Hi everyone!
I’m back! It’s only been two days since my last post, so I’m sure many of you are surprised to see/hear/read from me again so soon! Haha
I’m sitting here in my apartment alone and was reflecting back on my day, as I do, and realized that the events of the day lent themselves perfectly into a blog post. Today marked my first day seeing a patient in the school clinical setting!! Ahh! Super exciting! Let me tell you how it went!
Let me first start with some background information about my schedule this term. This term is jam packed with different classes that give us introductory insight on the different specialties. All term, we have orthodontics (Wednesday mornings), fixed prosthodontics (all day Thursdays) and endodontics (Friday afternoons). For half the term on Tuesday mornings, we have periodontics and the other half of the term we have pediatric dentistry. I lucked out and am in perio for the first half of the trimester, which means I get to see patients!
Now, the story actually goes back to last Friday. That was the day that I finally got to meet my treatment coordinator. So at our school, the treatment coordinator is the individual who is in charge of contacting patients and scheduling them for students initially. Each treatment coordinator, or TC, is responsible for about 16 students in each DDS class. So now, back to my TC, Raul. Because I missed the first two days of the term last week, I spent most of the week playing catch-up, at least it felt like I did. I had been meaning to see him all week because I knew that I had patient care for the following Tuesday (today) and I wanted to know if I had a patient or not and simply to meet him. So at the end of my endodontics lab, I ran down to the second floor clinic to catch him before he left for the weekend. Unfortunately for me, he had not been able to find a patient for me to work on for Tuesday. So, I went about my weekend thinking I didn’t have a patient and did my pre-session worksheet on a “reserve” patient (that’s a patient who is assigned to me to do medical history and theoretical treatment if they were to be my patient).
Then this morning, I headed to the group presession where the directors of the perio module give us lectures to help further our growth as dental students in this area of practice. After the presession, our faculty began to dismiss us to our different groups and because I didn’t have a patient today (along with the other students in patient care without a patient), I was asked to wait until she told us that we were to assist people that we did not know. She dismissed us and we hurried down to clinic. I had to go get my gloves from my locker before going down to clinic. When I was there, I saw a friend and told him that “we didn’t know each other” so I could assist him – bad students, I know – but as soon as I rounded the corner to go to clinic, I heard my name being paged.
Oh, having your name be paged over the speakers is horrifying – at least for me because I hate having that attention drawn to me. So I rushed down the hall to where my TC’s office was to be told that I had a patient transferred to me because my friend wasn’t feeling well. My TC told me that he’d called me three times and my friend even texted me; however, due to being in presession and not wanting to be in trouble with our director, my phone was on silent so I didn’t hear any of the calls or messages.
Okay, so now I was in clinic with a new patient handed to me and I needed to go through this patient’s medical history, set up the unit, find the patient, make sure the finances were cleared, do my own paperwork for the faculty in charge of my row, and all of this needed to be done before I could even get started. It was a whirlwind and I was so frantic and anxious – my blood pressure should have been taken!
Finally I was ready for the patient and could bring him into the unit. I went out to the lobby to find my patient, greeted him and the first thing I hear is “I’m grumpy.” Man, oh man, that is not the first thing I wanted to hear from my patient. BUT, I understood where he was coming from – he’d probably arrived at 8:00 am that morning and it was probably 9:00 am or 9:15 am by the time I’d greeted him and seated him – if I were a patient and this happened, I’d probably be grumpy too.
Once in the unit, I took his vital signs, went through medical history with him, and then had a faculty come listen to my patient presentation. I quickly went through the patient’s medical history and of course, being in a rush, did not do a good enough job of knowing what the patient’s medications were or what considerations had to be taken, or what the patient’s periodontic diagnosis was, or even if the patient had eaten this morning. This, though, was good because it gave my faculty someplace to begin when showing me how to access or learn different things. Yay learning!
Once the patient presentation was completed, I was told to do a quick assessment of the patient – do an extra- and intra-oral examination, plaque indexing, and probing before calling the faculty over again to be cleared to begin the actual procedure.
Time and time again, the faculty kept asking what I was doing – Upper Left Quad scaling (aka a deep cleaning of the upper left region of the mouth) 3rd quad. This was good, though, because it reminded me what I was doing as well. It kept us all on check for everything going on. So finally, I could get started.
This quadrant was probably the hardest quadrant to scale because the patient had most of his teeth in this region. However, it gave me good practice. I got to use topical anesthesia to help with any pain or sensitivity – this was a first for me. It was interesting, though, because I think eventually, there was a placebo effect. I only applied the topical once and due to the pharmacology of topical, I should have had to applied it again, but my patient never expressed too much discomfort. I went through the cleaning once with each of the instruments (known as Gracies) for each surface and then used a universal to go through again. I also explored the region I was cleaning to make sure I had gotten all the buildup and finished by scaling one last time.
Once I was done with the hand scaling, the faculty came over and checked the work I had done. Then told me to go over post-op instructions as well as do a betadine irrigation in order to help control any bacteria that may have been stirred. Once that was done, I was allowed to excuse the patient. So, I completed the tasks that were instructed to me and walked the patient out. As we walked out, my patient turned to me and said, “This has been the best experience I’ve had here,” with a smile. I couldn’t help but smile back and thank him, not only for what he had just said but for being my patient.
As a student doctor and being as nervous as I was, there is nothing like hearing that sort of appreciation from your first patient. Throughout the procedure, I checked in with him about comfort and pain; if he needed to fidget, he was free to do so; we chatted in the times we were waiting for faculty; I did all the things I would have done to anyone else, patient or not. Sometimes, it is so easy for practitioners to forget that the people in our chairs or rooms are PEOPLE and they need to be treated as such. I feel like that makes all the difference.
I have to admit, getting started was rough. I was frantic, nervous, and all over the place. I probably would have continued to have been in that state if it weren’t for my friends and peers reminding me that I knew what I was doing as well as the faculty for understanding the situation and helping me learn. I am extremely grateful to my patient for his patience with me and for reminding me of the little things like having a conversation to get to know them for who they are.
Who would have known that my patient had two sons – one becoming a pastor, the other a lawyer? Who would have known that my patient missed his parents every day and that he appreciated what his parents did right for him and how that translated into his own children’s success? Who would have known that this fidgety, anxious patient would leave after a procedure with a smile and such appreciation?
Every experience is a learning experience and today’s experience was no different. I have not stopped smiling and feeling warm all day. I’m still smiling as I finish up this story and letter to you all.
With that, I hope you’re all doing well and finding success in your endeavors! This is the first step towards my success! Tell me what you’re working towards down below – let’s have a conversation!
Have a wonderful day, afternoon, evening, or night!
As always, with love,
Antoinette xoxo
A Nugget's Letters 