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There are many departments and different types of job positions in the hospital for nurses. Two floors that employ many nurses are the emergency department and the medical-surgical units. Let’s talk about the difference between ER Nurses and Floor Nurses.
What is an ER Nurse?
An ER nurse works in an emergency department or emergency room. (Emergency room and emergency departments are the same things.) They are responsible for triaging patients who come in for emergency care. They can care for patients who have very simple and stable needs, like casting a broken finger, to very complex and elaborate needs, like stabilizing a patient who was in a car accident or suffered a gunshot wound.
What Does an ER Nurse Do?
The ER nurses have to work fast because every second is vital in saving someone’s life. They have to be able to quickly assess a patient’s condition and then act on that information. They also need to work well under pressure and make quick decisions.
They must also be good at managing many patients at once, some of whom have simple and less urgent needs.
There is no predictability in the emergency room. You could have a shift where the unit is completely full, while another where there are only a few patients. There’s no way to know what’s about to walk through the door.
The number of patients an ER nurse cares for will be different each shift. The ER nurse may care for a few critically ill patients at the same time as other patients getting ready to go home.
The goal of the ER nurse and medical team is to figure out the problem as fast as possible, provide the appropriate testing/diagnostics, and treatments, and then get the patient discharged home if appropriate. If the patient is too sick to go home, then they are “admitted” into the hospital and will go to a medical-surgical unit, step-down unit, or critical care unit.
Some Specific Duties of ER Nurses Include:
- Providing blood products and medications
- Providing care for traumas, cardiac arrests, strokes, and sexual assaults
- Washing and dressing wounds
- Conducting cardiopulmonary resuscitation (CPR)
- Releasing medically stable patients
- Educating sick individuals and their families about their disease and treatment plan
- Assisting in intubating patients
- Inserting IVs
- Assisting in setting fractures
- Stabilizing trauma patients
- Dealing with allergic reactions and critical injuries
- Safely transferring patients up to the medical-surgical unit, stepdown unit, or ICU
Average Emergency Room Nurse Hourly Pay
Following are the salaries stats of ER nurse practitioners according to Payscale.
- An entry-level Registered Nurse (RN) in the Emergency Room with less than one year of nursing experience can earn an average hourly compensation of $27.42 based on 681 salaries.
- An early career Registered Nurse (RN) in the Emergency Room with 1-4 years of experience earns an average hourly compensation of $29.57 based on 3,628 salaries.
- A mid-career Registered Nurse (RN) in the Emergency Room with 5-9 years of experience earns an average hourly compensation of $33.14 based on 2,436 salaries.
- An experienced Registered Nurse (RN) in the Emergency Room with 10-19 years of experience earns an average hourly compensation of $36.82 based on 2,303 salaries.
- In their late career (20 years and higher), employees make an average hourly compensation of $39.
Education Requirements for ER Nurse
To become an ER nurse, one needs to complete an associate’s degree in nursing (ADN) or a bachelor’s degree in nursing (BSN) from an accredited school, and pass the NCLEX-RN examination.
What is a Floor Nurse?
A floor nurse is an RN that works in a nursing unit. They can work in any area of the hospital, such as medical-surgical, pediatrics, oncology, etc.
While an ER nurse could have very sick and very stable patients at once, and have a very unpredictable day of patients, the floor nurse is different. Typically, a floor nurse will start out with anywhere from 4-7 patients, but none will be critically ill. They will not have more patients throughout the shift, as an ER nurse may.
The Floor Nurse may discharge a few patients and later get some admissions. However, they will have a maximum number of patients they can have in a shift.
While the ER nurse provides care very focused on the reason they came in, the floor nurse provides broader care over a longer period of time. The floor nurse will perform a head-to-toe assessment, give medications, work with the medical team on the plan of care, and carry out the plan.
What Does a Floor Nurse Do?
While the mantra of the ER nurse is to “treat ’em and street ’em” (meaning, get the patient what they need and get them out the door or admitted to the hospital ASAP), floor nurses have a different focus. It’s not as much of a rush to figure out the problem and provide the care.
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When patients are on medical-surgical floors, we often know what the problem is, or are in the process of figuring it out. We know the patient is sick enough to stay at the hospital overnight, and that they need constant medical supervision. If the patient isn’t critically ill, or close to it, then they can be on a medical-surgical unit, which is where the floor nurses will care for them during their stay.
Some Specific Duties of Floor Nurses Include:
- Assess patients
- Monitor their medical status (vitals, labs, assessments)
- Work with the medical team on a care plan; implement the care plan
- Educate the patient on what’s happening, what to expect, how to prevent further issues, and more
- Administering treatment and medication
- Providing emotional support to sick persons and their families
- Scheduling tests and procedures
Average Hourly Pay of Floor Nurse
The pay scale of a floor nurse is very similar to the payment of an ER nurse. Please keep in mind that pay for nurses varies widely across the United States. I recommend looking at Payscale and noting your location for the most accurate estimate.
Education Requirements for Floor Nurse
The education requirements for a floor nurse are the same as the ER nurse. You need to be an RN, which means you either have an associate’s degree in nursing (ADN) or a bachelor’s degree in nursing (BSN) and have passed the NCLEX-RN examination.
What are the Main Differences?
Following are some significant differences between ER nurses and floor nurses.
Number of Patients
The main difference between ER nurses and floor nurses is the type and number of sick persons they see. ER nurses typically see more critical and life-threatening situations than floor nurses. Usually, ER nurses have a caseload of 5-10 sick persons at a time – with some having minor issues, and others having very life-threatening issues.
The ER nurse may see 30+ patients in one shift. You could start out with 10, but discharge 8 of them and send 2 to the ICU, and as you discharge and transfer patients, more come in! You never know how many you will have.
On the nursing floor, you’ll likely start with 4-7 patients, but not get more than that. You could discharge 2-3, and get 2-3 admissions back, but you may have some shifts where you start with 5 and have those same 5 patients all day! There is far less “throughput” in the medical-surgical units (meaning, patients coming into and leaving the unit).
Type of Patients
Another significant difference is the type of sick persons that each nurse sees. ER nurses typically see sick persons with more severe illnesses or injuries than floor nurses.
Floor nurses see patients suffering from many issues but are not ICU-level sick. They’re not ventilated, or have things like CRRT, arterial lines, or other complex medical devices.
Duties
There is some overlap in the duties of these nurses. Generally speaking, both will be assessing patients, working with physicians/the medical team, giving medications, helping with procedures, monitoring patients, and discharging/transferring patients. However, the ER nurse will perform a wider array of duties. For example, ER nurses must know how to care for ventilated patients and assist with a chest tubes, arterial lines, and central line insertions.
Education
The education requirements are the same – ADN or BSN degree. Some hospitals may require or strongly prefer a BSN degree, however, and if you’re hoping to work in a prestigious hospital, it might be harder to land a position in the ER.
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Video on Differences Between ER Nurses and Floor Nurses
Ending Thoughts
In conclusion, both ER nurses and floor nurses are essential members of the medical field. They both have their own unique roles and responsibilities, which allow them to contribute to a sick person’s overall health and well-being. So whatever career you choose in nursing, know that you are making a difference.
More Resources:
- TrueLearn– (use code FRESHRN for 20% off)
- What Do Emergency Nurses Do?
- What Do Med Surg Nurses Do?
- What’s the Difference Between CNA and RN?
ED nurses are critical care nurses who choose to work in the ED. They usually have a few years of medical surgical nursing and than move into the critical care area. I would advice any nurse looking to specialize in the ED to have some ‘basic training’ before moving into the area. The pace of the ED is fast paced and you need to ‘think’ ahead to anticipate what doctors want and patients need. There is certification for ED nurses so that is one way to demonstrate your expertise in the area of emergency department.
Many people love the ED due to its fast paced nature as well as the anticipation of what’s coming in. This is different from a typical med/surgical floor or even ICU. What is good about nursing is that there are different areas of practice to meet each nurses goals.