Saturday, March 7, 2009

Mad Patient

This week I had my first patient walk out on me! Last year we did communications exercises where a simulated patient walked out on me. That was shocking and I really wasn't sure how to react. Sadly, I didn't learn anything from the exercise because I still had no idea what to do. Fiddle for an apology? We (my assistant, the assisting student, and the center aisle assistant) were all shocked.

The patient was upset when she was asked if she has any trouble with abuse at home. This is a standard question for patients at this clinic. Then, when I got started, she kept asking if I had the right tooth. We told her we would need to use a rubber dam (a stretchy piece of latex that goes over the teeth to keep them dry --we call them a "raincoat' with kids). My instructor started talking to me about a root canal on another patient and she got confused and thought the rubber dam had something to do with the root canal. I tried to explain that it had nothing to do with the complexity of the procedure, it was just a tool to help us get it done.

She had a difficult time opening wide enough for me to put the clamp on her tooth that holds the rubber dam in place. When I put it on, it pinched her gums (common but usually goes away in a few seconds). However, she kept complaining. I decided to numb her palate to make her more comfortable and she really did not like that. For whatever reason, I strayed from my habits and didn't warn her before hand. She scolded me for doing so. After some fiddling, we got the RD on. By now, she was fuming and told us to take it off. We reminded her we needed it for our treatment. She angrily demanded we remove it as she was leaving.

So, we did.

Oops. I don't know what went wrong!


shawn said...

What went wrong.. let's see.. after more that 20 years... ok, the patient THINKS that she knew more than you, the TRAINED professional!! Don't let it get to you.. It is her loss afterall.. I know still doesn't make you feel any better.. and you are worried that her tooth will get worse.. which it will... because as we all know.. the only things that get better in the mouth are cold sores and canker sores... so what ever was/is wrong with the tooth.. will continue to get worse.. and she will have to deal with it when it does! AND... to top it off, she won't have such a wonderful dentist to work on her!!
So to answer your questions.. what did you do wrong?? NOTHING.. but being a caring dentist.. gee that is a bad thing.. isn't it???
Sorry it had to happen....

Suz said...

There are always going to be a few people that you just can't please. She was ready for a fight before she even sat down in the chair.

There are books you can read and classes you can take that can help you understand what motives are behind the belligerant actions and sometimes that can help you find the right words to communicate, but in the end, sometimes it is best to just say, "good riddance".

Dave said...

I have found through life experiance that when things 'do not add up', many times mental illness comes into play. There is generally nothing logical if you are dealing with a mental nervous issue.