How to Become an Emergency Nurse Practitioner (ENP)

Learn more about emergency room nurse practitioners (ENPs), who work with and care for critically ill or injured patients. ENPs are specialty care providers who work in acute care settings—namely, emergency departments or urgent care facilities. They are skilled in diagnosing and treating children, adults, and seniors alike for primary care needs, illnesses, injuries, or trauma.

Steps to Become an Emergency Nurse Practitioner (ENP)

Aspiring emergency room nurse practitioners must follow a series of steps to obtain their role. That being said, there is some flexibility in the pathways to get there. Below is an overview of the general steps that lead to becoming an ENP.

1. Become a Registered Nurse

Anyone who wishes to be a nurse must first complete an associate’s degree or Bachelor of Nursing (BSN) program. Upon graduation, you are required to take and pass the NCLEX-RN exam. You can then obtain a state license as a registered nurse (RN). Be sure to check with your state’s nursing board for specific requirements.

2. Complete a Family Nurse Practitioner (FNP) program.

While there are multiple ways to become an ENP, you must first obtain a Master of Nursing (MSN) or other postgraduate degree in nursing. Many schools offer graduate programs specifically designed for future FNPs, with concentrations in emergency care. You can then apply for FNP credential through the American Nurses Credentialing Center (ANCC) and the American Association of Nurse Practitioners (AANP).

3. Complete Emergency Care Specialty Training

Once you complete an FNP program and earn certification as an FNP, you must complete an emergency care specialty in one of three ways: through continuing education (CE) and clinical practice, completion of an academic emergency care graduate or postgraduate program, or through an approved emergency fellowship program, according to the AANP Certifications FAQs.

4. Apply for and Take the Emergency Nurse Practitioner (ENP) Exam

Once you can confirm that you have met your state’s requirements, you will be eligible to take the ENP certification exam. Students enrolled in MSN and post-graduate ENP programs may begin the application process as early as 6 months prior to completion of their program and clinical requirements. Those enrolled in Dual FNP/ENP programs may apply for the emergency certification exam after their FNP certification is obtained. Upon completing the exam, an official final transcript showing degree or completion of a program is required to obtain your score.

Pathways to Becoming an Emergency Nurse Practitioner

Once you have completed an approved nursing education program to earn your RN license, there are a number of educational pathways you can take to become an emergency room nurse practitioner. Below you will find some common degree programs or certificates you can pursue.

Master's in nursing: To advance to a nurse practitioner (NP) role, you will need a Master of Science in Nursing (MSN).  You can also earn an MSN through a RN-to-MSN bridge program or an online MSN program. Many graduate schools offer dual emergency care and FNP degree programs, which you may find valuable.

Post-Grad Certificate: If you have already obtained a nursing master’s degree, then completing a post-graduate certificate may be the most efficient path to becoming an ENP. Most post-grad certificate programs may be completed within 1-2 years and are typically offered either online or in a blended model.

Doctor of Nursing: A Doctor of Nursing Practice (DNP) is a doctoral degree in nursing and is the highest possible practice-based degree in the nursing field. A DNP functions similarly to an MSN, as they can both prepare a nurse for certification as an advanced practice registered nurse (APRN). Either a DNP or MSN is accepted to become an ER nurse practitioner. If you hope to achieve an executive-level or leadership position in the future, a DNP may also help to get you there. Keep in mind that DNP degree programs tend to be a longer commitment, and may take anywhere from two to four years to complete.

BSN to DNP: The BSN-to-DNP is another method of obtaining a Doctor of Nursing Practice. BSN-DNP programs are unique in that they have integrated the MSN and DNP into one streamlined program, so that graduates can earn both degrees upon completion. If that’s your goal, then the BSN-DNP may be a good fit. BSN to DNP programs are offered online and in person, so you have options to choose one that fits into your schedule.

What Is an Emergency Nurse Practitioner?

An emergency room (ER) nurse practitioner is an APRN that provides care for patients in emergency departments or urgent care facilities. An ER nurse practitioner must be prepared to assess, diagnose, and treat patients of all ages and backgrounds, from infants and young children to adults and the elderly. Because emergency departments receive a wide range of patients and conditions, an ER nurse practitioner may provide primary care services—but they must also be equipped to treat traumas, injuries, and life-threatening emergencies.

Should I Become an Emergency Nurse Practitioner?

A career as an emergency room nurse practitioner can be demanding, but it can be incredibly rewarding too. As an ENP, you will have the opportunity to acquire and develop valuable skills, while providing safe emergency care for patients. Emergency departments typically see high volumes of patients, so ENPs are comfortable or used to working in dynamic, fast-paced environments, and develop the ability to quickly diagnose and treat a wide range of conditions.

Strong communication, efficiency, multitasking, and patient prioritization can be useful skills for this health care job. Depending on the state they work in, ENPs are sometimes even authorized to work independently of physician supervision, which may be a plus for those who value autonomy.

Overall, there is a growing demand for nurse practitioners.  According to the U.S. Bureau of Labor Statistics (BLS), nurse practitioner careers have a projected growth rate of 45% between 2019-2029, which is significantly faster than the average.

Salary

Nurse salaries are dependent on education, experience, role, location and other factors. However, because nurse practitioners must obtain additional education and training, their compensation is typically greater compared to that of other nursing careers that require less education. While averages vary from state to state, the median annual salary of nurse practitioners was $111,680 in 2020, according to the BLS.

Roles and Responsibilities

Emergency room nurse practitioners have many responsibilities across the spectrum of patient care from intake to discharge. An ER nurse practitioner may be responsible for admitting patients to the hospital, as well as making rapid patient assessments, diagnosing, and administering treatment or prescription. ER nurse practitioners may also order and interpret diagnostic tests, and perform bedside procedures such as intubations, central line access, and suturing. They work closely with physicians and can refer patients to specialists when needed.

Related Nurse Practitioner Careers

Nurse practitioners work in a variety of settings and can be certified in many population-focused specialties, like women’s health, pediatrics, or psychiatry (to name just a few). If you’re interested in becoming a nurse practitioner but aren’t sure if emergency care is right for you, there are many related nurse practitioner careers you can also consider.

•Acute Care Nurse Practitioner (ACNP): An ACNP specializes in the care of acutely ill or injured patients, upon completion of an on-campus or online ACNP program. Like ENPs, they work primarily in hospitals and urgent care centers. Unlike family nurse practitioners, ACNPs do not have the academic training to care for pediatric patients in emergency care settings.

•Family Nurse Practitioner (FNP): Similar to an ENP, FNPs are trained to treat patients of all ages, from infants to seniors. However, the key difference is that FNPs typically work in a doctor’s office as the primary care provider for families. In order to become a family nurse practitioner, you must complete an on-campus or online FNP program. This is true for both FNPs and ENPs, but unlike ENPs, an FNP does not need to receive additional schooling and/or clinical work experience specific to emergency care.

•Pediatric Nurse Practitioner (PNP): A PNP specializes in primary care for newborns, infants, toddlers, adolescents, and young adults up to the age of 21. To become a pediatric nurse practitioner, you must complete a nurse practitioner program with a specialization in pediatric primary care. While both PNPs and ENPs are qualified to treat children, PNPs differ in that they do not need to first be certified as a family nurse practitioner.

•Neonatal Nurse Practitioner (NNP): A NNP provides care to high-risk infants in both acute and nonacute settings. Like ENPs, NNPs can work in emergency rooms, but also in delivery rooms and outpatient clinics for infants.

•Psychiatric Mental Health Nurse Practitioner (PMHNPs): PMHNPs assess the mental health needs of patients. They may provide therapy or prescribe medications for mental health disorders. To become a psychiatric and mental health nurse practitioner, you must obtain a master’s or doctorate nurse practitioner degree specializing in psychiatric mental health.

•Women’s Health Nurse Practitioner (WHNP): A women’s health nurse practitioner provides comprehensive care to women throughout their lifespan, usually from adolescence and into adulthood. A WHNP is trained with a specialized focus on reproductive, obstetric, and gynecological health, but is well-equipped to address primary care needs of women, too. They are able to complete these tasks upon completion of an on-campus or online WHNP program.

FAQs

We’ve highlighted some key steps to becoming an ENP, but you might still have some questions about the profession. Here are some common questions and answers about the ENP profession.

What is an emergency room nurse?

An emergency room (ER) nurse provides treatment for severe injuries, trauma, and other high-risk medical conditions in emergency care departments. An ER nurse can monitor health conditions, administer medicine, use medical equipment, and advise patients and their families on illness.  

What does an emergency room nurse practitioner do?

An emergency room nurse practitioner’s scope of practice is wide-ranging: an ENP may assess, diagnose, and manage illnesses, injuries, and trauma of patients across the lifespan, but is also able to address primary care needs. On a daily basis, an ENP may engage in triage, patient management, monitoring, and coordinating transfer of care. ENPs can also order and interpret diagnostic tests, prescribe medication, and perform bedside procedures.

Where does an emergency room nurse practitioner work?

An emergency room nurse practitioner can work in hospitals, trauma centers, urgent care facilities, and ambulances.

What is the difference between an emergency room nurse practitioner and a critical care nurse practitioner?

An emergency room nurse practitioner and critical care nurse practitioner are both qualified in acute care, as they can each provide short-term treatment for injuries, an episode of an illness, or an urgent medical condition. However, beyond providing acute care, an emergency room nurse practitioner can also treat chronic illness and conditions while critical care nurse practitioner, specialize solely in treating acute conditions like heart attacks or respiratory distress.

What are the differences between the AANP and ANCC ER nurse practitioner certification exams?

Currently, the only organization offering ENP certification is the AANP. The ANCC offers only renewal for ENP certification, so you must go through the AANP for initial certification as an ER nurse practitioner.

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