Nailed It (The Foot, Not The Clinic)

When I was in college, my biology class took a day trip to a local watershed — in this case, a creek that drained into a larger river — to conduct a wildlife study. The procedure was simple: stand in the water and use special nets to capture and count the number and type of animals to determine how healthy or polluted the creek was. 

Naturally, I wore water shoes for this outing. Unfortunately, they were rather thin-soled, so when I stepped on a rusty nail that had somehow made its way into this creek in the middle of nowhere, it went right through my shoe and an inch into my foot. 

Because it happened during a school-sanctioned activity and it had been over a decade since my last Tdap (tetanus, diphtheria, and pertussis) vaccine, school policy required that I report to the campus clinic when we returned. [Professor] told me he’d speed things along by calling ahead to alert the clinic that I was coming and why. So, armed (footed?) with nothing but a holey shoe and the possibility of infection brewing in my extremities, off I traipsed to an unfamiliar two-story building at the edge of campus. 

The layout of this clinic was slightly unusual. Downstairs, there was a reception desk in front of a long hallway, which led to a small radiology unit on one side and a separate waiting room for anything to do with needles (vaccines, blood labs, etc.) on the other. The first-floor reception desk served as a gateway for those units but was NOT a check-in point; each unit had its own nurse to do check-ins and make sure you were in the right place. The main floor receptionist mostly provided directions and new patient paperwork that would be turned in elsewhere. The actual doctor’s offices, as I discovered later, were upstairs and behind a second set of receptionists, who DID do check-ins before appointments. (In theory.) 

But as this was my first time at this clinic, I didn’t know any of that.

Apparently, neither did the final-year nursing students who worked there. 

I approached the first-floor receptionist, [Receptionist #1], and explained that I was there to get my Tdap after stepping on a rusty nail during a school-sanctioned outing and that [Professor] should have called ahead.

Receptionist #1: “I haven’t received any such call, unfortunately. And all of our vaccine slots are booked for the day. But given your circumstances, I’ll squeeze you in for an appointment at [time].”

That time was right after my next class. I confirmed my appointment, handed over my student ID, watched her clack around on her computer, received my ID back, and then went to the next-door building for my mythology class. 

Two hours later, I returned to find that [Receptionist #1] had been replaced by [Receptionist #2].

Receptionist #2: *Smiling* “What are you here for?”

Me: “I have an appointment for a tetanus shot.”

She helpfully directed me to the waiting room down the hall. I trodded off, told [Nurse #1] behind the computer at the door my name, and sat down in the incredibly full waiting room (about thirty people) to wait.

And wait.

And wait. 

And wait. 

After almost an hour and seeing several new arrivals be called before me, I finally approached the nurse — again, a different one than the one who’d nodded me along when I entered the waiting room — and asked how long it would be before I would be called. She looked down at her computer and frowned. 

Nurse #2: “What’s your name again?”

Me: “[My Name].” *Presents my student ID* “I’m here for a tetanus shot because I stepped on a nail during [Professor]’s class today.”

She frowned and clacked around her computer for a minute. And then a minute more. She kept glancing between my ID and her computer screen with an increasingly confused expression on her face. 

Finally…

Nurse #2: “I’m sorry, but we don’t have a record of you in our system at all. Have you been here before? Which doctor ordered the vaccine?”

Me: *Now thoroughly confused myself* “I wasn’t seen by a doctor. [Professor] told me to come to the campus clinic. He said he’d call ahead to confirm that I just need a Tdap vaccine. I made an appointment with the front hall receptionist just a couple of hours ago.”

Nurse #2: *Sounding confused and apologetic* “I’m sorry, but all students are required to see a clinic doctor before receiving any treatment, even vaccines. [College] policy.”

In my state, pharmacies could give walk-ins Tdap boosters and other vaccines without authorization from a doctor. Hence, it hadn’t occurred to me that I’d need an appointment.

Me: “…ooookay. So, what should I do? [Professor] said it’s school policy that I get this shot today, and the receptionist made me an appointment, soooo…”

When [Nurse #2] replied, she sounded even more apologetic, if that were possible.

Nurse #2: “Again, I’m so sorry, but that reception desk doesn’t… actually… make appointments? That computer doesn’t even have the ability to access the schedule. I don’t know who checked you in, but you’re not in our system at all.” *Looking down at her screen again* “Unfortunately, we’re all booked today, but… Hmmm… You know what? Given your circumstances, I’m going to squeeze you into the clinic upstairs as an emergency appointment anyway.”

She scribbled a note on some official-looking paper and handed it to me.

Nurse #2: “Take this upstairs and check in with that reception desk. They should be able to help you. After your appointment, the doctor will send you back down here, and we’ll get you your shot.”

Confused and annoyed, I sighed, smiled, nodded, and found my way upstairs, waving to [Receptionist #2] as I passed. And that was that, right?

Oh-ho-ho, no. That would be too easy. 

When I reached the second-floor waiting area, it was empty. There was not a student, receptionist, nurse, or doctor in sight — just an empty, dark waiting room full of chairs, a line of what I presumed were reception desks, and a closed door. 

So, I went downstairs, explained the increasingly (and unnecessarily) long saga to yet a THIRD receptionist (where #1 and #2 went, I’ll never know), who accompanied me back upstairs, picked up a phone on the wall, and called back to the clinic. 

She explained my journey all the way from punctured foot to confused [Nurse #2].

Receptionist #3: “She has a paper here with [Nurse #2]’s signature on it saying she needs to be squeezed in today.” *Pauses* “Great, thanks.” *Hangs up*

Two seconds later, the door next to us swung open, and [Nurse #3] marched out. She and the receptionist greeted each other, I reiterated why I was there, and [Nurse #3] ushered me into the clinic where I was promptly dumped into the tiniest room I’ve ever seen. She asked what medications I was on and if I had any history of allergies, informed me that “[Doctor] will be in shortly,” and left, leaving the door wide open. 

And thus, I waited. I heard the sounds of nurses chatting on break, completing other patients’ intakes — apparently, the upstairs waiting room reopened shortly after my arrival — and generally doing nurse-y things. 

Another half-hour or so later, a harried-looking man in a white coat walked by the room, saw me, and did a double-take. 

White-Coat Man: “Are you waiting for a nurse?”

Me: “Honestly, I don’t even know.”

I explained the saga yet again.

Me: “A nurse took my history and left. I’m waiting for [Doctor].”

White-Coat Man: *Scrunching up his face* “I’m [Doctor].” *Checks the clipboard in his hands* “You’re not on the schedule at all. You say you’re here for a tetanus appointment?”

Me: *Nods* “The downstairs lab said I had to see you first, so here I am.”

Doctor: “…excuse me. I’ll be right with you.”

He scuttled off, and I settled back in my chair for another wait. Then, I heard a MASSIVE uproar in the front room. Thin walls or strong lungs — it’s anyone’s guess. 

Doctor: *Yelling* “WHAT THE H*** IS GOING ON OUT HERE?! THERE’S A PATIENT HERE WHO’S BEEN MYSTERIOUSLY ‘SCHEDULED’ FOR A PROCEDURE TWICE AND SOMEHOW STILL ISN’T ON A SINGLE SCHEDULE! AND WHAT THE H*** IS [RECEPTIONIST #1] DOING ‘SCHEDULING’ PATIENTS FOR LABS WITHOUT AUTHORIZATION IN THE FIRST PLACE? THAT’S THE THIRD TIME THIS WEEK! NOW BOTH [CLINIC] AND [LAB] WILL BE AN HOUR BEHIND FROM ALL THE F****** INCIDENT REPORTS I HAVE TO DO! HOW MANY TIMES DO I HAVE TO SAY IT? NURSING. STUDENTS. ARE. NOT. NURSES! [NURSING SCHOOL BIGWIG IN CHARGE OF CAMPUS CLINIC] WILL HAVE OUR HEADS FOR THIS S***!”

The yelling continued for another moment or two along those lines, and then there was blessed silence.

[Doctor] returned, gave a curt apology, and ordered me to remove my shoe so he could see the wound. Just wanting this saga to be over with — and not wanting to piss off the bulging vein in his forehead any further — I obeyed. He looked at my foot, seeming very unimpressed with the tiny hole — again, I was there for a tetanus shot, not the foot wound — scribbled something on his notepad, handed it to me, said a nurse would be in soon, and left. 

Seconds later, a very cowed [Nurse #4] appeared, gave me a bandage for my foot, handed me a paper authorization for my shot, and ushered me back downstairs. This time, I was seen immediately, given the hastiest vaccine I’ve ever received in my life by [Nurse #5], and all but pushed out the door. 

The kicker? When I tried to access my online transcript two months later, I received a notification that I had to pay an unpaid clinic bill — $90 and change — before the school could release it. That’s right: after all that drama and yelling, no one had written down anywhere that my visit should have been covered by the school as an in-class incident. 

Rather than try to argue my case, I paid the bill, got my transcript, and f***ed the h*** outta dodge. 

And that’s the story of how it took one doctor, three receptionists, and five nurses for me to get a single $90 tetanus shot.