Category: 01: Professionalism

Categories
01: Professionalism

Second Term Community Externship

This term for my community externship I was situated at Broadway Pental Coastal Lodge long term care facility. This facility is a Christian based lodge and has three different floors of elderly living there. When I first started my rotations at the lodge I was extremely nervous and did not enjoy working with the residents. I afriad because of how unpredictable they can be and didn’t know how to react if they became upset with me. I was unsure if I would even be successful at this particular externship, and didn’t know if I’d be able to provide care for the elders at all.

As the term went on the I slowly began to feel more comfotable around the eldery in terms of providing treatment and communicating with them, until the day I met Larry. He is a 92 year old resident who lives on the third floor of the lodge. He helped me to understand some of the issues that the residents are faced with and a few of the diseases they may be faced with (such as dimentia).

Larry was more cognitively available than any other elderly I had provided treatment for. He told me that he was lonely and that he just wanted someone to talk to. Each time I visited him to provide dental hygiene treatment I would set aside time to just simply speak with him. I could tell that it was more important to him than the health of his teeth. I learned that he has traveled the entire world over four times and he has quite the sense of humor! After I finished his care I began to develop rapport with the rest of the eldery, if possible, before I provided treatment. It made me feel great because I could tell that most of them really did just want someone to speak to. An elderly lady even told me “it’s great to have such a nice young lady come and talk to me because I get tired of looking at old folk all day”. I actually laughed out loud, but felt great about the fact that in some way, even if it was insignificant, I was providing companionship for a short while to the elders.

Categories
01: Professionalism

Local Anaesthetic and Client Management

I recently have been providing dental hygiene treatment to a client who has severe hypersensitivity. She also has a phobia of the dental office, especially of needles, but she is motivated to improve her oral health. This posed a huge problem for me because I couldn’t even probe her dentition without local anaesthetic. I thought that if I explained every step of the procedure to my client and gained her trust she would be more susceptible to having local anaesthetic administered. It worked, but while I was depositing the solution she began to scream. It was definitely alarming and it was an incident that I hadn’t experienced before. Luckily my clinical instructor was in my operatory and she held my clients hand while I calmly told her that she was “doing really well”. The screaming began to become quieter after I began speaking with my client, and was almost non- existent at the end of the injection. After it was finished I asked her if she was in pain, and shockingly she said she wasn’t, and claimed she screamed because it was invasive to her personal space. I realised that she was afraid of the idea of the needle and not the actual administration of it, and I spoke to her about this throughout the appointment to make the up-coming sessions go more smoothly. Client management and calming communication are extremely important in clinical practice to ensure that the patient feels comfortable.      

 

Categories
01: Professionalism

Client Rapport

During our community rotations at The Orchard I found it apparent that the target population expressed anxiety towards dental care, even dental hygiene treatment. They also exhibited lack of knowledge of oral disease and the link between oral and systemic health. Building rapport with this population not only facilitated change with their perceptions of dental care, but also enabled them to trust us and therefore be open to new information and knowledge. I felt this was extremely important for all community programs to assist them in building trust in the dental hygiene profession as well. Here is a photograph that I took at The Orchard that some of the residents that live there and the clients that we say made for us.

Categories
01: Professionalism

Professional Collaboration

I recently completed assessments on a client in the community that had a liver transplant seven years prior. I was unsure if this client needed antibiotic prophylaxis prior to invasive dental hygiene treatment. I therefore took the initiative to contact his family physician. After several phone calls back and forth with the receptionist I finally was able to speak with his doctor. She was unsure if he needed the antibiotics, so he gave me the phone number to the clinic where the transplant was performed. I again left several messages with the receptionist and finally spoke with the specialist. She was very helpful and faxed me a review of the patient’s last liver evaluation (which is done monthly) and a document stating that this particular client did not need the use of the antibiotic prophylaxis treatment. I felt this was an important experience for my learning because not only did it enable me to communicate professionally and effectively with other practitioners, but it also allowed for me to embrace collaboration with other health care environments.

Categories
01: Professionalism

Hypertension

I have been providing treatment to a client for two semesters, who we will refer to as Mr. Smith that has controlled hypertension. His readings are consistently between 130-150 for systolic pressure and 80-90 for diastolic pressure. I spoke with his family physician and she assured me that Mr. Smith sees her on a regular basis and that his blood pressure readings are usually in the stage 1 of hypertension category. She also told me not to worry because he takes his medication regularly and has a check up once a month. Mr. Smith would also explain to me that he sometimes experiences the “white coat effect” and that because of this it could make his blood pressure more elevated. One evening during a clinic session I routinely took Mr. Smith’s blood pressure prior to debridement and it read 204/102 mmHg. I was definitely alarmed and took another reading after five or so minutes had passed. The next reading was still around 200/100 mmHg. I informed Mr. Smith of the situation and explained that I would have my instructor take his blood pressure to be sure. Mr. Smith did not seem too concerned with what was going on; even though he was well aware from seeing his physician so frequently that this was definitely a high reading. My instructor came and took it again and the reading was now 203/102 mmHg. I know that was in stage 3 of hypertension, and that Mr. Smith should definitely be escorted to emergency. I communicated my concerns to him in a very calm and collected manner so that I did not alarm him anymore then needed as he was already quite upset. He was aware that his blood pressure was too high to do any invasive treatment, but there was a disconnect pertaining to the importance of his overall health because of his high blood pressure. I informed him about the severity of this reading and because of this new knowledge he gained he reluctantly agreed to come to the UBC hospital with me. If I had not of communicated in such a calm and professional manner with my client while relaying the information to him, he might not have understood how potentially dangerous the situation actually was, and therefore may not have gone to the hospital either.

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