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What Does an ER Nurse Do?

Jul 29, 2020
Casey Smith, RN

From the first day that I walked through the ER doors, I have loved it. Now, it’s not that way for every nurse, and I certainly understand why some would rather let a 1st year medical student attempt an IV on them than set foot in an ER. But for me, it was love at first sight. The palpable energy and the excitement of the unknown was what first drew me to the ER, but it was the teamwork, and my own personal growth, that kept me there. 

What are the typical responsibilities of an ER Nurse?

When I first started, I internally compared the ER to the Wild West; chaotic and lawless. While it can certainly feel like that some days, after six years spent in various ERs across the country, I now understand that a good ER is actually more like a well-oiled machine. 

It is a team of highly qualified medical professionals who work together to effectively and efficiently care for patients in a fast-paced, high turn-over setting. We are the gatekeepers of a sort. While we typically do not keep patients for long periods of time, as a team, we see or treat almost every patient that is admitted to the hospital and thousands more that we are able to send home. 

It is our job as ER nurses to assess, triage, and treat all patients that come through our hospital doors. If they require lengthy stays or treatments beyond the scope of the ER, then we get them where they need to go (surgery, inpatient, etc). 

What should nurses entering this specialty expect to encounter on a regular basis?

When asked what nurses should expect to encounter frequently in this specialty, the answer can be a little vague: everything. We see all ages and all diagnoses, from common colds to acute appendicitis to multi-trauma patients. We see adults in DKA, tiny babies with fevers, and patients in sickle cell crisis. 

I have seen everything from a broken fingernail to a double amputation (in the same shift, mind you!) For better or worse, no two shifts are the same, and you can never really know what to expect when you walk through the ER doors.

CPR dummy lying on table emergency medicine ER nurse


My experience as an ER Nurse

I personally specialized in pediatric ER and have cared for children, ages 0-18, for the last six years, with the occasional adult sprinkled in. I worked as a travel nurse for three of those years, primarily in Level 1 trauma and teaching facilities across the country. I prefer working in the Level 1 hospitals because I like the critical thinking necessary to care for high acuity patients, and I particularly loved working in the trauma bays. 

What are some of the benefits of working as an ER Nurse?

There are a multitude of reasons to choose the ER as a specialty. For starters, you will gain a wealth of knowledge about different diagnoses and medical conditions from working with so many different patients. With that, it means you are able to learn and master a wide range of skills. (And there’s always more to learn, too!)

We are the IV kings and queens of the hospital, but our skills aren’t limited to just that. We interpret EKGs, splint fractures, assist with cardioversion, and so much more.  While this can be considered a pro or a con, I personally love the high turnover of patients and fast-paced nature of the ER. It keeps things interesting and has made me incredibly adaptable and flexible as a nurse. 

You might not have the opportunity to develop long lasting relationships with patients as if you cared for them for months, but you are the person to help them in their moment of crisis. Whether a true crisis or not, patients and their families perceive whatever brought them to the hospital to be a crisis, and it is an honor that they place their trust in us to guide them through it.

The most beautiful moments I have ever witnessed in my life have happened on the job. Whether it was squeezing a new mom’s hand as she birthed her first baby, or supporting a family while they told their child goodbye for the last time, moments like these ultimately have shaped the person I am today. And I am proud of that person. 

What are some of the not-so-great parts of working as an ER Nurse? 

Being an ER nurse also has its downfalls. If you like being able to plan ahead for your shift or like a slower pace, then maybe the ER is not for you. I vividly remember having a wonderfully quiet night at the ER and was going to be sent home early, just to step outside to find not one, but TWO stab wound victims dumped on our front steps.

Note: don’t ever actually say the “Q” word on the unit unless you want a hellish night and to be shunned by your superstitious coworkers.

My night quickly evolved from chatting around the nurses station to a full-blown trauma response consisting of rapid infusing blood products and getting two simultaneously decompensating patients to the OR. And we worked on those patients so hard, only to have them transferred to someone’s care so soon and not really knowing the ultimate outcomes. 

This is common in the ER. We don’t get to care for patients for lengthy periods of time. Like I said, this can be a blessing or a curse. But once in a while, you have this really special patient or family that are so wonderful that you wish you could be their primary nurse for the entire duration of their hospital stay. In the ER, you don’t have the option to build these relationships.  

Share your favorite piece of advice for nursing new grads or students looking to become an ER Nurse

Overall, I wouldn’t trade my last six years in the ER for anything. If you are serious about pursuing a career in the ER, I have one solid piece of advice. Look for a good team. An ER is only as good as the teamwork it’s built upon. I think the hardest thing for me to understand as a new grad nurse was that I was not alone when caring for a patient. It was always a team effort and I could lean heavily on my coworkers, if needed. 

Your coworkers will make or break your experience and so when you interview, ask the hard questions. Ask about the turnover rates, the management styles, and the overall unit culture. And then when you get there, always be kind to yourself, your patients, and your coworkers. You will never regret it. 

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