I'm a new grad working in a small, community ER. I am super lucky to have a 4 month orientation before I'm thrown to the wolves, but I'm in the middle of week 8 (almost half over! Where did the time go?!?!?) and I'm feeling overwhelmed--mostly by time management and charting! For example, today I was partnered with a temporary preceptor because mine was out sick. I was handling all patients independently and she was available for questions. I did fine all morning, but when I got back from lunch my entire day was shot! I had an older woman with low sodium (117) who was very altered and confused. I had a pt. with CHF, a young girl who had a fractured arm that needed to be reduced via conscious sedation, and a young adult with cerebral palsy and tachycardia. I was working on getting the older woman with low sodium stabilized and admitted (every time I went to give meds or chart, another doctor would call or stop by to give orders! Many of the orders correcting earlier orders!) and got behind on my other patients; just when I was beginning to get caught up on her so I could work with my other patients, the young girl needed to go through conscious sedation. I've never done conscious sedation before which irritated the doctor and my temporary preceptor wasn't a super big help, which meant I was still behind on two other patients!By the time 1900 rolled around, I hadn't updated the charting for two patients for nearly five hours. I spent report watching the girl who had been sedated and trying to catch up on charting. I even apologized to the oncoming nurse because the patient with CP was upset because I hadn't done anything in two hours with her. Her vitals were stable, though, even if her HR was 115-120. What can I do on days like this to not feel overwhelmed? At the end of the day the temporary preceptor basically said that days like today are why she hates new grads in the ER, because we don't have time management down. I understand I have a lot to work on, but it's only my first week with taking all patients and using the preceptor as a resource only, and I'm learning! Now I'm feeling super discouraged. Any advice would be appreciated! Especially if you made it through this novel of a post!Thank you!