How to Become an Emergency Room (ER) Nurse – Career Guide

Pathways to Becoming an Emergency Room Nurse

There is no one path to becoming a nurse, let alone an ER nurse. Those interested in this career can consider different degree programs, formats and certifications. While one way to pursue this career is to attend an online nursing program, there are many options, including:

• Associate Degree in Nursing (ADN): An ADN is a pathway to enter the world of nursing. The North Carolina Board of Nursing describes a nursing program leading to an associate degree as generally two years in length, and an ADN may prepare you for the NCLEX-RN exam.
• Bachelor of Science in Nursing (BSN): A BSN is an undergraduate degree in nursing. According to the American Association of Colleges of Nursing (AACN), a standard baccalaureate nursing program is a four-year college or university education. In addition to the vocational training you would receive in an ADN program, you also gain additional education as you would traditionally in a bachelor’s program.
• RN to BSN: For registered nurses with an ADN who want to advance their education, an RN-to-BSN program may be beneficial. AACN notes that programs for returning nurses may offer flexible course schedules and credit for previous education and experience.
• Master of Science in Nursing (MSN): An MSN is a graduate degree in nursing. Obtaining an MSN is a great opportunity for RNs to acquire a high level of education and qualification. An MSN or other graduate program that prepares you in a specific role and patient population is one step toward becoming an advanced practice registered nurse (APRN). The NCSBN describes APRNs as registered nurses educated in a specific role and patient population at a master’s or post-master’s level; APRNs must also pass a national certification exam and hold an APRN license. There are also MSN programs online.

How Long Does It Take to Become an ER Nurse?

How long it takes depends mainly on the degree you choose. The ADN and BSN options above differ in length, and RNs with an ADN can add a BSN later through an RN-to-BSN program. AACN describes a standard baccalaureate nursing program as a four-year education. After you graduate, you take the NCLEX-RN, apply for licensure with your state board of nursing, and then look for work in an emergency department or a related acute care setting.

Certification is a separate step that requires a current RN license: BCEN recommends at least two years in your specialty before you schedule a certification exam, although it does not require that experience.

Should I Become an Emergency Room Nurse?

Though working as an ER nurse can be a highly rewarding career, it’s not for everyone. You may consider the following factors when deciding if this career is right for you.

Salary

According to the U.S. Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics, May 2025, registered nurses had a median annual wage of $97,550 (mean annual wage: $101,420). Registered nurses who work in hospitals had a median annual wage of $100,220. BLS reports these wages for registered nurses as a whole, not for ER nurses specifically. Nursing salaries do vary based on a number of factors including specialization, experience and even geographic area.

Roles and Responsibilities

According to the Emergency Nurses Association (ENA), emergency nursing includes several roles: trauma, rapid response, triage, disaster response and emergency preparedness, flight, critical-care transport, pediatric ED, burn center, geriatric ED, military, and charge nurse. Each of these has specific roles that help specific populations of patients.

In a typical day, an ER nurse might:

• Triage patients as they arrive at the ER
• Assist with or perform tests like blood tests
• Maintain patient chart notes
• Collaborate with the rest of the ER team to provide comprehensive patient care
• Observe and monitor patients
• Prepare medical equipment and stock rooms

Several of these tasks match duties that O*NET lists for registered nurses, such as monitoring and recording patients’ conditions, conducting laboratory tests, and preparing rooms and supplies, and for acute care nurses, such as obtaining specimens for laboratory work. ENA’s triage policy statement describes triage as primarily a nurse-led process.

An ER nurse cares for patients with a variety of conditions and injuries. These patients may range from the pediatric to the geriatric. As a result, ER nurses need to have comprehensive training and be prepared for almost anything.

Skills

ER nurses have a specialized skill set that help them succeed in this challenging environment:

• Multitasking Skills: Things happen rapidly in the ER, and nurses need to be able to keep up. Multitasking is common, especially when nurses must assess and treat patients simultaneously. An ER nurse may focus on multiple priorities at once without forgetting or overlooking anything important.
• Teamwork: Many ER staff often work together to treat a patient. It can be helpful for an ER nurse to have strong collaborative and teamwork skills. Good communication skills help keep the whole team working well together.
• Firm and Direct Communication Skills: ER patients are often in pain, and they can be confused and overwhelmed. A nurse may need to communicate firmly and directly in these situations.
• Decision-Making Skills: ER nurses have to make many decisions through the course of a single shift. It’s helpful for a nurse to have the knowledge, education, and confidence to make the decisions that are best for patients.
• Emotional Strength to Cope with Loss: Nurses will likely see some traumatic cases and, even with their best efforts, they’ll experience patient loss. It is helpful if an ER nurse possesses the emotional strength to deal with the tragic side of this career and to then go on and treat the next patient.
• Calmness Under Pressure: The ER is a high-stress, high-stakes environment. Nurses need to be able to triage patients and take action quickly, yet calmly. Staying calm under pressure may help patients feel more confident and calm.
• Flexibility: Situations in the ER can change rapidly, and working as an ER nurse requires flexibility. A nurse may need to suddenly change what they are doing with little to no notice, and immediately focus on that new priority.
• Dedication to Lifelong Learning: ER nurses are exposed to new cases and situations. Nurses may use these opportunities as ongoing learning, applying what they’ve experienced with previous patients so they can better help future patients. This dedication to lifelong learning may help a nurse build and improve their skills.
• Empathy: Though they may be multitasking and working under pressure, ER nurses also need to maintain empathy and compassion for patients. Taking the time to smile, speak to patients, and understand what patients are going through may help to reassure and calm frightened patients.

Emergency Room Nurse Certifications

If you want to become an ER nurse, one option is certification. Earning your nursing certification helps to validate your knowledge and expertise.

Board of Certification for Emergency Nursing (BCEN)

BCEN offers six nursing certification programs. According to BCEN, each requires a current, unencumbered RN license, and each certification renews every four years through continuing education or by retaking the exam.

• Certified Emergency Nurse (CEN)
  • Recommended: Two years of specialty experience.
  • Fee: $380 for the initial exam and $200 for a retest taken within one year of the initial exam; $280 for recertification.
• Certified Pediatric Emergency Nurse (CPEN)
  • Recommended: Two years of specialty experience.
  • Fee: $380 for the initial exam and $200 for a retest taken within one year of the initial exam; $280 for recertification.
• Trauma Certified Registered Nurse (TCRN)
  • Recommended: Two years of specialty experience.
  • Fee: $380 for the initial exam and $200 for a retest taken within one year of the initial exam; $280 for recertification.
• Certified Flight Registered Nurse (CFRN)
  • Recommended: Two years of specialty experience.
  • Fee: $380 for the initial exam and $200 for a retest taken within one year of the initial exam; $280 for recertification.
• Certified Transport Registered Nurse (CTRN)
  • Recommended: Two years of specialty experience.
  • Fee: $380 for the initial exam and $200 for a retest taken within one year of the initial exam; $280 for recertification.
• Certified Burn Registered Nurse (CBRN)
  • Recommended: Two years of specialty experience.
  • Fee: $380 for the initial exam and $200 for a retest taken within one year of the initial exam; $280 for recertification.

Certification and fee information reflects BCEN’s published certification pages as checked in September 2026. Reduced fees are available to some association members and military applicants. Be sure to check with BCEN for the most up-to-date information.

There are benefits to becoming BCEN certified. In BCEN’s 2017 Value of Certification Study, 92% of surveyed supervisors of emergency nurses agreed or strongly agreed that it is important to have certified emergency nurses in their organization. That is a reported opinion from a 2017 survey of 1,002 supervisors, not a current survey and not an employer requirement. BCEN’s Value of Certification page has more on its research.

BCEN offers official practice exams to help you prepare for its certification exams.

Emergency Room Nurse Resources

The Emergency Nurses Association (ENA) promotes excellence in emergency room nursing and is a valuable resource to ER nurses. Association members can access resources including practice and government relations information. The ENA also publishes multiple journals and magazines:

• ENA Connection is the ENA’s member publication.
• The Journal of Emergency Nursing is the ENA’s journal for emergency nursing.
• The ENA also lists Emergency Nursing News among its publications.
• The ENA offers emergency nursing education, including the Trauma Nursing Core Course (TNCC) and the Emergency Nursing Pediatric Course (ENPC), along with practice resources. ENA education includes continuing nursing education hours.

In 2004, the ENA established the Academy of Emergency Nursing to honor nurses who have made significant contributions to the field, advance the profession of ER nursing, and provide visionary leadership. The ENA’s Academy page states that more than 200 emergency nurses have been inducted into the academy.

Related Nursing Careers

Besides ER nursing, there are many other types of nursing careers that can be fast-paced and exciting. Some of these include:

• Registered Nurse (RN): To become an RN, one must complete a nursing program and pass the NCLEX-RN; the NCSBN notes that candidates should meet the requirements set by the board of nursing where they plan to practice. ER nurses are registered nurses who specialize in emergency care; BCEN describes the CEN as a foundational specialty certification for RNs working in the ED.
• Intensive Care Unit Nurse: An ICU nurse likely has specialized skills and extensive knowledge of disease pathology to provide interventions and sustain life. They should not be confused with emergency room nurses, who treat urgent patients and respond to crisis.
• Medical Surgical Nurse: A medical surgical nurse is a registered nurse who cares for adult patients who are acutely ill dealing with medical issues and diseases or who are recovering from surgeries.
• Trauma Nurse: A trauma nurse is a type of emergency worker who deals with traumas. They may work with an ambulance or emergency service or an outpatient care center. They need to be able to act quickly when patients come in with life-threatening injuries or conditions.
• Travel Nurse: A travel nurse may not have a set hospital and instead travels around a geographic area (wide or small) to fill nursing shortages or help with short-staffed facilities. Because they are in different settings, this may appeal to those interested in ER nursing for the ever-changing pace.
• Emergency Room Nurse Practitioner: For those who want to advance their education, a role as an emergency room nurse practitioner may be interesting. Like an ER nurse, ER nurse practitioners work in emergency departments. Nurse practitioners, however, typically have attended nurse practitioner graduate programs, and the NCSBN describes APRNs, including nurse practitioners, as educated at a master’s or post-master’s level.

If you’re just starting to explore the ER nursing field, you probably still have some questions about the roles and daily life of an ER nurse. We’ve answered some of the FAQs below.