Congratulations and welcome to organized chaos!
I will just list several things that were helpful for me:
* get a list of phone numbers and keep it close to you (lab, radiology, units, supervisor, security, EVS, etc)
* get yourself familiar with processes (assessments, discharges, admissions, transfers)
* assessments in ER are focused. For example, a patient with c/c left heel ulcer - check cap refill , pulses, color, temp, sensory-motor, BG if diabetic, etc. Expect Xray to rule out osteo.
* you may not have many patients with MI/stroke in the beginning, but one of your patients may develop one, so be prepared and know the procedure for those (when I started out, I wrote it all in a small notebook and kept it with me). If you are in a code, know who your code team members are (meds, procedure, family).
* when you get a new patient, talk to them while you are connect them to the monitor, ask how you can help, let them know you will be working on labs, XRays, etc. To chart assessment is important, but if you can draw the labs, you will actually save them time in ER. So, if I can speed up the process, I first get some things out of the way (have them provide UA sample etc) and then chart.
* my scissors on a lanyard are always with me and I use them a lot
* get to know the people you are working with: secretaries, transporters, housekeeping, security.... It is a lot, but if you learn one new name a day you will eventually know many and those people will be your life savers one day
* when you are offered a lunch/break - take it NOW if possible
* know at all times what is pending for the patients, if, for example, the blood was drawn 30-60 min ago, and still no results - call the lab
* look at your patient, then at the monitor, if concerned, seek a second opinion right away
* if a patient starts seizing - priority is to provide O2 via non-rebreather at 15 L/min and direct other nurse to give meds
If you ER has mentor/mentee program, it could be a great resource for you.