CYC-Online 124 JUNE 2009
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Lessons from a visit to the dentist

Lesiba Molepo

I was wondering the other day about the reasons why I keep on going back to the same dentist time and again. Then I thought of reflecting a bit on my experiences, especially my first visit to this particular dentist. The story goes as follows:

One night I had a sleepless night as a result of toothache. The first thing I wanted to do in the morning was to go to the dentist. I drove to town to try and find a dental place that was open. Obviously, as a result of the pain that I endured during the night, I had not many options but to go to any one that was open at that time. My first stop was at a place that appeared modern and fancy on the outside. In fact this place was attached to one of the most respected and expensive private hospitals in our town. When I approached the receptionist, I was asked if I had made an appointment and I answered “no”. As far as I was concerned, this was an uncaring question as I did not know in advance that I would have terrible toothache the previous night. I saw no need to even try to secure an appointment for a later time or date due to the fact that the dentist had not arrived (as it was too early). Of course without such an appointment, there was no way the dentist was going to accommodate me. The pain I was enduring needed to be attended during that moment, so I moved out, disappointed and still in pain. Then I walked around town looking for another dental place that was open and required no prior appointment.

When I found one, (which was not situated in a fancy building) I was told that the dentist was in and willing to see me. He was also prepared to examine me for a much cheaper fee compared to what I presume I would have been charged at the previous dentist.

When I got to see the dentist, the first thing he said to me was “you seem to have had no adequate sleep last night” and my answer was “yes indeed, I never slept at all”. Then I went aha...this must be a caring dentist. “How does he know that I had no sleep?” Immediately I felt cared for, even prior to the dental procedures that needed to be carried out. He then examined me and before he could start with the treatment, he explained what the condition of my teeth, especially the paining one, was. He did not use any medical jargon but simple language that I could understand. I must however admit that, as a result of the pain I was going through, I was not interested in the explanation but on the actual cure. On the other hand, he must have known better than me.

He must have known that it was my right and I deserved an explanation prior to the actual treatment. He went ahead to explain the advantages and disadvantages between filling and extracting the aching tooth. With such a simple and brief explanation, I was able to make an informed decision. It was at that point that I decided that I will definitely come back to this dentist should a need arise in future. In other words, what he did and said made an everlasting impression to me in such a short space of time.

In child and youth care we learn about the power of the moment but I wonder if we seize the opportunity, in practical terms, to use this power. This dentist did not say much but also did not compromise what he had to say. Then I wondered how often do we bombard the young persons who come to our programmes with information? Are we aware if during the initial encounters with us they are willing or able to absorb all the information that we burden them with? I am certain that during admission we tend to give young persons a lot more information, especially things like group rules, than they can cope with. Indeed that might be part of the procedures we need to follow but who said that information should be shared/given all at once, especially when the young person is not able to retain even a quarter of it? Our procedures are there as guidelines and it is our responsibility to implement them in a way that is suitable to the individual young person.

Taking my child to the same dentist
As a result of having experienced treatment I received as caring, I decided to take my child to the same dentist when she complained about her tooth. But this time I was in a different position. In other words, I was not a patient, not in pain and therefore in a position to “objectively” observe how the dentist operated. I was also in a different role in that I was a parent and obviously the one who is going to pay. From that position, I felt I had the power to decide whether to come back again the next time around or not. Basically the dentist was under my spotlight. I must also confess that it was during that moment that I decided to put on my “child and youth care lenses” in order to see how other professionals do their work in comparison to us.

As we were still in the waiting room, another man walked in and proceeded to the consultation room with some food in his hand. This was clearly a different man from the one who has treated me in the past. I began to ask myself questions about this man. Did he not have time to eat breakfast at home? Is he married “ if so, why did his wife not prepare him breakfast (perhaps another male stereotype here)? Could it be that he is such a busy man that he does not always have time to have proper time for breakfast? Obviously all these questions had nothing to do with him as a professional. However, I found myself entertaining them. Then I realized that as child and youth care workers, we too are always under the spotlight of those we serve. Unfortunately those we serve will continue to be interested in information that we may even deem to be “none of their business”. Hence we need to be conscious of what we do even beyond our professional lives.

We were finally called into the consultation room after about 15 minutes. Notice that I said “we” even if the patient this time around was my child. This dentist’s assistant must have realized the important role that I could play in the situation. I must not take it for granted that we have all come to the realization that family members have a role to play in child and youth care programmes. I presume that there might still be some programmes in other parts of the world where young persons are still being treated in isolation. Being invited into the consultation room made me feel important. I immediately realized my role in terms of supporting my child. As we walked into the consultation room, there was the same man who walked past us with food in his hand. The thought that crossed my mind was “he was preparing himself and getting ready for the work”. Then I thought, I would rather wait for 15 minutes for my dentist to be ready, physically, emotionally and otherwise than have someone who rushes to attend to my child whilst he is not adequately prepared. The first thing he said was “thank you for being patient with me, I really appreciate it”. My response was “you are welcome” and I genuinely meant it. This man not only showed concern that he wasted our 15 minutes but also acknowledged that he owed us an apology as clients. What a caring and professional gesture!

To what extent do we as child and youth care workers feel that those who receive our services, especially the young persons, deserve our explanation and apology at times? How many of us came to a point in their professional stage where they realize that we are in this business because of them? We do get paid and make a living out of offering them a service and therefore we had better account for every service we render. Given the economic crisis that is experienced by the whole world, the child and youth care sector, which mainly relies on funders, is likely to be badly affected. Individuals and companies are only willing to continue supporting those programmes that offer quality services. Quality service can only be offered if every individual staff member in the programme strives to do what is best for the service recipients. In order to ensure that our programmes survive this economic turmoil, we can do our bit by offering a better service to those we serve. Although this economic situation seems to be immediately affecting the NGO sector, which heavily rely on donors funds, over and above the subsidy they get from the state, I need to mention that state institutions are not immune from the situation. We all need to do our best to ensure that our programmes continue to get the funds they deserve.

Team work
In the consultation room, the dentist had an assistant. In fact, even the previous dentist had an assistant who worked with him. I am conscious of the fact that I am using the term “assistant” here as a result of lack of a better medical term to describe this position. I am in no way suggesting that her role is inferior or insignificant. Judging by the manner in which she did the mixture for the filling, I have no doubt that she too has received special training to carry out her tasks adequately and thoroughly. She had the right quantity of the filling mixture “ no wasted mixture and she was always ready to pass it on to the dentist when he required it. What a wonderful team combination! Then I wondered if the dentist can ever be effective without such an assistant. At no stage did I sense that either the dentist or the assistant were in competition with one another. Each one played his or her own role without feeling superior or undermined. Back to child and youth care, I often hear child and youth care workers who complain that they are not being valued as key role players within the multidisciplinary teams. Then I wonder if, within the child and youth care settings, there is any category of professionals that can achieve their goals without the role of the child and youth care workers. In fact the assistant was there when we arrived and therefore was our first point of contact. We know that in most cases, child and youth care workers are first point of contacts in the progammes and therefore they play a significant role. To try and undermine their role in anyway will be a recipe for unsuccessful programming.

Say something as I do something
Prior to the actual treatment, the dentist invited me to see the condition of my child's aching tooth. He explained what he was going to do as well as what needed to be done in future with other teeth. Once again, I felt that I was involved in the dental affairs of my child. He further explained to my child that he was going to give her an injection to minimize the level of pain during the extraction of the tooth. This gesture showed that he did not undermine the intelligence of the child but saw the need to involve her fully as well. We should not take it for granted that the young persons in our programmes want to know what we are doing and the reasons we are doing those things. When the actual treatment commenced, I was particularly intrigued by how the dentist and the assistant complemented each other. As the dentist was drilling the tooth, the assistant would spray something into her tooth in order to minimize the pain or dryness. She would also utter words such as “we are about to finish” in order to comfort her and at the same time she would wipe her tears. I was convinced that all her actions, despite seeming basic, were not accidental but came as a result of the training she had received.

During that process, I could see my child looking at me time and again from where I was sitting “ and I ensured that every time she looked at me, she found me keeping the necessary eye contact. By so doing, I was trying to communicate that I was there for her. This sounds like the skill every child and youth care worker should possess “ the skill of knowing when and where to position yourself in order to support the young person (or even the family) during the time of distress.

During the drilling, clearly the dentist was playing the hurting role, which was necessary for the long term healing and the assistant knew that her role was supposed to be the comforting one. At no stage did I see both of them carrying out a task that was hurting at the same time. Sometime in child and youth care one of us has to play the comforting role whilst another is carrying out the hurting one. We just need to master the skill of knowing who plays which one when. My concern is that when we deal with the most troublesome behaviour, more than one person tends to play the hurting role without anyone playing the comforting one. Comforting that will not result in long term healing is not necessarily helpful but hurting without comforting will not bear the necessary results either. In multidisciplinary team settings therefore, as one is opening the wounds, the other one must try to comfort. How often do you hear child and youth care workers complain about young persons” difficult behaviour after they have been for therapy with the psychologist or social worker? Child and youth care workers often complain that they are expected to manage the behaviour of the young person after therapy without having been informed or warned about the content of what transpired in therapy. If we are really serious about complementing each other we should communicate the important information in order to be effective as a team.

Once again, based on the care and concern I have experienced from my dentist, I am likely to go back to him should the need arise. You will notice that this time around I have referred to him as “my dentist”. This suggests that I now have some kind of connection with him. This connection was earned over a period of time through little things that the team has done. Much as no one would like to find himself/herself frequenting the dentist’s consultation room, we know for a fact that time and again we have to visit them, especially for normal preventative check ups. It is now comforting for me to know where to go for dental treatments. This dentist has now become a dentist of choice for my family instead of a dentist out of desperation. I hope that our child and youth care services can also become programmes of choice for those we serve. It is my wish that those we serve will one day, but preferably now, proudly refer to us as “my child and youth care worker, my social worker, my psychologist and my programme”.

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