As I was waiting for my patient to come back to start the next prep, I started to hear unusual things about my patient. One of the runners asked, "Is your patient ok? He literally stopped in front of an assistant, yelled 'You're beautiful' while staring at her, and then walked away". My assistant, who walked my patient to the line to get checked, said that the patient started dancing while in line while everyone looked at him.
To be honest, I thought his behavior was weird, but normal for him, and didn't think that I should stop working. His behavior was strange, no doubt, but had been for the past couple of appointments and ever since I met him. So I continued.
I start my class III prep. Patient again fell asleep. I thought that the cavity extended beyond ideal, so I asked for a modification. It was denied, meaning what I asked for was too small, or too big, or I didn't need to do anything at all. I frantically started analyzing, but looking clinically, I concluded that I didn't have to do anything and that the prep was fine.
Meanwhile, the patient could tell I was anxious, and started mumbling under his breath as I worked, telling me he was praying for me. Which was sweet, but again, weird.
I sent my assistant and patient off, and after getting the patient back, I was ok to restore and all was well. I succeeded in 2 out of 3 procedures, and was ready to bring it home. However, this is when it all went downhill (uphill?).
I hadn't eaten properly all day, and felt like I had a small window of time to take a break, grab some food, and regroup for the last part of the exam. I also wanted to give my patient a break. I gave him some food, and told him to come back in ten minutes so that we could get started.
Ten minutes pass, and he comes back, saying he needs to use the restroom. Ok. I tell my assistant to show him where the bathrooms are, and to bring him back after he's done... except that he takes thirty minutes. I still have sufficient time for perio, so I'm ok with this for the moment. The patient comes out of the bathroom and basically starts talking about his bowel movements as we walk him back to the chair.
I send him off to get approved, but he comes back with an officiant trailing behind him; have I done something wrong? Did he not get accepted? No, but I forgot to check and record his blood pressure for the final time that day. This makes me lose 15 minutes, and I will have to resubmit my patient after getting his pressure, potentially losing another 15 minutes. I check his blood pressure: 165/100mmHg. Not good. Far from good. I keep my cool, and tell my patient to walk around, go outside for a minute and come back, hoping the BP will drop. The patient starts losing confidence in the situation, and it looks like he wants to back out.
I lose it. I think of the fact that if I don't have a patient, I will fail, and due to the stress I was already feeling, I start tearing up. This makes the patient feel bad, and he says he will go for a smoke and come back. Meanwhile, I go to the front desk and ask about a back up perio patient. There are none, but some classmates start making calls in case I need one.
I start talking to the patient outside, as he's smoking, and a classmate comes out to try to help me. He says he will come back to the operatory. It's almost 4:00pm at this point, and I need to have started by 4:15pm. My wonderful patient care coordinator at school tells me they might have a back up for me, and to let me know if I need him.
Checking his blood pressure again, I get 150/94mmHg, which is acceptable for treatment. However, since the patient had a high reading initially, the floor monitors want to check the pressure again. For them, it is high. One gets 150/100mmHg, one gets another reading. Neither are acceptable, meaning I need to find another patient ASAP.
This is when everything falls to pieces. My patient begins accusing me of lying about the blood pressure, and putting him in danger. I tell him no, I wouldn't do that, and blood pressure readings change minute to minute. However, he is distraught and cannot be consoled. Meanwhile, I am frantically trying to think of plan B. I have ten minutes to find another patient. I tell my assistant to run to the front desk to tell them I NEED A NEW PATIENT.
I try to rationalize with the patient, but he is not hearing anything I am saying. Finally, I have a runner escort him out, even though he is mad. I am losing time.
Getting sleepy again. Part 3 later!
