Ethics Project

The ethics project was a way for us to learn that each person has their own personal ethical philosophies acquired through education and experience.  As dental hygienists, we need to advocate and incorporate ethics into our everyday lives, as we will face ethical issues when providing care, whether it be towards the patients or co-workers.  This project gave me the chance to ask the difficult questions pertaining to drug/alcohol abuse in the dental office.  A classmate and I interviewed a registered dental hygienist, who is still practicing and has much experience with this topic. 

When interviewing this person and describing scenarios where ethics came into play, I learned that everyone has a different method of dealing with these issues and that sometimes there’s not always a right or wrong way of doing things.  I learned that a lot of your own personality has a lot to do with your ethical practice and how you would handle certain situations.  Because the person I interviewed had so much experience with drug and alcohol abuse in the clinic, I think I learned above the scope of things. Like how to treat these patients and why some people abuse these substances in the first place. 

It gave me a great foundation to reference if I ever experience this issue.  The person I interviewed was extremely helpful and provided ethically based answers.  Above all else, you could really tell that her main focus was the patient’s well being, which is the kind of hygienist I would like to become.    

Clinical/Patient Experience

When choosing my patient for the practice case doc for Theory, I choose a patient who was diagnosed with down syndrome.  I had never treated a patient who presented with this condition and was interested to see how the syndrome affected the individual’s oral health, hygiene practice, and how I would need to modify my treatment.  I did some research before seeing my patient and learned that down syndrome can contribute to significant oral health effects and impact dental hygiene care by limited intellect and physical inabilities.  Periodontal disease and caries are the most significant oral health problems in people with down syndrome.  Xerostomia, mouth breathing, enlarged tongue, malocclusion, bruxism, poor oral hygiene, and conical-shaped roots can also be common negative contributing factors of the syndrome, which the patient is experiencing.  My patient was accompanied by her mother, who is solely responsible for her daughter’s oral hygiene.  The patient did report however, that she did brush her front teeth occasionally.

When using the cavitron to implement debridement, my patient reported feeling as though she was drowning, and she suffered from a severe gag reflex.  I had to cavitron two teeth a time, could not seat my patient fully back, and I placed warm water in the water bottle to decrease sensitivity.

I had a really positive experience with this patient and I learned a lot.  Many factors and conditions can contribute negatively to a patient’s current oral health.  It is my professional responsibility as a hygienist to not only identify these conditions, but to provide the upmost quality of care to restore current decay, prevent further disease, and to give patients the knowledge and skills to best suit his/her individual needs.  Each patient requires customized care by addressing current conditions and risk factors that could be contributing to his/her oral health.  I learned that no matter what condition the patient presents, every patient deserves customized quality care.  I also learned that I need not fear or be intimidated by conditions I am unfamiliar with.  My patient was the sweetest person imaginable.  I learned that it is not only important to inform the patient what you are doing step by step, but to tell the care-taker as well, especially in regards to at-home oral hygiene practices.     

Oral Surgery Rotation

I was fortunate enough to meet an elderly patient with leukemia and lymphoma with the most amazing and positive attitude.  She trusted in God to heal her.  While waiting for the oral surgeon, I was asking her multiple questions about her life.  She was so proud of her children and their accomplishments.  She was most enthusiastic about being a grandmother.  She "hates the dentist", but knows the importance of having her oral cavity a safe environment in order to have certain treatment done to facilitate getting her cancer free. 

 

While having multiple teeth extracted, she squeezed my hand to the point where I was in pain, but I let it happen.  When the resident placed gaze in her mouth after the procedure, she wasn't able to talk clearly.  I was giving her post-treatment instructions and gave her a piece of paper with hopeful reminder tips.  She asked me for my pen, unsure of what she was doing, but she wrote "keep your spirit, you was great".  It just goes to show I'm not just performing a job to these people.  This profession encompasses compassion, support, reliance, tolerance, patience, and emotion.  These people need to feel comfort and want to be able to trust their health providers.  She was truly inspiring, sweet, brave and real. I really hope she makes

Perio Rotation

Today I had an interesting experience in the perio rotation.  I was able to complete an AP for a periodontal patient who had received multiple surgeries to restore some attachment loss.  I got to use the ultrasonic for the first time.  I was amazed at its efficiency.  It was a lot easier and more convenient than hand instruments.  I was asked to ultrasonic generally and then fine tune with hand instruments.  This made the job extremely easy and was very time efficient, even with the patient having a plaque free score of 30%.  I had 35 minutes to do an AP.  Though I was a bit nervous, I set to work, the periodontist was in and out to check on me and I slowly became confident with the new instrument.  The doctor gave me positive feedback and told me I was natural. 

I also had an issue with the patient.  The patient was asking me inappropriate questions, asking me for my personal contact information.  This made me uncomfortable.  Though I continued to work on the patient to complete my task, I thought this was highly unfortunate.  I talked to the periodontist and expressed my concerns.  He told me that this is an issue I will have to deal with and should know how to encounter such patients.  He told me I don't have to stand for that and to remind my patients of our professional relationship if this were to happen again.  He documented the incident.  It taught me a lot about myself.  Though I truly do care and want to help patients achieve great oral hygiene as a clinician, there are boundaries and limitations that need to be in check at all times between a patient and clinician.  When these boundaries are crossed, and when I feel uncomfortable performing a task, I need to take action and let individuals what is going on, like the dentist, and that I don't appreciate and will not stand for such behavior from the patient.  Overall it was a great learning experience and i can't wait to visit perio again. 

Rally Day

Rally day was really interesting. I sometimes forget that Richmond is the capital of our state, because I am so busy with school and what-not.  It was fun to look at the architecture and the different buildings.  Unfortunately, I personally did not get to see or personally talk to any delegates or senators, but it was fun to walk around the different buildings to see where their offices are located and to see how busy these people are.  Sitting in on a session was my favorite part.  I was not aware of how many bills get passed a day; I was surprised.  Unfortunately, I was not able to go on the tour, because I was part of the group to last leave the chambers and missed the opportunity.  I would love to explore on a weekend day.

I thought the talking points, or the bills we were advocating were really important and very pertinent to dental hygiene. I think this is an experience every hygienist should experience.

cvs

I went to Washington DC this past Friday to visit my sister, who recently got engaged.  Ironically I forgot my toothbrush and went to the nearest cvs to buy one for the night.  While looking at the different toothbrushes, a man next to me was also picking out one.  He reached for a hard bristle toothbrush and I immediately told him he was making a mistake and to always buy a soft or extra soft one instead.  He remarked that he really liked the hard ones, because he feels like hard bristles, though "hurt him", do the best job.  I told him that he could actually be doing more damaged than good and that he could be causing abrasion and recession on his gums, especially if the brush hurt him.  After explaining this to him, he bought two soft bristle toothbrushes, one for himself and one to replace his daughter's hard bristled brush. 

Hygiene Alumni

Having the opportunity to meet and converse with some of the first women graduates of VCU dental hygiene was such a pleasure and is something I will never forget.  It was interesting that so many of them used DH as a stepping stone into other careers, however one did not and still practices. It is so gratifying to know that I will be entering a profession that will most-likely always be in demand, is universal and flexible, and is something I can practice for decades while still being able to have other interests.

 

 The ladies who did move on, still use aspects of hygiene in their current professions like the oral surgeon, who sometimes uses the universal curette for certain procedures.  Though I think that using DH as a stepping stone to pursue other career ambitions is amazing, after receiving a degree in marketing, I made an absolute sure, with-out-a-doubt decision that DH was my niche and calling. Thus far, especially with clinic time, I know I will be extremely happy with this profession.

 

It was also interesting to listen to how the program has changed, for instance, from what they were permitted/required to wear to how far women's right have changed.  I especially liked the story about how the hygienists split up during one class and received a standing ovation. 

 

It was also fun to watch Dr. P interact with her former classmates.  While sitting with my classmates, we were all expressing how one day that will be us.  It makes me feel like the comradery that our class shares is just as strong as it was when these first hygienists were in school. It's like we're family. 

 

Hearing about the generous donation that was made to the school of dental hygiene, I feel even more privileged to be here.  It's really wonderful to know that people care about the future of dental hygiene and hygienists.  This is something I would love to do, give-back...(once all my student loans are paid off).