Bothered

Yesterday I was forced to do something that goes against everything I've been taught since childhood. I was required to purposefully do a BAD job, to not give 100%...and it's driving me CRAZY!!

Yesterday at work I had a patient come in that had not had her teeth cleaned in a year, and in this time, her once maintained gingivitis had progressed into full-fledged periodontal disease. I explained to the patient about the infection in her gums and the necessity of a deeper cleaning to remove the debris and bacteria from the roots of her teeth. She acknowledged the disease, but because she did not currently have a job or insurance to help cover the cost of the deeper cleaning, the patient stated that she just wanted a "regular cleaning." I explained to the patient the consequences of these actions, but she again declined the procedure and agreed to sign a Refusal of Treatment form. I was then compelled to do a VERY POOR job of cleaning her teeth. I knew that the patient had significant bone loss around her teeth and I could feel the debris up on her roots, but legally I was not able to remove it. I wanted so badly to remove all the debris and infection anyway, but this would have taken hours and was not what the patient wanted or was paying for. The crowns of her teeth are now very clean, but below her tissues is a raging infection, that if left untreated, will ultimately lead to the loss of her teeth. Although I did exactly what the patient told me to do, I feel like I failed her.

I guess I never knew that purposefully doing less than the best of my ability would bother me so much.