Who is responsible for protecting us from cumulative trauma disorders? OSHA will not be coming to our rescue at this point ... so I guess it is time for all of us to accept that responsibility.
Disability can strike three months into your career or on the eve of your 25th dental hygiene class reunion. Disability can result from an accident, illness, or the effects of repetitive stress injuries. You would need a crystal ball to know what your future holds, but it is well-known that repetitive stress injuries can lead to both short-term as well as long-term disabilities. Whether you call these disorders repetitive stress injuries or cumulative trauma disorders (CTD) does not matter. These disorders do not respect age, gender, length of practice, or any other statistical parameter. CTDs are a very real risk for all clinical hygienists.
Perhaps you're saying to yourself:
- "I've practiced for years and nothing has happened ..."
- "It will never happen to me; I only practice part-time ..."
- "I've just been doing this for a couple of years ..."
- "These are the problems of older hygienists."
This approach can have disastrous results on your career, not to mention the potential impact on your personal life. If you are female, as most hygienists are, you are much more likely to develop a work-related disability. These events can put a temporary kink in your life, or they can alter everything you do for the rest of your life.
Let me give you an example of what I am talking about. Imagine your career is a forest in the wilderness. Wilderness forests can be managed in a number of different ways. Forest fires happen. Lush spring forests are at much less risk for a raging inferno than a forest full of dry underbrush made even drier by months of scarce rainfall. Perhaps a late summer shower can extinguish a tiny fire started by a careless smoker, but what if the smoldering tinderbox goes unnoticed and develops into a larger, isolated blaze? Will the blaze slowly spread throughout the forest? Worse yet, will unexpected winds whip the flames into a frenzy that no firebreak can control? Days later, the entire region is smoking, charred, and burned beyond recognition. Mother Nature certainly has taught us that an occasional devastating fire can be important for forest renewal, but we're talking about your professional career!
Are you willing to let your career go up in flames like a raging fire? If not, let me share my thoughts with you about how to circumvent some very real threats to your career.
Many of us were hopeful that the new ergonomic regulations would provide some impetus for workplace change. We hoped that these regulations would require our employers to provide safe working environments and would give us methods to make resistant employers accountable. Despite the fact that the regulations will not be enforced at the present time, no one can put a lid on the dialogue any more. Ergonomic issues are out in the open. These issues are very real and are causing hygienists to leave our profession because of work-related injuries or conditions that have spiraled out of control due to the unique physical demands of traditional dental hygiene practice.
Let me put some things in perspective. First of all, it is your career — not any one else's. It's not your doctor's. It's not your patient's. It's not your family's. So if it is your career, then it is your responsibility to protect it. OSHA has helped us in many ways to protect ourselves from the dangerous effects of chemicals, infectious diseases, ionizing radiation, and numerous other workplace-related hazards. But who is responsible for protecting us from cumulative trauma disorders and career burnout? OSHA will not be coming to our rescue at this point, like some knight in shining armor on a white horse, so I guess it is time for all of us to grow up and accept that responsibility.
If you are fortunate enough to practice dental hygiene with a dentist who is sensitive to these issues, then I am very happy for you. Yes, there are employers who will provide whatever dental hygienists need to practice safely. I think this is an unusual situation since dental hygiene practice is vastly different from practicing dentistry. Perhaps your challenge is to become the supreme educator. If you are on the other end of the spectrum and work with a dentist who has no clue how taxing dental hygiene is to our bodies, then you may be the one to protect yourself from career-threatening injuries — or the even more serious possibility of a lifelong disability. You might have to face up to the fact that you are the one who will provide the necessary equipment or supplies that will allow you to practice in comfort and perhaps save your career.
It is also very important to protect your career with adequate disability coverage. Women are much more likely than men to experience a career-related disability, either short- or long-term. They also have a lower earning potential and live longer. The majority of dental hygienists are women and most work with little or no benefits. Each of these factors should be carefully considered in your long-term plan. Affordable disability coverage is a benefit available to members of our professional organization. If you are ever disabled, even for a short period of time, you will be grateful that you made the decision to protect yourself in this way.
Some dental hygienists never experience career-related pain. Others either don't know they are hurting or are in denial. Unfortunately, some say they have gotten used to pain, but pain is your body's signal to take action. Don't you get frustrated when your patients are in denial about their dental disease? Don't you want to pull your hair out when their vacation, new car, or nail appointments are higher on their priority list than the health of their mouth? I feel the same way when hygienists dismiss the physical problems they are having as a result of practicing hygiene.
Each one of us has to decide what we are willing to risk and what efforts we are personally willing to make to protect ourselves. I know hygienists who have totally turned their careers around, and I am one of them. By age 38, I was hurting all over and clinical practice was my love, but enough was enough, so I began buying my own equipment. First it was larger-handled instruments, then my first pair of magnification loupes, and an ergonomic chair with arms. I did it because I loved dental hygiene.
My employers did not understand the pain and fatigue in my body. I was the one seeing the chiropractor two to four times a month, not them. They weren't particularly interested in how I was feeling, so I had to seek the solutions for myself. I never considered leaving dental hygiene. I just wanted to stop hurting. Until I made changes in how I worked and what I worked with, I was just throwing money at the symptoms and ignoring the smoldering forest fire about to destroy my career.
Let me share the experiences of another hygienist with you. Eighteen months after Tracy graduated from her dental hygiene program, she wondered how long she would be able to practice. She had studied hard and made good grades. Typical of all new graduates, she looked forward to a long career, but before she graduated she had surgery in one wrist for carpal tunnel syndrome.
Tracy is a southpaw and had learned to scale as a lefty. No one ever told her that this might be a problem. When she graduated, she took a position in an office with a retro 1970s setup — big executive cabinets; rear delivery; short, tight cords. In other words, there was no room to practice hygiene comfortably. Soon she faced surgery on her other wrist.
Tracy made a decision to take charge of her career and enrolled in a continuing education course that focused on dental hygiene ergonomics. She invested in her own equipment that would reduce her body stress and allow her to practice in comfort. Then Tracy made the final change. She retrained herself to practice dental hygiene right-handed. Yes it was hard, but the reality is that we live in a right-handed world. Tracy will never to be able to practice full-time hygiene, but rather than focusing on her loss, she is pursuing a bachelor's degree in finance and plans to split her time between dental hygiene practice and assisting hygienists with personal financial planning.
There are so many different ways that each one of us can "own our own career." The possibilities are endless. It can be as simple as asking your employer to provide equipment that will help you practice safely, or deciding that you are worth it and purchasing a few of your own instruments. Whether you get someone else to pay for your safety or you do it for yourself, every step you take to protect your career will empower you to take the next step.
Taking care of yourself will become as natural to you as taking care of your patients. Taking good care of yourself will become addictive. Most of us are used to taking care of everyone else's needs first. We are the nurturers. If you take responsibility for owning your own career, you will emerge the winner in the comfort zone year after year!
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 (www.ergosonics.com). She can be reached by phone at (713) 974-4540 or by e-mail at [email protected]
