Pride in excellence: Avoiding burnout

May 1, 2002
When you take pride in what you do and have a strong work ethic, you will go a long way in avoiding clinical burnout.

by Tammy L. Carullo, RDH, PC, PS

When you take pride in what you do and have a strong work ethic, you will go a long way in avoiding clinical burnout. Yet, many hygienists find themselves smack dab in the middle of a rather deep complacency rut. They simply go through the motions of "a day in the life of a dental hygienist." How do we escape this fate? Generally, you begin by determining what a strong work ethic is and then establishing where yours fits into the mix. Being proud of what you do to such a degree that you care about the outcome is the very gist of pride in excellence. If you don't care about what you are doing, are you going to put your heart and soul into doing the absolute best job possible? No.

You would be amazed, though, - or perhaps not - at the number of hygienists in private practice who simply don't get it! They don't understand that the stress, depression, and even physical symptoms weighing them down can be attributed largely to the fact that their work ethic has dipped below the line of acceptability.

While you cannot force someone else to care, you do have control over yourself. The knowledge and clinical skills required to do a superb job really do matter. Confidence is not a bad thing; it's necessary for acknowledging your role in the oral health care chain. The role of dental hygiene is one of developing trust with the patient. But it's also one of being an educator. As we become more involved with the various links that exist between oral health, systemic disease, medications, and nutritional components, this role expands to unlimited options.

Evaluate your own position with regard to your work ethic. Would you classify yourself as a hard worker who puts the patients and the practice ahead of the individual? The objective is to have our positive attributes outweigh the negatives.

Our patients deserve nothing less than our wholehearted effort. I know it isn't easy to stay motivated and positive when faced with the same old procedures and the same old four walls on a daily basis. Many hygienists - whether they have been in the field for 30 years or three years - find themselves in this precarious position at least once in their career. Even though you may crawl into a slump from time to time, it's important to realize that becoming complacent is a far more serious issue. Once enveloped by the doldrums of clinical hygiene, it doesn't take very long to slip into one of these vast ruts. Once there, it can be virtually impossible to climb back out. Some hygienists just give up. They quit the profession because they've lost their fire, their interest, and their focus. Others simply go through the motions.

When you graduated from dental hygiene school, did you have every intention of remaining on the cutting edge? Absolutely! That answer is a no-brainer! No one graduates from hygiene school and goes through the rigorous and stressful board examinations only to say, "Well, that ought to do for eight years or so." Each graduate enters the world of private practice with dreams and visions of maintaining that fresh and vital feeling of importance. But when faced with the sometimes cold, hard reality of private practice, filled with time restraints, difficult patients, and team-related obstacles, the dreams and visions can turn a bit cloudy. In fact, 12 percent of newly graduated hygienists quit the profession within two years of graduation. Burnout often can be avoided by not allowing the doldrums to take root. If you happen to be a veteran, figure out the best and quickest way to keep yourself from this destructive path. Eight steps to avoiding clinical burnout follow.

Do not isolate yourself. The worst thing you can do is to withdraw more deeply into a shell, cutting yourself off from the rest of the hygienists in your profession who could offer you solace and inspiration. Membership in the ADHA is alarmingly low. I frequently hear, "I don't join because it costs a lot of money. Besides, what has it done for me lately?"

The ADHA does not knock on your door to help you personally with your specific problems. If every hygienist were to have this somewhat selfish mindset, preceptorship would be accepted nationally. The ADHA functions to act for the majority, as well as to benefit patients.

Others desire isolation due to skepticism about sharing information with other dental professionals. Maybe they are afraid of competition, that someone will steal some secret way of applying sealants or billing patients. Regardless, dental societies, study clubs, associations, components, meetings, conferences, and CE classes all are great mechanisms for bringing the dental community closer together, allowing us to learn from one another about how to treat patients better.

Stay current with the high-tech evolution. It is reasonable to predict that dentistry soon will resemble a scene from Star Trek. With equipment advancements such as digital radiography, networking intraoral cameras, lasers, ultrasonic scalers, and Perioscopy, as well as new equipment and instruments (with more curvatures than you can imagine) for the hygiene operatory, all sorts of new and improved methods and materials are designed to make our jobs easier and the outcome of each case more successful.

Learn as a group. Hygienists frequently attend CE courses alone, without the doctors or other staff members. Many of these programs, though, offer great insights on how to apply clinical knowledge for improved patient care from each staff member. The obstacles facing the front office and the clinical staff still exist. Many misunderstandings from either side result in "they said, we said" issues that truly create havoc for the practice. It is crucial that the team present a united front for patients, developing a sense of continuity, organization, and maximum efficiency. If only one member of the team attends a seminar, vital information frequently is lost in the attempted implementation of an idea.

Agree that you do not know everything. This is a tough one! After all, no one wants to admit a lack of knowledge about the profession, indicating that you are less than perfect. Opening your mind to absorb information - whether it's new or a reminder of old - is guaranteed to help you stay far away from complacency.

Commit to change. Change can be scary. It's human nature to become comfortable, and it alarms us to even contemplate stepping out of that comfort zone. But we are talking about our jobs and responsibilities. We need to make the changes that need to be made. We need to always advance and maintain up-to-date clinical abilities and knowledge. After all, if you undergo knee surgery, would you want the doctor to have only the knowledge that he graduated with? Or would you be more comfortable with someone who is able to provide you with even better services, minimizing your discomfort and scarring, and maximizing the end result? Our patients are no different. They want and demand that we remain one step ahead of the game. It is not acceptable for a patient to ask you a question regarding the new water laser system that is out and for you to reply, "What water laser system?"

Read dental publications. Part of staying current is reading your dental publications, such as RDH, Journal of Practical Hygiene, and Access. Information that you can read and apply immediately to private practice is your lifeline to avoiding burnout and complacency.

Take CE courses. Do it even if you have fulfilled your requirements. I have heard so many times, "I really want to go to that seminar, but I have already gotten all of my credits." So what? The more the merrier! Whenever I hear this, I cringe; it's rationalizing in its most deceptive form. It says to me and every other professional who is truly committed that the only reason that these people attend seminars is because they have to. If it was not required, how many hygienists would actually go to CE courses?

Observe a specialty practice in full swing. This is really one for the books! Unfortunately, when I suggested this to a room of 120 hygienists, I got a resounding, "Are you crazy?" What better forum for keeping up-to-date than spending a day observing a periodontal practice, perio surgery, or a biopsy sent to an oral surgeon, or even an endodontic procedure? The more well-rounded you are, the harder it will be to replace you. The more value you can provide, the higher chance you have of avoiding burnout (and, perhaps, preceptorship).

Take pride in the services you offer your patients; it will go a long way toward helping you to steer clear of burnout. If you care about what you do, your patients will, too.

Tammy L. Carullo, RDH, PC, PS, is CEO of Practice by Design, Inc. She may be contacted by e-mail at jtncar@ or by phone at (717) 867-5325. For more information about her company, visit