The lift is broken and my dental surgery is on the 6th floor. The last patient is slightly obese 50+ year old lady who has a heart medication. It is the last appointment of the day and most of the practice staff has left the building.
She walks into the reception. She huffs and puffs when I call her in. The first wave of complains hits me. Apparently it is my fault the lift is broken. I manage to calm the situation and she sits down in the patient chair.
I am super-cautious with everything what I say but she – still out of breath – takes another round at me. Now she’s shouting. I try to follow the protocol of how to deal with an aggressive patient. No help. I ask if she’d rather cancel the appointment. She wouldn’t. Instead she demands me to start the treatment and not to speak to her.
But I must speak. This job cannot be done without informing of certain things.
I suggest again that we could reschedule the appointment. It’s the end of the world for the patient and she nearly screams at me. I sit silently, my whole body trembling (which I pray God she wouldn’t notice). The patient demands me to carry on with the treatment and I do so in a fear of… not sure what but I rather carry on than stop the treatment to find out.
I must use calming deep breaths every time the patient does not notice as otherwise it would be difficult to hold an instrument in my hand. But still I must support my mirror hand with the other hand to stop the handle clattering against the patient’s teeth.
Once we are finished with the treatment the patient has calmed down. She even apologies her behaviour. I smile and I’m friendly towards her but inside me I am totally worn out and in a need of comforting.
Aggressive Patients And the Protocol
When a patient is hostile towards you and criticises everything you do there is no way to stop your heart pounding. You may try to hide it and act as we are thought – be calm, remember to listen, listen, listen, address the patient’s feelings with sympathy
I’m sorry you feel this way…
I understand that you are upset…
and let the patient finish until you ask
Do you want to continue with the treatment or should we reschedule?
At the same time your heart is racing like mad and you think the patient can hear from your voice that you are far from being calm. If she doesn’t notice it from you voice she will notice your hands that shake frantically.
Sound familiar? Been there done that!
We Are Not Perfect And Definitely Not Superhumans
No matter how good people skills you have there will be a day when a patient does not like your chair-side manner. The patient might be verbally aggressive towards you or passive-aggressive when you sense that all is not well (arms crossed and hardly answering your questions). Or the patient might act normally during the visit and later on you find out that complaint was made against you.
Whaaat? Me? But I’m always liked by my patients!
I have learned long ago a very important thing that keeps me sane in my professions when it comes to the patients:
You cannot please everyone!
Embrace this sentence and remember it when you hit a difficult time with your patient. If you feel that you have done your best you can calm yourself down by repeating this simple sentence in your mind. And offer it to the newbie who has met her first aggressive patient.
The same was done to me by a kind and wise dentist after one aggressive patient.
Y o u c a n n o t p l e a s e e v e r y o n e!
I have noticed that there is a pattern of the aggressive behaviour amongst the patients. The fear of dentist is one thing for sure. But the ones that have given the hardest time on my professional life have been female patients between the age 50 to 60. I cannot help but thinking that this unstable behaviour (from 0 mph to 70 mph and back again) could be due to an undiscovered menopause.
Now could it?
But for your safety do not under any circumstance suggest this to the patient. It might be the last thing you do.