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Do you thrive focusing on trauma, injuries and caring for patients with advanced illnesses in a fast-paced work setting? If you responded yes, you should consider becoming an ENP. ENPs are specialty care providers who work in emergency settings.
An ENP is a board-certified advanced practice registered nurse (APRN) who treats patients of all ages in emergency departments (EDs) or urgent care facilities in collaboration with an interdisciplinary team. ENPs practice in community EDs, trauma centers, critical access hospitals and urgent care clinics. These practice settings require ENPs to work long hours — including night shifts, weekends and holidays — and to be on call.
Since the majority of patients who are seen in EDs are treated and discharged with minor health problems, ENPs must be prepared to provide primary care services, including managing patients with chronic disease conditions, caring for women with obstetric and gynecological problems and caring for infants and young children, who make up a significant percentage of all ED patients. However, ENPs must also be prepared to initiate care for patients with urgent, higher acuity illness, traumas and injuries and to provide acute resuscitation and stabilization of patients with life-threatening emergencies.
Most ENPs are family nurse practitioners (FNPs) who obtain additional emergency specialty education either through the completion of an academic or post-graduate fellowship program or through on-the-job training and continuing education (CE). Nurses interested in pursuing ENP preparation and board certification must first obtain certification as an FNP. Then, you can select from a growing number of academic and post-graduate ENP specialty training programs.
While, like all FNPs, ENPs are prepared to provide primary care services — such as educating patients, managing acute and chronic diseases and prescribing treatments — ENPs must also understand how to recognize and quickly manage complex patient needs. The pace of care translates to ENPs typically seeing a higher number of patients per shift and prescribing a greater number of medications. ENPs must also be masters at multitasking, prioritization and working within a care team.
Becoming an ENP will allow you to contribute to providing safe emergency care in your community and will provide you with a challenging, dynamic career. As your national NP community, the American Association of Nurse Practitioners® (AANP) recognizes that your career decision will have an impact on our health care system and is here to help guide you through the stages of your career. As a student member of AANP, you have access to a comprehensive collection of resources created specifically for you — from NPs who have been in your shoes. AANP also offers a list of NP certification boards and a searchable list of NP programs.
“Prior to becoming an NP, I worked as an emergency nurse in my community ED. I had only ever met two NPs at that time, and one was working in the hospital in employee health. When I went to see her for my annual exam, I had never had a physical evaluation as thorough — the depth of questions she asked about my life, stress, diet and more really surprised me. Even though there were very few NPs in my community, I had read about the role they were playing in small towns across the U.S. and thought it would be a fun career that would allow me to add knowledge of how to better help people maintain their health. As I approached graduation from my NP program, I asked our ED medical director to precept me. I worked alongside him and conducted research for him on patient demographics. Once he understood the role of the NP in the ED, he hired me. I became the first NP ever hired in the ED in my community and also became the first NP to be granted hospital privileges.
“I love the challenge of the ENP role. You never know what you will see in this environment — it’s so intellectually stimulating. I love being able to develop a relationship of trust within minutes with a patient and then put their story and exam findings together to create a plan that works for them and provides safe care. Today’s challenge as an ENP is to be able to work in a very stressful environment with high patient volumes. The ED has become a safety net for many patients who are otherwise unable to access health care — it’s not unusual to come to work any hour of the day and walk through a waiting room with 20 or more tired, hungry and frustrated people. There’s also the challenge of making the right decision for people with limited resources or limited access. If a patient isn’t sick enough to be admitted, we need to arrange follow-up care for them that they can actually access.
“It’s amazing how the ENP role has advanced since the 1990s. When I think how fast our role as NPs has evolved since I started my career in 1990, I am grateful for the advocacy that AANP has provided nationally and within states to clarify our role and scope of practice. For NPs wanting to move into the ENP role, it’s becoming increasingly competitive if you do not have emergency-specific preparation and certification. Enrolling in an academic or post-graduate fellowship program are two pathways to preparing for the ENP. Another way would be to attend the AANP conferences each year to build your emergency-specific CE hours by signing up for the hands-on procedural skills workshops and attending sessions related to caring for patients with emergent and higher acuity problems. As a chair of the Emergency Specialty Practice Group (SPG), I also invite NPs interested in emergency care to join our online discussion forum. It’s a good resource and a great way to network with ENPs from across the country, to find jobs and to learn about state and organizational issues. We invite you to join us to enrich our special practice forum with your ENP stories and practice tips!”
— Dian Dowling Evans, PhD, FNP-BC, ENP-C, FAANP, FAAN, clinical professor and coordinator of the Family/Emergency Nurse Practitioner Program at Emory University, founding Board member and past chair of the American Academy of Emergency Nurse Practitioners (AAENP)
Are you ready to start your career as an ENP? Visit the AANP JobCenter to find available positions. You can filter your search by state, experience level and job type, including full-time positions, part-time positions or internships. You can also upload your resume to the JobCenter and let employers find you!
If you need help navigating the process of finding a job, please check out the JobCenter’s resources. The JobCenter is dedicated to helping you prepare for interviews, negotiate your salary and polish your resume. AANP also offers tips on becoming certified, finding the right practice setting and staying informed on important health issues at every stage of your NP career.
If you want to learn more about working in emergency settings, you should complete the Evaluation and Management of the Possible CVA in the Emergency Department (1.0 contact hours of CE credit), Neurological Emergencies for the Generalist Nurse Practitioner (1.0 contact hours of CE credit) activities and Diagnosing and Managing Ischemic Cardiogenic Shock in Adult Patients: Essentials for Nurse Practitioners in Emergency Department, Acute and Critical Care Settings (1.25 contact hours of CE credit, 0.25 of which may be applied toward pharmacology) available in the AANP CE Center. These activities are completely free for AANP members!
By now, you may have decided that this career path is right for you. If you are not already a member of AANP, you should consider joining to gain access to: