Emergency Nurse Practitioner and Clinical Nurse Specialist

Emergency nurses work on the front lines providing urgent care in emergency situations. From dealing with emergency room trauma, to providing care during emergency medical transport, they are known for their nerves of steel, remaining calm under pressure while skillfully observing, assessing, and prioritizing injuries. They must be decisive and confident in their training to quickly and deftly follow emergency protocol when a life hangs in the balance.

In addition to working in emergency rooms, emergency nurses work in settings such as:

  • Correctional facilities
  • Crisis intervention centers
  • Emergent care centers
  • Emergency prehospital ground transport
  • Flight nursing in aircraft
  • Poison control centers
  • Telephone triage

Advanced Practice Nurses in Emergency Care

Nurse practitioners (NPs) and clinical nurse specialists (CNSs) frequently work in emergency settings and are eligible to obtain national certification, although no advanced practice emergency certification is currently available.

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Nurse practitioners and clinical nurse specialists can serve in their primary specialty patient population focus, with emergency care as a subspecialty. According to a survey conducted by the Emergency Nurses Association, 43 percent of advanced practice nurses working in emergency care were family NPs, 13 percent were acute care NPs, 12 percent were adult care NPs, 7 percent were pediatric NPs, less than one percent were women’s health NPs. All other survey respondents were clinical nurse specialists.

Advanced Emergency Nursing Education

Emergency care is offered as a subspecialty under patient population focus in graduate-level nurse practitioner and clinical nurse specialist programs. Available options for an emergency nursing specialty focus within MSN programs include:

  • Acute Care Nurse Practitioner with Emergency Nurse Practitioner Subspecialty
  • Advanced Emergency Nursing (Family NP/Adult-Gerontological Acute Care Dual Role)
  • Dual Family Nurse Practitioner/Acute Care Nurse Practitioner Program with an Emergency Care Focus
  • Emergency Nurse Practitioner Program
  • Family Nurse Practitioner in Emergency Care
  • Family Nurse Practitioner/Emergency Subspecialty
  • Family Nurse Practitioner/Emergency Nurse Practitioner
  • Trauma, Critical Care, and Emergency Nursing: Blended Clinical Nurse Specialist and Acute Care Nurse Practitioner Program

Post-master’s certificate programs in emergency care are available to nurses who already hold an MSN. There are also DNP and accelerated BSN-DNP programs that focus on emergency nursing within a specific patient population. Most programs are designed to provide the didactic learning and clinical experience necessary for NPs and CNSs to qualify for certification in their primary specialty patient population focus, as well as subspecialty certification in emergency nursing.

Emergency Nursing Certifications

Emergency nurses have a number of certification options available to them through the Board of Certification for Emergency Nursing (BCEN). Eligibly requirements that must be met in order to attempt the certification exams are as follows:

  • Certified Emergency Nurse (CEN) requires an unrestricted RN license or equivalent issued in the US or its territories. The BCEN does recommend, but does not require, two years of experience in a related subspecialty.
  • Certified Pediatric Emergency Nurse (CPEN) requires candidates to have no fewer than 1,000 practice hours in pediatric emergency nursing practice during the two-year period prior to applying. This exam is offered jointly through the BCEN and the Pediatric Nursing Certification Board (PNCB).
  • Certified Flight Registered Nurse (CFRN) was developed for emergency nurses who provide services during emergency medical transport flights. The BCEN suggests two years of experience as a flight nurse, although this is not a requirement.
  • Certified Transport Registered Nurse (CTRN) was developed for nurses providing services during emergency ground transport. Two years of experience as a ground transport nurse are recommended, but not required.

BCEN exams are administered third party through AMP Assessment Centers, which has testing locations around the country. Renewal for all BCEN certifications is required every four years. Nurses have the option of taking a recertification exam or completing continuing education hours to meet recertification requirements.

Emergency Nursing Associations and Resources

The Emergency Nurses Association (ENA) is an advocacy organization for all nurses involved in emergency care. The ENA provides continuing education opportunities through its state chapters, and publishes the Journal of Emergency Nursing.

The Society of Trauma Nurses is dedicated to advancing trauma nursing, education, and leadership, and publishes the Journal of Trauma Nursing.

The professional association for ground transport critical care nurses and flight nurses is the Air & Surface Transport Nurse Association (ASTNA).

The Advanced Emergency Nursing Journal and International Emergency Nursing are publications focused on evidence-based material that advanced practice emergency nurses and related professionals can apply in their daily practice.

Emergency NP Salary

The National Salary Report of 2011 published by the peer-reviewed journal, Advance for NPs and PAs, shows that the average annual salary for nurse practitioners working full-time in emergency departments was $103,722. The average hourly rate for part-time emergency NPs was $49.82.

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A 2011 survey conducted by the American Academy of Nurse Practitioners (AANP) showed an even higher average among survey respondents working in emergency care. The results of this survey showed a base salary of $101,580, and total income of $115,070 when full compensation packages were factored in.

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