Wednesday, March 28, 2012

First cancellation that I couldn't fill

My patient cancelled her appointment yesterday while I was in class.  She said she had a school meeting she couldn't get out of.  I have all of my requirements met plus some so I wasn't too worried about that just that I need a patient in my chair so I get experience.  I got her message when I got home.  I decided to call around and got nothing.  I went to school today and told Prof. Costley about it asap and she just said to try hard to find one.  After multiple attempts  to find a patient, I didn't find one.  I knew my instruments were so dull from Monday's appointment, so I decided to sharpen all of my instruments.  This was good practice!  I was able to get them all sharpened again and help a few of my classmates with charting and cleaning up.

12th Patient 2nd appointment (March 26, 2012)

Goal: Finish my Class III patient, take 1 PAX on Kelsi's patient, 2 PEs for my Class III (Universal #2 and Area specific)
Actual: Completed 2 quads Class III, 1 PAX

My patient was 15 minutes late which made my heart race because I needed to finish her whole mouth to fulfill my Class III requirements.  I left her a message on her phone to call me right as she walked in the clinic.  I was so relieved she showed up.  Cancelled and no show patients make my life so stressed.  I wish people knew what they do to us students when they don't show up for their appointments.  Anyway, I am so thankful she finally came!  

Based on x-rays, I knew the maxillary quads were going to be harder to complete than the mandibular teeth because of bone loss and calculus that show on the x-rays so I chose to do the maxillary teeth last so she would show up! :)  I know most people don't like the dentist so the chance of her coming back if I really beat her up wouldn't be likely so I was kind to her last week ;)  Boy, is she in for a treat today!  I had no idea how hard it was going to be, but sheesh!  I'm pretty sure every one of my instruments are dull and she was bleeding like a stuck pig! HA!  I guess that's what happens in deep perio pockets full of calculus.  She was a real trooper though.  Most patients need L.A. for what I did and she stuck through the whole thing flinching a little, but for the most part she was great! 

I was able to complete the rest of the cleaning and do the PAX before she showed up for her appointment.  Really truly, it went very well if only I knew she was coming just running a bit late!  Oh well!  I was so exhausted after that.  I just wanted to go home and sleep!  Thank goodness the weather was so crappy Monday so I was able to skip my run and not feel so bad about it :)

Sunday, March 25, 2012

13th Patient (March 21, 2012)

Goal: Complete my partial PE and anything above that would be great!
Actual: 4 quads IB, 4 BWX, and Partial PE

Today was such a crazy day!  I had Mark confirm this patient the day before because she speaks spanish.  She mentioned that she was unable to come until 10:30am.  I didn' think anything of it and said it was fine.  He looked at me funny and said Really?  That wasn't enough of a clue for me I guess.  I went home Tuesday afternoon still not worried about what Wednesday was going to bring.  It wasn't until Wednesday morning when I realized what I did.  Walk-out is at 10:45am and I was going to complete a full OD and partial cleaning!  YIKES!  I knew this wasn't going to work.

I showed up to school on Wednesday and immediately walked into Prof. Costley's office.  She was putting on her makeup for the day (this woman is always perfect it doesn't matter if she is wearing a business suit or scrubs! I don't know how she does it!)  Anyway,  I explain my situation and she tells me to have Mr. Soloman call this patient and see if she can come in earlier or reschedule her and find a new patient for the day.  Even though I am close to having my requirements completed, I am still required to have a patient in my chair every clinic session.  Mr. Soloman talks to my patient (thankfully she answered) and explained the situation.  She asked if she can come in at 12:30.  I ran to ask Prof. Costley if this would work and she said YES!  AH!  I couldn't believe it!  Mr. Soloman had her come in at 12:30 and sure enough she did!

I worked on other homework for the time being which worked out well actually.  I had Stephen bring me lunch since I wasn't planning on beign there the whole day.

When it came time to get set up for clinic, I noticed a hispanic girl with a young boy in the waiting area.  I didn't think anything of it other than, she is way early and how nice for someone else not to worry!  I walked into clinic and had to set up a different chair because I was going to be in a right-handed unit for the overflow since it was a different group and different clinic session and my left-handed unit had another left-handed classmate in it.  This didn't seem to be a big deal other than the chair wasn't set which bugged me!  12:30pm comes and my patient ticker turns yellow saying my patient is here and ready.  I go out to the waiting area and sure enough this patient that I saw in the waiting area was my patient!  As I was walking back, I thought to myself, "She's kind of young to have a partial but maybe her partial is her lateral incisors" since that's pretty common.  I remember she can't understand anything I say, so I go ahead and try and show her what I need to do.  She was very compliant.  Somehow I was able to communicate whether or not she had a partial and she nodded her head no..... oh no!  I laid her back and sure enough she had NO PARTIAL!!!!  Frantically, I run into the radiology room where Kayla was and tell her (she was the one who gave me this "partial patient".  She asked if I had the daughter or the mother.  I assumed daughter since she was young.  She told me there was a mix up because the daughter was supposed to see Karlie and the mother was supposed to see Kayla who found a different partial patient so she gave this patient to me. 

I ran to Prof.  Costley and gave her the news.  She told me to call Karlie and ask her what she wanted me to do.  45 minutes after 12:30 I got it all figured out.  The daughter and mother (who actually is a grandmother) live in the same household and have the same name!  Karlie didn't need her and told me to go ahead.  Meanwhile, McKinlei had a patient who had 2 partials!  Prof. Costley told her about my situation and then had me come over and do my partial PE with her!  I couldn't believe it!  What chaos!  It's amazing how everything turned out!

Anyway,  I was able to take 4 BWX on this patient and complete 4 quads of Class IB... and get my partial PE taken care of on a different patient!  Sheesh!  This girl was so sweet to be patient while I worked out the bugs and was so grateful I was able to complete her i none appointment.

You ask what about the grandmother?  She is now scheduled with Marie (another classmate who needs a partial patient) in April!  WOW!  How does stuff like this happen??  Only in the Dental Hygiene Program!  HA!

12th Patient (March 19, 2012)

Goal:  I wasn't sure what I was going to get with this patient since all of my requirements were completed except for Class III.  I was just hoping to finish her if she was a IB.
Actual: 2 Quads of Class III, 4 BWX

I went in this clinic not expecting much because I was unsure what was going to happen.  I knew I needed more patients over my requirements, so I was just expecting this.  I took horizonal BWX not thinking I would need vertical.  After looking at the films, I noticed she had boneloss.  I am still pretty new at noticing what each level means, so I didn't get my hopes up.  I took her back for probing and didn't get anything significant like I thought I would with a Class III.  I was expecting maybe a Class II.  My instructor came over and noticed the bone loss on the films and probed where I did.  She told me my patient was a Class III, and I was so excited!  I was able to complete the lower half of her mouth and will bring her back for the rest at another appointment!  YAY!  What a great day!

WREB clinical board experience (March15-18, 2012)

Since I am the Vice President of the Junior class, I was given the opportunity to be the Floor Assistant for WREB (western regional examination board) over spring break when they were going to have boards given at Weber State University.  At first, I had no idea what an experience this would be.  As time went on and the news set in I realized what I great opportunity this is!

First I was able to be a Local Anesthesia board patient thursday for my peer-pal (the Senior student one class ahead of me).  I did this and was able to experience what it was like, then I had Floor Assistant orientation.  I learned what was expected which I already knew reading through the Floor Assistant manuel.  I had to get the clinic ready for the candidates for the boards in the morning.  I barriered 12 chairs for the candidates and 4 chairs for the examiners.  I didn't eat lunch that day becasue I didn't think I would've been there that long.... I was wrong.  I was so hungry adn orny but I made it through.

Friday morning, I arrived at 7 am to start the first group of examinations.  I was running with my head cut off at times and then at other times sitting around doing nothing.  This went on for the remaining days of the boards which were from Friday through Sunday.

I took good notes and I am going to post them on my blog so I don't lose them (On the back of my anatomy notes from my 3rd exam didn't seem like a good place for them permanently)

-Patient and Candidate go right downstairs at the beginning of the exam and after the exam to avoid coming in contact with the examiners.  The exam needs to remain objective and this is how they do it.
-Chief Examiner or Floor Assistant will notify the Candidates and patients of the time to come into the clinic to start the exam.
-There is 45 minutes from the start time to submission time (check-in with the examiners).
-Once set-up with examination forms and tray for the examiners, go to the sign-in sheet and write in candidate #, if you have a back-up patient, and what the time is.  This is located in the instructor pod.
-The Chief Examiner will then come over to your unit and check the Health History, Process of Care form (what the patient needs to do after the board exam i.e. continue care and OHI), Submission form(both sides filled out), x-rays (BWX and PAX), anesthesia form (purple form notifying you that you passed L.A.).
    -If a DDS/RDH is administering for you, you need to have their license (shows L.A.), proof of  malpractice insurance, and consent form.
-There are 2 stickers with your candidate # on them at your unit.  These are to be placed on your patient's clean bib before check-in and on a new bib before check-out.
-For Check-in,  Have HHx form, X-rays, submission form (1st and 2nd submission filled out), Tray (barriered) w/ mirror, probe, explorer, gauze, safety glasses (not regular glasses shield cover).
- If first submission isn't accepted automatic -4 points.
-If you are late for check-in, 3 minutes will be docked for every 1 minute late.  (no points associated)
-While waiting for patient to return, set up unit/tray on paper barrier, instruments, ultrasonic ($45 rental), anesthetic, disposables, and any other things needed.  This takes a long time, so it is beneficial to be the first one to submit (unless you are administering L.A.).  This means less stress waiting.
-Biohazard bags are in the island at each pod, and the biohazard bin will be made available.
-When your patient is done with the examiners, they will walk back into the clinic with the tray for the examiners, Blue acceptance form (has teeth marked, areas to mark probing and recession, and start and end time), and HHx form.
-The x-rays submitted remain with the examiners.  You must print a copy if you want one for yourself.
-Set the examiner's tray aside while instrumenting.
-You have 2 hours for instrumenting, marking probing and recession, and getting your patient to the front desk for check-out with appropriate examiner items.
-For Check-out, Blue form (marked with probing and recession) in clear plastic sleeve, HHx form, and Tray (mirror, probe, explorer, gauze, safety glasses).
-If you are late for check-out, 1 point will be docked for every 1 minute you are late.
-While patient is being checked-out, clean up area, unit, and instruments.
-Ultrasonic remains at the unit for the Floor Assistant to pick up.  If the ultrasonic came in a bin return it to the bin and leave it at the unit.
-Instruments do not have to be sterilized but must be in a sealed instrument bag.  If you want them sterilized, put your candidate # on them and bag them yourself.  The Floor Assistant will sterilize them and return them in the room downstairs where you and your patient were seated originally before the examination started.
-As a time saver and advice, run your instruments through the ultrasonic first, then clean up your area, and before you walk out of the clinic with all your items, bag your instruments to be processed through the autoclave. This is especially important for the morning group as the afternoon group will be minutes behind you.
-Barrier and dispose the chair exactly the way it looked before you arrived before you leave the clinic.
-Before you leave the clinic with all your items, submit your white packet before.  This contains a carbon copy of the process of care, badge, and a carbon copy of ITC form if applicable)  The ITC form notifies the Chief Examiner and Candidate of 2nd submission acceptance or late check-in/check-out.  In other words, you'll know if you have one of these.
-Go directly downstairs to wait for the examiners who are with your patient AFTER the exam is complete.  The patient will be sent down with everything on the tray in a sealed bag.  You will not get the tray back since it remains in the clinic
-The Floor Assistant will deliver the sterile instruments into that same room once they are complete. This generally takes about 20 minutes once they are bagged since the sterilizer is to be run constantly regardless of fullness.
-The left-handed chair was designated for left-handed candidates, but don't count on it.  I don't know if this was because the Chief Examiner was nice or if it is standard.

First screening experience (March 9, 2012)

I have never screened for patients to meet my requirements before, so this was a good experience to learn for the time when I really need to know how!  I wasn't planning on screening with the rest of the class this day because so many people were interested.  I had my mid semester counseling with Prof. Costley who mentioned the screenings.  I, then, learned how important the screenings were.  Yes, they are good to find patients and meet requirements, but what about if I don't find patients who suits my needs?  At least I tried!  I figured this would be my only saving grace at end of semester conferences if I didn't meet my requirements.  I caught on to her lead very quickly.  It was that day that I realized I needed to find 3 patients to screen and be there the whole time.  Prof. Costley was giving of her time for this opportunity, and I needed to take advantage of it.. for the experience and what I mentioned above.  As the time grew closer, more and more people decided they didn't want to do the screenings because it's hard to find patients who are willing to come in and it's hard to tell them why we're doing it.  Either way it didn't matter how "hard" it was going to be, I had to put forth an effort and get as many people to schedule as possible. 

I was able to do it!  I got 3 patients scheduled in my chair for the time frame of 8-11.  That gave me 1 hour per patient to get the x-rays needed taken, probe readings measured, an accurate perio description done, and had Prof. Costley to check and verify what I did was good.

The morning of the screening, my nerves took full force.  I wasn't sure what I was doing because I wasn't well informed, so I decided to just try and go with it for my first patient.  Sure enough, it went fine!  I was able to get everything completed in enough time to see my next patient.  My second patient was full of questions and things he thought he knew.  This would've been more than fine during a regular cleaning period but not really during a screenign since there is such a short amount time time given.  I did the best I could, and I think I made him happy.  My 3rd patient arrived early so a girl who's patient no-showed went ahead and took him back for me.  She got started, and when I was done with my patient, I was able to go help finish him up.  All in all, this experience went really well!  I was so proud of myself for having a full schedule and getting all that I needed to get done completed.  I was able to classify 3 patients as Class II and help one girl in the program to meet that requirement.  While I had arleady seen my Class II patient and was screening for my Class III, I felt really good about this day and knew I worked hard and did the best I could!

11th Patient

Goal: Complete 4 quads Class IB, 1 set of BWXActual: 4 quads Class IB, 4 BWX and 2 PAX, Blood Glucose PE

My dear friend came in to let me clean her teeth to meet my requirements.  I have been so fortunate to have such great friends and family to support me through this program.  I was able to get so much accomplished and serve her as well.  I was able to pass off my Blood Glucose PE which I was nervous about because no one likes to be stuck for fun, but Kim didn't bat an eye when I asked her.  I was able to complete everythign within the alloted time which made her happy as well.  This was such a good experience and a confidence booster.  Kim had such great teeth and oral hygiene!  There really wasn't anything to nag about which made it so nice! :)

Monday, March 5, 2012

10th Patient

Goal: Complete IB in one appointment, possible sealant experience, 4 BWX
Actual: Completed IB in one appointment with time left over :), 4BWX and 1 PAX, and 4 Sealants placed!

I was a little nervous for today because this was my first patient I actually wanted to finish in one appointment.  I was nervous for the actual patient because it seems like family/friends have a harder time with me than other people (I'm pretty sure I already explained why before this post).  I was able to complete 4 BWX and 1 PAX without any retakes which was such a relief and good on time.  My patient was very jumpy during the probing and scaling.  She had gingivitis so I explained to her why is hurts.  I think she understood after that and got motivated to control her oral health.  Today was a good self-esteem booster.  I was able to meet my goal and do a little more.  I want to be able to continue to increase my time, so I can see 2 IB in one appointment.

7th patient Final appointment

Goal: Complete Class II quads (3), PEs Anterior #2, Ultrasonic #2
Actual: Completed Class II (3), PEs Anterior #2, Ultrasonic #2

Today was such a good day!  I came prepared to get my patient completed today and ready to pass off a couple PEs.  My patient had a really hard time holding still in the chair as I was scaling because she was really sensitive to the ultrasonic and hand scalers.  I tried to be kind, and because of this, I missed a lot of the anterior maxillary calculus.  Professor Costley was my instructor for today.  She noticed 11 missed areas.  She asked Karen (a TA) to come over and help me get the calculus removed.  This was the highlight of my total dental hygiene experience!  I loved having her right there with me.  Since I am left-handed and she is right we were able to sit in the right positions and not move.  We passed instruments back and forth and was able to get all the calculus off!  I was so impressed with this experience!  It made my whole week!  I know my patient had a sore mouth, but I made sure she knew how great of a cleaning she got and told her how thankful I was that she allowed me to do this.  I think by the end and after a few days she appreciated the cleaning and knew what a great value she received.  I wish I could express how excited I was able this experience.  I really felt what calculus feels like and was taught a few tricks to get it the first few times.