An ER Nurse, or Emergency Nurse, is in charge of providing healthcare to patients who urgently need treatment, working quickly to stabilize patients’ vital signs and limit their pain and discomfort. US demand for ER nurses is high and growing; ​​the Bureau of Labor Statistics projects a 7% job growth rate for RNs from 2019 to 2029. Global Nurse Partners interviewed Thalia, an ER nurse with over two decades of experience, to look at a day in the life of an ER nurse in the United States.

Thalia’s career in nursing began in the Philippines after graduating from the University of the Philippines in 2000. After two years of working as a nurse in the Philippines, she moved to England to further her career. Her career as an American ER nurse began in 2016 in Oklahoma. Of her early life, Thalia states she’s always enjoyed helping other people and, from a young age, was fascinated by medical shows on TV. “I had a neighbor who was a nursing student when I was in high school, and I would ask her questions all the time,” she shared.

Differences in American and UK Nursing

One of the habits Thalia carried over from nursing in the UK was offering patients a cup of tea after assessment, but she notes, “When I came to the US, people found that funny.” She describes nurses in America as more independent and very competitive. Thalia adds, “In England, it was more of a Florence Nightingale thing, like a care and support role. In the US, things have a faster pace. You do more critical thinking, even challenging the doctors at times.”

The move to the United States also required adjusting to American city planning and transportation. Thalia explains, “In England, I could go anywhere by walking. In America, everything is big, vehicles are big, and there’s a lack of public transportation. Trains here are mostly for moving products, not people. It was an adjustment to get used to driving at least 15 minutes by car to do anything.”

A Day in the Life of an ER Nurse

Thalia has always preferred the night shift, “I’ve done the night shift for years. I can’t do a day shift; I’m asleep. I’ve always been like that.” Her typical shift begins at 6:30 PM when she arrives at the hospital. She meets with the day shift team for reporting at 7 PM. “Night shift change is the busiest part of the day because everyone [seeking care] waits until they get out of work or school. It’s super busy; everyone wants your attention,” she explains. Her first priority is to triage patients and prioritize care according to their acuity, which can vary drastically.

“Patient safety is top priority. I stay alert and respectful and try not to take things too personally,” she explains. As the first person to assess a patient, “I set the tone for their experience in the hospital. If the nurses in the ER are rude or abrupt or not compassionate, that becomes the experience.” ER nurses experience a ton of pressure, both physically and emotionally. Thalia describes the many roles ER nurses have to fill in order to provide compassionate care to their patients, “If I have a patient who’s grieving, I have to grieve with them too. Then I have to forget I was grieving a minute ago in order to be a happy nurse for the scared two-year-old. I play a lot of different roles: a friend, a mother, an advocate, and an educator. There will be a patient with dementia, and they need someone; you become their grandchild and hold their hand and help them feel they’re being listened to.”

As an ER nurse, Thalia’s day-to-day tasks vary significantly, “In the ER you don’t take care of just surgery or physical traumas. In one day you can be the first person to see someone born and the last person to hold another person’s hand when they die.” Some of the responsibilities included of providing urgent care are inserting IV lines, catheters, nasal tubes, gastric tubes, providing emergency blood transfusions, applying sutures, and preparing a patient for emergency surgery. Thalia notes that what you do in the ER becomes your normal, no matter how extreme. “I’ve delivered five babies in the ER. Twice I’ve had to manually pump a heart for emergency CPR.”

If working as an ER nurse comes with such high pressure, what draws nurses like Thalia to that career? Thalia says, “It’s the most satisfying. People come in crying and go home smiling and saying thank you. You can see that you’ve actually helped them.” She adds, “It’s an urgent job. It is overwhelming, but by the time you sit down, you realize you’ve helped so many people. It humbles me because I feel like these patients depend on me. They depend on how fast I can get them medications or how efficiently I can move between patients. And it’s not just doing your job, it’s about how you make them feel when they are in your care.”

Advice for Nurses Considering the ER

Thalia considers patience and forgiveness two critical qualities for working as an ER nurse. “Being forgiving is important, don’t take what patients say personally. When they go to hospital, they are scared. They take it out on you because they are scared. It is your role to remove the fear.” She adds, “Working in the ER is crazy. I go to work with 110% patience because I need it for my patients. Not because I want to be the nurse of the year but because that’s what they need from me.”

Step Forward with Expert Support

Are you interested in expanding your nursing career in the United States? Global Nurse Partners brings internationally experienced nurses and US healthcare facilities together for permanent positions and supports their employment relationships throughout the process. Learn more about our partnership program and opportunities for international nurses here.