What is it Like to Work in an Emergency Room?

Nancy Burgess

The primary goal of the emergency room staff is to stabilize the patient's condition by treating the acute problem and discharging the patient.

Working in an emergency room (ER) requires astute assessment skills, flexibility and the ability to function in a high stress department. Highly skilled, compassionate healthcare providers staff the emergency department 24 hours a day, 7 days a week, 365 days a year. The ER team consists of nurses, physicians, medical and radiology technicians and more, working in unison to stabilize the patient who makes an unplanned visit to the ER for urgent or emergent health care.

The focus of an ER is to stabilize and treat the population of patients who arrive in the department independently or via ambulance.

The primary goal of the emergency room staff is to stabilize the patient's condition by treating the acute problem and discharging the patient. A trauma patient or accident victim is treated in the ER before being transferred to an inpatient unit or other treatment area like the operating room.

The prime responsibility of the emergency room staff is to deliver timely, compassionate care in a critical setting for a patient who presents with an acute, often life threatening, illness, injury or trauma.

Who is Treated in an Emergency Room?

The range of patients arriving for treatment in an emergency room vary widely, from an earache or minor laceration that needs suturing to cardiac arrest after suffering a heart attack or multiple organ trauma as the result of a car accident. There is no accurate means to predict the type of case that comes through the doors of the ER at any moment.

Some of the commonly treated maladies are: myocardial infarction (heart attack), multiple trauma from a car accident, fall or gunshot, acute respiratory distress from asthma or COPD, mental illness in which a patient becomes a danger to themselves or others. This patient population requires quick and accurate assessment and treatments ranging from simple advise to thrombolysis (clot busting medication) and cardiopulmonary resuscitation (CPR).

What is the Work Environment Like in the Emergency Room?

Emergency rooms are filled with high tech equipment to treat the wide variety of maladies that they treat. The department is rarely quiet as they deliver care to the ever-changing patient load traversing the system. While patient privacy is paramount, some ERs have private treatment rooms and others have treatment areas curtained off, offering a little less privacy.

What Kind of Training is Needed to Work in an Emergency Room?

The American Medical Association (AMA) reports that 45 of licensed physicians in the U.S. work in an emergency room. Most ER physicians are board certified in Emergency Medicine by the American Board of Medical Specialties, which carries with it a requirement of a 3 to 4 year ER residency, while others are board certified in Internal Medicine or Family Practice.

RNs working in this department are BSN prepared and can choose to be certified in emergency nursing by the Emergency Nurses Association (ENA). Beyond the basic educational requirement, ER nurses acquire specific skill certifications through the education department of their employer for skills such as intravenous insertion, CPR certification and other hospital policies.

The ancillary and support ER caregivers complete approved educational programs to satisfy their specialty and licensing requirements. Depending upon the specialty, completion of a certificate program, Associates and/or Bachelors degrees is required, followed by a state licensing exam.

What Does the Emergency Room Staff Do?

The diverse patient population that seek emergency room treatment requires a wide variety of healthcare providers such as:

  • Emergency Medical Physician/Urgent Care Physician: This board certified licensed physician assesses and treats patients presenting in the emergency room as the result of an acute illness, accident or traumatic injury.
  • Trauma Surgeon: A physician, board certified in trauma and specializing in treating critically ill patients who have suffered a life-threatening trauma, usually involving multiple organs, assesses the patient in the ER and formulates a surgical plan, if indicated.
  • Medical Technician: Collecting and testing bodily fluid samples, such as blood, urine and wound drainage, is the main assignment for these trained laboratory workers. Reporting the results in a timely manner is critical to the care of an ER patient.
  • Emergency Medical Technician (EMT): Stabilizing an emergency call patient in the field and transporting them to a healthcare facility is an EMTs main focus. Some EMTs are licensed to treat patients with medications and other emergency treatments until they arrive at the emergency room.
  • Ambulatory Nurse: This registered nurse (RN) works in a variety of high volume, rapidly changing outpatient settings and has keen assessment skills.
  • ER Nurse: Triaging, assessing, monitoring, treating, medicating, transporting and discharging a high volume of patients describes this, usually BSN prepared, RNs job.
  • Nurse Practitioner: This advanced practice nurse is a master's prepared RN with certification as a Certified Registered Nurse Practitioner (CRNP) in a specialty area, such as adult, gerontologic or family nurse practitioner (NP). NPs report to the attending physician but can independently assess patients, order diagnostic studies, prescribe medication and treatments for patients.
  • Radiologist: Using a variety of imaging technologies, radiologists diagnose and treat patients. These licensed physicians use traditional x-rays, ultrasound, computerized tomography (CT scan), nuclear medicine, positron emission tomography (PET scan), mammography and magnetic resonance imaging (MRI) to evaluate patients.
  • Radiology Technician: These technicians perform the radiology procedures ordered by the physician after appropriately preparing the patient. They are responsible for explaining the procedure, positioning the patient and protecting the patient from unnecessary radiation exposure.
  • Respiratory Therapist: RTs evaluate and treat patients with respiratory issues such as asthma and COPD as well as participate in the emergency care of patients necessitating life support ventilation such as heart attack, stroke or respiratory arrest.