Are You Cut Out to be an Emergency Department (ED) Nurse?

For many nurses, the epitome of nursing is to work in the Emergency Department (ED). Have you ever wondered if ED is a good fit for you?

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Emergency Room nurses are a special breed. They are highly skilled, compassionate folk who work well as a team. They are open to experience, and agreeable. Here are some more traits common to most ED nurses.

Game On

ED is a noisy, fast paced environment with stimulus coming from every direction. There is no normal in the ED. It's noisy and chaotic.

ED Nurses Thrive In Chaos

Unlike their neatnik ICU sisters and brothers, ED nurses don't require a controlled, structured environment. They adapt quickly to rapidly changing conditions.

They tolerate ambivalence and prefer change to structure.

Emotional Intelligence

ED nurses are high in emotional intelligence. They can establish a rapport with an elderly woman desperately grasping her husband's hand as he is being rushed to surgery, and seconds later, elicit a giggle from the feverish two-year old in the next room.

They can smoothly manage both the wife and girlfriend showing up at the same time situation. They can approach the busy doctor and get him/her to order the pain med they need for their patient...now.

ED nurses may cry inside, but not on the job. They're not seen as overly emotive types. They remain calm while projecting an attentive demeanor. They have the ability to put highly anxious family members at ease while listening for the vent alarm in the next room over.

Breadth Over Depth

They prefer broad to deep. An ED nurse will not study H&Ps from previous encounters to delve deeply into patient history.

They don't get bogged down in the details and are not interested in non-presenting patient complaints. They aren't there to study; they're there to stabilize.

But they are comfortable with babies to toddlers to middle-agers to seniors.

Heart rhythms are either normal, too slow or too fast. If it's too slow, speed it up. If too fast, slow it down. Done.

Treat 'em and street 'em and.... next, please!

Fast on Their Feet

ED nurses make instant decisions, react quickly, and think fast on their feet. Often they do this with minimal information.

Should they see the 58-year-old male clutching his chest or the 24-year-old doubling over with cramps or the 18-year-old with hand wrapped with dripping bloody gauze first?

They can sniff out sepsis and spot an impending code.

They make rapid assessments in under 30 seconds and can manage several emergent patient situations at once.

ED nurses have excellent time management skills because they RACE from pod to pod, and front to back. They efficiently discharge, admit, transfer, treat and triage in record speed.

Adrenaline Junkies

Self-proclaimed junkies, ED nurses love the rush they get from true emergencies; a trauma, a pulseless John Doe...and never knowing what's rolling in next!

They thrive on change, and preferably change with an element of risk or harm. ED nurses need high stimulation, charged action, and immediate results.

Esprit d'Corps: High Fivers

ED staff are often tight knit, team oriented, and socialize across job titles. They value their team identity and count on each other to survive. They form close ties to their work friends.

They are highly social, known for having a wicked sense of humor, and are witty and sarcastic. They are friends with the EMTs, paramedics, policemen, and prison guards.

Breakfast after your shift? They're in. Volleyball challenge from Respiratory Therapy? Accepted. Game on.

Physical/Kinesthetic

They're physical, always moving, have stamina, and cannot tolerate sitting for a shift. They can rig up practically anything and are creative at dressings.

Always ready to Spring into action, they dislike paperwork and routine, repetitive tasks.

Street Smart

ED nurses score high in common sense and street smarts. They are down to earth and sensible.

They are not easily conned, and they can spot maligners a mile away.

Does this sound like you? Did you read this and keep thinking, "That's me! That's so me!"

If so, you may be an ED nurse at heart. I hope this helps you find your nursing niche.

Been doing ED Nursing for 16 years now. Yes at times there is adrenaline involved, but mostly time management is what is most needed. If you cannot turn on a dime and switch modes from a drunk combative patient, to your other patient having respiratory distress, your other patient having an MI, and the last one throwing up all over the room, then it is not for you !! But oh I love every minute of it. Sure we gripe about it all, but we come back for shift after shift :) .. You almost also have to be a good detective at times also. Plan on another good 14 years of doing ED nursing !!!

Started on the floor, moved to the ED and never looked back since. I plan to stay here for a long time. :yes:

I don't know if I'd agree that "For many nurses, the epitome of nursing is to work in the Emergency Department (ED)." ;)

ED nursing is so vastly different from the majority of acute care nursing that it could be its own nursing genre. ED nurses miss out on a lot of activities that we traditionally think of as 'bedside nursing.'

That said, they are incredible at what they do. Time management, prioritization, assessment, emergency response, and psychomotor skills out the wazoo. ED nursing isn't for me--I love the minute precision and relative orderliness of the NICU--but I am glad that we've got nurses who thrive in such an unpredictable environment!!

Dear Nurse Beth,

I was hired about a month ago by the pool as a unit clerk and just had my first ER shift on Tuesday. Were you stalking me?:) I've always wanted to work ER and now I know why; your description was so perfect and that's so me!!

I am just now beginning my journey as a nurse, I start school August 25, pursuing my second degree/career as a nurse. I was previously in Social Work. I am so very excited about this change I am beginning. As I read this article I was grinning from ear to ear! I kept saying yes. yes. YES! lol I know I have years before I am skilled enough to fill these shoes, but oh I can not wait!!

Specializes in Pediatrics, developmental disabilities.

Great piece Beth...but for me? Thanks but no thanks!

So grateful that there are nurses out there who love the ED!

datalore said:
ED nurses are amazing, and I hope to be one someday. I thought, "That's me, a thousand times over" for each entry. It's in the 5-year plan!

I would love to have a chance to train in the E.R but I'm not sure I am the right personality type. I wonder if Nurses who aren't adrenaline junkies can adapt to this environment.

Specializes in Emergency/Trauma/LDRP/Ortho ASC.

Thank you to all of the COB ER nurses who grabbed me by the hair, tossed me into the fire, turning me from a shy wallflower who didn't even want to touch a patient to the crazy trauma junkie pushing everyone out of the way to get in on the "good stuff." The ED wasn't my first choice but I am so thankful for all I have learned there. Shout out to all my ED peeps!

Specializes in Family Nurse Practitioner.
ambr46 said:
I would love to have a chance to train in the E.R but I'm not sure I am the right personality type. I wonder if Nurses who aren't adrenaline junkies can adapt to this environment.

Yes they can. I like being busy and saving lives, but dont consider myself an adreneline junkie.

Specializes in Emergency Department.

I have worked in the ED as a Supervisor for the past 25 years. I love it just as much today as I did the very first day I walked through those doors! ED nursing is my passion!

I'm entering nursing school in about a month, and I am looking at the ED as a place where I eventually want to work. I used to work Booking at a county correctional facility, and there are a lot of the same elements involved. You have basic work that doesn't change from person to person (basic commitment process compared to patient assessments, routine process doesn't really change a whole lot), but there is an element of unpredictability (either from the inmate/detainee, or from inmates already committed) that just makes every day different. One minute you could be committing a fairly stable inmate, and the next dealing with a different, combative and suicidal inmate while also rapidly treating a suicide victim (really happened, craziest day in my memory), and a few hours later commit 19 federally-charged detainees in 4 hours (also happened, different day, best teamwork scenario I've been a part of besides cardiac arrests). I'm currently an EMT, and that fills the unpredictability void pretty well until I get my dream job. Everything the article mentioned is what I want in my career, and I certainly hope I'll be good enough to get there.

Oh man I'm almost the complete opposite of this, but I still chose to work in an ED of a level 1 trauma center. I'm pretty much reserved, don't mind sitting around to an extent,and the opposite of an adrenaline junkie. Though I have the sarcastic wit, treat'em and street em mentality, and am flexible.

The ED to me was my entry into critical care nursing. As much as I would love to work on the Unit the ED affords me flexibility. Don't feel like taking care of ESI 1's and 2's? I can always go to fast-track. Also, the floor nurse in me doesn't mind taking care of chest pain patients.