RN to BSN: Working as an Emergency Room Nurse

The field of nursing offers a number of crucial and rewarding career paths across the healthcare industry. Professionals can take part in serving patients through emergency care, administration and other specializations. This career profile series will explore some of the potential job opportunities available to those looking to help make an impact as a nursing professional.

Hospital emergency departments are varied, fast-paced and unique work environments where every second can be crucial and no two days are the same. The constant challenge is just one of the reasons some nursing professionals choose to pursue careers as emergency room nurses. Unlike a floor nurse, an emergency room nurse typically won’t care for the same patient two days in a row and must be prepared to handle a range of cases that come through the door, from the minor to the severe.

The Emergency Routine

When considering any nursing specialization it is important to look at what life in that role will typically be like. More than anything, emergency room nurses thrive by being ready for the unexpected as well as knowing how to act quickly and calmly in a variety of scenarios.

Each new patient has to be immediately and accurately prioritized based on their individual medical needs, including mental and physical conditions. The ability to effectively triage - escalating patient service by the urgency of their condition - is among the most valuable services emergency room nurses provide. For each person who comes through the door, an ER nurse must take the following steps:

  • Identify their medical problem.
  • Document their medical history.
  • Check for any allergies and current medications.
  • Obtain their height, weight, body temperature, heart rate and blood pressure.

Having the capacity to assess a patient’s medical condition is only the beginning. Nurses can also have a profound impact on each individual’s emotional health as well as their ability to cope with the stresses that can come from undergoing emergency services.

“Sometimes just helping someone with their breathing can make a difference,” says John Yuhas, an emergency nurse from Palm Springs, CA, who earned his Nursing - RN to BSN degree through Arizona State University Online. “In the ER, we are trained to carry out a series of life-saving tasks and interventions, but we also need to be mindful of how these interventions are impacting the patient's body, mind and spirit.”

Nurses assisting doctor

Time management is among one of the most crucial parts of the emergency nurse routine as they must balance triage and clinical care with mindful attentiveness. Additionally, they must exhibit sensitivity to their patient’s thresholds and the availability of the other members of the medical team with whom they are working. Time management also plays into other emergency room nurse responsibilities, such as moving patients to other floors or units at the appropriate moment, taking scheduled samples of blood for testing, caring for wounds in a timely manner, administering medications at the correct intervals and restocking supplies and equipment.

Despite their busy workdays, many men and women who work as emergency room nurses cite autonomy as one of the major perks, although they are quick to acknowledge that complying with protocols, procedures and safety policies while maintaining a high level of autonomy is essential.

The Emergency Nursing Skill Set

Getting more specific, there are a number of practical skills that truly define the role of emergency nurses and can help caregivers to evaluate and provide quality patient care in this fast-paced environment.

  • Critical-Thinking: This includes the ability to assess patient health quickly and accurately, to recognize if symptoms or pain have changed and determine if alternative action is required.
  • Organization: Depending on the day or even the hour, emergency nurses may have just a few patients or a completely full ward. Some of them may even spread outside the emergency department into other areas of the hospital. This makes being able to accurately triage and administer care regardless of the setting essential.
  • Communication: When delivering time-sensitive care, cooperation among your team requires fast, concise and deliberate communication. Everyone must be able to understand one another and make themselves heard. Outside of delivering trauma care, emergency nurses are frequently expected to speak with both patients and their families about the patient’s status and care plan. Being able to de-escalate worry, address concerns and provide information in an easy to understand manner is necessary.
  • Patience: Despite your own experience dealing with similar cases time and again, remembering that this isn’t a typical day for your patients can go a long way. Patients and their loved ones might not be as good at handling the pressure and stress of a traumatic situation and the ability to remain tactful in handling others’ anxiety can make all the difference.
  • Compassion: A tremendous number of people fall under an emergency nurse’s care ranging in age, background and medical needs. Being sympathetic, understanding and empathetic with people in varying states of pain and trauma is essential.
  • Staying Calm Under Pressure: Life or death situations aren’t uncommon. Therefore, the ability to remain collected, manage stress and handle pressure is a non-negotiable skill for an emergency room nurse. There isn’t time to process and work through emotion in a crisis situation and being able to handle extreme cases and multiple patients requires a level head and steady hands.

Career Outlook

According to the Emergency Nurses Association, working as an emergency nurse doesn’t just mean serving in hospitals. In fact, there are a number of different environments that can be considered, including poison control, flight and transport, the military, correctional facilities, federal and state agencies and more.

As with all nursing occupations, salary can vary widely depending on a person’s state, region, degree and experience. Similarly, demand for emergency room nurses can also vary according to location and the size of the employer. In general, jobs requiring a registered nurse are expected to grow upwards of 26 percent through 2020. Due to the high demand, the outlook is good for individuals with the skills and education needed to serve specialized roles across the field.

Fortunately, there are multiple educational options that can help those wanting to work in emergency nursing. A Bachelor of Science in Nursing, for instance, is one of the most popular.  Schools like Arizona State University offer such degrees to further improve the education and employment of nurses.

After graduation, an additional two years of emergency care training is required before being able to work as a specialized emergency room nurse. Following those two years of training, it is required that nurses also receive Emergency Nursing Certification through the Board of Certification for Emergency Nurses (BCEN).



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