A Day In The Life of An ER Nurse Practitioner

Check out my guest blog post on Nurse Teeny's blog, Makings of A Nurse.  Nurse Teeny has an excellent blog where she documents her nursing experiences.  She is planning to pursue a nurse practitioner degree in the near future. 

A Day In The Life of An ER Nurse Practitioner

Working in the ER, my shifts are usually at odd hours.  Today I work from 6pm to 2am which I actually enjoy as it leaves the morning and afternoon free.  I spend an hour at the gym, return home to have breakfast and do a few chores around the house.  I write a blog entry for MidlevelU.  Then, I meet a friend for lunch, read a book on my porch and get ready for work.  Already a great day and my shift at the hospital hasn't even started.

I arrive at work a few minutes early and immediately start seeing patients.  The ER seems to be constantly busy.  My first patient is a 40 year old male with abdominal pain.  I pick up his chart, go into the rom and observe him writhing in pain.  Kidney stones.  After two years in the ER I can usually diagnose them within seconds.  I order him pain medication along with a CT scan and some lab work to verify my initial diagnosis.  

My next patient is a 25 year old female involved in a rollover MVA (Motor Vehicle Accident).  She is complaining of right wrist pain.  I remove the rudimentary splint the paramedics have placed to examen her wrist more closely.  Her wrist is swollen, bruised and deformed.  I suspect a fracture and order pain medications and an X-Ray.

Then, I move on to my third patient, a 42 year old male who was doing construction on his home and has gotten a nail stuck in his index finger.  He was unable to remove the nail on his own and suspects it is in the bone.  I order an X-Ray to confirm his suspicions and find they are correct.  I then attempt to remove the nail by pulling it with hemostats.  It is stuck so far into the bone, I have to enlist the help of a male physician .  After successfully removing the nail, I write the patient a script for antibiotics, update his tetanus vaccine and send him home with strict instructions to return immediately if signs of infection develop.

In the ER, I never know what each day will bring.  I see patients with chest pain, abdominal pain and orthopedic problems.  I do procedures such as drain abscesses and suture lacerations.  I enjoy the variety and challenges my job provides.  I learn new things everyday.  I love my job and highly recommend the nurse practitioner career

Comments

The scope of practice for NPs in the emergency department depends on state laws and the rules of your facility. 

Overall, provided that the NP is trained, nurse practitioners are permitted to intubate and place chest tubes. Suturing is a very basic skill and nurse practitioners are permitted to do this in all settings that I am aware of, provided they have appropriate training. 

Erin Tolbert

Hello,

I'm curious about the scope of an Emergency room nurse practitioner. What can you do and what can you not do as a ER nurse practitioner. I've scoured all over the internet, and I can't find the limitations? Can you do sutures, intubate, place chest tubes etc?

Dartagnan Smith

Hi Linda, 

Thanks for reaching out!

You will need to get an RN or BSN degree to enter a nurse practitioner program. This blog post, How to Become a Nurse Practitioner Without Nursing Experience, outlines your three options for doing so with a health sciences degree. Once you select the best path for you, this will help you narrow down your options as far as schools. 

Volunteering in the hospital is a great way to get healthcare experience before graduating. You could also consider getting your CNA certificate, or completing another type of healthcare certificate to get more direct patient care experience. 

As far as job shadowing, most facilities will allow you to job shadow an NP. Reach out to any NPs you know to see if they are up for hosting you for a few hours. Most will be more than willing. 

Good luck!

Erin Tolbert

Hi Erin,
I am interested in becoming a nurse practitioner. I have a lot of questions, and I hope you do not mind answering them :)
I am a rising sophomore in college, majoring in Health Sciences.
If I continue the next 3 years in college majoring in Health Science, would I have to find a bridge/another path after I graduate to connect back to nursing in order to become a registered nurse ? Or would Health Science be enough to connect me to a nursing path?
Also, what ways can I get experience in while in college to benefit me before graduating? I currently volunteer in the hospital, any specific departments I should take into consideration? And, am I allowed to shadow nurse practitioners?
What schools in the New York area have a NP program ?

Thank you very much!!

Linda

Linda

The salary of an ER nurse practitioner varies based on region. The best way to get an accurate read on the salary for your specific specialty in your area is to ask other NPs working in the same or similar settings.

The U.S. Bureau of Labor Statistics gives salary information for nurse practitioners but it is not specialty specific. Salary.com gives specialty specific information but based on my experience I haven't found it to be highly accurate. Either of these resources can, however serve as a point of reference at very least. 

Erin Tolbert

I have found that may sights give information about our salary, but these numbers seem incorrect to me... Can u help me find some real numbers?

Texas ER FNP

Hi Javier, 

Congratulations on your upcoming graduation!

Yes, urgent care and ICU would both be great experience for a dual NP degree. This would allow you to work in both inpatient and outpatient settings so you get the skill sets of each. 

Erin Tolbert

I found your blog to be very informative and passionate about your profession. I will be graduating with a BSN in March 2016. I'm applying to graduate school to pursue a NP/MPH dual degree after working a year in ICU. The program allows students to specialize in two areas; I would like to I've read through some of your advice about preparing for ER. Would you recommend to work in ICU as well as get some experience in Urgent Care before pursuing the dual specialty NP?

Javier

Hi Matthew,

Thanks for reaching out!

Your first step to becoming an FNP is to get your bachelor's degree in nursing. Then, you can enroll in an FNP program where you will get you master's degree in nursing. Some schools have programs that roll these two degrees into one. 

Once you graduate from your nurse practitioner program, you will take a certification exam allowing you to practice as a nurse practitioner. Then you will be ready to start working!

Erin Tolbert

Hello, my name is Matthew and I have enjoyed reading this blog. I have a passion for emergency medicine, and I only a Freshman in College. I have had the opportunity to do New Visions Medical Professions my senior year of high school and the opportunities were wonderful, I spent almost every rotation in the ER. I also volunteer at a hospital near my school between 6-8 hrs a week. I am interested in becoming an ER FNP, however how do I get these credentials ? My college does have an FNP program as well as a DNP program. I am very strong academically, as well as through community service. What books would you recommend I read on being an ER FNP. I have a room full of medical books and I just love to read up on anything pertaining to medicine !.

Matthew

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