Stab lab: Learning how to give injections
FIVE days post-NBDE I we began Stab Lab. For those of us that aren't keen on this lovely and terrifying phrase, it's basically a week of very-underqualified dental students (most of whom have never held a needle before) stabbing one another in the mouth in hopes of anesthetizing a nerve. Absolutely terrifying both when being the patient and when being the provider. It definitely was such an awesome experience, it's definitely going to be a skill that will be developed with time and through many patients.
Day 1: starting ivs and glucose readings
Okay, so this day was totally the easiest for me given my EMT and medical assistant background. HOWEVER, I am totally the worst patient. Ever. If you've ever had a needle poking you to either draw blood or to receive drugs, you know that really annoying and cringe-worthy feeling of metal sliding out of your arteries, basically sucking the life out with it. I've never had my glucose reading taken, and I'm probably (most definitely) being dramatic about it, but that was pretty traumatic. Really, though, it was the tiniest little prick. But that level of anxiety I was experiencing was a eye opener for the days to come.
*PSA: As Priya reads this over my shoulder, she has dubbed me the "Dramatic Queen," so there you have it. And she wants everyone to know that it's really not that bad and that I'm just scarring and scaring you now.
*PSA: As Priya reads this over my shoulder, she has dubbed me the "Dramatic Queen," so there you have it. And she wants everyone to know that it's really not that bad and that I'm just scarring and scaring you now.
Day 2: mandibular injections
So the way that Stab Lab works is basically as follows: you learn about the injections that you're going to be performing in the morning, then you actually do the injection right after lecture. On a real person. On your classmate, nonetheless. So, we learned about the different mandibular injections, all of the terrible things that can happen if you go too far into a canal, or what happens when you accidentally inject someone with epinephrine in an artery because you didn't aspirate (could literally kill someone), or how you can paralyze someone because you numbed their entire V3 branch (temporarily, until the anesthesia wears off). Then they sent us on our merry way into the deep abyss that is the 4th floor clinic, gave us a syringe, and wished us luck.
Granted, there were oral surgery residents and partitioners present, so we weren't really on our own. But I kid you not, each time I was about to give an injection I'd call over a faculty member so that they could watch me and double check my positioning. Make sure you hit the bone, pull back, aspirate, then slowly inject.
I volunteered to go first in my group. Some people might call me brave and courageous (jokes on them), but honestly it was for purely selfish reasons. I wanted to get it over with and I didn't want to see what it looked like on other people and then have it done on myself. I figured that I would go ahead and have that adrenaline rush once, be done with it, then inflict pain onto others rather than living through it twice as I watched the gruesome being performed on my partners.
So there I was, Kesha blasting through my headphones to drown out the voices of the residents instructing my classmates to how to properly align the needle end through the mess of arteries and nerves. I was/am such a wimp. The injection really wasn't that bad, but I literally started crying because I was so nervous. I still feel terrible for Priya (my injector) because I feel like I made her more nervous and ruined her self-confidence. But she was kind enough to only inject a small amount and then gave me a few moments to regroup before proceeding to the mental block and PSA block. Now I understand why patients hate needles. It's not really the pain (esp for the mandibular teeth), but more so the anxiety that comes with it all. Priya was a champ though, and at least she now knows how to handle the more, let's just say, anxiety-ridden patient.
Helpful hints for providing the best mandibular injections to your patient:
1. Keep calm and be confident. Not all of your patients will have headphones like muah, so be strong for yourself and for them. Believe me, patients can tell when you have shaky hands and are unsure about where to penetrate their flesh.
2. Know what you're doing. This kinda definitely goes without saying, but it makes the world of difference if you can get in there, hit your target, and get out. It's less painful for the patient and it ensures that you'll only have to stab them once because you did it right the first time.
3. Talk to your patient during it. I was sure to talk to the classmate that I was anesthetizing, and she said that it made the world of difference. It not only distracts your patient, but also forms that real human connection.
Granted, there were oral surgery residents and partitioners present, so we weren't really on our own. But I kid you not, each time I was about to give an injection I'd call over a faculty member so that they could watch me and double check my positioning. Make sure you hit the bone, pull back, aspirate, then slowly inject.
I volunteered to go first in my group. Some people might call me brave and courageous (jokes on them), but honestly it was for purely selfish reasons. I wanted to get it over with and I didn't want to see what it looked like on other people and then have it done on myself. I figured that I would go ahead and have that adrenaline rush once, be done with it, then inflict pain onto others rather than living through it twice as I watched the gruesome being performed on my partners.
So there I was, Kesha blasting through my headphones to drown out the voices of the residents instructing my classmates to how to properly align the needle end through the mess of arteries and nerves. I was/am such a wimp. The injection really wasn't that bad, but I literally started crying because I was so nervous. I still feel terrible for Priya (my injector) because I feel like I made her more nervous and ruined her self-confidence. But she was kind enough to only inject a small amount and then gave me a few moments to regroup before proceeding to the mental block and PSA block. Now I understand why patients hate needles. It's not really the pain (esp for the mandibular teeth), but more so the anxiety that comes with it all. Priya was a champ though, and at least she now knows how to handle the more, let's just say, anxiety-ridden patient.
Helpful hints for providing the best mandibular injections to your patient:
1. Keep calm and be confident. Not all of your patients will have headphones like muah, so be strong for yourself and for them. Believe me, patients can tell when you have shaky hands and are unsure about where to penetrate their flesh.
2. Know what you're doing. This kinda definitely goes without saying, but it makes the world of difference if you can get in there, hit your target, and get out. It's less painful for the patient and it ensures that you'll only have to stab them once because you did it right the first time.
3. Talk to your patient during it. I was sure to talk to the classmate that I was anesthetizing, and she said that it made the world of difference. It not only distracts your patient, but also forms that real human connection.
day 3: Maxillary injections
This was definitely the worst day for me. Maybe it was because I already lived through the mandibular injections, or because maxillary injections definitely do hurt more. Either way, my injections ended with a panic attack, mascara rolling down my cheeks, and my 2 classmates literally having to calm me down as I cried. Y'all, I'm not even kidding you, it was not one of my better moments.
Here's why the maxillary injections *tend to* hurt more than the maxillary ones:
There's less underlying musculature and fatty tissue beneath the skin (compare your cheeks vs. your palate), so when you inject a liquid there is very little room for it to space out. Therefore, the key here is to inject slowly and to inject "comfort drops." Comfort drops are way helpful things because they are just little drops of anesthetic that you place superficially, let them work their magic for a few moments, then go in deeper to deliver more anesthetic.
Priya (still my injector) was wonderful. I jammed my headphones into my ears, cranked up the tunes, and braced myself for the greater palatine nerve block. As I felt the needle entering my tissue I started crying. Then about 5 seconds later I started hyperventilating and having a full blown panic attack. Priya literally had the needle in the roof of my mouth and I started shaking. She immediately withdrew it out, and I sat up bawling uncontrollably. I don't know what came over me. I was so unbelievably nervous and I had built up the thing in my head the entire morning. I guess watching videos of the blocks and what could go wrong (but veryyyy rarely does--like 0.00001% rare) really unnerved me. Eventually I calmed down and Priya was able to finish her practice.
Helpful hints for the maxillary injections:
1. Talk to your patient and tell them what to expect. This looks different per individual based on the mental age of your patient (older adult vs. children), they're level of anxiety, and if they've ever had it done before. I appreciated that Priya walked me through exactly what she was going to do so that I knew what to expect. Some patients would rather not know so that they don't have to envision the entire thing. I would just ask my patient which they preferred to cover my bases.
2. Comfort drops. Same thing as I talked about before. They really do help ease the patient, which in turn also eases the provider.
3. Topical anesthetic. So there's this debate about whether this actually works or if it's just a placebo effect since it only really reaches 2-3mm below the surface. Personally, I think that this helped me so much for the maxillary and mandibular injections. It doesn't completely get rid of the pain from the needle puncture, but it does ease it slightly (and I'll take whatever I can get!).
Here's why the maxillary injections *tend to* hurt more than the maxillary ones:
There's less underlying musculature and fatty tissue beneath the skin (compare your cheeks vs. your palate), so when you inject a liquid there is very little room for it to space out. Therefore, the key here is to inject slowly and to inject "comfort drops." Comfort drops are way helpful things because they are just little drops of anesthetic that you place superficially, let them work their magic for a few moments, then go in deeper to deliver more anesthetic.
Priya (still my injector) was wonderful. I jammed my headphones into my ears, cranked up the tunes, and braced myself for the greater palatine nerve block. As I felt the needle entering my tissue I started crying. Then about 5 seconds later I started hyperventilating and having a full blown panic attack. Priya literally had the needle in the roof of my mouth and I started shaking. She immediately withdrew it out, and I sat up bawling uncontrollably. I don't know what came over me. I was so unbelievably nervous and I had built up the thing in my head the entire morning. I guess watching videos of the blocks and what could go wrong (but veryyyy rarely does--like 0.00001% rare) really unnerved me. Eventually I calmed down and Priya was able to finish her practice.
Helpful hints for the maxillary injections:
1. Talk to your patient and tell them what to expect. This looks different per individual based on the mental age of your patient (older adult vs. children), they're level of anxiety, and if they've ever had it done before. I appreciated that Priya walked me through exactly what she was going to do so that I knew what to expect. Some patients would rather not know so that they don't have to envision the entire thing. I would just ask my patient which they preferred to cover my bases.
2. Comfort drops. Same thing as I talked about before. They really do help ease the patient, which in turn also eases the provider.
3. Topical anesthetic. So there's this debate about whether this actually works or if it's just a placebo effect since it only really reaches 2-3mm below the surface. Personally, I think that this helped me so much for the maxillary and mandibular injections. It doesn't completely get rid of the pain from the needle puncture, but it does ease it slightly (and I'll take whatever I can get!).
why i decided to detail my stab lab experience with y'all
Well, firstly I told y'all that I'd keep you updated on the dental school life.
But really, I wanted to share this with you guys for a few reasons. I want you to know that even dentist/ soon-to-be dentists struggle same fears as our patients. There are a whole lot of people that don't like needles, and dentist are the same way. Just because most of the time we're the ones behind the syringe doesn't mean that we don't feel the same anxiety and pain as those we treat. On the bright side, this makes providers more empathetic because they went through the experience long before they ever treat you.
I want you to know that I struggle with things, and that anxiety is a big one. I know that it's easy sometimes to think that this girl who writes this blog/ goes to dental school/ sits on various committees for different groups has it all, but I promise you that that is absolutely not the case. Some days I'm treading water to keep myself afloat. Others I'm as free as a bird without any worries. And on the other days I'm so low that you may as well just get the shovel now and bury me 6 feet under. So, remember that everyone has their own struggles, even those that portray themselves in a rose-tinted light.
I also want you to know that in dental school, it is absolutely vital to find people that you know have your back and that you would literally trust with your life (or at least your nerves). Seriously though, relationships in dental school are absolutely crucial. Make sure that those people are real friends that you can absolutely confide in. It's really helpful to be able to not only study with your friends, but to also vent about how hard a class is or to share the joy of a new patient experience, or to just chill with outside of school. Sure, going to school is about learning the academic side, and that is most definitely important. But school is more than that. These are your colleagues that you'll be consulting with and referring patients to in just a few years. Plus, they're the only ones who truly know what this whole dental school experience is like. So, surround yourself with some solid friends who you know you can share the next 4 years+ of ups and downs with.
But really, I wanted to share this with you guys for a few reasons. I want you to know that even dentist/ soon-to-be dentists struggle same fears as our patients. There are a whole lot of people that don't like needles, and dentist are the same way. Just because most of the time we're the ones behind the syringe doesn't mean that we don't feel the same anxiety and pain as those we treat. On the bright side, this makes providers more empathetic because they went through the experience long before they ever treat you.
I want you to know that I struggle with things, and that anxiety is a big one. I know that it's easy sometimes to think that this girl who writes this blog/ goes to dental school/ sits on various committees for different groups has it all, but I promise you that that is absolutely not the case. Some days I'm treading water to keep myself afloat. Others I'm as free as a bird without any worries. And on the other days I'm so low that you may as well just get the shovel now and bury me 6 feet under. So, remember that everyone has their own struggles, even those that portray themselves in a rose-tinted light.
I also want you to know that in dental school, it is absolutely vital to find people that you know have your back and that you would literally trust with your life (or at least your nerves). Seriously though, relationships in dental school are absolutely crucial. Make sure that those people are real friends that you can absolutely confide in. It's really helpful to be able to not only study with your friends, but to also vent about how hard a class is or to share the joy of a new patient experience, or to just chill with outside of school. Sure, going to school is about learning the academic side, and that is most definitely important. But school is more than that. These are your colleagues that you'll be consulting with and referring patients to in just a few years. Plus, they're the only ones who truly know what this whole dental school experience is like. So, surround yourself with some solid friends who you know you can share the next 4 years+ of ups and downs with.
And, oh, I PASSED MY BOARDS! To read the journey and get a promo code for
the resource I used, click here!
the resource I used, click here!