ok, you are really being afforded an increased opportunity, in that med surg does not have the benefits of the monitor technology, and you still have to make same critical thinking skills, and ER you never know what will be coming in the door. You have the foundation, fairly decent time of orientation. Just keep on doing it...... I had been out a lot longer, and now am working ER in a small rural hospital....... Some times it is like riding a bicycle, other times, where did they put my training wheels....... Just keep on putting one foot in front of the other, your confidence will return, with clinical practice and repetition.