The work environment in the emergency department includes a high work pace, large patient flow and an advanced healthcare environment. Nurses need to have broad competence and be able to make quick decisions. In the emergency room, nurses face a large variety of acute situations. Aim: The study aimed to illuminate nurses' experiences of caring for patients with life-threatening conditions in an emergency department. Method: A literature-based study based on analysis of qualitative data. The study included nine qualitative articles that were analysed with the five-step model by Friberg. Results: The result was presented in three main themes Competence is crucial which included trusting your knowledge and the ability to handle your emotions. Be a professional support, which included meeting each patient as a person, meeting the relatives' worries and concerns and being a part of the team. A demanding work environment, which included working in a stressful situation and its organizational shortcomings. Conclusion: Nurses' experiences showed that great competence, the ability to be a professional support and the ability to cope with a demanding work environment are required. The nurses need to be able to trust their skills, make quick decisions and be able to work both independently and in teams. Nurses need to maintain their skills, have more opportunities for training and more guidance of experienced colleagues to handle the work in the emergency department. It takes a long time to build up professional skills and to feel secure in the professional role.