It is always hard to work up a belly, whether it be in the ER or in the Office. But when in doubt, send them to the ER. Sometimes ppl are just in the wrong place. They come into the office with a gangrene toe just about ready to fall off asking for oral antibiotics. They are just in the wrong place. Its is great that you know when to say when, and you do refer them to the ER. Im sure you are not sending everyone to the ER and your doing the best you can. Its important to look up the doses when you are not sure. To me its much better than nursing. Although I am not in an urgent care, I am in the office and I have more history and more time to think than you probably do. I think ppl are right when they say it takes time. Even the ER send ppl home and the person may go to another ER and find that they have a life threatening illness. So dont feel bad at all. Just be excited and diligent like you have been being and ask when you are not sure and look things up when you are half way sure. Dont be so hard on yourself! That is one thing I have learned. I am pretty new too and it is going to take time to develop into an awesome practitioner that knows things like the back of my hand. It takes a special person to do what we do , congrats to you and keep up the good work!