Case Based Reflection Q7
I have always been a people pleaser and deeply upset whenever someone is unhappy with me or something that I’ve done. This quarter, I had a patient that seemed to be unhappy with everything I did and displayed some behavioral issues that I had to learn to adapt to and address. My patient had heavy calculus on his lower anterior dentition and in the middle of his SPT he told me I was taking too long, the “scraping” was uncomfortable, and he stormed out. I was taken aback by his abrupt exit, I blamed myself, and this interaction made me question myself as a dentist and my ability to handle criticism. I felt terrible and embarrassed that he had a negative experience, so after his appointment I reached out to check on him, apologize, and make suggestions so that his next appointment go more smoothly (bring headphones to listen to music or use local anesthetic even though he initially refused). When my patient came back to the clinic to finish his SPT he was irritable, made frustrated noises throughout the cleaning, and constantly asked if we were done yet. I felt bad that he seemed so miserable, but I realized that my patient simply doesn’t like going to the dentist, and even doing my best would not be sufficient. I felt less self-blame and I apologized that the patient felt I was taking too long. I reminded him that this was a learning institution and I am still learning to provide faster treatments, but I’m doing my best work and making sure I provide him with the best treatment possible. A few weeks later, I was doing a Class V filling on this patient and while I was drilling, he tried to close his mouth and lift his head to stop me. I gasped and asked him what was wrong and if he was feeling pain. He informed me that the Isolite was too loud and wanted to know when we’d be done. I sternly told my patient he should never move while I’m drilling. I reminded him that if there’s an issue, he can make a noise or raise his hand and I will stop and address whatever problem or question he has.
My experiences with this patient taught me that despite doing good work, sometimes patients will be unhappy, and some patients have dental anxiety that manifests as frustration and unfriendly interactions. Majority of people don’t like going to the dentist, but as long as I’m doing my best work, I shouldn’t let their comments and reactions upset me. I need to get a stronger backbone. As I’ve gotten older, I’ve been hoping to gain more self-confidence and be less effected when someone is confrontational or upset with me. I firmly believe that my future experiences in clinic will expose me to such confrontations and allow me to practice dealing with these conflicts and my emotions in a productive way.
Case Based Reflection Q8
During our first group huddle this quarter, Dr. McLaren made an announcement that she was looking for students willing to take on Spanish or Mandarin speaking patients. I naively thought about the minimal Spanish I learned in high school, and I made a mental note to talk to Dr. McLaren about my interest in taking on a few Spanish-speaking patients. During my Oral Surgery rotation a few weeks later, I was assigned a patient that only spoke Spanish. The receptionist informed me that the patient had an extraction last week on her upper 1stmolar and now she felt like her 2nd molar was loose and suspected that her student dentist loosened the tooth. After careful examination, I came to the conclusion that the tooth was already loose, evident in the widened PDL space present in the radiograph taken before the extraction. I knew my Spanish was too minimal to communicate my diagnosis, so I asked for the translator phone but someone else had checked it out. I then asked around the entire OS department to try to get someone to come translate. The only person that could speak a little Spanish was my classmate Nico, and as hard as he tried, he couldn’t get my message across and couldn’t understand what my patient was trying to say and ask. Understandably, my patient was frustrated, confused, and she appeared defeated. It felt like hours passed before I was able to get the translator phone and able to communicate my findings to my patient. However, I wasn’t sure if she truly understood what I was telling her, and her allotted appointment time was over, and she had to get back to work. I worried that she left with more questions than she came with and I felt like I didn’t do my job to make my patient feel comfortable and cared for. I was unable to provide the chairside manner that I strive for with all my patients.
This experience made me realize the complexities associated with caring for patients that speak other languages. I question if it’s ethically irresponsible for me to be their provider when I can’t guarantee that I’m able to deliver the best care possible by accurately explaining my diagnosis and ensuring that they understand the benefits and risks associated with procedures I’m performing. As much as I want to challenge myself and provide dental care for any and all patients, I don’t know if it’s fair for me to expect a patient to put their trust in me unless I can ensure that I will have a translator there for every appointment. Moving forward, I’m considering the possibility of only scheduling Spanish-speaking patients when I’m positive a classmate and/or faculty will be present and able to translate. I also hope to become more competent in Spanish and invest in my own translator phone that is available to me at any time so that I can become more comfortable working with Spanish-speaking patients in the future.