“The Problem Patient”: 3 Ways to Deal with the Less than Pleasant Patient

By Mikayla Cox, RDH, BSHS

We have all been there.  You turn on your computer, look at the schedule and there it is...Mr. Smith’s 3pm prophy appointment. You immediately start to feel your blood pressure rise and a mixture of dread and defeat. For any hygienist that has been practicing longer than a few months, the “problem patient” has a way of ruining your whole day or possible your week.  But what if we could re-envision the way we approach these appointments? When we take a moment to step back, see how we can best approach this patient and create a more pleasant dental appointment for both parties. 

1. Breathe

Start with taking a few moments in your operatory to practice some deep breathing.  Just a few minutes of deep breathing can reduce blood pressure, relieve stress, and reduce tension.¹ In a stressful moment most people tend to resort to chest breathing.  Chest breathing is short quick breaths using the upper chest muscles.²  This can result in harnessing tension along the shoulders, neck, and head.  As practicing hygienists, we do not need additional wear in those already strained areas. Rather, we should practice diaphragmatic breathing, a form of breathing using our diaphragm.³ Diaphragmatic breathing encourages your body to relax rather than stiffen. Try taking 3-5 deep breaths before walking out to greet you patient. 

2. Avoid Judgement

It is easy to make assumptions about why a patient is in a bad mood.  Try instead to think about the patient’s perspective. Have they just come from a difficult day at work?  Are they fearful of dental treatment or self-conscious about their teeth? These feelings could easily manifest as a patient being “rude” or “cold”.  As you are seating the patient or reviewing medical history, ask about any apprehensions they may have. When we take time to listen to our patient’s concerns it can start to build trust, which can result in smoother future appointments.  

3. Remember You’re in Control 

At the end of the day, we can only control how we respond to the patient. Even though it may be difficult, using every bit of self-control you have, try to respond to the patient in a calm manner.  The more composure you have, the less chance there is of a situation escalating in a negative manner. It can even be beneficial to excuse yourself for a moment and walk to another room. Also, it is important to keep in mind that you may be the only person who treats them kindly or with respect that day. 

There are several reasons why a patient is difficult but if we focus on what we can control and how we react to the patient, it is likely that we can have a more positive experience with that patient. As dental hygienists, it seems that we hold most of the responsibility to create a positive appointment.  While we too may have had a long and trying day, we should still strive to do our best, which means providing the best care for our patients. These are also the moments that I am thankful for only 1 hour appointments! ::smile::

References:

¹ Staff, H. (2018, June 28). Stress Management: Breathing Exercises for Relaxation. Retrieved May 15, 2019, from https://www.uofmhealth.org/health-library/uz2255

² Peterson, L. A. (2017, March 23). Decrease stress by using your breath. Retrieved May 15, 2019, from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/decrease-stress-by-using-your-breath/art-20267197

³ Peterson, L. A. (2017, March 23). Decrease stress by using your breath. Retrieved May 15, 2019, from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/decrease-stress-by-using-your-breath/art-20267197

About the author:

Mikayla Cox, RDH, BSHS has worked in dentistry for 7 years, including 3 years in public health.  She graduated from Missouri Southern State University in 2012 with her degree in Dental Hygiene and Health Sciences. While working part time in clinical practice she spends most of her time as a hygienist for a Community and School-Based Dental Program at the local health department.