The emergency department (ED), also called accident and emergency (A&E) or casualty, is where hospitals meet the unexpected. Emergency nurses care for people of all ages with every kind of problem: heart attacks, strokes, road traffic injuries, severe infections, mental health crises, poisoning, labour complications and much more. If you thrive on variety, quick thinking and teamwork, emergency nursing could be for you.
What emergency nurses do
- Triage: rapidly assess patients on arrival and decide who needs to be seen first.
- Resuscitation: work in the resus area with critically ill and injured patients, including cardiac arrest, major trauma and sepsis.
- Majors and minors: care for patients with serious illness (majors) or minor injuries and illnesses (minors), including wound care, plastering and simple procedures.
- Paediatric emergencies: assess and care for sick and injured children.
- Mental health: support people in crisis and keep them safe.
- Communication: work closely with doctors, paramedics, specialists and families, often under pressure.
- Flow: manage admissions, transfers and discharges, especially when the department is overcrowded.
Triage systems around the world
Triage means sorting patients by urgency. Different countries use different systems:
- Manchester Triage System (MTS): widely used in the UK, Ireland and parts of Europe. Five categories from “immediate” (red) to “non-urgent” (blue), based on flowcharts of presenting complaints.
- Emergency Severity Index (ESI): common in the United States. Five levels based on acuity and expected resource use.
- Canadian Triage and Acuity Scale (CTAS): used in Canada and some other countries.
- Australasian Triage Scale (ATS): used in Australia and New Zealand, with target times to be seen for each category.
- South African Triage Scale (SATS): designed for resource-limited settings and used in several African countries.
- WHO Emergency Triage Assessment and Treatment (ETAT): for children in low-resource settings, focused on recognising emergency and priority signs.
If you plan to work abroad, learning the triage system used there will give you a head start.
Key skills
- Rapid ABCDE assessment and recognition of deterioration
- Calm decision-making under pressure
- Prioritisation and multitasking
- Basic and advanced life support
- Trauma care
- IV access, blood sampling and ECG recording
- Medication knowledge, especially emergency drugs
- Communication with frightened, angry or grieving people
- De-escalation of aggression
- Teamwork and resilience
Training and courses that help
Many nurses join an ED after a period on a medical or surgical ward, although some departments take newly qualified nurses with structured support. Useful courses include:
- Basic Life Support (BLS) and Advanced Life Support (ALS/ACLS)
- Paediatric life support (for example EPALS or PALS)
- Trauma courses such as the Trauma Nursing Core Course (TNCC) or equivalents
- Triage training in your local system
- ECG interpretation
- Postgraduate certificates or diplomas in emergency nursing, available in many countries
- Certification exams such as the Certified Emergency Nurse (CEN) credential in the US
In Nigeria and several other African countries, post-basic programmes in accident and emergency nursing are available at approved schools. Check that any programme is recognised by your nursing council.
Career pathways
- Staff nurse to senior or charge nurse running shifts
- Emergency nurse practitioner or advanced clinical practitioner, assessing, diagnosing and treating patients independently (usually requires a master’s-level qualification)
- Trauma nurse coordinator
- Emergency nurse educator
- Pre-hospital or flight nursing in some countries
- Disaster and humanitarian nursing with organisations responding to outbreaks and crises
- Management roles in emergency services
Emergency nursing abroad
Emergency nurses are in demand in the UK, US, Canada, Australia, Ireland and the Gulf. Recruiters often ask for at least one to two years’ recent ED experience. Tips:
- Keep a record of your ED experience: department size, patient numbers, types of cases, and skills you’ve performed.
- Get BLS and ALS certification, and keep them current.
- Learn the destination country’s triage system and emergency protocols.
- Be ready for scenario-based interview questions such as “Two patients arrive at once…”
The challenges
Emergency nursing is rewarding but demanding:
- Overcrowding: many EDs worldwide face long waits and patients on trolleys in corridors.
- Violence and aggression: ED staff are at higher risk; report incidents and use de-escalation training.
- Emotional load: trauma, sudden deaths and child injuries can affect staff deeply.
- Shift work and night shifts.
Good teams, debriefs, peer support and access to wellbeing services help emergency nurses stay in the specialty for the long term.
Is it right for you?
You might love emergency nursing if you enjoy variety, think fast, can stay calm when others panic, like learning something new every shift and value teamwork. If you prefer continuity and getting to know patients over weeks, ward or community nursing may suit you better, and that’s fine too. Nursing needs all kinds.