OP, I am also about 3 years into nursing, I've done it all in the ER though. I am constantly running my patients through my head, thinking what's next, always looking in their rooms as I pass, and I make a point about every hour to give them an update, even if I just say we are still waiting on results, how are you feeling, etc. I don't know how it is where you are, but the ERs I have been in have one major assessment when the patient gets there, and then just charting response to treatment, nurses notes, etc after that. I see my patient every hour, even if I don't talk to them, and I chart it. Are they on the phone, conversing with family? Up to the bathroom, how is their gait. pain meds given, etc. Assessments are more focused and quick. Often you can ask your co worker or CN to check on a patient for you while you are in the sick patient's room. Usually they don't mind and can get the patient simple things or communicate back to you if they need something more complicated. Hopefully your doctors will move patients through fast enough that you don't have too many hours of patients holding in the ER. Good luck!