Adding value to a dental hygiene career

Real change is coming to America and it’s reflected in the profession of dental hygiene. COVID-19 is running in waves like a rough surf after a surprise pandemic tsunami and whether the American people like it or not, physical distancing, masks and frequent handwashing will be the norm for who knows how long.

Dental hygienists are not just prophy machines and should demand change so they can do their jobs better, value themselves and be rewarded.

Protests against police brutality rooted to generations of injustice, big city murders, mass murders and systemic racism have struck a nerve with Americans. Cops went from being a simple model of collaboration between the police and the community to crime fighters armed to the teeth with weapons designed to kill. Unlike some other countries like Australia where police follow national guidelines on the use of lethal force, American lethal force laws vary from state to state and some states allow lethal force to suppress opposition to arrest.¹ Americans are restless and life-as-usual has been turned upside down. 

Dental hygiene was born in the early 1900s and the first dental hygiene textbook, Mouth Hygiene, described a dental hygienist’s role as a “woman assistant.”² These were humble beginnings for sure but how far has the needle moved and where is the dental hygiene profession headed now during the COVID-19 pandemic?

I left a clinical position once and it was one where I had established close relationships with patients. I watched children grow from preschoolers to high school graduates and I was there to comfort families who faced life tragedies. My employer at the time told me several times that he wanted me to “clean teeth” and he didn’t want me spending time educating patients and talking in scientific terms about biofilm’s role in oral disease or question a patient with diabetes about their A1C. I never questioned his delivery of care to patients and found his comments to be disrespectful. I was of little value to him and it made me feel small and insignificant.

Am I just a prophy machine? No way, definitely not and I would like to encourage all RDH practitioners everywhere to value themselves as a licensed health care provider authorized by the state to perform within the scope of practice. A dental hygienist is NOT just a member of staff who is at the mercy of a dentist-employer. Right now, when challenges to our PPE, scheduling and overall work environment are creating even more workplace stress, many hygienists are questioning their role and future careers. For some, it’s a sequel to a horror movie and for others, it’s business as usual. Some dental hygienists are motivated to take on the many new challenges to the delivery of care and they are soldiering on and staying busy.

In the midst of the COVID-19 pandemic, what will it take for you to feel valued?

I read a lot of group posts on Facebook where hygienists and dentists are sharing their frustrations. Among hygienists, a common theme is not feeling valued as a health care provider. Mostly, it’s not about pay or benefits but it’s a sinking feeling that something’s just not right. Some hygienists feel unappreciated, especially if they dare to complain about not having assistance or time to breathe and rest between patients. I’ve personally felt this way before and it left me feeling dissatisfied and unmotivated. In other industries, workers who feel this way aren’t as productive due to stress and oftentimes start looking for a new job.³

In exploring this issue, I talked to several colleagues and wanted to share some perspectives that might help a dental hygienist cope a bit better during this COVID-19 pandemic. Maria Perno Goldie, RDH, MS, Past President of ADHA, exudes professionalism and has always been a positive force in the profession of dental hygiene. Maria’s words of wisdom may ring true to many:

As oral health care professionals, we are in close contact with others in order to do our job. We are facing challenges like never before due to the COVID-19 pandemic. We need PPE to protect the physical health of our patients, co-workers and ourselves, and we must demand or supply it. We also need to take care of ourselves, both mentally and physically, in order to take care of others. Employ coping strategies and be strengthened by remembering the importance and meaning of our work, as we are keeping our patients healthy. Remember self-care, check in regularly with colleagues, family and friends and consult with peers and supervisors. Practice compassion, as your commitment to the health and wellbeing of others is valued, respected and appreciated. Compassion is the driving force that unites us in our collective efforts. We will get through this together.

Dr. Andrea Brandt, a licensed therapist, says “Self love means taking care of your own needs and not sacrificing your well-being to please others. Self-love means not settling for less than you deserve.”

Another inspirational mentor and RDH who I’ve known for several decades says this:

During this pandemic (COVID-19) it is more important than ever to demonstrate “self-love” and that includes treating patients with the utmost respect. Practitioners who have both of these qualities will be better able to cope during these stressful times. ~ Jane Weiner, RDH

When a hygienist’s value is questioned, what happens next?

Make no bones about it: many hygienists are worried about their careers since the pandemic reared its ugly head. The organizational culture they’ve always worked in (clinical practice) has to adapt to a new normal and dental practices across the U.S. are scrambling to re-open. Times were already tight before COVID-19 with increase in discounted insurance reimbursement and concerted efforts to contain overhead. Even as far back as the early 2000s, practice management consultants like Linda Drevenstadt, RDH, MS, were writing about controlling the overhead monster.⁴ Linda writes realistically about increasing production with current resources (facility, people, procedures) and reducing and controlling costs as needed. She emphasizes investing in people first as the dental practice’s most valuable assets.

What a hygienist can do when he/she feels undervalued depends on relationships with co-workers and supervisors.

Talk to your office manager/employer. An office manager/employer can make changes to your work environment to make your job more rewarding. As a provider, you should have input on PPE, modified protocols including more time per patient and assistance from a dental assistant when required. Speak up and don’t be shy about doing it.

Blog with your peers. Fear of the unknown with added PPE and concerns about exposure to COVID-19 is real and studies are ongoing to learn more about COVID-19 transmission in a dental practice.

Ask for support from co-workers. Positive relationships with your co-workers go a long way in maintaining motivation. Regularly discussing how to provide a quality service is helpful.

Short-term vs long-term goals. Don't be unrealistic when assessing your short-term goals. Be flexible and understanding during the pandemic if possible. It may be hard now and you may be miserable for many reasons but determine whether or not you should stick it out in the short term. Sometimes when we are only focused on short-term goals, we lose sight of our long-term goals. If you find yourself not caring about the practice you’re working in or if you just don’t care anymore about your performance and sometimes mentally check-out in your operatory, talk to yourself about feeling appreciated. Take time to figure out what is making you feel dissatisfied and bring it to the attention of the appropriate person. They may not know you’re miserable if you don’t tell them.

Dental hygienists who demand change so they can do their jobs better value themselves and should be rewarded for their persistence and tenacity, especially now. There’s no such thing as too much communication or too many pats on the back. Feeling valued leads to increased commitment and dedication and it’s that unmistakable good feeling that keeps the RDH going strong.

References

1. Goldsworthy, T., I was a cop in Australia. We don't shoot the people we're sworn to protect; Vox; https://www.vox.com/first-person/2017/7/27/16038820/justine-damond-police-shooting-brutality-gun-laws

2. Slim, L., To understand prospcets for a bright future, take a look back at our humble beginnings; RDH Magazine; https://www.rdhmag.com/infection-control/personal-protective-equipment/article/16403707/to-understand-prospects-for-a-bright-future-take-a-look-back-at-our-humble-beginnings

3. Matta, C.; Why It’s Important to Feel Valued At Your Job; Psych Central; https://psychcentral.com/blog/why-its-important-to-feel-valued-at-your-job/

4. Drevenstedt, L., 12 ways to control the overhead monster; Denitsyry IQ; https://www.dentistryiq.com/practice-management/article/16362772/12-ways-to-control-the-overhead-monster