How to become an A&E Nurse

"I loved my time in A&E, it sculpted and chiseled me into the nurse I am today."

Former A&E Nurse, Suzanne Armstrong, gives a detailed overview of the job of an A&E Nurse as well as a guide on how to become one.

Topics covered in this article

What inspired you to become an A&E Nurse?

What is an Accident & Emergency Nurse?

Training to be an Accident & Emergency Nurse

Placements for Accident & Emergency Nurses

Finding the right mentorship

Continuing professional development

Key duties and responsibilities of an A&E Nurse

What you do as a A&E Nurse day to day?

What are the key soft / personal skills needed for an A&E Nurse?

How long does it take to become an A&E Nurse?

What is the salary like for an A&E Nurse?

What do you love about your job?

What challenges do you face as an A&E Nurse?

Career prospects and opportunities

Further studies you can do to advance your career

What inspired you to become an A&E Nurse?

I am one of the lucky people, I always knew what I wanted to do with my life.

I dreamt of being a nurse long before I could actually be one.

As a little girl all my teddy bears had bandages and splints.

Caring is just in my nature and I wouldn’t want it to be any other way.

What is an Accident & Emergency Nurse?

I started my nursing career in Blackpool Victoria’s accident and emergency department.

I spent over a decade fighting the constant tide of almost every injury you can imagine.

You will certainly see it all as an Accident & Emergency Nurse.

You are the first point of call for patients seeking emergency treatment, many of which will be anxious, emotional or irrate.

It is a fast paced high pressure nursing role that is not for the faint hearted.

I loved my time in A&E, it sculpted and chiseled me into the nurse I am today.

The lessons I learned during those hectic years have stayed with me and formed the foundation of my nursing experience.

Training to be an Accident & Emergency Nurse

When I started my nursing career you did not need a nursing degree to get a nursing job.

However today a nursing degree is compulsory in order to take a position as an Accident & Emergency Nurse.

Most universities offer nursing degrees, application criteria tends to vary depending on university.

The average requirements are usually 2 / 3 A Levels or equivalent qualifications.

Some universities require specific subjects such as biology as application requirements.

There are also a growing number of nursing degree apprenticeships becoming available across the UK.

This is a combination of fixed placement training and classroom training.

It is a very similar process to how I trained to be a nurse myself.

Becoming a nursing associate is also a recognised career path to becoming a A&E Nurse.

This role opens up nursing training to a wide range of people from various levels of training and backgrounds.

Although not a registered nurse, a nursing associate may just be the stepping stone to getting that pin and becoming one.

Placements for Accident & Emergency Nurses

Placements can be very daunting for trainee nurses, thrown into real world situations for the first time, even those of us that thrive under pressure feel that surge of anxiety on the first day on a new ward.

I was very lucky, by the time I started going on my university placements I already had years of experience under my fob.

I still found some of my placements challenging and was pushed in new ways regularly.

I think the best piece of advice I could give anyone going into a new placement is pay attention!

You are there to learn as much as possible in the short time you are there.

Keep a notepad on you at all times and make lots of notes.

If you don’t know something, ask and research the subject when you can.

Be friendly and polite, talk to the staff you will be working with during the placement.

You should hopefully find a friendly face that will help you settle into the new environment.

These people will be your best chance of support and mentorship during placements.

Finding the right mentorship

Over the course of my nursing career I have enjoyed a number of fantastic mentors that have taught me huge amounts of invaluable information.

Everything from techniques and practises to general etiquette and coping strategies.

A good mentor is worth their weight in gold.

Picking the right mentors for you is important and shouldn’t be done rashly.

Some of the general qualities to look for in a mentor are having a passion for sharing skills, knowledge and expertise.

They should also have a positive attitude and interest in mentoring.

Of course expertise in a particular subject is essential in any mentoring role.

Continuing professional development

Continuing professional development (CPD) has always been an essential part of nursing and medical care.

It is extremely important to keep up to date with training, new procedures and retirement of outdated practises.

As with any field of research, medical science is advancing into new ground every day.

As nurses it is our duty to be aware of changes relevant to our roles.

It is one of the many ways we can ensure we deliver the very best care we can to our patients.

Continuing professional development is more relevant today than ever before as it is soon to be a mandatory requirement of revalidation.

On paper CPD is already a mandatory requirement of revalidation, however there is currently a transition period that will allow applicants without logged CPD hours until December 2020.

After December 2020; thirty five hours of continuing professional development, twenty of which must be participatory training, will be a mandatory requirement of revalidation.

All thirty five hours must be in a field relevant to the nursing role you fill and be completed every three years to comply with revalidation requirements.

There is a vast wealth of CPD sources and resources available to nurses.

There are more online courses than you could possibly complete in a lifetime.

Many parts of your average working day and activities can be logged towards CPD hours.

When you start logging and recording your CPD hours you will soon find they add up very quickly.

Remember, any nurse is only as good as their training, don’t let yourself fall behind.

Key duties and responsibilities of an A&E Nurse

The key duties and responsibilities of an A&E Nurse can be listed as;

● Triage

● Recording patient vital signs and symptoms

● Administering medication and treatment

● Assisting doctors with examinations and procedures

● Completing paperwork and records

● Providing support and information to patients and relatives.

These six bullet points broadly cover the duties and responsibilities of an A&E Nurse, the reality of the role however is even broader.

At certain times during my years in A&E it felt as if I wasn’t even a nurse, occasionally I felt more like a nightclub bouncer, long Saturday night shifts where the department sounded and smelled like a stag and hen party had violently collided in a barrel of alcohol.

These were always very challenging shifts indeed.

As an Accident & Emergency Nurse you will often be the first point of contact for patients seeking emergency treatment.

Many cases will need immediate action.

A large number of patients will be in shock, disorientated, anxious or irrate.

These factors can combine into the perfect storm of tricky patients.

Dealing with these situations is arguably one of the most important duties of any A&E Nurse.

You will need to be comfortable in a high pressure and fast paced work environment, be flexible and adaptable to any given situation, act fast and think even faster.

What you do as a A&E Nurse day to day?

Below I outline a typical working week.

Wednesday

Tonight was as close to an “average day” as you get in A&E.

A steady flow of patients, ranging from minor injuries to serious conditions.

The shift passed quickly and pleasantly.

Having a good team around you makes all the difference.

Thursday

Tonight’s shift started off slow and quiet but at around 8:30 we were alerted that a major traffic accident had occurred on the edge of town.

The department geared up, preparing for the incoming emergency patients.

It was high pressure and extremely busy for a few hours while dealing with the situation.

Friday

This was a very challenging and stressful shift.

It was extremely busy and being Friday we had a large number of intoxicated patients added to the mix of normal admissions.

We did not have the staff levels needed to efficiently cope, meeting breach times became a slog.

At the end of my shift I left the unit feeling exhausted and relieved to be leaving for the day.

Saturday

I left A&E in tears tonight, It has been a very hard shift for me.

A lovely little girl came in with a severe burn covering her hand and forearm.

You deal with a lot of accidents in A&E and are trained to recognise certain signs and behaviours.

The mother’s explanation of the injury was concerning.

I followed procedure and reported my concerns to my ward sister.

The little girl’s burn would leave her with scarring for the rest of her life.

As I was treating her I couldn’t help but wonder if it could have been avoided somehow.

I left the hospital tonight, on my way home to my own girls, and couldn’t stop thinking about another little girl and how safe of a home she has, I spent most of the journey home in tears.

Sunday

Tonight was a nice shift, It started very busy.

The department was already full when my shift started.

Many of the patients at that time were elderly people who had sustained minor falls and injuries, had symptoms or problems caused by existing medical problems or needed minor healthcare support but had no alternative source of treatment.

Many of the patients did not need to be in A&E but had nowhere else to go.

This is a growing problem faced by every A&E department up and down the country.

There is no instant solution and the issue is extremely complex.

As a front line health care professional, It is left up to us to roll up our sleeves and deal with it in the short term.

Long term solutions need to be implemented as soon as possible.

The shift was busy but not unpleasant.

It reminded me of my time starting out in healthcare as a carer in a nursing unit.

Supporting people who have no one else to help them, It reminds me why I do what I do.

It was a nice way to end the week.

What are the key soft / personal skills needed for an A&E Nurse?

An A&E Nurse really has to be a Jack of all trades but unlike the proveriable Jack, you have to master them all!

The key skills needed in a competent Accident & Emergency Nurse are numerous and varied.

Many which are relatable to nursing as a whole but a large number are more necessary in A&E nursing specifically.

Some of the most vital A&E Nurse specific key skills are;

● Decisiveness

● Good communication and team work

● Multitasking

● Problem solving

● Pressure / stress management

● Adaptability

● Sensitivity

If you are reading this and thinking “I’m not great at any of that”, fear not, all these skills can be learned, honed and built upon.

But to those of you out there that have these skills already under your fob, A&E needs you.

How long does it take to become an A&E Nurse?

The short answer is three years.

Personally I started working in A&E before I had a nursing degree but times have changed somewhat.

These days, unless you are doing a nursing apprenticeship, you will need a nursing degree to gain a job as an Accident & Emergency Nurse in the United Kingdom.

A nursing degree usually takes a minimum of three years to complete.

Once you are a qualified nurse you are free to apply for any of the many A&E nursing jobs available and advertised across the country and internationally.

However in a sense merely succuring an A&E Nursing position is not enough to make you an A&E Nurse, except by definition.

I worked in accident and emergency for a number of years before I truly considered myself an A&E Nurse.

It took time, experience and a whole lot of learning.

It’s hard to put a time frame on that, you will get there but it doesn’t come with the uniform.

What is the salary like for an A&E Nurse?

Over the years I have been asked by a multitude of people “how much does an A&E Nurse earn?”.

In truth, the answer is not a simple one.

There are a range of ways you can work as an A&E Nurse; bank, contract, permanent, temporary.

All of which have slightly different pay rates and systems.

Then you have different levels of training and banding, experience and specialisation, all of which can affect a Nurse's pay rate.

You also have the difference between working for the state or in the private sector.

Personally I can say for sure, I was not on a particularly high or rewarding salary as an Accident & Emergency Nurse.

The monetary rewards may not have been great but the experience was invaluable.

Current salaries for UK A&E Nurses can range from anywhere between £18,000 to £40,000 a year.

There are so many variables that it really does revolve around you as a professional and the specific role / medical organisation you will be filling.

Find out more about NHS pay scales here.

What do you love about your job?

I loved my time in A&E for a number of reasons, many of which would apply to any nursing position but some are very specific to Accident & Emergency Nursing.

I love the pace of A&E, The hustle and bustle of a busy department, it's never boring that is for sure!

I love the constant challenge of new patients with different problems.

I love the fantastic learning environment that accident and emergency provides.

Spend enough time working in A&E and you will see everything you can imagine and then some.

Everything is a learning opportunity, take advantage while you can.

I worked with a wonderful team of really talented individuals during my years in Accident & Emergency Nursing.

We were a very close bunch, I think the high pressure and fast paced environment helps to forge strong bonds and relationships between colleagues.

You work closely, at times you laugh together, at times you cry together.

It’s a demanding job and the people around you, the people living and experiencing what you do, are the best support you can have.

It was the hardest thing to leave those people behind.

One of the things I loved the most about A&E is simply the patients.

You meet and treat people from every level of society, every cultural background, every type of person possible.

It can be a challenge but it is also ultimately hugely rewarding to get a chance to meet and treat all these people.

Some of which you may wish would leave your care as quickly as possible, some you almost wish could stay longer.

As an A&E Nurse you get a brief snippet of time with them.

Nobody stays in A&E, the good patients like the bad are all just passing through to other wards or back to their normal lives.

What challenges do you face as an A&E Nurse?

If an A&E department were a war zone, a A&E Nurse would be on the frontline.

The challenges you may face on any average shift can be vast, varied and incredibly vexing.

The very nature of an accident and emergency department ensures a certain level of chaos will be on its way to you every day.

You never know what is coming, so you have to be ready for anything.

Personally, one of the more frustrating challenges I regularly faced during my time in A&E was dealing with intoxicated / drug addicted patients.

These patients invariably required more time to treat, were far less cooperative and occasionally have you running around the department after them!

Every accident and emergency department in the country must get it’s fair share of these patients.

Blackpool Victoria Hospital’s A&E department certainly did during my years there.

Patients like this just add an extra level of challenge to an already challenging role and environment.

Drug addicted patients have also raised some very specific clinical challenges that can be extremely hard or impossible to overcome.

I remember an occasion when a patient came into A&E with serious tissue damage to his left hand, the patient was extremely agitated and clearly in substantial pain.

After some coaxing the patient allowed me to start examining his hand, he had a nasty wound that would require cleaning and suture.

During this examination of the patient's hand I also observed what I recognised to be intravenous needle marks scattered across his arm.

I knew at that moment this patient was going to pose a real clinical problem.

Sadly the patient was addicted to heroin, as a result all sources of pain relief we could offer the patient were essentially useless, making administering his treatment extremely challenging for all involved.

You will be challenged every day in A&E.

Adapting and being ready to meet those challenges head on is what will shape you into a great Accident & Emergency Nurse.

Career prospects and opportunities

Nursing is a wonderfully open field of employment.

It allows for progression and change into a bafflingly wide range of positions and specialist training.

A&E Nursing is a great starting point or stepping stone to any of the expansive range of career paths open to you in nursing.

Opportunity is all around you, take advantage of it when you can.

Take ownership of your own career and forge ahead with a clear objective in sight.

Do your research, think about where you want to go in your career, roles you are interested in, be proactive in seeking routes to your goals.

Even if you think there is no opportunity around you and you will never escape the rut, you just have to make those opportunities yourself.

You can do it, anyone can.

Try and arrange informal visits or shadowing in areas / departments in which you are interested.

Volunteer and complete additional training when possible.

Make the most of the resources around you as best as you can.

It’s all there to help you and push you forward in your career.

Further studies you can do to advance your career

The doors really are open for you in nursing.

The first and most important step is working out where you want to go.

For instance if you are an A&E Staff Nurse and wish to advance to a Ward Manager type role you should look to acquire more leadership skills and demonstrate use of these skills.

Programmes, training and resources such as the Edward Jenner NHS Academy course and the NHS Ward Leaders Handbook can be invaluable sources of learning and advancement in this particular field.

The options are there for you but only you can make the choices.

So the only question really is, where do you want to take your nursing career?