ER vs. OR: Which Setting Is Right for You?

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A medical team works on a patient in the emergency room.By providing comprehensive health services and promoting wellness, nurses play a vital role in improving the health outcomes of patients, families, and communities, making nursing the backbone of health care in the U.S.

Nurses provide crucial care in hospitals, clinics, nursing homes, schools, and many other health care settings. The nursing profession is not homogenous, which means those entering or advancing in the field have many career paths and options to choose from. Two popular roles include emergency room nursing and operating room nursing.

A comparison of ER vs. OR nursing reveals some similarities. Both are frontline providers of medical services, delivering compassionate care to those who need it most. ER and OR nurses also educate patients on self-care techniques and promote healthy lifestyles, serve as advocates for their patients, and work to ensure every patient receives the highest quality of care possible.

But there are significant differences — most notably their work setting. ER nurses work in environments that are often intense and at times chaotic, where the ability to think fast is a highly valued trait. OR nurses are also quick on their feet, but they typically work in more controlled environments, where attention to detail is the most important element in ensuring successful patient outcomes.

For those considering a career in nursing, these roles can provide rewarding experiences. An advanced education can help prepare nurses for a variety of roles in a wide range of settings.

Emergency Room Nursing Job Description

Emergency room nurses provide urgent medical attention to patients who have severe injuries, allergic reactions, or who are experiencing some other type of medical emergency such as a heart attack. ER nurses may work with doctors to perform minor medical procedures such as cleaning wounds, setting broken bones, and drawing blood. ER nurses need to execute multiple tasks in a hectic atmosphere, including rendering care to patients with different medical requirements, while adhering to the highest standards of care.

While administering life-preserving treatments, ER nurses provide emotional support and comfort through superior communication skills, the ability to stay calm under pressure, and superb clinical knowledge to help optimize patient outcomes. They must also be able to think fast on their feet, enabling them to rapidly evaluate patient needs and demonstrate excellent judgment in emergencies.

The educational requirements for ER nursing can vary. For example, the baseline requirement to become an ER nurse involves earning a four-year bachelor of science in nursing degree (BSN) from an accredited institution. However, some organizations may prefer candidates with a Master of Science in Nursing (MSN). Individuals can also pursue a certification credential, such as the Certified Emergency Nurse, Certified Flight Registered Nurse, Certified Pediatric Emergency Nurse, Certified Transport Emergency Nurse, or Trauma Certified Emergency Nurse.

Emergency Room Nursing Salary

The intense nature of emergency rooms can be a stressful environment for ER nurses, but helping patients overcome serious injury or illness can provide immeasurable personal and professional rewards, including financial rewards.

An emergency room nurse’s salary may vary based on factors such as their level of experience and individual role. For example, the median annual salary for a family nurse practitioner with ER skills was approximately $104,000 in January 2023, according to Payscale. Nurses with more experience tend to command higher salaries: those with 10 or more years of experience earned upward of $112,000, while early-career nurses earned closer to $100,000.

Operating Room Nursing

OR nurses work in surgical settings in hospitals, clinics, ambulatory centers, and outpatient surgery centers. They assist surgeons during surgical procedures by providing sterile items, passing instruments as needed, monitoring patient safety, and administering medication as prescribed by surgeons or anesthesiologists.

OR nurses must be efficient to ensure the timely completion of all necessary tasks. They need to pay close attention to detail, including maintaining a sterile environment in the operating room, preparing patients for surgery, and monitoring patient vitals during and after surgery. As in the ER, OR nurses must think quickly and accurately while remaining calm under pressure and anticipating surgeon and patient needs.

OR nurses use their comprehensive understanding of medical terminology and anatomy to operate specialized medical equipment in the operating room. They also leverage interpersonal skills to communicate effectively with surgeons, anesthesiologists, and other surgical team members. OR nurses also provide compassionate care for patients before, during, and after surgical procedures.

Nurses with a BSN can become OR nurses, but it’s common for organizations to require candidates to hold an MSN degree. Operating room nursing licensure — such as Certified Medical-Surgical Registered Nurse (CMSRN) and Certified Perioperative Nurse (CNOR) — can help those in pursuit of attaining an OR nursing role.

Operating Room Nursing Salary

An operating room is a sterile, organized environment, and an OR nurse is responsible for keeping it that way. Ensuring successful surgeries through painstaking detail provides OR nurses with a sense of satisfaction, and the experience of helping patients can be rewarding.

Similar to their emergency room counterparts, individual experience may determine an operating room nurse’s salary. Payscale reports that the median annual salary for a nurse practitioner with OR skills was approximately $101,000 in September 2022. This climbs to approximately $105,000 for those with 10 or more years of experience.

Prepare for a Career Focused on Saving Lives

Nurses are essential to providing superior medical care and ensuring positive patient outcomes. The work of ER and OR nurses is particularly vital to ensuring patient health and safety.

The job prospects for each role look promising. The U.S. Bureau of Labor Statistics (BLS) projects 40% employment growth for advanced nursing roles from 2021 to 2031, far exceeding the average for the job market as a whole. Employment of registered nurses, meanwhile, is expected to grow by 6% over the same period, adding nearly 200,000 new jobs.

Succeeding as an ER or OR nurse requires remaining current on the latest medical knowledge and techniques. An advanced nursing education — such as the Regis College online Master of Science in Nursing program — can help students learn about today’s prevailing medical practices and prepare them with the critical thinking, problem-solving, and communication skills to excel in both the emergency and operating room.

Discover how our MSN program can help prepare you for a demanding — yet rewarding — advanced practice nursing career focused on saving lives.

Recommended Readings

MSN Degree Meaning and Overview

The Importance of Teamwork and Collaboration in Nursing

Why Is Evidence-Based Practice Important?


American Association of Nurse Practitioners, “Are You Considering a Career as an Emergency Nurse Practitioner?”

Association of periOperative Registered Nurses, “How to Become a Surgical Nurse”

Emergency Nurses Association, “Emergency Nursing – Is It Right for You?”

Indeed, “How to Become a Surgical Nurse Practitioner (Plus Salary)”

Payscale, Average Family Nurse Practitioner (NP) with Emergency Room (ER) Skills Salary

Payscale, Average Nurse Practitioner (NP) with Operating Room / OR Skills Salary

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners

U.S. Bureau of Labor Statistics, Registered Nurses