Im a new grad and have been in the ED for going on 4 months. I was suppose to get 12 weeks orientation but at 8 weeks they thought I was ready. I have had my good days and my bad days, yesterday I just kept getting slammed with patients and I fell behind on a few things, but I just tell them that Im working as efficiently as I can, and Im prioritizing who is more critical and who can wait. At the same time im being sure to be a safe nurse and do my nursing checks on giving meds. I tend to fall behind when I get an elderly patient or an obese patient, because they are hard sticks, which delays my labs, which delays everything, I have Lab come to draw them or I get an experienced nurse by then 30-40 minutes have gone by. My hospital tends to hold a lot of ED patient due to no rooms, and that's when it gets tricky, especially if there are no PCU,ICU,MED/Surg nurses available to come and help out. Overall, advice don't forget what they said in nursing school, Be Safe, Be efficient, and Prioritize.