Ask yourself these questions...Are they breathing? Is there any reason to believe they won't be soon? Are they pink, warm, and dry? Are they bleeding massively? Do they have bones protruding from their skin? These are the #1 folks to take care of.
Baby comes in with a fever....take the temp. under 102', you have a minute. Someone comes in with low BP/P....is it under 90/60 or 60 BPM? Then you have a minute (put them on a monitor and set it to beep if it falls). Remember, you can't stop a miscarriage. The problem is if they are bleeding heavily.
I'm new to the ER, my first job, and I was thrown to the wolves. Mid into my 2nd week, I was taking pts alone. 3rd week, triaging on my own. 4th week, getting possible MI/stroke pts on my own. At the same time, hearing how I shouldn't be doing any of these things because I was too new....but no one jumping in. Luckily, I know enough to know what I don't know and not afraid to "demand" help/answers. Also got read the riot act by a few how I should have never taken an ER job as my first job--I need to have floor first. I disagree. Sure, it strengthens a lot of your core skills, but the pace is so much different, I think it would have been detrimental. Getting good at IVs is easier in the ER than floor, but floor sees more G-tubes, etc.
You are never alone in ER. If you are at the limit of pts you can handle safely, say so. I told my super (about 7 weeks in), when she said another pt came in (back pain), can I take them, NO! I have a baby with a 103.4, head injury, and a bad GI bleed. I cannot handle any more! (being new, no cert's yet, and we are a very small ER, usually 2 pts to a nurse max, and the long-term nurses had only 1 or 2 pts)Have a voice!!! It does get easier!!!