i too know what its like to be thrown to the wolves as a new nurse. my orientation was very limited. but i was fortunate to have a good seasoned team to work with. working in a busy er is like trying to plug a busted dam with your finger. its tough for even a seasoned nurse thats new to the er world, now multiply that factor by x and thats how hard it is for a rookie. all the nurses you are workin with should expect you to be lost and it should come as no suprise that you need assistance. dont put yourself in the position of screwing up cause you feel as if you are slowing the other team members down with their assignments by seeking help. litsen to your gut feelings, if you think you need to ask someone..then by god ask someone! time management is a killer. its something thats learned from exp. my personal theory is pretty simple..if its not emergent or urgent than it can wait. "the a-febrile kid in room 6 that needs a strep can wait a few minutes so i can finish charting on this icu admit" ive watched many a fresh nurse go through the same thing that you are going through (and the same thing i went through not long ago) and its funny and unfortunately painful at times to watch, but take comfort in the fact that there have been many a new nurse that was not near as smart or as hard working as you that have made the transition, so you can too. be on time, be available, be flexible and be humble.