I've been trying to be thorough as I can, making sure to clear out a much of Old Yharnam as I can. I think I've done so, and pretty early on managed to get a very convenient shortcut that made it pretty easy to get back to Blood Starved Beast without too much of a headache. I spent two or three Insight on summoning Alfred to help with the boss and also upgraded my Flamesprayer up to the same level as my Kirkhammer (+3,) and while the Flamesprayer strategy did do tons of damage, I found myself at a loss for bullets (it really seems pretty feast-or-famine with those things.)
So instead I used some Fire Paper, and boy howdy did that work well. Once using the paper, I managed to down him in two attempts (not total - with the Fire Paper.) I was still poisoned and out of antidote when I killed him, so I lit the lantern and warped to the dream just as I was about to die.
I believe that BSB opens up the first of the Chalice Dungeons, and I figure I should probably check those out soon, but I found myself drawn to a new area that had just opened up: The Church Workshop. While very familiar enemy types, the guys here hit quite hard. I also think I've missed a few of the things found there, but ultimately I got a badge and opened up a shortcut to Vicar Amelia that should make the many attempts I'm sure to make go smoother.
It's a little jarring to so quickly get to the next boss, but then again, I had cleared much of Cathedral Ward before heading to Old Yharnam, so I guess it's not so premature.
Amelia seems similar to the other beast bosses I've faced - encouraging you to get close and dodge around her. But she has some close-quarters moves and one particularly devastating AoE attack that has killed me on the two attempts I've made against her.
Even with the shortcut, getting to her is a bit of a challenge, as there's a Church Giant and a few of the big minister-types who you have to dodge quite carefully to avoid. Still, on attempt one I managed to get Amelia down to about two thirds of her health, and while the second phase is often where these bosses get their obnoxious mechanics, I'm feeling confident that she shouldn't take too many tries.
There's also a summon for a new NPC to assist, though my Madman's Knowledge is a little on the low side and I only have about three liquid Insight. And Alfred wasn't all that helpful in taking down BSB, so...
Right now my only complaint about the game is that I wish Blood Vials would drop more frequently. Or they could give you ten free ones when you die. Still, I love the artistic design and the flow of combat is quite good.