The power of the four-letter word

June 1, 2004
Change is scary for many people. The fear of the unknown can prevent a person from moving forward. Getting stuck can keep a person from being open to a lifestyle change, or even a change in the way we practice.

by Anne Nugent Guignon

Change is scary for many people. The fear of the unknown can prevent a person from moving forward. Getting stuck can keep a person from being open to a lifestyle change, or even a change in the way we practice.

Psychologists have demonstrated for years that people are entirely capable of creating their own mental/emotional state of mind. Each one of us is in charge of our own thoughts ... thoughts that determine how we view the world around us.

For example, do you know anyone that automatically leaps to a negative conclusion regardless of the situation? People with a mindset like this are convinced that the universe is out to foil their plans. As a result, they are not really responsible for what is happening around them or, even worse, having to come up with a solution for a bad situation.

Over the years, I've encountered dental hygienists who seem stuck in impossible situations — situations that would make a sane person crazy. Frequently, these people expend tremendous amounts of energy justifying why they stay in bad situations or rationalizing why it is impossible to make a change. Does the fear of change prevent people from exploring other options?

Some hygienists feel they can't leave a noxious practice because "of the patients." Granted, you may feel that you have bonded with Mrs. Jones or Little Johnny, but if the practice environment is emotionally toxic or an ergonomic nightmare, what are you willing to sacrifice for the sake of a poorly run business replete with a physically taxing clinical environment?

If you feel an obligation to those that you have cared for over the years, what are you willing to risk to continue those patient relationships?

There are good, grateful patients everywhere. I've learned this over the years. So what is the message? If you are involved in a practice that is stealing your love for dental hygiene, get out! No, I don't mean heading for the door at 10 a.m. tomorrow morning when you've had it up to here with the latest demand on your time and sanity. I mean taking a good hard look at where you practice.

Remove the "fear factor" and add up the score:

• Are you treated with respect?
• Do the doctor and other staff members value your input and ideas?
• Do you feel like you are just the cleaning lady/gent?
• Are you really an integral part of total patient care, or are you just putting in time at the office, collecting a paycheck and going home with an aching body and a tongue sore from being bitten all day rather than saying what you think or how you feel?

If you've lost your enthusiasm for dental hygiene practice, perhaps you need to make a change.

In contrast to this type of negativity, do you go to your practice looking forward to spending time with your office mates and the patients you care for? Yes, there are some wonderful dental practices out there. It may take a while to find the right spot. It can happen if you focus your energy on finding a dental office that will support all of the wonderful things you know about practicing dental hygiene.

Some of you may think that I am practicing in the La-la Land of dental hygiene. Yes, I am very happy where I practice now. I am treated with respect and am an integral part of my patients' oral care plan. However, for many years, I was just the cleaning lady in dental practices that were all wrong for me.

Even though I loved being a dental hygienist, it took me years to find my perfect practice. I was stuck for a long time. I thought I couldn't stand one more change in my life at the time. I loved the patients but worried about stability and money, and did not have the energy to find a dental practice that would suit me better. It took a lot of mental effort to justify staying in the wrong dental practice because one more change was just too hard.

Fortunately, the decision was made for me. On the eve of my 46th birthday, I got my walking papers. Instinctively, I knew this was the silver lining and an inner calm came over me. There was something else that I needed to do with my life. I wasn't sure what it was but knew that it was out there.

Since I still had to earn a living, I began to work as a temporary dental hygienist.

Temporary positions were unpredictable. If the resident hygienist invited you to take her place for a vacation or maternity leave, the dental hygiene day would most likely be pleasant. Often, I was the permanent substitute hygienist. Those practices valued my skill and expertise and it was a joy to work with them again. The days usually flew by and the time spent seemed like visiting old friends.

On the other hand, if I was the hired hand for the day, some practices were determined to get their pound of flesh because they had to pay extra for my services. These offices were nightmares at best. It was hard to feel good about being a hygienist when everything I knew about quality dental hygiene was being questioned or ignored.

Practices like this wanted me to work by their own unique edition of The Book. They wanted 30-minute adult recare visits, bitewings every six months (regardless of patient risk for disease), and production was the only number that made my daily dental hygiene score count, as long as I stayed on time. This just did not work. These practices forgot about the patients that had compounding medical risk factors, recent changes in their medical histories, a propensity for gagging, or the fact that the patient strolled in 20 minutes late for their half-hour appointment.

Practices that valued my services took these glitches into account. These offices either provided extra support staff or expected fewer dental hygiene services to be performed or rescheduled the patients. These practices allowed me to make professional decisions and supported an altered appointment plan. I was treated as a competent professional, capable of making an informed decision that would support the best interests of the practice and the patient.

Now I know better. I will never allow the four-letter word, fear, to make me stay in a place that does not appreciate my value. Fear keeps people from moving on ... moving toward change. Fear can keep us frozen — stuck in the same toxic, unforgiving, unnurturing environment that we have become accustomed to. Rather than live in fear, I will look for that other great four-letter word, exit — the word that is on the red sign above the doors in every business in the land. This word can free all dedicated, caring dental hygiene professionals willing to risk a change in their practice settings.

If we don't open the doors of change, how can we ever know if we are missing the chance of a lifetime or an opportunity to join a dental practice that is everything we dreamed of and more? Embracing change can lead to another great word, hope, and a new focus for the future.

There are excellent practices all over the country where we can provide quality services in a positive, nurturing environment. These practices will not only allow us to be the extraordinary professionals that we can be, they will also encourage us to reach our full potential professionally.

So, if you are stuck, I give you my personal blessing to get your career moving forward. If you are desperate, I'll hand you my imaginary crowbar so you can be free to find your own special new comfort zone.

P.S. I received an e-mail from a hygienist in the Philadelphia area regarding my April column and accidentally deleted it. Please contact me again.

Anne Nugent Guignon, RDH, MPH, practices clinical dental hygiene in Houston, Texas. She writes, speaks, and presents continuing- education courses on ergonomics and advanced ultrasonic instrumentation through her company, ErgoSonics ( She can be reached by phone at (713) 974-4540 or by e-mail at [email protected].