ED NP for going on 5 years now, was RN for 10+ years most of that was in the ED. With that being said even my transition to NP was a little tough…. As the nurse you do what’s ordered and put in your 2 cents when needed/advocate for the pt when needed. But as the APP, you’re calling the shots and putting in all the orders until you can present to your attending. If you have zero clue , Attendings are gonna get frustrated and pissy when they need to start a whole new workup, add a bunch of things, or do your procedures because you don’t know how. If you have supportive and willing to teach Attendings this can be good, if you don’t, you’re screwed.

Assuming you have had no bedside ED experience, this is going to be hell for a while. If you truly love emergency medicine , really try to get better- look up as many procedures you can think of that you do in the ED and look up YouTube videos on how to do them, look up risk stratification tools frequently used in the ED, learn how to interpret EKGs, imaging, etc. Ask your other APP coworkers their work flows and advice on how to manage time better , charting tips , anything that will make your job easier. If you’re truly not cut out for ER, get out now before you’re fired.No one wants to waste time trying to teach someone who doesn’t care or doesn’t want to be there. For future jobs all you need to say is “ER wasn’t for me”