Patients come in swinging on Friday nights at Middlemore

Therese Renouf switched from orthopaedic to emergency care nursing because

As a nurse in one of the country's busiest emergency departments, Therese Renouf sees first-hand the grim toll of excessive drinking.

Victims of road accidents, domestic abuse and alcohol-induced assaults are a commonplace sight along the corridors of Middlemore Hospital's emergency department on Friday nights.

"It's pretty busy and noisy in here on the weekend with a lot of patients that are quite drunk," said Ms Renouf, one of the emergency department's clinical charge nurses.

"Auckland Hospital probably sees more of other drugs, but alcohol is the drug of choice in South Auckland. It's the cheapest drug and it's mainly what we see."

At least a third of weekend cases would be alcohol related, although on some nights the figure is higher.

"We get a lot of young guys that have hand injuries - punching windows, punching other people."

Most come in three to four times over the legal limit.

"People just don't seem to know when to stop." But it's the staff that bear the brunt of it.

Ms Renouf, who has spent half of her nine-year nursing career in the emergency department, has been threatened with physical harm. She has colleagues who have been hurt by out-of-control drunk patients.

But it's mainly verbal abuse.

"We often just have security present. That sometimes calms them down, but sometimes we call the police in as well, depending on the situation."

The abuse can be difficult to take, but most staff get used to it, she said.

"You think you're helping people, but they come in and they abuse you. It wasn't what I thought when I started out to be a nurse - but everything else makes up for it."

The pace of emergency medicine is what drew her from orthopaedic care in the first place. "I just thought there was a lot of variety. You never see the same thing."

Stitches tell stories of bingeing

Damian can easily count one of the costs of his hard-drinking: 36 stitches on his arms.

A 23-year-old Aucklander, he can recall several trips to hospital emergency departments after accidents while drinking.

The worst was in Christchurch in 2002 when he was a student. After drinking six jugs of beer and a bottle of wine, he was making his way up steps leading to a glass and timber door at a friend's house. He tripped and crashed through the door.

"There was quite a bit of blood," says Damian, who does not want his full name used. "But I missed every major artery. I got a little cut on my nose: I was very lucky."

A friend drove him to Christchurch Hospital's emergency department.

It was Friday night and he ended up spending seven hours at hospital, but he was extremely drunk: "I can't remember most of the night."

He admits to still being a heavy drinker, but says he does it less often now.