Sunday, November 20, 2011

For the Hygienists

This past week I was down in Ramstein for the whole week... again. I worked Monday thru Friday, which is something I haven't done in a lot of years. I had thought by the end of the week I would be exhausted. I was. However, my exhaustion was more mental than physical, which was surprising to me. I was figuring my back would be incredibly sore/cramped and I would be ready to spend the weekend in bed. To my surprise my back was fine, it was my brain which needed the rest.

I'm finding myself challenged with the job in ways which I haven't been before. I'm facing things I haven't had to think about since hygiene school. And maybe... maybe this is something only other hygienists could understand. But... I'll give it a shot and see if a non-dental person follows me.

My first concern when starting this job was time management. At my last office I had an hour per patient (no matter what I was doing). At this office I generally get 45 minutes per person, sometimes an hour if they are a new patient who needs x-rays. I was worried about staying on time. I am a person who is always on time. In fact, if I'm not early to something, I feel like I'm late. I am on time and I expect others to be. I expect my patients to be on time for their appointments... so I should be on time and ready to go for them when they arrive. I was worried how I would be able to shave 15 minutes off of my "usual" routine to stay on time. Somehow I've managed. I'm not even sure how... I just... do. I think it's just that I know I've got less time and I don't have the extra minutes to waste. Every day is still a challenge, and frankly every appointment can be a challenge... but I still try my best to stay on top of it.

This week I faced some tough dynamics. I'll try to break down some basic dental ideas as easily as possible. In dentistry there are different types of "cleanings" you can receive. Not everyone has healthy teeth and gums. Some people are treated for gum disease and therefore have a different type of cleaning. These different types of cleanings are coded/charged out differently to insurance companies. There is a lot... a LOT... of debate about gum disease and how to treat it. Well, not HOW to treat it... but there are a lot of different opinions about when you should make the call to treat a person. Gum disease can be similar to high blood pressure or diabetes... a lot of the times there are "warning signs" or signs that things are moving to an unhealthy state. As a hygienist you look at these signs and discuss what you see with a patient. Sometimes changes (flossing daily, getting an electric toothbrush, coming in for cleanings every 6 months) are enough to return things to a healthy state. Sometimes this isn't enough. Each dental hygienist is different, and in a room of 20 hygienists you would probably have at least 15 different opinions of what you should do for treatment of the same patient. We all think differently and approach things in our own way. That being said... there can be a lot of debate over what is "right" and what isn't.

At work I found my judgement was being called into question. I was asked why I had chosen to code/charge out treatment certain ways with some patients, but other ways with others. I had to explain and rational my decision making process. This isn't something new to me (although it reminded me of being back in school). Was was new to me was that I was having to explain this to the office manager. And maybe here is where only the dental people will understand. Let me start by saying I am not meaning to belittle or degrade anybody. But. I went to school for 5 years and earned a degree. I passed multiple written and technical exams to obtain my license, which I have to maintain and uphold. So... yes... with my background I think I do have a bit more "authority" than the office manager. Frankly, she is far over-stepping her boundaries by questioning what I am doing. She doesn't have the education, the background, and most importantly she does not have a license to protect. If a patient were to come back and file suit against the office... she will walk away scott free, but I have legal liability. The fact that the office manager even thinks she has the right to question what I'm doing frankly irritates the SHIT out of me. However, I'm a reasonable person so I sat down with her and calmly explained my thought process behind each case in question. I am hoping by doing this she will understand how I think/process things and will trust my judgement (although really, it doesn't matter if she does or not because it's none of her damn business).

This adds the biggest dynamic which I am facing... which is the human factor. Every workplace has it. We are all human, we all have personalities, and sometimes those personalities clash. I work in an office with one office manager, one receptionist, four hygienists, six dentists, and ten assistants. There are a LOT of personalities... specifically, female personalities. Really do I need to say more? I don't like conflict. I don't do well with conflict. I think of myself as an ugly duckling... because... well, I am. I definitely had a very long awkward phase as a child, and had my fair share of bullies and teasing. To this day it affects my confidence. As an ugly duckling you can never view yourself as the beautiful swan you've become because of all the time you spent being ugly. It is something I struggle with. A lot of the confidence I have is faked. But, as long as you are fooled... Needless to say, when I enter into any situation full of girls where I know there will be cliques, backstabbing, and gossip in my mind I transform from a capable 26 year old professional to the chubby 12 year old with bangs and braces. I get very nervous in situations like the one I am in where I'm starting a new job in an office full of females. Don't get me wrong, I have discovered many of my coworkers are wonderful and are easy to work with. But there are still those few people in the office who make it interesting. It is a challenge to not only to not be a part of it (because it is always easier to join in and gossip about someone else... as long as you're not the target) but to keep myself completely removed from it. So far it is easy since I'm the "new girl." I'm hoping to stay out of it permanently.

I was very lucky at my first job to work with Nancee. Nancee was the other hygienist in my former office, and she had worked in the dental field for over 30 years. At times I felt myself having to compete with her, or feeling frustrated by situations within the office... but overall I was lucky to have her as a mentor. She had excellent tips, pointers, and was wonderful to talk to both as a hygienist and as a friend. She was my biggest supporter at the office, and in a office that was also full of dynamic personalities, we had a special understanding between us. She was a great example for me to follow. She was a great leader of our hygiene department, and she taught me how to be a leader, mentor, and comrade.

As I said I am one of four hygienists. One hygienist is leaving, so we will soon be three hygienists. I have noticed things I would like to change (at the moment it's minor things... update some instruments, have some agreement between hygienists). I have spoken to the other hygienists about it, and found the things I'm wanting are things the other hygienists have wanted for a long time... they just haven't done anything about it. Suddenly I find myself in the position of being the leader. It is strange, for me, to look at a situation and realize that I am the one who will have to "step up" to lead. To realize I am the "strong" one. I didn't think I would be in this situation... but I feel ready for it thanks to Nancee.

At the end of the day I have to remind myself that it is just a job. It's just a job - a job I am passionate about - but just a job.... and one that I don't need, I don't have to have. Just knowing that fact takes a lot of pressure off of me. It gives me the strength, the confidence... and perhaps the audacity to take the stands I have to because I really feel I have nothing to lose.

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