Are you protecting your license?

How many of us take the time to reflect on the value of our dental hygiene license and ensure its protection?

by JOANN R. GURENLIAN, RDH, PhD

How many of us take the time to reflect on the value of our dental hygiene license and ensure its protection? We find ourselves working hard and sacrificing to successfully complete our dental hygiene education. We miss out on time with our family and friends to meet our requirements, stress over our national and regional board examinations, and Facebook our closest five hundred friends that we passed and have our dental hygiene license. It truly is a time for celebration.

Then, we get our clinical practice jobs, hang our license on a wall, and – what? Forget about it? Treasure it and everything it represents? Take it for granted?

Recently, I had the great joy of teaching an ethics and jurisprudence course to senior dental hygiene students. They understood key concepts, but were challenged by the idea that they could compromise their license. All too often they wanted to rely on their employers to make the tough decisions and to sacrifice their professional standards. It was a good learning experience for me to have to keep finding ways to reinforce the idea that their license would be in jeopardy based on their decisions.

Likewise, at a recent national conference, this issue was raised and our colleagues repeatedly seemed to want to rely on someone else to make decisions about periodontal treatment and prophylactic antibiotics. The discussion caused some concern because there was an over-reliance on others without taking professional responsibility. In addition, it appeared as though there was little recognition for the fact that our license has meaning for every patient, not just the ones that are medically complex or require antibiotic prophylaxis.

The reality is that when any person walks into the office, our license is on the line. If we neglect to provide a dental hygiene diagnosis and treatment plan with options, we are jeopardizing our license. If we do not offer our patients an informed consent and right of refusal, we jeopardize our license. If we shortchange our patients by providing less than our best in terms of professional standards, we jeopardize our license.

The time has long since arrived when we should stop taking a backseat to other health-care providers. We need to stand on our own two feet. We are quite capable of making important decisions on behalf of our patients. We can use the many guidelines that are available to us in conjunction with patient circumstances, confer with specialists as needed, and partner with our patients to discuss and arrive at appropriate decisions. Why then do we doubt ourselves? Why do we paint this picture of helplessness when we have the ability to be better?

I think there is an inherent quality among dental hygienists that can be disarming – we aim to please. In doing so, we often relegate our responsibilities to someone else. Many of us of a more “experienced” age grew up deferring. That might be the answer for some, but there was a time when we worked on being more liberated. Did we somehow forget to teach independence and critical thinking skills to our students? Did we not provide enough clinical experiences that challenged our students to think for themselves? Or are we fostering codependent behaviors? Are we still teaching our students to defer rather than assert? Are we still teaching students to rely on others to make decisions rather than themselves?

It may be time to reexamine how we teach professional skills to dental hygiene students. Imagine offering senior dental hygiene students the chance to create their own dental hygiene practices during their fall semester. They must identify their philosophy of practice, goals, and evaluation plan. During the spring semester, the students get to implement their practice models, testing their ideas, how they provide care to their patients, and assessing the effectiveness of what they do. They would bear the responsibility for the decisions they made throughout the process and be challenged to consider the scope of their responsibility, including ethical, moral, professional, legal, and practical issues. They would be asked to identify whether or not they protected their license or compromised it, and if they would do anything different in terms of care and documentation with each person treated.

While this concept may sound like a good idea in theory, don't be so quick to dismiss it as a reality. My colleagues at Thomas Jefferson University did this 20 years ago. We abandoned counting calculus (even though our accreditation consultants thought that was essential) and focused on giving the students an opportunity to develop decision-making and critical-thinking skills. We graduated skilled clinicians and professionals who could function and make sound decisions.

Now, let's take this idea one step further. Let's foster and support this level of growth and development among current practitioners. Let's change some of our professional education sessions so we can develop our own practice philosophies and practice parameters. Let's give ourselves the gift of meetings that focus on managing the challenges we face in practice that support our practice framework. Something tells me it would be a welcome change and well worth our time to invest in building confidence, solving professional issues, and helping us recognize our knowledge and abilities so we trust ourselves to be the decision makers for our clinical practice! RDH

Consider reading: How dental hygienists should plot their 2013 goals
http://www.rdhmag.com/articles/print/volume-33/issue-1/coumns/how-dental-hygienists-should-plot-their-2013-goals.html

Consider reading: What is an ideal dental practice?
http://www.rdhmag.com/articles/print/volume-32/volume-12/columns/ideology-to-reality.html

Consider reading: Yes, we can!http://www.rdhmag.com/articles/print/volume-32/issue-10/columns/yes-we-can.html

JOANN R. GURENLIAN, RDH, PhD, is president of Gurenlian & Associates, and provides consulting services and continuing-education programs to health-care providers. She is a professor and interim dental hygiene graduate program director at Idaho State University, and president-elect of the International Federation of Dental Hygienists.

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