By Blanche Kadjo, DFT
I never believed that I would have to deal with an angry patient at dental school and not to sound dramatic, but it was one of the most memorable yet life changing moments of my dental student life. It's safe to say I never expected it but it's important to be alert and professional with any patient, being aware of your duties and rights as a clinician.
The main reasons for patients becoming angry in the dental chair (especially as a student) are:
Long appointment times
As a dentist or dental student your professionalism towards the matter must always be kept constant and respectful. Remember it can happen to anyone even when you're not at fault
1. Know the signs before it escalates
One thing that I wish I realised sooner was the importance of knowing the warning bells of a patient becoming irritated. Trying to get things under control is imperative to preventing an escalation in anger. These signs can include a lower, slower or abusive tone of voice. Loss of eye contact, eye rolls, frowning and movement of arms and head in an aggressive manner.
The signs may be very subtle so its important to be alert in the changed behaviours of all your patients. This can be difficult as you're probably already overwhelmed with other clinical duties but multi-tasking in the dental chair is a great skill to start implementing at dental school.
2. Stay calm and breathe!
Take a deep breath. Don't take this simple bodily movement for granted. It can really help to keep you calm and prevent any panic attacks from occurring. It can also allow you to gather your thoughts and remain professional throughout the situation.
Do not match anger with anger. This will only create more tension and make the patient even angrier. Responding in a calm manner has been shown to decrease the patient's aggressiveness.
3. De-escalate the situation and get help
If the patient is upset about waiting times or the length of the appointment then apologise for how they feel, not the situation as it was most likely out of your control. One way to de-escalate the situation before it has even happened is to apologise beforehand and anticipate how the patient may feel. Remember patients are human beings with their own unique lives, therefore their emotions are justified, to a certain extent.
Begin to empathise with the patient about how they feel and find a solution that may help solve the situation, like completing treatment in another appointment or rearranging next patient's next appointment with another clinician. If you're a dental student, you will need help from your supervisor about how to continue with the appointment.
Never be afraid to ask for help, you should not go through this alone, especially as a dental student or beginner dentist.
4. In a position of threat?
Make yourself safe by stepping back along with your nurse. Do not be close to the patient and if you believe they may physically attack you don't be afraid to shout for help. Your safety and the safety of your nurse is important. Consider going on self-defence courses for health care professionals to become more confident in a physical situation.
Keeping up to date with your school or practice policy regarding aggression towards staff will make you feel more confident with the actions to take for the future when there's a breakdown in the patient and dentist relationship.
5. Next steps
Keep great notes and an incident report. Remember the 4 C's: keep them Clear, Concise, Contemporaneous and Complete in line with the FGDP(UK) guidelines.1 This will be very important in case a complaint arises.
Remember: no notes, no defence. Great notes, great defence.
Written and personal reflection is key. Reflecting on your experience will be helpful for the future. You'll be even more equipped and confident in handling a situation like this again. You may consider bringing up this incident report in a staff/student meeting to showcase how you handled yourself to support your peers if they are ever in the same position as you one day.
6. Bonus step: reward yourself
Your confidence may be lowered immediately after the situation. However, be proud of how professionally you handled the situation because you will only get better in the future. Remember things like this can happen to anyone, even when you have done nothing out of line or unprofessional.
FGDP(UK). 2.2 Basic information about records. Available from: https://www.fgdp.org.uk/clinical-examination-record-keeping-standards/22-basic-information-about-records (Accessed June 2020).
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Kadjo, B. Dealing with the angry patient. BDJ Student 27, 13 (2020). https://doi.org/10.1038/s41406-020-0147-5