Dental hygiene careers: The art and science of temping
Here are my three Ps of temping: Be prepared, positive, and professional.
SURVIVAL TIPS ON WORKING TEMPORARILY IN STRANGE PLACES
BY VICKI L. MUNDAY, RDH
Here are my three Ps of temping: Be prepared, positive, and professional. Last year I had 48 W-2 forms to file with the IRS, my highest number to date. Over the last 20 years, I have chosen to do fill-in or temping when I have had extended time off or have been underemployed and looking for additional days.
I believe I have a good handle on what it takes to be a good temp and realized that attitude is vital to having a positive experience temping. Temping is an adventure and an opportunity to see how other offices operate. You might learn something new or make a new friend. But the key is to have the mindset that you can handle anything for one day. No matter what is thrown at you, you are a professional and you will survive.
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First and foremost, be warm and friendly! Then, be prepared and flexible. Call the office several days before you are scheduled to work there, unless you get the call early the same day. Ask for driving directions if you need them. I always try to dress the same as the regular staff, so I ask if the office is a scrubs or a black slacks office. If they are a scrubs office, I ask if there is a color of the day. You would be surprised how many offices really appreciate your thoughtfulness. Yes, I was a Girl Scout; I always try to arrive prepared for whatever curveballs might come my way. Always arrive early to get the lay of the land. Find where the instruments are kept; familiarize yourself with the sterilization area and their protocol for handling dirty instruments and disposables. Be prepared, meaning everything from your clinical attire and lab coat, safety equipment, headlamp, instruments (yes, I carry a few of my own hand instruments). You never know what shape the instruments will be in, and it is a total disservice to the patients to attempt to scale their teeth with less than desirable instruments. Periodically I have actually seen rusty instruments in very high-end dental practices, and Cavitron inserts that are more than five years old and bent like crazy. Your day will run much smoother if you are not stressing over the instruments.
If you have not been given a tour, ask for one. After you’ve been shown around the office, ask a dental assistant what you can do for him/her. Yes, ask – you will be surprised at how much help you will receive if you ask what the assistant needs of you. Ask where the dirty tray setups go and how they would like you to put the instruments into the ultrasonic – banded or not banded. Do not be an “I-am-better-than-you-I’m-a-hygienist” hygienist. That is the fastest way to have the staff ignore you or make your life difficult for the entire day. Be willing to go the extra mile for the office and they will in turn help you have a great day. If you live in a state like I do and can administer anesthesia, I offer to do anesthesia if needed for the doctor. I have been taken up on this offer quite often and it scores big brownie points with both the staff and the doctor.
Ask how the dentist likes to be addressed in front of patients. How does he/she want to be informed you are ready for an exam? Ask how he/she wants you to communicate your findings (sticky notes are great for this). Do they feel comfortable with you identifying and discussing the findings with the patient prior to their coming in to do the exam, or do they prefer to be the person who initially informs the patient of clinical findings?
MAKING YOURSELF AT HOME
Now go explore the operatory. Open drawers and cabinets. Check out the X-ray head and where the patient home-care aids are. Is there a darkroom or digital radiographs? Ask how their X-ray system works; what are the settings for bitewings and periapicals (not all units are the same and you want to use what the office has found gives the best radiographs). Also, if the office uses digital radiography and you’re not familiar with their software system, ask for a quick run-through on how to use it. Do the best you can to remember where the disposables are kept so room turnover will be faster.
Review the schedule and make notes on what each scheduled patient needs. Is this a paperless office or a traditional one? Charting and chart notes can be a challenge when temping. Some offices like SOAP notes; others want more of a narrative, and then there are the offices that have the peel and stick type of notes for you to check off boxes on. In my office, radiographs are noted in red, chart notes are green, exams are black, and front office notes are blue. It’s the way the doctor wants it, so that’s the way I do it. Paperless offices quite often have a template that you can cut and paste into each chart. I find it interesting to read what the templates say in the paperless offices. In many of the offices I have been in, the hygienists have their own personalized templates with their signatures already on them. In some offices they have a “temp hygienist” template. I find that sticky notes are a lifesaver; I don’t forget anything that I want to include in my chart notes.
YOU HAD ME AT HELLO
Always, always ask where the regular hygienist is, because you know that you are going to be grilled by the patients. “Where is my regular hygienist?” “Are you new here?” “What happened to…? He/she was great.” “How long have you been doing this?” You will need to have ready answers to these questions.
If you are there because someone left or was let go, you need to know that ahead of time. You must be very careful how you answer questions. Do yourself a favor: Ask the office manager or the dentist how you should answer those questions.
Now you are going out to greet and escort your first patient of the day back to the hygiene operatory. After you have given them a friendly greeting, be up front and let them know you are filling in for (insert name here). You are happy to be able to help out a colleague and it is a pleasure to work with Dr. (insert name here).
Once you have reviewed their health history and taken their blood pressure, it’s time for a head and neck exam. Please be aware that not all offices do thorough head and neck exams. The patient might not have experienced one before. You will need to give an explanation, and it can easily be done while you palpate for nodes.
I always ask the patient about their regular home-care routines. I let them know that we will play “twenty questions” since I have not had the pleasure of working with them before. Usually they smile and share how often they brush and that they need to floss more. I smile and ask what kind of toothbrush they use, manual or power. If they are really into their home care, I hear about their Waterpik or other “mouth toys” they might have and what kind of floss they use.
After I have bibbed them and given them dark safety glasses to wear, I usually say, “Let’s take a peek,” and tip them back. I let them know I am going to rub the mirror on the inside of their cheek. As I am taking a look, I make mental notes of inflammation, plaque, supra calculus deposits, and any broken fillings or cracked teeth. I then tell the patient that I do not believe in giving lectures, but I will tell them what I am seeing in their mouth. I also tell them that I believe in treating every patient as if they were a member of my family, a member I want to see at my dinner table. We laugh and the ice has been broken. Now I can do my job and share with them in a nonconfrontational manner what I am seeing and what minor or major adjustments to their home-care routine they should make to improve their oral health. It is pretty common knowledge that most people are visual learners, so I try to paint a mental picture for patients. I have developed a couple of cute stories that create mental pictures for people. Remember: Never talk down to an adult patient!
Don’t try to change the way things are being done. You are there to help out, not change the world. I can guarantee you will go on a list and will not be invited back if you rock the boat. I did a day in a very high-end office in Seattle where they have a list hanging in the staff room with names of hygienists that are not allowed back in the office. I have no idea what happened to put them on the list, but I never want my name to be on such a list. So unless a patient is in danger, keep your thoughts to yourself. It may not be the way you would have planned treatment for the patient, but you should follow the established plan that has been discussed with the patient.
It’s important to keep the office flow going. Make sure that you’re in the operatory when the dentist enters to do the exam. I am a fan of leaving notes for the dentist. However, I also ask how he/she likes to be communicated with. Many doctors have rules concerning how to let them know you are ready and whether or not the patient is to be sitting up when they enter the operatory. We all know that some dentists are very controlling. My employer admits he has OCD. We actually laugh about it. You may find that the dentist wants to “put you in your place” by “educating” you about something in their office. I have had this experience. I just smiled and thanked the doctor for the information. Remember, it is their office and if it makes them feel better, who cares? Obviously, he/she felt the need to feel superior. Remember who signs your check.
I always bring a lunch. You never know if you will actually get a lunch, so be prepared. Most offices have at least a small refrigerator and a microwave. I work in an office that is 25 minutes from any kind of food. I always carry a can of soup or some fruit, a granola bar, and a bottle or two of water. Be prepared. Do yourself a favor and stay in the office and visit with the staff during lunch. Ask how the morning went for them and if you need to do anything different. Nine times out of 10 they will ask you the same thing. I also always carry a book or a magazine with me.
Blast through your afternoon, knowing that you are an amazing person and temping is an adventure. At the end of the day, ask the staff how they would like the room left: chair up, set up for the morning, garbage out? Some offices have a cleaning service so you don’t have to take out the trash. Thank the staff at the end of the day and gather all of your belongings. Remember your instruments! Make sure you have filled out all the necessary paperwork to be paid for your time and talents.
When you get in your car, take a deep breath and hold it. Let it out and know you made a difference in the lives of the patients you saw. Remember, a positive attitude is infectious, and the doctor, staff, and patients will be influenced by it. Also, if you want to be asked back in the future, always ask the staff what you can do to help during downtime due to holes in the schedule or last minute cancellations. There is nothing worse to the doctor or staff than seeing a temp sitting around doing nothing when they are being paid to work.
Many years ago, it was common to go home with a paycheck at the end of the day of temping. This is no longer true. With more and more offices using payroll services, you may not get your check for up to 30 days. If you think your check is overdue, politely call the office and remind them when you worked and ask if the check has been mailed. If they haven’t mailed it, ask them to please do so. If it does not arrive in a reasonable amount of time, call the agency that sent you and have them follow up on it.
If you are like me and you like adventure and stepping outside your comfort zone, you might actually enjoy temping and making new dental friends. Remember the 3 Ps: Be prepared, positive, and professional! RDH
VICKI L. MUNDAY, RDH, is a 1992 graduate of Shoreline Community College. She is very involved in the American Dental Hygienists’ Association and the Washington State Dental Hygienists’ Association (WSDHA), where she has been chair of the political action committee for the last eight years and served as president in 2000. She is currently president of LVS2SMILE Dental Hygiene Services, where she represents several dental products under her business license.
COMMENTS FROM THE FIELD: TEMPS, OFFICES SHARE INSIGHTS
Most of the agencies that do placement and temping assignments ask the offices for feedback. I contacted one of the agencies I have worked with over the years and they agreed to share with me some of the comments received from dental offices about hygiene temps.
- “Under no circumstances send me a hygienist with visible tattoos.”
- “Her earrings and makeup were over the top. Please ask her to be more conservative next time.”
- “Wow! What an amazing hygienist. Is she available?”
- “I sent the hygienist home because of her nose piercing. Please do not send me anyone with their nose pierced. This is not the image I want my office to have.”
- “She smelled like an ashtray.”
- “His slacks had holes in them.”
- “Goth makeup is not appropriate.”
- “She fit right in, and it was a pleasure to have her in the office. My patients were well cared for.”
Conversely, I have also asked several of my colleagues to share comments about some of the offices in which they have temped:
- “The office looked amazing, but the instruments were horrible. Some had only one end and others had no blade left.”
- “Great office – everyone was so helpful. The dentist even took everyone out to lunch.”
- “I had a two-hour lunch due to a late cancellation.”
- “The most complicated charting system ever!”
- “The receptionist was reading a romance novel and playing cards on the computer. The dentist had his feet up on his desk, reading the paper. The DAs where talking. I think I was the only one working.”
- “This office goes on my “never going back there” list! It was assisted hygiene with quad perio therapy! No time to do a thorough job and I felt as if I were running from room to room all day. I had to ice my arm at lunch.”
- I loved my day with Dr. XYZ!”
So, as you can see, temping can be fun or can be a very negative experience. I have heard of hygienists walking out at lunch and not going back. As much as I have felt like doing the same (once), I would never walk out of an office. I am a professional and once I have committed to working in an office, I stay. I may choose to never go back there, but I will never leave in the middle of the day.
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