Emergency room nurse

A Day in the Life of an ER Nurse 

A Day in the Life of an ER Nurse 

Jasmine Jarrett, MBA, BSN, RN

For one week every October, Emergency Room (ER) nurses are recognized during ER Nurses Week for their outstanding work. In honor of this recognition, we wanted to highlight the excellent work done by all the fantastic ER nurses across the country and shed some insight into a typical day in the life of an emergency room nurse. The ER is a unique specialty of nursing, driven by its fast-paced, critical thinking skills, and ability to shift priorities depending on the patient’s conditions quickly. 

Earlier in my career, I worked as an emergency nurse, a position that taught me many valuable clinical skills. I learned more about prioritization, triage, and handling emergency situations more effectively. So join me as we walk through a day in the life of an ER nurse. 

What is an Emergency Room Nurse?

Emergency room nurses are specially trained nurses who work in the emergency department. Depending on the hospital, nurses may work primarily with adult patients, pediatric patients, or a combination of both. Not only can emergency room nurses work in a hospital emergency department, but they can also work in the following areas: disaster zones, critical access hospitals, and even stand-alone emergency departments. 

During a shift, nurses working in the emergency department can treat patients with some of the following conditions:

  • Stroke & other neurological injuries
  • Heart Attack
  • Cardiac & Respiratory arrest
  • Shock/Sepsis
  • Fractured/dislocated limbs
  • GI bleeds
  • Falls
  • Altered levels of consciousness
  • Drug and alcohol overdose
  • Traumas

Some of the responsibilities of ER nurses include the following:

  • Triage of patients who arrive. Based on vitals, patient condition, and severity, nurses can prioritize the order in which patients are taken into an exam room. 
  • Obtaining lab samples
  • Inserting IV lines 
  • Assessing patients
  • Administering medications
  • Admitting & Discharging patients

 

Pros & Cons of Emergency Room Nursing 

As with any specialty of nursing, there are advantages and disadvantages related to the type of work required for the role. If you’re curious if being an ER nurse is right for you, here are a few pros and cons to think about. 

Pros:

  • Exciting work
  • Fast-paced environment
  • Exposure to a wide variety of patients and clinical situations
  • Countless learning opportunities
  • Rewarding

Cons:

  • High levels of stress
  • Can see emotionally difficult patient situations
  • Very physically demanding
  • Must adapt quickly to changing situations with minimal warning or notice

 

How Do I Become an ER Nurse?

To become an emergency room nurse, you’ll need to obtain a nursing degree. After gaining your degree, some hospital programs will have residency programs for new graduates in areas such as the emergency room, intensive care unit, or medical-surgical nursing units. If you don’t initially start working in the ER, hospitals will still hire nurses with experience in other areas, usually after gaining 1-2 years of experience in other areas. Check with hospitals in your area for hiring requirements and residency opportunities. Also, make sure you sign up for a NurseHub Premium Membership so that you can start taking our Prepare for Nursing School Courses!  

By gaining CEN certification, nurses can also gain competency and stand out among other candidates. CEN, or Certified Emergency Nurse, is a credential that denotes additional skills and competencies specific to emergency nursing. To be eligible for CEN certification, you must hold a license as a registered nurse. The board of Certification for Emergency Nursing recommends that nurses have two years of experience to sit for the CEN exam, but it’s not required. 

Nurses should also consider gaining the following certifications, as they are typically required of emergency nurses either before or at the beginning of their time in the ER:

  • ACLS-Advanced Cardiac Life Support 
  • BLS- Basic Life Support 
  • PALS- Pediatric Advanced Life Support  

A day in the life of an emergency room nurse

As with other areas of hospitals, emergency nurses work varying day or night shifts that are generally 12 hours. Depending on your hospital’s emergency room schedules, these shifts can be staggered and include shifts other than the traditional 7-7 model. For example, some emergency room nurses work 11 AM-11 PM and 3 PM-3 AM. 

Now let’s take a look at a shift in the life of an ER nurse: 

7 AM: Clock in and check the assignment board. Once I confirm my room assignments, I receive a handoff report from the night shift nurse

7:30 AM: once I finish getting a report, I read the previous shifts ER notes and review labs. I then do a focused assessment of my 2 current patients: 

  • A 70-Year-old man from a nursing home with confusion.
  • A 23-year-old female suffering from DKA (Diabetic ketoacidosis) with a blood sugar of 500

I have an additional empty room that I’m sure will be filled as the morning progresses. 

8 AM: Due to my 23-year-old patient’s very high blood sugar level, the doctor ordered an insulin drip. I review the order with a 2nd nurse and start the infusion. 

8:45 AM: my 70-year-old patient’s labs return. He’s positive for a urinary tract infection (UTI). The doctor has ordered antibiotics and for him to transfer to a med-surgical unit for observation. I begin his antibiotics and wait for a room upstairs to become available. 

10 AM: The DKA patient has orders to transfer to the ICU for further monitoring. I call the ICU and report to the nurse assigned to care for her. 

10:15 PM: My third room doesn’t stay empty for long. I have a 20-year-old male who arrives with a prolonged nosebleed. Aside from the nosebleed, he has no other symptoms. I draw labs to rule out any bleeding disorders. The physician then packs the patient’s nose with special gauze. After the packing, I wait 10 minutes to make sure there are no additional signs of bleeding. 

10:30 AM: My diabetic patient is transferred to the ICU. 

11 AM: Once transferred, I clean the room and prepare for the next patient to arrive. My nosebleed patient has orders for discharge. I review his discharge paperwork with him, and he was discharged home with orders to follow up with an ENT specialist. 

Noon: I now receive a new patient in my empty room—a 60-year-old female with a history of hypertension whose chief complaint is chest pain. We immediately begin a chest pain workup, checking labs, obtaining an EKG, chest X-Ray, and placing her on a continuous cardiac monitor. 

12:15 PM: The Chest pain patient’s EKG reveals ST elevation, and we immediately notify the Cath lab. 

12:30 PM: The cath lab team arrives and rushes our patient to the cardiac cath lab. 

1:00 PM: Lunch Time! 

1:30 PM: When I return from lunch, I have orders that a room is available for my patient with the UTI. I call, give a report, and assist with transferring him upstairs to the nursing unit. 

2 PM: EMS pages and notifies they are 5 minutes away with a 50-year-old male in cardiac arrest. We immediately prep my empty room to prepare for this patient and notify our respiratory team, Chaplin, and bed management in the event the patient will be transferred to the ICU. 

2:05 PM: Our cardiac arrest patient arrives, and the team immediately begins lifesaving measures. We initiate CPR and airway management, give medications, insert additional IV lines, draw labs, and perform chest X-rays. 

2:45 PM: We are successful in resuscitating the cardiac arrest patient. While the team prepares to transfer him to the ICU, I call the ICU nurse and provide a report. 

3 PM: I get an update on the chest pain patient that was rushed to the cath lab. It turns out she had Takotsubo Cardiomyopathy, or “Broken Heart Syndrome.” She was transferred to the Cardiovascular ICU for observation. 

4 PM- 5 PM: I now receive a 40-year-old woman with reports of abdominal pain, nausea, vomiting, and weakness for 2 days. I immediately insert an IV so she can receive fluids and medications and draw labs. The doctor orders IV fluids as well as medications for nausea. The patient also has orders for a CT scan, so transport arrives and takes her to the test. Her CT scan reveals she has appendicitis and will need surgery. 

6 PM: I round on my patients and review their charts for any additional orders or lab results. I also make sure I’ve charted vital signs and have ER assessment notes in their charts. 

6:50 PM: It’s time to report to the oncoming night shift nurse. 

7:15 PM: Time to clock out and head home. It’s been a jam-packed but exciting 12 hours. Just another Day in the ER! 

 

Conclusion

Overall, a career as an emergency room nurse can be very rewarding. It’s fast-paced, unpredictable, and full of excitement, as you never know what is coming through the door. As you can guess, no two days in the ER are the same. Some days are calm, while other days can be quite the opposite. 

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