I wish I could forget about yesterday.

I was working in the E.R.  It was already very busy, busier than usual:  tons of flu patients (a good portion of them wearing masks), asthmatics, crying, fussy babies or young children, people with injured arms, backs, or legs, older people in diabetic crisis or older people complaining of various aches and pains, etc.

Suddenly, from out of nowhere, there appeared three people:  male, Hispanic.  Two were walking; a third man hung between them, head lolling limply, mouth hanging open, eyes glazed over.  The poor fellow was in rough shape.  He was saying something; as to what, I couldn't understand:  I think it was Spanish.

I don't speak or understand Spanish.

The one man said in halting English:  "Eet's my fran'.  He no good.  He sick.  He need doctor."

I asked a fellow nurse to grab a wheelchair, so the man could sit down in it.  I then told them (the sick man's friends) to fill out the form and then wait for a nurse to call them back; we'd get to them as soon as we could; the room was full of patients; it would probably take a while.

For over an hour, we were put through our paces: dealing with each patient as best as we possibly could, treating their symptoms, admitting those who were truly ill or injured, and sending others home, where they could be seen by their own doctors. 

We were running around like chickens with our heads cut off.

It was then Mr. Gonzalez' turn.  We called his name.  The one friend wheeled Mr. Gonzalez in to the treatment cubicle.  Room #18.  We helped him get onto the table, started asking questions.  Mr. Gonzalez's friend said Hector didn't speaka da Engleesh. 

No problem:  we got a translator.

She started speaking to Hector Gonzalez in Spanish and translated his mumbled replies back to me in English.  Either he was drunk or suffering from a cerebralvascular accident (CVA, or stroke).  I couldn't diagnose him; I wasn't a doctor.  But nursing experience made me certain that it was either one of those two problems.

The doctor on call, Dr. Brady, came into the room.  I gave her the information on Mr. Gonzalez, and his latest vital signs.  So far, so good.  He appeared to be stable, just very drunk or on the verge of suffering a massive stroke right in our emergency room.

Winnie Brady started examining the fellow, then started hooking him up to oxygen, EKG monitor, I.V.'s.  That's when all hell broke loose.

Mr. Gonzalez started screaming in rapid-fire Spanish and waving his limbs recklessly:  they became lethan weapons, as attested to the nasty kick he gave Winnie Brady in the jaw.  She immediately flew into the wall from the force of Mr. Gonzalez's kick, hitting the back of her head, hard.  She then slumped to the floor into unconsciousness.

I started screaming for assistance, "SECURITY!  STAT!"  Two burly security guards came flying into the room, adding to the chaos.  Thank God they'd brought four-point leathers (straps used as a last resort to calm down a combative patient).  Winnie was already down; didn't need to add to the casualty list (out in the waiting room and in our E.R.). 

Two patients for the price of one.

Soon, Mr. Gonzalez was sleeping like a baby, thanks to another doctor ordering a shot of Haldol.  Another nurse gladly injected Mr. Gonzalez (enduring a torrent of being cussed out in Spanish:  at least it sounded like curse words).  In a few minutes, the big gorilla was sawing logs:  it was good night, nurse, oblivious to anything that was happening to him or being done to him.  We then sent him to the MRI area, to see what was going on with him internally.

About five minutes later, Winnie Brady opened her eyes.  She was startled to find herself lying on the treatment table, hooked up to oxygen and heart monitor.  We told her what had happened; she didn't remember much, only to say that she had a whopper headache:  the back of her head was killing her.  She seemed to have all of her faculties intact, much to our relief.  It was apparent that she wasn't severely injured; she would be hurting for several days afterwards.

She would be going home; as for Mr. Gonzalez, not so fast.  He had a massive stroke right there in the MRI machine.  He immediately went to the CVICU area for treatment.  There was no telling how long he'd be in the hospital.

It was an unexpected ending to a stressful shift for me.  My body ached from trying to hold down Mr. Gonzalez, and I had bruises on my chest, arms, and shoulders, from where he grabbed me in his panic attack.  I would be hurting for several days, too.

I don't mind taking care of patients, but drunks or people who act like they are are the worst:  they are so unpredictable; there's no telling what they are capable of doing to themselves (or to others).

~Written by Kelly Mantooth, E.R. nurse, Nashville, Tennessee.

*Not patient's real name.