Young nurse standing in front of a sign that says EMERGENCY

A Day in the Life of an ER Nurse

Daily Duties, Responsibilities, and What to Expect

Young nurse standing in front of a sign that says EMERGENCY

Emergency rooms are one of the fastest-paced and most varied environments in all of nursing. They’re the front line of care for any injury, illness, or accident you can imagine—and several you probably can’t. There’s a running joke that ER nurses have seen it all, and it’s largely true.

ERs are also the primary source of healthcare for many uninsured or underinsured people, so a typical day in the life of an ER nurse might include treating a sore throat within minutes of responding to a severe heart attack.

From triaging incoming patients to watching over trauma victims, a typical shift for an emergency room nurse can look very different depending on the day and their assigned duties. Let’s take a closer look at ER nurses’ responsibilities and daily routines, plus a few of the specific tasks and duties they perform.

Clocking In as an ER Nurse

The beginning of any shift for an ER nurse is a critically important time to ensure continuity of care between patients. Punctuality is mandatory for nurses, as they’ll often have pre-shift meetings to hand off patients, review charts, and get briefed on the overall situation in the ER.

These meetings are when nurses are assigned their responsibilities for the day, whether that’s screening and triaging patients, overseeing certain rooms, or caring for trauma victims. Especially for ER nurses, it’s essential to show up a few minutes early, both physically and mentally, prepared for work, as things will often be fast and furious once your shift starts.

ER Nurse Morning Routine

After gathering info on their patient’s condition and consulting with their colleagues on the current state of the clinic, the beginning of their shift is usually when ER nurses take inventory of their assigned area and restock materials as necessary. The middle of a patient rush is a bad time to realize you’re out of the supplies you need to perform a critical procedure!

Early in their shift, nurses also map out a tentative plan for the coming hours based on the needs of their patients. While adaptability is always paramount while working in the emergency room, it’s good to take note of when certain patients may need medication, additional tests, or other forms of treatment or observation.

Night Shifts for ER Nurses

Though night shifts in the emergency room tend to be slower overall, there are also fewer physicians, fellow nurses, and other support staff available. While there’s usually some downtime, the night shift in the ER also tends to come with a higher percentage of true emergencies and adrenaline-pumping moments, which many nurses find exciting and fulfilling. Lots of hospitals also pay more for night nursing shifts—a plus for nurses looking to save for a big purchase or pay off debts.

ER Nurse: Daily Duties and Responsibilities

Assessing and treating patients in a hectic emergency room environment requires several different duties and skills, which means ER nurses have a broad range of responsibilities during their shifts. Let’s take a look at some of the most important things ER nurses typically do throughout the day.

Patient Triage

Triage involves the initial assessment of a patient to determine the urgency of their symptoms, so they can be treated as quickly as possible. Many emergency departments see high volumes of patients, so it’s important to prioritize which patients need to be seen first. While conditions like a sprained knee or sinus infection may be uncomfortable, they’re less demanding of immediate treatment than somebody who’s bleeding severely or going into cardiac arrest.

Triage nurses are an essential stabilizing force in a busy emergency room, as they direct traffic, establish priorities, and help physicians and other nurses understand critical details about each patient’s condition so they can receive appropriate care.

Immediate Care

When patients arrive at the emergency room, they’re usually in pain or some type of distress. One of an ER nurse’s most important duties is providing initial first aid to stabilize a patient until they can be seen by a physician or admitted to the hospital for longer-term care. That could mean stitching up cuts, providing pain medication, splinting injured limbs, or preparing patients for testing to screen for potentially serious issues.

Team of medical professionals rushing to transport a patient

Collaborating with Healthcare Professionals

Collaboration between providers is critical for top-notch patient care. Patients may share different symptoms or information with the various professionals on their healthcare team, so it’s vital for ER nurses, physicians, and other health staff to communicate effectively with one another. Many health conditions that share similar symptoms require vastly different treatments, so close collaboration between providers ensures each patient gets the care they need.

Emergency Procedures

Sometimes, patients in the emergency room have life-threatening concerns that require an immediate response. Whether it’s choking, severe bleeding, an adverse medication reaction, or a stoppage in a patient’s heart rate or breathing, ER nurses are trained and prepared to take action and remain cool under pressure. A nurse’s primary goal in any emergency is to stabilize the patient’s condition and prevent long-term harm until they can receive appropriate follow-up care.

Charting and Documentation

Accurate record-keeping is vital in any healthcare environment, especially a dynamic one like the emergency department. While ER nurses are often pulled in many different directions, they must make time to keep every patient’s charts up to date. From recording any medications given to documenting communication with the patient’s families or caregivers, recording every step in the patient-care process helps minimize errors and encourages continuity of care across different shifts and healthcare providers.

Patient Advocacy

Beyond the treatment they provide in the emergency room, great nurses are also advocates for their patients’ health, safety, and overall well-being. For ER nurses, patient advocacy could look like raising an important concern to the attending physician, educating outgoing patients on follow-up care, or connecting people with community resources that could help with their individual circumstances.

Adaptability and Flexibility

Emergency rooms can be unpredictable, to say the least. One of the most important skills any ER nurse can develop is the ability to go with the flow and remain calm amidst occasional chaos. Even if things slow down in your zone, you should always be prepared to jump in and help your colleagues handle an emergency in one of their assigned areas or simply cover them for a few minutes so they can grab a quick bite to eat.

Clocking Out as an ER Nurse

As their shift winds down, ER nurses usually check in with their patients one more time and finish up any leftover charting or documentation. It’s common for nurses to prepare an end-of-shift report that includes details on each patient’s condition and any recent changes.

While it’s important for all these details to be documented in a patient’s medical charts, a quick in-person meeting with the incoming nurse is also quite helpful. Thoroughly briefing the incoming nurse helps protect patients’ safety and ensures nothing falls through the cracks during patient handoffs.

Self-Care Tips for ER Nurses

Working as an emergency room nurse is rewarding, but also demanding. It’s a high-stress, high-stakes environment with many competing priorities, and it’s easy for ER nurses to focus on their patient’s needs to the point they neglect their own well-being. Let’s take a look at some simple ways emergency nurses can take care of themselves during an intense day on the job.

Short Breaks and Breathing Exercises

During an average day in the ER, nurses have to make many quick decisions with potentially major implications—and it’s difficult to think clearly when your nervous system is overstimulated. When you feel yourself getting stressed out, pausing for a few minutes to take some deep breaths can be amazingly effective in calming your nervous system and restoring your ability to think clearly.

Close up of a hand moving blocks that say wellness and stress

Nutrition and Hydration

When things get crazy in the emergency room, it can be difficult for nurses to find time to eat a snack, let alone a full meal. Remember to pack healthy snacks so you can grab a quick bite whenever there’s a break in the action, and set reminders to take a drink of water every few hours. Make sure you plan enough time to get a wholesome meal before your shift, as you never know what a day in the ER will bring.

Asking for Help

Nurses instinctively want to take care of everyone, which can sometimes cause them to take on more than they can realistically handle. Something as simple as asking a colleague to check on one of your patients can prevent you from becoming regularly overwhelmed and eventually burned out. Try to get into the habit of speaking up when you’re struggling—you don’t have to save the world all by yourself!

Staying Emotionally Resilient

At some point in their career, nearly every ER nurse will lose a patient they’ve tried hard to save. You’ll also be exposed to many people in severe pain or other significant distress. It’s important to allow yourself space to feel sad for the patients you can’t save, and to feel empathy for the people in your care. Meeting with a mental health professional outside of work can help you process some of the difficult events you’ll occasionally experience while working in the ER.

Wellness Outside of Work

To be their best at work, it’s mandatory for nurses to take care of themselves outside of the emergency room. That means getting plenty of high-quality sleep, regular exercise, and pursuing fulfilling hobbies and relationships that allow you to unplug from the stress of the ER. Physical and mental health are the cumulative sum of your lifestyle, so building healthy habits is important for your career success and your personal well-being.

Begin Your Nursing Career Journey at Brookline College

There’s no doubt that life as an ER nurse is demanding, intense, and sometimes stressful. It’s also incredibly rewarding to be a hands-on participant in saving lives and caring for patients in their time of need. Emergency room nurses have one of the most important roles in the entire healthcare system, as their quick decisions and actions have a major impact on patient outcomes for all types of urgent health issues.

When starting your career as an ER nurse, the right nursing program can make all the difference in preparing you for the massive variety of situations, patients, and emergencies you’ll encounter. The Bachelor of Science in Nursing program at Brookline College is designed to help you master the skills you need to thrive in the ER, with high-tech simulation tools to build your confidence in different scenarios. You’ll learn from experienced ER nurses, and graduate ready to make a difference for your patients and colleagues.

Looking to learn more about life as a nurse? Check out our in-depth guide on how to become a registered nurse, or explore our detailed list of the highest paying nursing jobs.