How to Become an Emergency Nurse Practitioner (ENP)
If you find yourself wondering how to become an ENP, you've found the right resource. We'll cover not just how to become an Emergency Nurse Practitioner, but also their job role, where they work, and how much money they can expect to make.
What Is an ENP?
An Emergency Nurse Practitioner (ENP) is a nurse practitioner certified to see patients of all ages in emergency departments and ambulatory care centers. An ENP is specialized to work in settings like:
What Do ENPs Do?
At work, an ENP evaluates and treats patients who present to the emergency department or urgent care. They may work in fast-track, seeing lower-acuity patients like extremity injuries and coughs/colds, or on the main side seeing chest pain, abdominal pain, headaches, sepsis, strokes, and more.
ENPs usually work in conjunction with an attending physician, especially within emergency departments. These physicians serve as a resource for help, guidance, or if escalation of care is needed.
How Much Does an ENP Make?
As with most nurse practitioner salaries, an ENP can expect to make at least six figures. According to ZipRecruiter, an Emergency Medicine Nurse Practitioner can expect to make about $133K on average ($64/hr), whereas a general nurse practitioner averages $110K per year ($53/hr).
The emergency setting is higher risk, more stressful, and has less desirable hours, so the increased pay makes sense. Of course, pay fluctuates with location, employer, and experience. Many ERs and urgent cares use an RVU pay system, so the busier you are — and the higher the acuity and procedure volume — the higher your effective hourly rate.
What Is an RVU?
RVU stands for Relative Value Unit — a way to measure the productivity of physicians, NPs, and PAs. The more patients you see, the higher their acuity, and the more procedures you perform, the more RVUs you generate. Each facility pays out RVUs differently: monthly, quarterly, or added onto your hourly rate.
How to Become an ENP
Now that we know what an ENP is, what they do, and what they make — how does someone actually become one? There are four steps, with some flexibility built into step three.
1. Become an RN
As with any NP specialty, the first step is to become a registered nurse. The main recommended route is to attend a program that grants you a BSN (Bachelor of Science in Nursing). After graduation you take the board-certification exam — the NCLEX-RN — then apply for state licensure and get a job working as an RN.
2. ER RN Experience
Once you're an RN, you can start working. If your goal is to be an ENP, prioritize working as an ER nurse. This is huge for developing your assessment skills, getting comfortable with which patients present to the ER and with what symptoms, and familiarizing yourself with treatments and medications. It also gives you a chance to confirm that emergency medicine is truly what you want.
How long you need to work first is debated. Some nurses go straight into their program (more common for FNP), but all ENP programs require at least 1 year of work experience as an ER RN. As an ER nurse you'll typically have 4–8 patients at a time, and you'll learn an enormous amount that benefits you as a future ENP.
3. Become Eligible for the ENP Exam
This is where you have options — there are four different paths to becoming eligible to sit for the ENP exam.
The ENP certification launched in 2017 and is still relatively new, with at least 10 programs now (top schools include Emory and Vanderbilt). Content is specific to emergency medicine, and almost all clinical rotations are in the ER and urgent care. Nearly all ENP programs are dual FNP-ENP, so you'll earn your FNP too — making them a bit more expensive and longer, averaging 3 years with 600–1,000+ clinical hours across emergency medicine, family practice, women's health, and pediatrics.
A practicing FNP can return for a post-masters certificate, completing only the ENP portion of the curriculum. This takes about a year.
An FNP already practicing can apply by portfolio if, within the last 5 years, they have over 2,000 hours in an ER setting plus over 100 hours of emergency-medicine continuing education (with over 30 related to emergency procedures).
An FNP can complete an ER fellowship or residency, which makes them eligible to sit for the exam. These typically take 1–2 years; you'll be paid less during training but gain excellent ER experience.
4. Take the ENP Exam
The final step is sitting for the ENP certification exam once you're eligible. It is currently only provided by the AANP and consists of 150 multiple-choice questions, 135 of which are scored. The exam covers medical screening, medical decision making and differentials, patient management, patient disposition, and professional, legal, and ethical practice.
Once you pass, you're certified as an ENP. You can then apply for your state's nurse practitioner license and get a job working in the ER as an ENP. And that's how you become an ENP — along with what you'll do, where you'll work, and what pay to expect.
Key Takeaways
Related Guides
References
- Emergency Medicine Nurse Practitioner Salary. ZipRecruiter.
- Family Nurse Practitioner Salary. ZipRecruiter.
- ENP Certification Exam Information. AANPCB.
- Emergency NP Program FAQ. Vanderbilt University School of Nursing.
- 2020 NP Sample Survey Report. AANP.
Thanks so much for the information. I love to be ENP.Am an emergency nurse from Ghana.How can this be possible. Thanks