Transitions in Practice: ER Nurse Training

Course Overview
Stepping into the Emergency Department requires more than clinical knowledge—it demands rapid prioritization under uncertainty, simultaneous multi-patient management, and confident decision-making in an environment where conditions change without warning. Transitions in Practice: Emergency Nurse Training is a 5.0 contact-hour continuing education activity designed to equip registered nurses with the competencies, clinical judgment, and communication strategies needed to deliver safe, effective care in the Emergency Department.

This course addresses the unique demands of emergency nursing, including triage accuracy and prioritization using the Emergency Severity Index (ESI), systematic rapid assessment using the ABCDE framework, recognition and escalation of high-acuity presentations, multi-patient time management, interdisciplinary communication and structured handoffs, behavioral safety and de-escalation, and legal and regulatory compliance including EMTALA. Using scenario-based learning and evidence-based frameworks aligned with the AACN Clinical Judgment Model and Tanner’s Model of Clinical Judgment (Noticing, Interpreting, Responding, Reflecting), participants develop the situational awareness and clinical reasoning skills essential to emergency practice.

This activity is appropriate for registered nurses who are new to the Emergency Department, nurses transitioning from medical-surgical, critical care, or other specialty settings, preceptors supporting new ED nurses, nurse educators designing ED orientation programs, and nurse managers responsible for onboarding and clinical competency validation. Upon completion, learners will be better equipped to close the professional practice gap between general nursing preparation and the specialized knowledge, skills, and practice behaviors required for competent, independent Emergency Department nursing. 

Learning Outcomes 
Upon the completion of this course, the learner should be able to:

• Identify the core roles, team structure, and physical workflow of the Emergency Department environment.
• Classify patient presentations into appropriate Emergency Severity Index (ESI) triage levels based on acuity and resource needs.
• Apply the ABCDE framework to conduct a systematic first-five-minute patient assessment in simulated emergency presentations.
• Select appropriate prioritization and delegation strategies when managing multiple simultaneous patients in a high-acuity ED environment.
• Recognize clinical red flags associated with high-acuity presentations—including STEMI, stroke, respiratory distress, overdose, and trauma—and identify appropriate escalation actions.
• Apply SBAR communication principles to construct accurate, concise clinical handoffs across ED care transitions including admission, transfer, and discharge.
• Explain the core requirements of EMTALA, including the obligations to screen, stabilize, and avoid inappropriate denial or transfer of care.
• Identify safe documentation practices and behavioral safety strategies, including de-escalation techniques and restraint protocols, in high-risk Emergency Department situations.
• Apply integrated clinical judgment—encompassing triage, prioritization, safety, escalation, and communication—across a multi-patient ED simulation reflecting real-world orientation conditions.

About the Author/Presenter 
Shirley Aycock, DNP, RN, is a Registered Nurse and healthcare leader with extensive experience advancing clinical excellence, operational performance, and professional development across acute care and continuing education settings. Her leadership background spans medical-surgical service line management, learning operations oversight, emergency care leadership, and healthcare content strategy. Most recently in clinical operations leadership, she served as Director of Nursing at Hospitality Health Emergency Room, where she provided strategic and operational leadership for a freestanding ER averaging more than 70,000 patient visits annually. Her work centered on elevating clinical quality, strengthening the patient experience, developing the nursing workforce, and ensuring safe, efficient emergency care delivery. 

Shirley holds a Doctor of Nursing Practice (DNP) from Rush University, an MSN in Nursing Administration from the University of Texas at Tyler, and a BSN from the University of Texas at Arlington. She is passionate about building strong teams, elevating nursing practice, and driving continuous improvement throughout healthcare systems through both clinical leadership and transformative education. 

Audience/Accreditations and Approvals 
TRC Healthcare/ NetCE 
In support of improving patient care, this activity has been planned and implemented by TRC Healthcare/ NetCE. TRC Healthcare/NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 
This course is designed for the following healthcare professions (select your profession for details): 
Nursing

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