Day 19 - Wed, Jun 25, 2025

I guess it was bound to happen ... But this was my first bad day. Like I might not go back tomorrow.

I got there at 7, and the day was pretty slow.  Their medicine here comes in glass ampules, I think from the 1800's, that you have to break the top off.  Well a nurse couldn't break one, so I offered and with my kung fu grip I managed to shatter the whole thing in my hand.  Strike one.  Then I was filling an IV with 100 ml of basically water before I put in the meds, and the nurse was like 'no, just hang the whole bottle.". Now I knew the meds and how much it was, and I could have injected it without any solution.  But whatever.  Strike 2.

Then... 😡

A kid walked in at maybe 11a with, everyone say it ... an infected foot.  So we shot about a pint of antibiotics in his butt and out the door he goes.  Skipping past the imprudence of that, his family brought him in about an hour later and said he had a seizure at home.  Of course I'm by myself, and the parents are wound up and are speaking Spanish so fast I'm not getting a word ... I do my own exam and his foot's not warm, discolored or swollen, so I'm not even sure there was an infection. And I no sooner get him on the table than he seized again.  Full on gran mal for about 2 min.  I told his mom to go up to triage and get a doctor, and about 5 minutes after the seizure was over a doctor comes strolling in.  I haven't worked with him, but he's an asshat to patients.

He's about 5' tall and walked past me without saying a word and asked the parents what happened.  They told him that after their son got the medicine he had two seizures, etc.  So without an exam, or history, or any other questions really, he wrote a script for 4 10mg doses IV of diazepam, which A. is a hero dose, especially for a kid that wasn't much over 120lbs, and B. is a benzo, which won't do anything if it's an allergic reaction, and may or may not impact the seizures.  He told the kid he could hang around for an hour and then go home. So he walked out looking annoyed that he was bothered, totally a Little King, and I was more annoyed that he was annoyed.

By then it was 1p, and the clinic is closed for an hour for lunch.  Not shifts, or a rotation, it's closed.  I volunteered to stay behind with the kid, cause I'm off at 1p anyway. 

Not even 15 minutes later, the kid seized again.  I loaded up the diazepam, and then thought I don't even know why tf I'm giving him it unless it's an emergency cause it won't much help and might only hurt, but it was all I had. And I definitely wasnt going to give him 10mg IV.  I sent Mom to go find the doctor again while I'm trying to keep the kid stabilized, and she comes back with a nurse. The nurse calls everyone, no one answers.  The seizures happen a few more times, the kid's exhausted, and I asked the nurse for oxygen ... Blank stare.  How about a bag?  Nothing.  Depakote?  I don't think we have that.  Topiramax?  I don't think we have that.  I was getting pissed, but starting to see why he prescribed diazepam.  The nurse was giving me some attitude, like this is how we always do it and he's not your patient and I don't want to do anything until the treating md gets back.  Ok, maybe that was just a conversation I was have in my head, but it was the sense I got.

Now it's 2:30, the other doctor is still enjoying his long lunch, and the kid had another hard seizure.  I was flaming pissed and so I just told the nurse I'm leaving, my shift was over awhile ago and it's your problem now.  I didn't want to be responsible for this clown show, so I left.   I know it probably wasn't fair to the kid, but there was nothing I was able to do to help him at this point and I was about to lose my mind on someone. Best to just step away. Maybe the nurse would give him the diazepam, or maybe the treating md would get off his ass if I'm not there.  Whatever, I have no idea what happened.  But I learned why the locals think the place is a dumpster fire...

just me, once again covering the ER.  Idk who thinks this is a good idea 🤔

I give the kids this candy that is basically stale fruit loops, and it's a game-changer. But the other employees look at me like, "why are you being nice to these people?"

under the light in the ER .   I haven't seen any exam tables or equipment wiped down since I've been here.  What I have seen is them rolling cotton balls out of basically what is comforter stuffing 🙄