Emergency room nurses work in a variety of often fast-paced settings and roles assessing, triaging, and treating patients with injuries or acute and chronic illnesses who require immediate or urgent access to care. Emergency room nurses are registered nurses (RNs) who may also be nurse practitioners (NPs).
Where Do Emergency Room Nurses Work?
Although some may assume that emergency room nurses work only within hospital settings, the Emergency Nurses Association (ENA®) refers to emergency room nurses in the broader category of “Emergency Nurse” and says they can work in various subspecialties of emergency medicine, which may include:
Trauma
Stroke
Cardiac
Burn
Neuro
Disaster Response
Military
Pediatric
Adult
Geriatric
The ENA also notes there can be significant variations in the types and amounts of resources available depending on where a facility is located. The following are some of the settings for emergency departments as described by the ENA:
Critical Access: “Remote settings with very few resources”
Rural Areas: “Moderately remote areas with more resources within a few hours by road or air”
Community Settings: “Mid-size cities with a moderate amount of resources”
Urban Areas: “Major metropolitan areas, usually a lot of resources”
Teaching Hospital: “Large facilities associated with a university or two, many resources available”
Stand-Alone Emergency Department: “Available in only certain states, not physically connected with a hospital”
Disaster Settings: “Extreme environments after a disaster, few resources, often associated with federal or military response programs”
What Does an Emergency Room Nurse Do?
The emergency room nurse’s credentials and state practice laws determine the scope of practice permitted. The setting in which care is provided also influences an emergency room nurse’s duties.
The duties of an emergency room nurse may include those similar to other patient care settings, such as:
Assessing, triaging, and monitoring the patient’s status
Documenting the patient’s medical history and symptoms in the patient record
Creating and updating the patient’s plan of care
Collaborating with the patient
Administering medications and treatments
Performing various procedures
Operating and monitoring medical equipment
Teaching patients and families
However, the ENA describes various “Emergency Nurse” roles which will have a significant impact on the types of duties involved, including:
Trauma Nurse: “Trauma Nurses work in Trauma Centers and run the show when trauma patients come in…”
Code Nurse: “Code Nurses run the Code Rooms where the sickest of the sick patients go in the ED. …The Code Nurse will run the ACLS-based codes and provide emergency care for these critically ill patients.”
Triage Nurse: “Triage Nurses sort patients based on complaint, vital signs, and resources needed to help decide who gets seen first by an ED provider.”
Disaster Response or Emergency Preparedness Nurse: The ENA notes that although “all ED nurses are first-responders during a disaster,” most EDs have a “Disaster Champion or Emergency Preparedness Nurse” who is in charge of ensuring the department is “always up-to-date on their disaster response plans and policies.”
Flight Nurse: “Flight Nurses are a type of Critical-Care Transport (CCT) Nurses who work out of helicopters and planes to transport critically injured or ill patients to emergency departments or from one ED to another facility.”
Critical-Care Transport (CCT) Nurse (Ambulance): “CCT Nurses that work on ambulances are responsible for transporting critical care patients from one facility to another. They work out of an ambulance with a care team of paramedics or EMTs.”
Pediatric ED Nurse: “Pediatric ED Nurses work in facilities that primarily take care of patients less than 18 years old, usually in a pediatric hospital.”
Burn Center Nurse: “Emergency Nurses that work in Burn Centers are specially trained in burn victim resuscitation and burn care.”
Geriatric ED Nurse: “Nurses that work in Geriatric Centers are responsible for the care of elderly patients. Geriatric ED Nurses get trained on the specialized care that older adults require.”
Military Nurse: “Emergency Nurses in the military are specially trained to work in military hospitals, clinics, or combat zones. A nurse must be enlisted in one of the military branches to be considered for a military nurse position.”
Charge Nurse: “The Charge Nurse… [is] responsible for staffing, patient assignments, throughput, communication with the ED providers and nursing leadership, and much, much more.”
How Much Does an Emergency Room Nurse Make Per Year?
According to salary data from the Bureau of Labor Statistics (BLS), the median annual wage for registered nurses was $77,600 in May 2021—with half of nurses earning more than that amount and half earning less. Wages of nurses in the lowest 10 percent were less than $59,450. Wages of nurses in the highest 10 percent were over $120,250.
The BLS does not provide a pay breakdown according to specialty but does provide median annual wages for registered nurses according to general categories of work location. According to ENA descriptions of potential work settings, the following median annual salaries may apply:
General medical and surgical hospitals: $85,020
Outpatient care centers: $93,070
However, the salary for a military nurse is determined differently. According to the U.S. Department of Defense (DOD) Military Compensation website, Basic Pay is “the fundamental component of military pay. All members receive it and typically it is the largest component of a member’s pay. A member’s grade (usually the same as rank) and years of service determine the amount of basic pay received.”
Nurses enter the military as commissioned officers. According to the monthly Basic Pay table for January 2023, a commissioned officer at the 0-1 pay grade with less than two years of service will make $3637.20 a month. As military nurses move up in rank and add years of service, pay increases.
In addition to Basic Pay, military members are provided with additional benefits related to compensation, including:
Special and Incentive (S&I) Pays—which can be used “to improve recruiting and retention by increasing compensation in key occupation specialties or critical skill areas. These pays are also used to compensate for onerous or hazardous duty assignments or conditions. In addition, S&I pays can be used to provide incentives for service members to develop certain skills that are important to national security objectives.” Of the more than 60 S&I pays authorized by law, four of the most popular are Hardship Duty Pay (HDP), Hostile Fire Pay/Imminent Danger Pay (HFP/IDP), Assignment Incentive Pay (AIP), and Hazardous Duty Incentive Pay (HDIP).
Allowances—which are described as “the second most important element of military pay.” These funds are provided for “specific needs, such as food or housing. Monetary allowances are provided when the government does not provide for that specific need. …The most common allowances are Basic Allowance for Subsistence (BAS) and Basic Allowance for Housing (BAH). A majority of the force receives both of these allowances and, in many cases, these allowances comprise a significant portion of the member’s total pay.”
Tax Exemptions—“A substantial, but often unseen and overlooked, aspect of military pay is certain built-in tax advantages. Most allowances are tax-exempt. Additionally, certain hardship circumstances will change normally taxable pay into tax-exempt.”
The salary of an emergency room nurse is also influenced by factors such as education, experience, and geographical region of the country.
Emergency room nurses who are advanced practice nurses, such as nurse practitioners, are licensed registered nurses who obtain at least a master’s degree in their specialty role, pass a national certification exam, and hold an APRN license in their state.
The American Academy of Nurse Practitioners (AANP) says it is “collaborating with the American Academy of Emergency Nurse Practitioners (AAENP) to develop the Emergency Nurse Practitioner specialty certification examination for Family Nurse Practitioners who work in emergency care. Due to the lifespan scope of the ENP examination, only certified FNPs [Family Nurse Practitioners] who meet eligibility criteria will be able to take the AANPCB Emergency NP certification examination.”
What Are the Benefits of Being an Emergency Room Nurse?
In “What I Wish I Knew Before I Became an Emergency Department Nurse,” one emergency department director describes the many dynamics involved with being an emergency room nurse, including one of the most powerful benefits: providing a healing presence for patients and families.
“Most people, when they come to the emergency department, are not making a planned visit. Patients and their families are dealing with a lot of anxiety and stress, and we have the opportunity to be there when people are most vulnerable. Just being there, holding their hand, listening — that can go a long way,” he writes. “Most emergency nurses would never want to work in any other specialty once it’s in their blood. It takes a special person to be an emergency nurse, a person who possesses the ability to rapidly organize thoughts and prioritize tasks, a master multitasker with a bladder of steel, a compassionate person who can hide her emotions well so that patients feel her warmth and empathy – no matter what just happened in the other room. If that describes you, you’ve got what it takes to be an ED nurse!”
Additional Resources About Becoming an Emergency Room Nurse
To learn more about becoming an emergency room nurse, these additional resources may help:
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