Emergency Room Nurse Salary by State for 2025

by Imed Bouchrika, Phd

Co-Founder and Chief Data Scientist

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How much do Emergency Room Nurses make?

An emergency room nurse in the United States typically earn between $79,000 and $109,000 annually, depending on the data source. The variation comes from whether only base salary is reported or if additional compensation, like bonuses and differentials, is included.

According to various sources, ER nurses can make: 

• ZipRecruiter (2025). ER nurses earn an average of $86,737 per year. Hourly wages can be as high as $75.00 and as low as $15.62, with most falling between $30.29 (25th percentile) and $48.32 (75th percentile).
• Zippia (2025). The average salary for ER nurses is $79,886 annually, with a typical range of $50,000 to $126,000 per year. The average hourly rate is $38.41.
• Glassdoor (2025). Glassdoor reports higher earnings, estimating ER nurse pay between $92,000 and $129,000 per year, with a median total compensation of $109,000 when factoring in bonuses and additional pay.
• Indeed (2025). Based on the thousands of salary postings on Indeed, ER nurses in the US receive an average pay of $114,419. The salaries are between $88,703 and $147,592.

Salary variations in nursing often spark comparisons with non bedside RN jobs, where registered nurses step away from direct patient care into roles like case management, informatics, or insurance review, which can provide competitive pay without the physical demands of emergency care.

Which states offer the highest salaries for Emergency Room Nurses in 2025?

Salaries for ER nurses vary widely depending on location. Looking at the highest-paying states for nurses, particularly in emergency care, provides valuable insight into where ER nurses can maximize their earning potential.

The salary data outlined in the chart below highlights how location plays a major role in shaping the earnings of emergency room nurses.

• Hawaii leads the nation, offering the highest average pay at $138,666, which reflects both the high demand for healthcare professionals and the elevated cost of living in the islands.
• California follows with $113,512, consistent with its large metropolitan centers and high healthcare costs. 
• Massachusetts ($109,099) and New York ($106,369) also stand out, as these states are home to major teaching hospitals and urban trauma centers where ER nurses often handle complex cases.
• Interestingly, smaller states like Rhode Island ($104,571) and New Hampshire ($97,547) appear in the top 10, showing that high salaries are not exclusive to the largest states but can also be tied to regional workforce shortages or state-level investment in healthcare.
• Rounding out the list are Oregon ($93,086) and Nevada ($92,878), both states where ER nurses benefit from competitive wages due to growing populations and expanding healthcare systems.

Do ER nurses earn more in metropolitan areas compared to rural regions?

An emergency room nurse working in metropolitan areas generally earn more than their counterparts in rural regions, largely due to higher patient volumes, demand for specialized skills, and union representation in larger hospitals.

For example, according to Zippia (2025), metropolitan areas like Urban Honolulu, HI, San Jose, CA, and Boston, MA consistently rank among the highest-paying locations, often offering ER nurses six-figure salaries. In contrast, rural areas, where living costs and demand are lower, tend to offer salaries closer to the lower end of the range.

It’s important to keep in mind that higher pay in metropolitan areas doesn’t always mean more disposable income. For example, while Urban Honolulu, HI offers ER nurses an average salary of $138,824, Hawaii has the highest cost of living in the country (186.9), which significantly reduces purchasing power.

Similarly, San Jose, CA, salaries may average over $116,126, but the state’s cost-of-living index is around 144.8, making everyday expenses far more expensive than in smaller cities. On the other hand, a city like Philadelphia, PA, with an average salary of $87,644 and a cost-of-living index below the national average (93.9), can actually provide better real-world value for an ER nurse’s income (World Population Review, 2025).

This is comparable to pay differences in fields such as US air force nurse salary, where location and duty station play a large role in determining total compensation.

Does education affect Emergency Room Nurse Salaries?

Education plays a major role in determining the salaries of not only ER nurses but all types of nurses in the United States. While the minimum qualification is typically an Associate Degree in Nursing (ADN), many hospitals prefer or even require a Bachelor of Science in Nursing (BSN). Nurses with advanced education not only have broader career opportunities but also tend to earn higher salaries.

According to ZipRecruiter (2025), registered nurses with an ADN earn an average of $87,868 per year, while those with a BSN earn about $90,046 annually. 

Nurses who pursue graduate-level education see even greater financial rewards. Those with a Master of Science in Nursing (MSN) earn around $102,263, and nurses with a Doctor of Nursing Practice (DNP) reach the highest median salary at $117,859, largely because MSN and DNP roles and responsibilities involve advanced clinical decision-making, leadership in healthcare teams, specialized patient care, and, in many cases, shaping policies or managing departments.

Education is not the only factor—experience level also has a direct impact on pay. According to Zippia (2025), entry-level emergency room nurses earn about $63,300 ($30.46/hour), mid-level nurses average $79,700 ($38.30/hour), and senior-level ER nurses make around $109,000 ($52.54/hour).

How does workplace type affect Emergency Room Nurse salaries?

Workplace type has a significant impact on Registered Nurse (RN) salaries in general, and this trend extends to Emergency Room (ER) nurses as well. According to the U.S. Bureau of Labor Statistics (BLS), pay varies by setting: nurses working in government, excluding state and local education and hospitals, earn an average of $106,480, compared to $97,260 in hospitals and $83,780 in ambulatory healthcare services.

For ER nurses, the highest salaries are typically found in large hospitals and Level I trauma centers, where the patient volume and case complexity demand advanced skills and rapid decision-making. These specialized environments not only require more expertise but also place higher demands on staff, which contributes to greater compensation.

By contrast, ER nurses employed in urgent care centers, smaller clinics, or ambulatory settings usually earn less because the work environment is less acute and the cases are less complex.

Other possible workplaces include ambulance transport teams, burn centers, disaster response units, flight transport services, government agencies, poison control centers, prisons, trauma centers, and triage centers, each offering varied pay scales based on responsibilities and risk level.

In summary, workplace type plays a critical role in shaping ER nurse salaries. Nurses in high-acuity hospital environments tend to earn the most, while those in outpatient or clinic-based settings typically see lower compensation, reflecting differences in workload, patient acuity, and overall job demands. Comparisons can also be made to professions that require distinct training paths, such as dental assistant pay by state, which varies widely depending on workplace and regional demand.

How do scheduling, night shifts, and overtime affect annual earnings?

Scheduling, night shifts, and overtime significantly affect the annual earnings of Emergency Room (ER) nurses. Nurses who work overnight, weekend, or holiday shifts often receive shift differentials, which add to their base pay. In addition, overtime opportunities are common in emergency departments due to staffing shortages and unpredictable patient surges, allowing nurses to substantially increase their annual income.

On average, ER nurses earn about $12,500 annually from overtime pay (Indeed, 2025). Glassdoor (2025) also reports that ER nurses receive $12,000 to $22,000 in additional pay per year, which includes overtime, bonuses, and shift differentials. These extra earnings can make a noticeable difference in total compensation, especially for nurses working in high-demand hospitals or trauma centers.

However, the financial benefits come with trade-offs. Extended hours and irregular schedules often lead to physical and emotional strain. In fact, 53% of emergency nurses reported experiencing high burnout (Journal of Emergency Nursing, 2025), highlighting the challenges of balancing financial incentives with long-term health and job satisfaction.

These trade-offs echo the dilemmas seen in other fields where credentials and time commitments weigh heavily, such as meeting certified fraud examiner certification requirements, which also require significant effort beyond standard working hours.

What certifications can increase an Emergency Room Nurse’s salary?

Certifications are a proven way for ER nurses to boost their earning potential. Hospitals and trauma centers often provide higher pay, bonuses, or advancement opportunities to nurses who hold specialty credentials, as these demonstrate advanced clinical knowledge and a commitment to professional excellence.

In addition to making nurses more competitive for high-demand roles, certifications also help secure leadership opportunities and eligibility for specialized units, both of which come with financial incentives.

Several certifications are particularly effective in helping ER nurses increase their salaries, with each credential signaling a unique area of expertise.

• Certified Emergency Nurse (CEN). This is the most widely recognized emergency nursing certification, validating advanced knowledge in emergency care. Nurses with CEN often earn 5–10% more than non-certified peers.
• Trauma Certified Registered Nurse (TCRN). This certification focuses on trauma patient management and is especially valued in Level I trauma centers, often linked with higher-paying roles.
• Certified Pediatric Emergency Nurse (CPEN). This credential highlights expertise in pediatric emergency care, making certified nurses attractive candidates for children’s hospitals and pediatric ERs.
• Critical Care Registered Nurse – Emergency (CCRN-E). This certification covers critical and emergency care, opening opportunities in specialized and higher-paying critical care units.
• Advanced Cardiac Life Support (ACLS) & Pediatric Advanced Life Support (PALS). Although often required, these certifications still give nurses a competitive edge for shift leadership or preceptor roles that come with additional compensation.
• Emergency Nursing Pediatric Course (ENPC) & Trauma Nursing Core Course (TNCC). Completion of these courses demonstrates specialized trauma and pediatric skills, which hospitals frequently reward with salary differentials.
• Certified Flight Registered Nurse (CFRN). This certification applies to transport and air nursing, where the high-risk environment translates into significantly higher pay.

How do ER nurse salaries compare to those of other nursing specialties in 2025?

While Emergency Room (ER) nurses often earn competitive pay due to the unpredictable and critical nature of their work, other nursing specialties can surpass ER salaries depending on the setting, responsibilities, and level of expertise required. 

Here’s how ER nurse salaries compare to other nursing specialties, according to Indeed (2025):

• Rehabilitation nurse ($100,550 per year). A rehabilitation nurse supports patients dealing with chronic illnesses, helping them adapt and improve their quality of life through personalized care and therapy coordination. 

• Flight nurse ($113,224 per year). Flight nurse job requirements involve providing critical care to patients during air or land transport, often under high-pressure conditions requiring advanced life support skills. 

• Pediatric Intensive Care Unit nurse ($117,786 per year). A PICU nurse delivers life-saving care to critically ill infants and children, closely monitoring patient status and collaborating with multidisciplinary teams. 
• Oncology RN ($105,829 per year). An oncology registered nurse cares for patients undergoing treatment for cancer, administering therapies, providing symptom management, and offering emotional support. 
• Clinical nurse liaison ($103,003 per year). A clinical nurse liaison acts as a bridge between patients, families, and healthcare providers, coordinating care and facilitating transitions across settings. 
• Informatics nurse specialist ($76,460 per year). An informatics nurse specialist integrates nursing with information technology, optimizing clinical systems and improving patient care workflows. 
• Bedside nurse ($79,995 per year). A bedside nurse provides direct patient care, managing daily clinical tasks such as monitoring vital signs, administering medications, and collaborating with healthcare teams. 
• Clinic LPN ($79,129 per year). A clinic licensed practical nurse (LPN) works in outpatient settings, providing basic nursing care such as taking vitals, administering medications, and assisting with patient assessments. 

In addition to specialty comparisons, it is also important to consider how ER nurse salaries differ from those of other professions in the emergency department. For instance, the average ER physician earns $201,636 per year, compared to $86,737 for an ER nurse—a difference of 232.5% (ZipRecruiter, 2025).

How can Emergency Room Nurses advance to leadership positions?

For Emergency Room (ER) nurses, stepping into positions such as charge nurse, nurse manager, or director of emergency services not only expands professional responsibility but also typically leads to higher salaries and stronger career stability. Nurses who prepare for leadership roles, such as charge nurse, nurse manager, and director of emergency services, position themselves for both greater influence and increased earning potential.

Here are five tips to help ER nurses move into leadership roles:

• Pursue advanced education such as a Bachelor of Science in Nursing (BSN). While an Associate Degree in Nursing (ADN) is often sufficient for entry-level positions, most hospitals prefer or require a BSN for leadership roles. Consider enrolling in the fastest RN to BSN program to equip yourself with foundational management and research skills and be eligible for more advanced nursing jobs.

• Earn a Master of Science in Nursing (MSN) with a focus on leadership or administration. An MSN in Nursing Leadership, Nursing Administration, or Healthcare Management prepares nurses for roles like nurse manager or director. This degree emphasizes organizational strategy, finance, and advanced decision-making.
• Seek specialized leadership certifications. Certifications such as Nurse Executive (NE-BC), Nurse Executive Advanced (NEA-BC), or Certified Nurse Manager and Leader (CNML) validate leadership competencies and can give candidates a competitive edge.
• Gain hands-on leadership experience in the ER. Serving as a preceptor, charge nurse, or committee chair provides valuable experience in supervising staff, coordinating workflow, and managing crises—essential stepping stones toward formal leadership positions.
• Consider pursuing a Doctor of Nursing Practice (DNP) for executive-level roles. A DNP with a concentration in organizational leadership or systems management positions nurses for top-level administration, policy-making, and executive leadership in hospital systems.

What is the job outlook for Emergency Room Nurses?

There is currently no specific BLS data about the job outlook for emergency room nurses as a distinct specialty. However, we can look at the broader category of registered nurses (RNs), which is projected to grow by 5% from 2024 to 2034—faster than the average for all occupations (BLS, 2024). This steady demand reflects the essential role nurses play across all healthcare settings, including the emergency department.

Beyond projections, real-world workforce data reveal the urgent need for ER nurses. A survey found that 98.5% of respondents reported nursing shortages, with 83.3% describing shortages lasting more than 12 months (International Journal of Emergency Medicine, 2024). These staffing gaps have direct consequences for patient care, including misses or near-misses (93.9%) and a rise in “left without being seen” rates (90.9%). 

For those considering career advancement, pursuing higher roles can expand opportunities even further. For example, the job outlook for nurse practitioners is projected at 40%, one of the fastest-growing roles in healthcare (BLS, 2024). This has sparked growing interest in advanced education—many aspiring NPs often ask, “Is a DNP required for nurse practitioners?” While a Doctor of Nursing Practice is not always mandatory, it can provide access to leadership roles, clinical autonomy, and the highest salary tiers in the profession.

Other Things to Know About Emergency Room Nurse Salaries

How do ER nurse salaries in the U.S. compare to those in other countries?

ER nurses in the U.S. earn some of the highest salaries globally, averaging around $79,000 and $109,000 annually, depending on location and experience. In comparison, nurses in Canada typically earn an average of $65,826.58, while those in the U.K. get $63,725.21 yearly (Salary Expert, 2025). Overall, the U.S. remains one of the most lucrative destinations for emergency nurses, although salaries must be weighed against the higher cost of living.

What are the long-term career growth opportunities for ER nurses beyond the bedside?

ER nurses can advance into leadership roles such as charge nurse, nurse manager, or director of nursing. Many pursue advanced practice degrees to become nurse practitioners, clinical nurse specialists, or nurse educators. Specializing in trauma, flight nursing, or critical care can also expand career options. Ultimately, combining experience with advanced education opens pathways into higher-paying and more autonomous roles.

What benefits and perks are commonly included in ER nurse compensation packages?

Typical ER nurse compensation packages include health, dental, and vision insurance, paid time off, and retirement plans such as 401(k) matches. Many hospitals also offer tuition reimbursement, continuing education support, and professional development stipends. Shift differentials for nights, weekends, and holidays are common, significantly boosting overall pay. Some employers also provide wellness programs, childcare assistance, and relocation bonuses.

Which type of nurses make the most money?

The highest-paying nursing roles are advanced practice positions, particularly nurse anesthetists (CRNAs), who earn median salaries above $200,000 per year (Indeed, 2025).

Nurse practitioners, especially those in specialized areas like acute care or psychiatry, also command six-figure incomes. Nurse midwives and clinical nurse specialists typically earn more than bedside RNs as well.

In general, advanced degrees, specialization, and leadership roles correlate with the highest salaries in nursing.