The Day to Day Challenges of a Nurse in the ER

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Nurse in the ER: Have you ever witnessed the chaos in a hospital’s ER (Emergency room)? And thought of the challenges the ER nurses face?

Every year, according to CDC, 130 million people visit the emergency department in the US for better health and to avoid potential unpleasant medical issues. 

Being a hospital’s front liner demands a lot from an ER nurse every day.

An ER nurse faces significant mental and physical stress attending to dozens of high-acuity patients and prioritizing immediate care through triaging literally from infants to adults. 

Read on, as this article will cover the daily challenges of an ER nurse, from well-developed and resourced to low and middle-resourced countries.


As the alarm calls for an emergency nurse in the morning, they report to the most demanding and challenging duty. 

A typical day of an emergency nurse includes but is not limited to:

  • Reviewing the patient charts from the night shift and assessing the patient care, from giving intravenous (IV) to sample collection and administering medication.
  • Attending to new patients in emergency, some of which could be traumatic and unpredictable. They require proper assessment, performing differential diagnosis, giving pain killers, and screening tests to rule out the possible problem.
  • Discharging patients involves removing IVs, checking vitals, and administering medications for home use. 
  • Educating patients about their problems and possible signs that would require a visit back to the hospital.

Being in the emergency as a first responder is a chaotic experience and could break the spell of even a naturally calm and positive person. 

So, to deal with complex medical cases, nurses need advanced education. A degree similar to masters of nursing nurse practitioner is an excellent idea for graduate nurses to equip themselves with the necessary skills to work autonomously and gain knowledge regarding the latest developments in medicine.

Why is a Master’s degree essential for today’s nurse? As opposed to a specialty nurse, it is a must for an ER nurse to understand a little bit of everything in the medical field to qualify caring for an unpredictable emergency case. 

Facing Traumatic Events

Due to the nature of their job, ER nurses encounter many unpleasant emergencies and events like terrible accidents, child abuse, and especially — sad demises. 

According to a recent survey, most nurses developed post-traumatic stress disorder (PTSD) due to frequent confrontations with severely ill patients and other traumatic occurrences.

The fact is, emergency room nursing involves tragic situations, but ultimately, it could be emotionally hard to handle and drain your energy.

Facing Violence

Cases of violence involving patients and their family members aren’t unheard of in the ER. This makes it one of the most traumatic and stressful areas of a medical facility for nurses and physicians. 

The Emergency Nurses Association (ENA) reported many physicians and nurses were abused and physically assaulted by the patients. For this very reason, a campaign, ‘No Silence on ED Violence,’ was started to sort these pitiful issues.

In some instances, the visitors or relatives of the patient started a stressful conflict with nurses, forming a barrier to providing quality and timely care to patients in need.    

Lack of Management Support

It is one of the most critical responsibilities of senior management to ensure the best working environment in a busy and chaotic department for their workforce. 

The minimal managerial support is a challenging factor for emergency nurses to deliver quality care to their patients.

In a survey, the underdeveloped and secondary referral hospitals’ ER nurses were speaking on how negatively patient care was affected by the lack of management.

As a result, this issue brings out the demoting factor in nurses. Also, the lack of administrative efforts leads to insufficient medical drugs and vital emergency unit supplies.

Hospitals should prioritize making proper plans to motivate emergency nurses to gain further training, skills and continue professional education. 

Without it, the future of emergency care nursing in hospitals is at risk.

Lack of Resources

Recently, the number of emergency cases has significantly increased around the globe, especially since the COVID-19 pandemic. 

The emergence of the COVID-19 pandemic placed immense stress on emergency care units in the low developed part of the world, resulting in more deaths.

Also, part of the developed world — in such instances, also faced issues like:

  • Managerial Planning
  • Trained healthcare staff and
  • Scarce resources

In a recent study on a secondary referral hospital, the lack of necessary medical equipment affected the quality of patient care.

The problems these hospitals were coping with are:

  • The ward capacity was inadequate to accommodate patients.
  • Wheelchairs and stretchers were in unusable condition.
  • They were sharing some apparatuses between departments to attend to patients.
  • In vital cases like labor, nurses would wait for patient relatives to purchase necessary resources to proceed with treatment.

As a result, the continued state of emergency patients and poor state of the hospitals made working in the ER very challenging for nurses. 


In the context of this article, the day-to-day challenges of an ER nurse can vary according to the situation. Usually, it is a very stressful environment that requires nurses to be on their toes all the time. 

With medical facilities already facing a shortage of nurses, it is challenging to find qualified nurses ready to deal with an influx of patients. 

What’s more, the ongoing pandemic isn’t making things easy. Most countries still struggle to accommodate patients in critical condition due to a lack of resources. 

The lack of managerial support puts the medical staff at risk of violence and trauma, resulting in them quitting the job and looking for a different career. 

The government should fund resources to emergency departments and provide security for all medical personnel to ensure patients receive the highest level of care.

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