How to Become an Emergency Nurse Practitioner
Do you enjoy helping people in vulnerable situations? Are you an ER nurse looking to advance your practice while providing critical medical interventions? An emergency nurse practitioner (ENP) is an advanced practice registered nurse (APRN) who assesses, diagnoses, treats, and plans care for patients. They can work in emergency departments (EDs), urgent cares, mobile units, detention centers, and more.
Emergency departments serve a critical role in communities, and the number of ED visits is growing worldwide. In the U.S., EDs provide 11% of all hospital services and admit nearly half of all hospitalized patients. If you’re looking for a role with job stability, working in the emergency department could be a good choice.
Emergency nurse practitioners are essential, especially in rural areas. Many work 30–36 hours per week in 12-hour shifts that may include nights, days, weekends, and holidays. Problems you’ll likely see in this role include:
- Abdominal pain
- Chest pain
- Head injuries
- Infections
- Obstetric emergencies
- Overdoses
- Respiratory distress
- Seizures
- Sprains
- Traumatic injuries
In a busy ED, an emergency medicine nurse practitioner might see all of these problems in a single shift. The range of conditions you’ll see will depend on your location and patient population.
What Do Emergency Medicine Nurse Practitioners Do?
ENPs have specialized training in emergency medicine and can perform a wide range of assessments, diagnostics, treatments, and interventions to address acute and critical health issues. In this role, you might go from splinting a 26-year-old patient after a skateboarding injury to admitting an elderly patient with a urinary tract infection.
Individual states set licensure scope for NPs, but in general, the emergency nurse practitioner scope of practice is similar to that of a physician in many states. Your responsibilities could include these clinical skills, depending on your state:
- Chest tube insertion
- Draining abscesses
- Inserting central lines
- Ordering and interpreting diagnostic tests
- Ordering medications
- Performing regional blocks
- Planning discharge, transfers, and admissions
- Rapid intubation
- Wound suturing
What’s It Like to Be an Emergency Nurse Practitioner?
Working in the ED can be challenging. For many patients, the ED is their only access to medical care, and you’ll see patient needs that you can’t help with, such as homelessness, poverty, and abuse.
It can be distressing to know that a patient requires more assistance than you alone can provide. You’ll also need compassion when communicating and working with patients who come from different backgrounds and are going through traumatic life events. You’ll have days where you make a big difference in someone’s medical care. You’ll build the confidence to treat patients who have a broad range of problems and to anticipate emergencies before they happen.
ENPs also have even more opportunities down the line — you could advance your education, teach other nurses, or even start your own practice.
How Much Do Emergency Room Nurse Practitioners Make?
The average nurse practitioner salary in the U.S. is $128,490 per year. ENPs in general medical and surgical hospitals earn slightly more than the national average. Additionally, many emergency facilities use a relative value units (RVU) payment system. This means that the busier you are, the more you’ll make per hour.
How much you earn will depend on your, experience, credentials, and other factors. Your location has some of the greatest influence on what you make. Here are the states with the highest pay for nurse practitioners:
How to Become an Emergency Nurse Practitioner: 5 Steps
Compared to the role of an RN, being an ENP offers additional independence, and the ability to advocate for patients at the provider level. It also comes with additional licensure and education.
If you’re not a nurse yet, becoming an ENP will likely take at least six to seven years. If you’re already an RN in the emergency department, getting the education and certifications needed for this role could take as little as two to three years.
For detailed information about the first part of this career path, see our article on how to become a nurse practitioner.
Step 1: Nursing School
One way to begin your journey of becoming an ENP is by completing a bachelor of science in nursing (BSN) degree from an accredited nursing program. This lays the foundation for your nursing career and provides essential knowledge and skills.
Another potential route is to complete an associate degree in nursing (ADN), and attend a bridge program to become a nurse practitioner. Learn more about comparing ADN and BSN pathways.
Step 2: Gain Licensure
After completing nursing school, you’ll need to pass the NCLEX-RN exam to become a licensed registered nurse and start practicing.
Step 3: Get Experience
While nursing school lays a foundation for entry-level practice, you’ll learn many skills on the job. Working in an ED or urgent care setting will help you build confidence, critical thinking skills, and technical expertise. Most ENP programs require one to two years of ED experience to build proficiency in assessments, treatments, and working in the ED environment.
By practicing in these settings, you’ll learn how your skills align with the role, and you’ll also get comfortable working in this dynamic and varied area. Search for ER nurse jobs or urgent care jobs to learn more.
Building on your specialty expertise can make you a more competitive candidate when applying for ENP school. Emergency nursing certifications and courses include:
- Advanced Cardiac Life Support (ACLS)
- Pediatric Advanced Life Support (PALS)
- Certified Emergency Nurse (CEN)
- Trauma Nursing Core Course (TNCC)
Step 4: Earn a Master’s or Doctoral Degree
ENP programs are typically paired with family nurse practitioner (FNP) degrees because you’ll see many primary care and obstetric issues in the ED. This schooling typically takes at least three years and requires 600–1,000+ clinical hours in areas including family medicine, trauma settings, pediatrics, and women’s health.
There are three main options for emergency nurse practitioner programs:
- An MSN ENP/FNP program
- A doctoral-level (DNP) ENP/FNP
- A post-master’s ENP fellowship for existing APRNs
Additionally, the American Academy of Nurse Practitioners (AANP) also allows FNPs with enough ED experience to sit for their exam. But you’ll still need to have at least a master’s-level education to become a nurse practitioner.
Step 5: Board Certification & Continuing Education
To begin practicing independently, you’ll need to pass the emergency nurse practitioner certification exam. This 150-question test is serviced by the AANP and covers medical screening, diagnosis, patient management, patient care planning, and more. Once you’ve passed, you can apply for state licensure in the area where you want to work.
Once you’re licensed, you’ll need to maintain your certifications and RN licensure to continue practicing. In most states, this includes continuing education and work-hour requirements. To be in this role, you’ll also need soft skills, including:
- Bedside manner
- Critical thinking
- Emotional intelligence
- Empathy
- Interprofessional communication
- Juggling several patient needs at once
- Therapeutic communication
- Time management
Check Out Emergency Nurse Practitioner Jobs
Curious about jobs for ENPs? IntelyCare can connect you with specialized nursing jobs that match your expertise, location, and preferred care setting.