The pressure cooker

Dec. 1, 2008
I've been a hygienist for five years, but I'm starting to feel like I've chosen the wrong profession.

by Dianne Glasscoe-Watterson, RDH, BS

Dear Dianne,
I've been a hygienist for five years, but I'm starting to feel like I've chosen the wrong profession. When I got out of school, I was very excited about working as a hygienist and helping people have healthy mouths. I actually loved the clinical challenges of hygiene. Now I feel disillusioned. The practice where I work is all about production, production, production! The harder I work, the more the doctor pushes. I leave so tired at the end of the day that I need to lie down and rest when I get home before I start preparing dinner for my family. I'm drained physically and emotionally!

I need to work, and hygiene jobs are scarce in my area. Is there any way to turn this situation around?
Disillusioned and Defeated

Dear D&D,

Years ago, my mom gave me a pressure cooker. I learned there are many advantages to pressure cooking, such as decreased cooking time and less chance of scorching. I also learned that the heat level under the pot is critical. One day, I filled my pot with water and pinto beans and put my pressure cooker on the stove over high heat. I walked away to do something else, and a few minutes later I heard what sounded like a gunshot and a loud "whoosh." Too much sustained heat caused the pressure to build up to the point of popping the safety valve off the lid. The "whoosh" I heard was the sound of pintos and water spraying all over my ceiling. The lesson I learned that day was never leave a pressure cooker on sustained high heat.

It sounds like you are in a "pressure cooker" work situation, and the heat is too high. If someone does not turn the heat down, one of these days your safety valve will pop, and you will suddenly quit. When that happens, the pressure will be relieved, but there will be a mess for you and your employer to clean up.

All pressure cooker work situations are not bad. In the pressure cooker, we learn to work efficiently and not waste time. We develop strength of character and perseverance. We develop systems and problem solving skills so that we are effective at our jobs.

However, I also learned that if you leave something in the pressure cooker too long, it turns to mush. The food is ruined and must be thrown out. Too much time in the work pressure cooker can make people develop "unpalatable" attitudes such as indifference, disillusionment, and chronic discontent. These negative attitudes affect how we interact with each other and our patients.

The ideal practice would have these aspects:

  1. Sufficient time to deliver high–quality care.
  2. Great equipment and instruments.
  3. Patients who show up and appreciate our care.
  4. Bosses who appreciate us and our contribution to the practice.
  5. Coworkers who function as a team.

Unfortunately, ideal practices are few and far between. My experience is that staff members will adapt to almost any practice situation if they feel loved and appreciated. Some doctors have mastered the most difficult clinical techniques and spent thousands of dollars on technology and education, yet they have never learned what makes an effective leader in a practice. It begins with expressing sincere appreciation to staff members. These doctors have never learned that the heat has to be carefully controlled under the pressure cooker.

In addition, doctors who are so money–driven that they focus not on excellent patient care but on achieving some arbitrary daily number are not aware of the damage they do to staff morale. Staff members lose respect for these doctors. Also, staff turnover costs the practice significant amounts of money.

Please understand that production IS important. If the practice is not producing adequately, it cannot pay its debts, which include staff salaries. The current economic hard times will affect all businesses, and those practices with significant debt will suffer most. Who knows? The doctor you work with may be worried about keeping the practice solvent, which may explain his or her preoccupation with production.

Since you stated that leaving is not an option, my advice is for you to change the way you view your job by being thankful every work day that you have a job. Demonstrate excellent care to patients by doing your best, and look for ways to work efficiently. Treat your patients and coworkers with kindness and compassion, and remember why you're there in the first place. Make the doctor glad to have you as a team member. A good attitude will help you control the heat in your particular pressure cooker. Finally, try to avoid the negative feelings that come from the doctor's preoccupation with production.

Life is full of pressure cooker situations. Whether we like it or not, every one of us will be in the pressure cooker at some time. Whether pressure situations make us bitter or better depends on how we respond. We cannot change people, but we can change how we respond to pressures by developing positive attitudes to help us cope.

The holiday season causes many of us to reflect on our blessings and reasons to be thankful. One thing I am especially thankful for is all of you who read my column month after month. It is such a joy to meet many of you at my speaking engagements across the country. I am also thankful to Mark Hartley, my wonderful editor at PennWell, and the opportunity I have to address problems faced by working hygienists. April 2008 was my 10–year milestone writing for RDH magazine, and it has been a labor of love. I wish all of you a blessed holiday season and a new year filled with full schedules, sharp instruments, and appreciative bosses!

Best wishes,

About the Author

Dianne Glasscoe–Watterson, RDH, BS, is a professional speaker, writer, and consultant to dental practices across the United States. She is CEO of Professional Dental Management, based in Frederick, Md. To contact Glasscoe–Watterson for speaking or consulting, call (301) 874–5240 or e–mail [email protected]. Visit her Web site at