When I tell people I work in an Emergency Department, they gasp in astonishment 'oh wow can't imagine the things you see'. I'm not part of the medical team, however my involvement is always negative. Very few moments of walking away with a sense of accomplishment or gratification. The tragedies are hard, the sudden deaths are difficult to see, the violence is unforgettable. These are not my stressors. Although now that I have an established PTSD diagnosis, I'm sure all events take a piece of me now not just my actual stressor. My stressor are high risk patients, mental health crisis, suicidal ideation, dementia, adult protection orders. Some of these become frequent fliers, they're in my ER often. I'm there to watch, protect, observe, interact and keep the patient calm and safe. These interactions go from calm to violent with highly charged emotions. I go up and down with them. The suicidal patients hurt the most, unfortunately some eventually connect the dots and I am left to receive their body at the morgue. Their words and emotions never leave your head once you've learned they succeeded in their mission. Tonight, I'm on day number 10 of a patients 16 day stay in my ER, 72 year old male, close to my fathers age. He is a retired Corrections Officer with PTSD stemming from being held hostage. He now has dementia an explosive combination combined with PTSD. Thus requiring a secured lock room with only a mattress. His emotions are everywhere from reality to his fabricated sense of awareness, I go up and down with him because no matter where he is in his mind he seems to trust me mostly. However my response is baseline restrain and hold due to his violent outbursts. It's always a tackle and restraint scenario. To a point that he cowers when he sees me and gives up easily. It's not a good feeling to feel someone give in this way. It's a feeling of breaking human spirit. You always go in hoping for the best scenario. Sometimes it doesn't work that way. He was so agitated tonight, throwing himself to the door, floor, raging and yelling, that I had to rush in with height level of force to restrain his self harm. As soon as the door unlocked, I rushed in to restrain, but he gave up immediately, meaning I hit him with far more force than needed since he had no resistance. His head hit the floor as we fell, eyes rolled back into his head, he was non-responsive. It became a code response, the entire medical unit rushing in. I stayed on for another hour to see how he was, he's ok, resting off a bad concussion. Nurses waking him up periodically to check. I go back in tomorrow to make it Day number 11 of his 17 day stay. I needed to vent. Sorry!