"But Margaret, you know I never work on Fridays!" It was the office manager calling me from the pedodontic practice that I often help with dental hygiene on a temporary basis. Well, she explained that this was a special situation. No one was absent from work. As a matter of fact, the whole staff would be there to see 45 kids from Kosovo in six hours.
I gasped. "Margaret, are you all crazy?" That would give us a whole eight minutes per patient! Margaret replied: "Well, maybe we are. And you are too. Thats why we want you to help us. By the way, most of them dont speak any English."
Now, this is one of the highest production offices I know. But even for the kiddie factory, this agenda sounded impossible. How could we possibly deliver quality care? Margaret explained details and I ended up participating in what would be one of the most rewarding days of my dental hygiene career.
Why we did it
A local church had sponsored these families from Kosovo, helping to bring them to this country, get housing, and assimilate them into our city's culture. They had managed to get all the children on Medicaid and needed dental care for them. This office was contacted because it is the largest provider for dental Medicaid in the state.
Ive seen lots of Medicaid patients and I have strong feelings about the system because I have seen it so often flagrantly abused. On the other hand, my heart went out to these families, who had been wrenched from their war-torn homeland. They came to a new country where they didnt speak the language and were trying to repair their lives and start over. This pedodontic office evidently felt the same way and decided to help.
How we did it
The whole office contributed that day, even people who didnt ordinarily work on Fridays. We established a game plan, and many staff members contributed in ways that were not customarily their duties.
The 45 children were brought into the office in two groups. This would help alleviate crowding. There would be two adults per group who could speak English. There would be two other hygienists, in addition to myself, working out of three chairs. Several other staff members would take and process X-rays. Two doctors would be present to do the exams and to provide simple restorative procedures. More difficult and timely procedures would be re-scheduled. Remaining revolving staff members would help with patient check-out and patient flow. Everyone tried to help make these kids feel comfortable in what was, for many, their first dental experience ever. Ages ranged from six to 16.
What we did
Patients were escorted in from the reception room six at a time. We tried to keep families together so that siblings could help to re-assure each other. We set up chairs in the hallway so the patients could sit with their friends while waiting for their turn getting X-rays. This also gave them the opportunity to watch their friends getting X-rayed and see how easy it was.
The hygiene room is large with several treatment bays. The three hygienists kept our chairs full providing prophys and fluoride treatments. When each child was finished, they could play video games or wait with their friends. One doctor attended the other treatment chair in the hygiene room where he conducted ongoing exams. The other doctor provided restorative treatment in another room.
Fortunately, several of the children had already learned some English. We utilized the help of these kids, as well as the two adult escorts, to communicate. Oral hygiene instructions were accomplished with some verbal communication and a lot of hand signals and demonstrating.
What I did
My first patient was a 15-year-old girl who spoke English remarkably well for her four months in America. What incredibly good luck! I had my own personal interpreter. We bonded. I asked her to teach me several basic words that I wrote down. The words were please, thank you, open, close, and tickle. Then I asked her to help me explain to the other children. She was delighted to assist, and we made a great team. I enjoyed attempting to communicate with the Kosovo kids in their own language even if it was only a few words. Anyone who has ever traveled to a foreign country knows the power of speaking the native language, if only to say please and thank you.
What was accomplished?
We were able to provide treatment for all of the Kosovo kids. We had a few overwhelmed and frightened children, but, for the most part, they were amazingly well behaved and cooperative. Only two had to be hospitalized for treatment. We were able to take care of the needs of all the others in the office. Some of them had rampant decay and gingivitis, but many had mouths that required little or no treatment.
What I learned
My last patient was a 16-year-old boy. He was dark and very handsome. His mouth was another story, not a pretty sight. He spoke almost no English. I learned that his parents had not made it to this country with him, that he was here alone, and didnt know where his parents were, or if they were dead or alive. I, on the other hand, have had the luxury of enjoying the company of both of my wonderful parents for more than 50 years. I held back tears as I cleaned his teeth. As you might imagine, I was reminded of how very blessed we are to live in this country of peace, and enjoy the very highest standards of health care.
I also once again learned the value of great teamwork. We can always push ourselves a little bit farther than we think. An unusual situation required an unusual solution. Everyone rose to this challenge and I suspect they all went home feeling, as I did, a rewarding sense of accomplishment.
Janet Hagerman, RDH, BS, is a coach with Fortune Management. She can be reached at (888) 347-4785 or [email protected].
