I started in the ER as a new grad in March. Luckily Covid slowed everything down so I had plenty of time to research every patient and staff with the attending. Like another person said, at about the 5-6th month I finally wasn't terrified anymore. In hindsight, working at an UC would be terrifying. In the ER I basically have unlimited labs, imaging, and consults available to stomp out any liability issues. This usually isn't available at an UC. Even now I wouldn't feel comfortable in UC and would probably send too many patients to the ER just to cover my ass. It was an incredibly steep learning curve, but I never wanted anything else besides ER (did 4 years of EMS before PA school). Now I wouldn't trade it for anything. I probably applied for over 100 ER jobs before I graduated, since I didn't care where I ended up. So while Covid makes everything more complicated, just find a good organization that will train you well, stay there a year, then hit the ER running.