First Real Patient Encounter  

Optometry school is full of ups and downs, triumphs and tribulations, and countless  impactful events. The most memorable, however, is encountering your very first real patient.  When you walk into an exam room and see a stranger sitting in your chair, you realize that it’s  not your classmate or family member, and the pressure starts to set in real quick. Every skill  you have learned throughout your years in optometry school starts to become a foreign  language. Your nerves can make you forget small things like how to adjust a slit lamp or a  question to ask during case history. Then after feeling overwhelmed, you step out of the exam  room to find your preceptor. And your preceptor begins to criticize everything you just did. You  feel a sense of anxiety mixed with doubt. Then when your exam is complete, you escort the  patient to the front desk and finally feel a sense of relief that it is over and done  with. You reflect back at all of the mistakes you made or things you forgot to do during the  exam, or the criticism your preceptor gave you. And at this moment your mind can go two  different ways. You can feed yourself negative information and slip into the “imposter  syndrome” mindset. Or you can realize that you will mess up, you will get nervous, you will feel  overwhelmed, but that is okay.  

That “first real patient” experience only makes you a better clinician and a stronger  individual. That is just one of many patient encounters you will have. As you continue on, your  skill set will improve drastically with more patients. With that being said, those nerves might still  be present for the first few patients. You can help calm those nerves, though, by taking a few  preparatory steps before seeing your patients. Here’s a small list of things you can do to feel confident before seeing your patients:  optometry, clinic, patient, student

1) PREP THE EXAM ROOM: Right when you get into the exam room, prepare it for patients.  Clean all of your equipment and organize your workspace with everything you’re going to  need for the exam. It’s important to know where everything is, that way you’re not  scrambling for a fixation stick when you need to do a cover test. This helps make the exam  run a lot more efficiently. It is also important to know how your room “works.” Before your  patient arrives, make sure you know how to use your slit lamp. Familiarize yourself with the  knobs, lights, and magnifications as not all slit lamps are set up the same. Know how to  work your M&S chart so you aren’t fumbling with buttons while trying to get visual acuity. Taking an extra 10 minutes to set yourself up before the patients come in is a great  way to decrease anxiety levels. 

2) REVIEW YOUR PATIENTS: Take time to skim over your patients’ charts for the day. Some  patients are new so prepare yourself with everything you need to do for a new patient  comprehensive exam. Some patients are existing so reviewing their previous exams and  case history can give you an idea of what’s to come. Some patients are office visits or Rx  checks. Knowing what to expect with these patients can be very helpful to allow you time  to think about what the next steps should be. Reviewing your patients’ charts is an excellent  way to gain insight of what your exam is going to look like and how to execute it.  

optometry, clinic, patient, student3) KNOW YOUR NOTES: One of the best and most valuable things you can do before even  walking into the clinic is to read up on your notes. Reviewing the order of completing the  exam and other small steps, such as having the correct working distance for certain tests,  is so crucial. Be sure to also review tests you perform outside of a typical comprehensive  exam. You’re going to come across ocular health patients such as those with diabetic  retinopathy, glaucoma, cataracts, etc. And you will also come across patients who have  accommodative insufficiency, convergence excess, etc. So you need to be familiar with  how to do a variety of tests on patients who are not your “typical” cases. 

By preparing yourself to see patients, you can ensure you have smooth and efficient  encounters. You can also help relieve yourself of the extra stress and anxiety that comes with  lack of preparation. Taking steps like these can boost your confidence and allow you to  perform to the best of your ability and give your patients a great experience. Remember, you  do know all of these techniques and skills. You have studied and practiced everything. You  have been given the privilege to care for real patients because you are a qualified, smart, and  exceptional individual. Don’t take what your preceptors say to heart, learn from their  constructive criticism and incorporate that into your practice. Soon you will be your own  independent doctor and will have your own style in the exam room. And that is why your  patients will come back to see you again and again!

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