Emergency Nurse Practitioner: 5 Essential Responsibilities

The demand for medical professionals is skyrocketing. Emergency and other non-primary-care providers are especially in high demand in rural settings. A 2020 report in the Annals of Emergency Medicine noted that many emergency physicians in rural areas are near retirement age, with 71% having completed medical training more than 20 years ago.

In 2020, the Association of American Medical Colleges (AAMC) projected a shortage of as many as 86,700 non-primary-care physicians nationwide by 2033. The group recommends that nurse practitioners help mitigate the physician shortage. No surprise, then, that the U.S. Bureau of Labor Statistics (BLS) anticipates a 52% growth in nurse practitioner (NP) jobs between 2020 and 2030.

As advanced practice registered nurses (APRNs) who can perform many of the same duties as physicians, emergency nurse practitioners (ENPs) are ensuring that those in need of emergency care can access it. Nurses who want to help meet the growing need for emergency medical care professionals should consider a career as an ENP. An advanced education, such as Master of Science in Nursing and Master of Science in Nursing, Nurse Practitioner programs, can help provide the foundation for this important and in-demand job.

The Role of an Emergency Nurse Practitioner

APRNs are advanced-level nursing professionals who direct patient care, providing primary and specialty treatment. ENPs are APRNs with specialized expertise in acute care in emergency departments and urgent care facilities. They diagnose and treat patients of all ages with an emphasis on disease prevention and health management.

While ENPs treat patients suffering from trauma, injuries and advanced illnesses, they also provide primary care services, as many emergency and urgent care patients are diagnosed with minor health problems.

Emergency nurse practitioner jobs generally are in fast-paced settings such as emergency rooms, intensive care units, and urgent care facilities. These settings often draw a high volume of patients each nursing shift. Emergency facilities typically require ENPs to work long hours, including night shifts, weekends, and holidays. They also may be on call.

Responsibilities of an Emergency Nurse Practitioner

The scope of ENPs’ responsibilities varies. Many states grant nurse practitioners the autonomy to prescribe medications and order laboratory tests without physician supervision, while other states require a greater level of collaboration with other medical professionals to direct treatment. Factors such as these can affect an ENP’s autonomy and specific responsibilities.

Generally, ENPs are responsible for tasks ranging from evaluating the severity of patients’ injuries and illnesses to developing and overseeing treatment plans.

Five essential responsibilities of an ENP are:

1. Performing Triage

Emergency nurse practitioners evaluate the severity of patients’ illnesses or injuries as they enter the emergency department or critical care facility. ENPs must quickly establish whether each patient’s condition is life-threatening.

ENPs consider the critical nature of a patient’s injury or illness when determining who receives treatment first. After this initial evaluation to determine the severity of a patient’s condition, the ENP performs a more thorough examination to pinpoint the cause of the injury or illness and determine how to address it.           

2. Stabilizing Patients

Patients with traumatic injuries or life-threatening conditions—such as an airway obstruction or heart attack—require stabilization prior to evaluation and treatment. ENPs must ensure that patients’ vital signs are within an acceptable range, directing the measurement of indicators such as pulse, temperature, and blood pressure.

Once critically ill patients’ conditions stabilize, ENPs can conduct more in-depth testing of these patients for a detailed diagnosis.

3. Ordering Diagnostic Tests

Based on an initial evaluation of a patient’s condition, the ENP may determine the need for  further diagnostic testing. If a patient faces multiple health concerns, the ENP typically addresses the most severe problem first, evaluating potential issues through tests such as electrocardiograms (EKGs), X-rays, and ultrasounds. The results of these tests inform approaches to treating patients’ conditions.

4. Coordinating Treatment

ENPs collaborate with a team of medical professionals to direct patient care. Emergency treatment often includes procedures related to:

• Airway obstructions
• Anesthesia and pain management
• Bone fractures
• Ear, nose, and throat concerns
• Gastrointestinal issues
• OB-GYN emergencies
• Psychiatric problems
• Resuscitation
• Skin injuries
• Spinal injuries
• Toxicological exposure

Emergency nurse practitioners must coordinate common emergency procedures such as suturing, casting, making incisions and draining fluids, and splinting.

Open communication with other medical professionals is critical. This communication should include enlisting the assistance of physicians or delegating tasks as appropriate, as well as keeping healthcare teams up to date on patients’ treatments. ENPs also must communicate with patients and family members, and refer individuals for follow-up care as needed.

5. Providing Primary Care

Individuals with primary care concerns often turn to the emergency department or a critical care facility for assistance, requiring ENPs to treat nonemergency conditions related to chronic disease, pediatric conditions, and OB-GYN issues. In addition to providing treatment, ENPs generally encourage patients seeking primary care to incorporate healthy behaviors into their lives to help prevent illness and injury.

How to Become an Emergency Nurse Practitioner

Because ENPs work with patients of all ages, including infants and young children, most are family nurse practitioners (FNPs) who gain additional education or experience in the subspecialty of emergency care. Taking the following steps can put individuals on the path to becoming an ENP.

ENP Education Requirements

Emergency nurse practitioners must meet the educational requirements for licensing as a registered nurse (RN) and certification as an APRN. That starts with an undergraduate nursing education focused on anatomy, microbiology, physiology, psychology, and social and behavioral sciences.

ENPs typically also hold at least a master’s degree, with MSN programs frequently including classroom instruction and advanced clinical experience. Aspiring ENPs may also pursue a Doctor of Nursing Practice (DNP) for more specialized knowledge.

ENP Licensing and Certification Requirements

While licensing requirements for RNs vary by state, all must pass the National Council Licensure Examination-RN (NCLEX-RN), administered by the National Council of State Boards of Nursing (NCSBN).

After becoming an RN and earning a master’s or doctoral degree, nursing professionals can pursue certification as nurse practitioners. While state certification requirements for NPs and other APRNs vary, most states require national certification. FNP certification is available through the American Academy of Nurse Practitioners Certification Board (AANPCB) and the American Nurses Credentialing Center (ANCC).

The AANPCB also offers additional ENP certification for certified FNPs. The exam for ENP certification includes 150 questions, 135 of which are scored, with focus areas such as screening, decision-making, and professional practices. Certification requires periodic renewal. The ANCC only offers ENP certification renewal.

ENP Experience Requirements

A few years of experience working as an RN in an emergency department or critical care facility is helpful in finding employment as an emergency nurse practitioner. MSN programs typically offer clinical experience, helping nursing professionals to sharpen their skills working in a fast-paced environment.

On-the-job experience applying the procedural skills required of ENPs is an important step in preparing for positions in this profession. During their careers, ENPs can also keep their knowledge up to date and hone their skills with continuing education (CE) courses or resources.

Make an Impact in Nursing and Emergency Care

Nursing leaders play an important role in meeting the rapidly growing demand for emergency medical care providers, with jobs for APRNs— especially NPs—projected to dramatically increase in the coming years. Nurses who want to pursue a career that can help ensure emergency care for those who need it should explore Norwich University’s online Master of Science in Nursing and online Master of Science in Nursing, Nurse Practitioner programs.

Norwich University’s programs can provide the skills and expertise required of nursing leaders, with specialized tracks including an FNP concentration that can help prepare nurses for an ENP subspecialty. The programs also offer the flexibility and convenience of online learning.

Discover how Norwich University’s online Master of Science in Nursing and online Master of Science in Nursing, Nurse Practitioner programs can help you pursue your professional goals.

Recommended Readings

How to Prevent Nurse Burnout

Nurse Leadership Qualities for Your Future Career

The Nurse’s Role in Preparing Patients for Flu Season During a Pandemic

Sources:

New AAMC Report Confirms Growing Physician Shortage, Association of American Medical Colleges

Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners, U.S. Bureau of Labor Statistics

National Study of the Emergency Physician Workforce, 2020, Annals of Emergency Medicine

What’s a Nurse Practitioner (NP)? American Association of Nurse Practitioners

Are You Considering a Career as an Emergency Nurse Practitioner? American Association of Nurse Practitioners

Practice Standards for the Emergency Nurse Practitioner Specialty, American Academy of Emergency Nurse Practitioners

State Practice Environment, American Association of Nurse Practitioners

What Does an Emergency Medicine Nurse Practitioner Do, ZipRecruiter

FAQs About Becoming an Emergency Nurse Practitioner, ThriveAP

Emergency Department Triage, StatPearls

Emergency Nursing & Triage NCLEX Practice (40 Questions), Nurselabs

Emergency Nurses’ Attitudes Toward Interprofessional Collaboration and Teamwork and Their Affecting Factors: A Cross-Sectional Study, Nursing and Midwifery Studies

National Model EMS Clinical Guidelines, National Association of State EMS Officials

Standards of Practice for Nurse Practitioners, American Association of Nurse Practitioners

Preventable Emergency Department Visits, Agency for Healthcare Research and Quality

How to Become an Emergency Medicine Nurse Practitioner, ZipRecruiter

The Path to Becoming a Nurse Practitioner (NP), American Association of Nurse Practitioners

NCLEX & Other Exams, National Council of State Boards of Nursing

Family Nurse Practitioner Certification (FNP-BC), American Nurses Credentialing Center 

Emergency Nurse Practitioner (ENP), American Academy of Nurse Practitioners Certification Board

Family Nurse Practitioner (FNP), American Academy of Nurse Practitioners Certification Board

Emergency Nurse Practitioner Certification (ENP-BC), American Nurses Credentialing Center