can increase based on job experience and location. For example, New York City ER nurses earn closer to $80,000 per year, on average. Carefully weigh your expected salary with expected stress levels.
• Diversifying workforce: If you are a man considering a fast-paced career in the ER, you’ll add your name to a growing list of those defying career gender roles. Male nurses tend to pick critical care nursing specialities: 76 percent of male nurses work in hospitals (compared with 61 percent of female nurses).

Cons of becoming an emergency room registered nurse:

• Mental strain: Emergency room nurses are at an elevated risk of developing PTSD. They must find healthy coping mechanisms to deal with the violence, pain, aggression, confusion, and fear they witness.
• Long hours: In most hospital emergency rooms, nurses work three 12-hour shifts per week. That’s fewer hours than a traditional workweek, but they are often grueling shifts. Nurses are constantly on their feet, sometimes literally running from patient to patient. Being frequently on-call can add to fatigue.

Kinds of emergency room registered nurse careers

Emergency room nurses don’t always work in the ER, especially when patients need attention in ambulances or emergency helicopters. Other specialized career paths for ER qualified nurses include:

• Combat nursing: The Army Nurse Corps has more than 11,000 members who are active nursing personnel. These nurses can be reserve or active duty. They serve both troops and their families.
• Sports and arena events: ER nurse specialists use their trauma background to assist at large-crowd events.
• Travel nursing: You’ll still work in a hospital, but not the same one all the time. These contract or freelance professionals are able to travel the world providing emergency medicine, often to underserved communities.
• Mental health nurses: Treatment centers and mental health facilities often require specialized trauma nurses to help establish a safe, healing environment.
• Geriatric nurses: By specializing in the elderly population, an ER nurse can be a part of the growing need for geriatric carein critical care or emergency facilities.

Educational commitment to become an emergency room registered nurse

You’ll need an Associate’s Degree in Nursing (ADN) and a passing grade on the NCLEX-RN exam, which tests basic competency, to become a registered nurse. It is possible to earn a relatively inexpensive ADN from a local community college and go straight to work after graduation. You should be aware, however, that an increasing number of employers require RNs to hold a bachelor’s degree in nursing (BSN), and that this trend is likely to continue.

That’s why many nurses opt to earn a Bachelor of Science in Nursing (BSN), which is a traditional four-year undergraduate degree. Some jobs require a BSN; having one should improve your chances of getting hired in nearly all circumstances. Like an ADN, however, it is probably more cost-effective to earn this degree from a local college, since tuition is often considerably less for in-state students. As you consider nursing programs, conduct a cost-benefit analysis and ask good questions in order to determine the educational path for your needs.

Luckily, there are numerous time-saving RN-to-BSN programs for nurses who have an ADN and an active license. Indiana University – Bloomington, for example, offers a program that is entirely online.

Some nurses earn a Master of Sciene in Nursing (MSN), which typically takes two years to complete. This degree opens up a variety of career options, a handful of which are listed below. You can also consider an RN-to-MSN program to get your BSN and MSN faster, rather than earning them separately.

Potential opportunities for MSN holders, depending on their concentration, include:

• Advanced practice registered nurse
• Clinical nurse specialist
• Nurse anesthetist
• Nurse educator
• Nurse midwife
• Nurse researcher
• Nurse practitioner
• Legal nurse consultant

These job titles often come with substantial pay increases, enough to justify attending a more selective (and expensive) school, such as Duke University, to earn your MSN.

Licensure and accreditation for becoming an emergency room registered nurse

In addition to the mandatory NCLEX, ER nurses can opt to take the Certified Emergency Nurse exam (CEN), which demonstrates a high level of competency in emergency practice. More than 38,000 nurses have taken the CEN through the Board of Certification for Emergency Nursing (BCEN).

Though being an RN is the only eligibility requirement to take the CEN, applicants are encouraged to have at least two years of experience before attempting the test.

Resources for becoming an emergency room registered nurse

The Emergency Nurses Association offers plenty of resources (including conferences and publications) for nurses and students. It shares best evidence-based practices and help nurses expand their networks.

Additionally, the ENA lobbies the government for funding and legislation and works with the American Psychiatric Nurses Association to provide a clinical framework to help nurses navigate any challenging mental health circumstances that they face.

To keep up with the latest findings in emergency nursing practice, check out the Advanced Emergency Nursing Journal, the International Journal of Trauma Nursing, or the Journal of Emergency Nursing.

Typical advancement path for an emergency room registered nurse

Though there is no single advancement path for emergency room registered nurses, a common option is to earn a Master’s Degree in Nursing.

Some nurses might choose to earn a doctoral degree in nursing. These options include:

• Doctor of Nursing Practice (DNP)
• Nursing PhD
• Doctor of Nursing Science (DNSc)

These programs can take three years or longer.

A DNP focuses on clinical aspects of nursing. Programs often “build on traditional master’s programs by providing education in evidence-based practice, quality improvement, and systems leadership, among other key areas,” according to the American Association of Colleges of Nursing.

For those interested in research or teaching, a DNSc, such as the one at Louisiana State University Health Sciences Center – New Orleans, or a nursing PhD, such as the one at Columbia University, might be a better fit.

Further accreditation or education for an emergency room registered nurse

In addition to Certified Emergency Nurse, ER nurses can earn other credentials through the Board of Certification for Emergency Nursing. ER nursing career specialities include:

• Flight registered nurse
• Pediatric emergency nurse
• Transport registered nurse
• Trauma-certified registered nurse

If and when you become an active emergency room registered nurse, continuing your education will definitely add value to your résumé and strengthen your general abilities because the field is continually evolving. Advanced degrees and additional credentials will help you stay competitive and qualified for nursing opportunities that most interest you.

Whether you work in a hospital or find yourself in a more specialized setting, one thing you can know for sure: being an ER nurse is a demanding medical career, but one where you’ll never be bored. If you will thrive in a job where you have a direct role in saving lives, and if you have the empathy and drive to handle it, an emergency nursing career may be right for you.

(Last Updated on February 26, 2024)

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