Beware of overactive bladders: A dental office restroom visit can be a shout-out for empathy

By Eileen Morrissey, RDH, MS

I'll wager that the following scenario is something that happens in your dental practice at least twice a week. An episode one day in my office taught me an important lesson.

Linda had arrived at my office for her recare visit 20 minutes early. She sat in the reception area reading a magazine, knowing full well that her appointment with me would take place promptly at 10:30. (Our practice prides itself on punctuality, and she is a long-time patient.) At precisely 10:30, I walked out to retrieve her, greeted her with enthusiasm, and asked her if she was ready to come back? She put her magazine down and responded: "I'm not ready. I'm going to visit the ladies' room first."

She walked off toward the restroom. Once she was well out of earshot, our administrative assistant and myself exchanged glances. I found myself remarking in a snarky fashion, "I thought you said she was here 20 minutes ago?" "Yes," the administrator replied knowingly. "I hear you." This was in response to my agitation and a bit of an eyeroll. (I know, readers, conduct unbecoming for a professional.) No one saw or heard us, thankfully, but I later realized that I needed to revisit the concept of professionalism.

When Linda returned, I brought her into my treatment room, seated her, and exchanged pleasantries. We were now 10 minutes into the appointment and I was practicing meditative breathing because I knew I yet had to take films on her, and further, she is a person with a challenging mouth to maintain. I updated the medical history. Linda offered that she was taking oxybutynin, which as you are likely aware, is a medication for an overactive bladder.

She then turned, looked me straight in the eye, and what she said made my blood momentarily run cold. "Eileen, I must drive you crazy, don't I?"

I said, "No, why would you think that?"

She shared that, since she has been on the medication, she is always fearful that she is not going to be able to "make it" through the length of the dental hygiene visit, and she would never want to interrupt me in the middle of it. That was why she would wait until the last possible moment to use the restroom before coming back, and that she would imagine how the restroom break must agitate me.

Did I mention my blood running cold? It was as if she had read my mind while she was in the restroom. I felt angst, but it was a learning moment. In retrospect, selfishly, it had always been about me in the past with patients who did this-how I was being inconvenienced by their need to answer nature's call.

I reassured Linda as best I could that if she ever needed to excuse her self during our visit together, it was absolutely not a problem. If using the restroom just before we started made her more comfortable, then that was fine too.

But mind you, I felt awful. I can't begin to tell you the number of times I have been annoyed when patients do this the moment they are called back. To this day, when I present this learning reminder at CE seminars, all the dental professionals present laugh hardily, because it is part of their world too.

But I left the discussion with Linda with some newfound empathy; a dose having been delivered to me that was urgently needed. I thought about all those patients with possible bladder issues I have potentially treated throughout my years-males with prostate glandular challenges, and women who have had hysterectomies, or are postmenopausal. Neurological disorders. Diets!

These are but a few that could contribute to irregularity and incontinence.

It was shame on me, for the eyeroll and impatience. I declared a fresh intent of starting anew from that day forward. Now I remind others. I began with two colleagues. One of them, upon hearing the story, suggested initiation of a policy. Upon arrival, why not announce to patients: "If you need to use the restroom, would you do it now, while you have 15 minutes of wait time before your appointment..." (What?)

The suggestion from the other colleague was: Have that verbiage instead posted on a sign for all patients to view in the reception area, which would somewhat soften the blow but still get the message across... (Can you imagine?) Again, it was all about us and our convenience rather than patient empathy and care. I rest my case.

Professionalism: Being part of an educated group who exercise consistent expertise, empathy, graciousness in their dedication to a calling and vocation. Onward we go; it is in our hearts' core! RDH

EILEEN MORRISSEY, RDH, MS, is a practicing clinician, speaker, and writer. She is an adjunct dental hygiene faculty member at Burlington County College. Eileen offers CE forums to doctors, hygienists, and their teams. Reach her at [email protected] or 609-259-8008. Visit her website at www.eileenmorrissey.com.