Internship dilemma....advice please!

[spider367]

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I just started a orthodontic internship this week and was a little overwhelmed since I have never been around orthodontics and know nothing but still was working with patients my very first day. Also, the orthodontist is a female whom I find very intimidating. On my second day, I was instructed to place elastics on a patient and make sure that the little girl understood how to put them on herself. I showed her and she understood but after she had already left, I got thinking and am not entirely sure that she is wearing them the way the doctor wanted them meaning that the girls teeth could be way out of place whenever she comes back. I'm nervous that if I say something at this point, I will be in trouble for both messing up initially and waiting almost 2 days to say anything. I feel reallllly bad and am not sure what to do?

 

[yellowjeeep79]

This is an ethical question where a patient could be harmed and the ortho will def. find out about it. Come clean and let the team know that it was your concern for the patient that is your motivating factor.

 

[Jackson-Ave-Dental]

I just started a orthodontic internship this week and was a little overwhelmed since I have never been around orthodontics and know nothing but still was working with patients my very first day. Also, the orthodontist is a female whom I find very intimidating. On my second day, I was instructed to place elastics on a patient and make sure that the little girl understood how to put them on herself. I showed her and she understood but after she had already left, I got thinking and am not entirely sure that she is wearing them the way the doctor wanted them meaning that the girls teeth could be way out of place whenever she comes back. I'm nervous that if I say something at this point, I will be in trouble for both messing up initially and waiting almost 2 days to say anything. I feel reallllly bad and am not sure what to do?

What I've learned is to immediately report all errors if you commit any... This is especially true if you break anything as you will come to know, everything in dentistry is EXPENSIVE. Once you become in charge of ordering, you will see how easily the costs rack up.

I've made quite a few boo boos over these past 8 months... ie Autoclaving a non-autoclavable amalgam polishing kit LOL.


Also, its not the end of the world... whats the worst that could happen? Treatment slows down 2 weeks? 4 weeks? Nothing that is irreversible unlike drilling on the wrong tooth! Noobie error and I'm sure your employer will take that into consideration. Live and learn.

 

[wkupredental]

Also, its not the end of the world... whats the worst that could happen? Treatment slows down 2 weeks? 4 weeks? Nothing that is irreversible unlike drilling on the wrong tooth! Noobie error and I'm sure your employer will take that into consideration. Live and learn.

Totally agree - you need to say something now. If you wait, then you could cause more damage. I think that the dentist will respect you more for letting her know.

But definitely say something, and soon!
After all, you could find out that you did it perfectly right, and that you had nothing to worry about. Either way, you'll feel much better when this is behind you. Good luck!

 

[spider367]

This is an ethical question where a patient could be harmed and the ortho will def. find out about it. Come clean and let the team know that it was your concern for the patient that is your motivating factor.

I agree 100% but am still unsure of how to approach the doctor without her getting upset at me. I mean, how do I explain being silent for 2 full days? On top of that, how will the patient's family be notified? The whole situation is feels like a five hundred pound weight on my shoulders.

 

[wkupredental]

I agree 100% but am still unsure of how to approach the doctor without her getting upset at me. I mean, how do I explain being silent for 2 full days? On top of that, how will the patient's family be notified? The whole situation is feels like a five hundred pound weight on my shoulders.

Just tell the dentist that you got to thinking about patient x, and you're not sure that you instructed them properly. If you can remember exactly what you told the patient, just tell her what you said - and see if it was a mistake or not.

If it IS an issue, they'll probably call the patient and tell them that they just want to make sure that they are placing the bands properly. They most likely won't say, "Sorry, someone in here made a mistake... You need to come back." So don't worry about it.

 

[spider367]

Totally agree - you need to say something now. If you wait, then you could cause more damage. I think that the dentist will respect you more for letting her know.

But definitely say something, and soon!
After all, you could find out that you did it perfectly right, and that you had nothing to worry about. Either way, you'll feel much better when this is behind you. Good luck!

I know I need to say something but am unsure of how to do so! Would it be best to maybe approach one of the assistants whom I feel much more comfortable around?

Also, and I don't know for sure how much of a difference this makes, I know for certain that the patient is wearing the elastics on all the correct teeth. I'm just now sure if she was supposed to wear them actually on the back bracket and make a little triangle or if she was to wear them over the back bracket, and make a L shape (I did the latter)

 

[wkupredental]

I know I need to say something but am unsure of how to do so! Would it be best to maybe approach one of the assistants whom I feel much more comfortable around?

Also, and I don't know for sure how much of a difference this makes, I know for certain that the patient is wearing the elastics on all the correct teeth. I'm just now sure if she was supposed to wear them actually on the back bracket and make a little triangle or if she was to wear them over the back bracket, and make a L shape (I did the latter)

Hmmm... If I were in your situation, I would speak with the actual dentist - you're sure that they're the right teeth, that's step one. So there's a CHANCE that you did it the correct way. Speak to the dentist about it because she'll know what she wanted. Don't say, "Hey, I was nervous and didn't wanna talk to you for two days." Just act like it's a learning experience. You wanted to make sure you did something right. She'll understand.

 

[spider367]

Just tell the dentist that you got to thinking about patient x, and you're not sure that you instructed them properly. If you can remember exactly what you told the patient, just tell her what you said - and see if it was a mistake or not.

If it IS an issue, they'll probably call the patient and tell them that they just want to make sure that they are placing the bands properly. They most likely won't say, "Sorry, someone in here made a mistake... You need to come back." So don't worry about it.

If you're familiar with palmer system, I told the patient to wear them on 3 and over 4 down to 4 on both sides. However, I'm thinking the doctor wanted her to wear them on 3 and on 4 then down to 4.

 

[spider367]

If you're familiar with palmer system, I told the patient to wear them on 3 and over 4 down to 4 on both sides. However, I'm thinking the doctor wanted her to wear them on 3 and on 4 then down to 4.

Just curious, but I'm wondering how great the difference in movement will be between these two configurations?

 

[wkupredental]

If you're familiar with palmer system, I told the patient to wear them on 3 and over 4 down to 4 on both sides. However, I'm thinking the doctor wanted her to wear them on 3 and on 4 then down to 4.

There's no way to know until you talk to her about it. But seriously, I can't imagine a dentist being REALLY mad about something like that, unless she found out during the NEXT scheduled appointment that they're teeth are not how they're supposed to be.

 

[spider367]

There's no way to know until you talk to her about it. But seriously, I can't imagine a dentist being REALLY mad about something like that, unless she found out during the NEXT scheduled appointment that they're teeth are not how they're supposed to be.

I know!!!!...but I'm still nervous about how to bring it up!!! It's gonna look really bad if I'm like "So I think I put elastics on a patient wrong 3 days ago." She's obviously going to wonder why I didn't say anything until now....

 

[SeattleRDH]

Just curious, but I'm wondering how great the difference in movement will be between these two configurations?

You could ask this in the practicing dentists/residents forum.

 

[bluepills]

You definitely need to tell your orthodontist. Improper placement of elastics can completely shift the patient's bite and really mess up their treatment plan. It's not that big of a deal at this point, since it's only been a few days; all they have to do is bring the patient in to make check that they're wearing them on the right teeth. But it's extremely important that you do it now.

Come on. This should honestly be a no-brainer. The patient's health/bite should be a higher priority than the status of your job.