ER physician assistant vs ER Nurse

ER Physician Assistant vs ER Nurse [Job Comparison]

I’ve been working as a PA in the ER for several years. And I get a lot of questions about the differences between PA’s and nurses in the ER.  

What does each one do? How’s the job satisfaction? How about the pay? And so on.  

In this post I’ll explain what it’s like to be a PA in the emergency room, and also what I think it’s like to be a nurse in the emergency room (based on observations, conversations, etc).

Let’s dive in.

What Does an Emergency Room PA Do?

A physician assistant in the ER is very similar to a doctor in the ER. So most of the time, we do exactly what you would imagine a doctor would do in the ER.

That includes evaluating patients, ordering tests, writing prescriptions, and making decisions like whether to admit the patient to the hospital or send them home.

There’s one main exception:

Oftentimes some of the “sicker” patients end up being cared for by the doctor rather than the physician assistant. And there are a variety of reasons for this.

For example, some of those patients with a cardiac arrest, a stroke, or who are unable to breathe might be taken care of by the physician because the physician is a little more practiced at “advanced” procedures (like intubation). And some hospitals have a policy saying physicians need to run certain types of “codes” (e.g. strokes or heart attacks).

These kinds of policies vary from facility to facility. 

Outside of those caveats, a PA basically does exactly what a doctor does in the ER.

What Does an Emergency Room Nurse Do?

In the previous section I explained what a PA does in the ER. Now let’s talk about nurses.

I’ve worked with a bunch of nurses in the ER. I’ve seen what they do, and I’ve discussed it with them. 

Basically nurses are the “frontline” workers in the ER, the people who spend the most time with the patients, and take care of everything in the patient room.

This might include doing a brief assessment of the patient, drawing blood, giving medications (like pills or injections), putting on an oxygen mask, and many other similar things.

Emergency room nurse drawing blood

Nurses also collaborate in the care of the patient by making suggestions to the physician or the physician assistant. But the most common responsibility of the nurse is to execute the orders that are placed by the physician, PA, or nurse practitioner (a similar career to PA).

In some ways, the nursing job doesn’t seem as “glamorous”. And it can be kind of a slog for nurses. But on the upside, they do a lot of hands-on procedures which makes it kind of fun and helps the time go by.

Nurse Education vs PA Education

It’s also perhaps worth mentioning what the differences are in terms of becoming a nurse or becoming a PA.

I’ll try to keep it quite simple.

To become a nurse typically requires somewhere between about 2 and 4 years of college education (depending on whether you get an associate’s degree or a bachelor’s degree). And then you can get a job as a nurse.

To become a PA typically requires a bachelor’s degree (4 years of college), and then a master’s degree in physician assistant studies, which typically takes between 2 and 3 years. 

There are some other versions of the PA education track, but that’s the most common version currently.

As you can see, it takes quite a bit longer to become a PA (~7 years total) versus becoming a nurse (2-4 years). And that’s related to why PA’s do more of the decision making in the ER versus what a nurse does. 

PA Income vs Nurse Income in the Emergency Room

Both careers have pretty good income. But as you might imagine from what I explained above, PA’s generally make a little bit more than nurses. (They may also work fewer hours.)

There are some exceptions to this as well.

From what I’ve seen, physician assistants typically make somewhere between 1.5x and 2x what an emergency room nurse makes.

comparing ER physician assistant and nurse salary

However, due to the shortage of nursing staff, travel nursing is becoming a more common phenomenon. And travel nurses tend to get paid more. 

So I’ve also worked with travel nurses who make more money per hour than I do. Basically the hospital pays them more because they’re considered a short-term commodity. But some nurses try to “travel” on an ongoing basis, and go all around the country so they can make more money.

Job Demand for Emergency Room PA’s vs Nurses

The bottom line is both PA’s and nurses are in high demand, in the emergency room and elsewhere.

Overall, I would say there’s probably more of a shortage of nurses across the country, so you could argue that nurses are in higher demand. But there are a ton of job opportunities for both careers (in the ER and elsewhere).

Summary: ER Physician Assistant vs ER Nurse

There are some similarities between ER nurses and PA’s, but also a lot of differences.

Overall, the job of an emergency department physician assistant is very similar to the job of a doctor in the ER. With just a handful of caveats, as I explained above.

However, the job of a nurse in the ER is quite different from a physician or PA. 

Nurses are more on the “frontlines”, interacting with the patients more consistently, and doing more tests and procedures on the patient (based on the orders placed by the physician or PA).

It takes quite a bit longer to become a physician assistant versus becoming a nurse. Which is related to why PA’s do more of the decision making in the ER.

Both careers get paid pretty well, but PA’s usually get paid a bit more. And both jobs are certainly in very high demand.

I hope this was helpful if you’re considering becoming a PA or a nurse in the emergency room!