By Anne Guignon, RDH, MPH, CSP
There are forums all over the internet where discussions can go on for days about people’s career choices. One frequent topic revolves around whether nursing is a better career path than dental hygiene. One recent discussion caught my eye. It was remarkable, insightful, and civil. It resonated with me from two points of view.
Personally, back in 1968, I was scheduled to begin school to become a registered nurse, but I jumped ship right before the semester started. My part-time job in college was in a dental office. I fell in love with the ongoing patient care relationship in dentistry, so I switched majors.
Fast forward to this past January. My husband spent two days in a cardiac ICU recovering from Wolf Mini-Maze surgery to treat his atrial fibrillation. The nurses were stunning. They were smart, they cared, they had great people skills, they were great educators, and they were totally focused on helping my husband with a smooth recovery. While a nursing workload is quite different from that of dental hygiene, the personal skills and integrity were amazing and reminded me of the hygienists I truly admire.
The conversation also resonated with me professionally. Pat Jacobs started off the conversation by saying she had just lost her job. Since there were very few dental hygiene jobs in her area she was considering a career change. Her state unemployment office in Ohio determined she is eligible, through the Workforce Investment Act, to receive two years of college for certain health care programs, including nursing. Since she has already taken many of the prerequisites, nursing was high on her list.
Weighing in next and looking for guidance from her peers, Tosha posed the following questions: “For those of you that have gone from RDH to RN, is the money comparable? Are you happy with the switch or do you wish you had chosen a different field?”
Tracey McCready wished Tosha the best, and then shared several interesting observations. Before entering dentistry, Tracey worked as a radiology technician in a hospital. She loved working in an emergency room and being up all night in surgery. But she reflected, “There is a big difference in patients’ moods and attitudes. Most people choose to visit the dentist, while going to a medical doctor or hospital is usually driven more by necessity. Patients in the hospital aren’t always the perky, happy-go-lucky clients we see in our dental chairs.”
After 26 years in dental hygiene, Pamela Cromwell Hardman received her BSN in December 2015. She now works in both hygiene and nursing. “As an older graduate I don’t think I would have been a good nurse in my 20s. As a new nurse in my late 40s, I really enjoy taking care of my patients.” She still works in a pediatric dental office in Georgia and loves those patients. “Maturity has taught me a lot and I try to treat everyone like family. I don’t take anything personally and I just smile.”
Tracy Frasier tried nursing school a few years ago and found it was not for her. “I learned that it takes a special individual to become a nurse. All along I thought I was that special type of person. It was a huge wakeup call.” She wisely counseled readers that if the main motivation for going to nursing school was the money, disappointment lay ahead. “Go for nursing only if you have always wanted to be a nurse.”
Tracy was shocked with how much responsibility nurses are forced to carry in terms of daily workload and ethical decisions. She feels the nursing shortage is a result of mistreatment, being forced to work 16-hour shifts, and having to be responsible for the lives of 12 patients at a time. One of her nursing classmates in Michigan feels nursing is extremely hard. “The money isn’t worth it. And I thought administering local anesthesia was a liability. Ha! After nursing school, I appreciated hygiene so much more.”
After reading all the back-and-forth chat, Pat chimed in and said money was not her driving factor. She likes patient care but is looking for “a career where she doesn’t have to worry about finding a job.” The discussion brought up another concern, that of being an emotional person afraid of how she will handle dying and critical care. Tracy suggested having a heart-to-heart talk with a nurse to really understand what the career entails.
Betsy Hassler has two bachelor’s degrees, one in nursing and one in dental hygiene. Even though she was plagued with doubts about nursing while in school, she convinced herself that it would be different in the working world. She quit after one year of pediatric oncology. “Nursing is the most undervalued, underappreciated profession there is. It takes a special soul to work as a nurse. I went home after shifts physically exhausted from being in my feet all day or night. I was emotionally exhausted from dealing with sickness and dying, and with people’s poor attitudes in general. Some people think they get a pass from being nice because they’re sick.”
Fifteen years ago, Betsy became a dental hygienist and is much happier. She doesn’t have to deal with debilitating pediatric illness and never has to work weekends or graveyard shifts. “My patient is the one in the chair, not the whole family of the sick individual. I would strongly think about other options before choosing nursing.”
After being a hygienist for four years, Ashley Lambie Schider is starting nursing school this summer in northern Wisconsin. When she was in dental hygiene school, she had doubts about her new career, and subsequently found dental hygiene repetitive. Today she is ready for a different career that has the potential to offer more opportunities for advancement and more challenges in a variety of settings. Fortunately, all of her science courses transferred, which makes furthering her education much easier.
Kathleen Young Endres is another one with a double degree in dental hygiene and nursing. Public health turned out to be the ideal setting for her dual careers. Before retiring, she oversaw programs in Wisconsin that included the senior center nursing program, maternal child health, radon testing, pediatric vaccines, and dental sealants. Her BSN helped her land a full-time position that includes a vacation package and retirement benefits, and she never has to work holidays or weekends.
Carol Tiso Anderson Maddalena is also an RN and RDH who found dental hygiene school much more difficult than nursing school, but she gets an emotional high from nursing. While she says salaries are similar, she cautions, “One does not delve into the nursing profession because of the salary. One must yearn to care for patients.” Carol readily acknowledges that dental hygiene has provided her with a wonderful career, but she feels that the profession has changed drastically through the years. Her final counsel is, “Attaining a degree in nursing will benefit you immensely.”
The conversation also discussed nursing opportunities outside of the hospital setting. Options for day jobs that did not involve working holidays or nights included urgent care clinics, dialysis companies, doctor’s offices, visiting nurse programs, public health clinics, nursing homes, public schools, and hospice care. Most of those in the discussion felt these positions were primarily filled by nurses with years of experience and that less attractive positions, from a time and lifestyle standpoint, were staffed by newer graduates.
Melissa Johnson-Velez shared these thoughts. “Nurses here in Nevada have asked me about hygiene because they’re sick of their jobs as well. There is no perfect job. Everyone’s experience is different. I know some nurses who love their job and some who hate it. They’re just like us.”
Dental hygienists who have practiced for many years have seen many changes in the profession. While some changes have improved clinical practice, the health care delivery model known as dentistry is vastly different than it was four decades ago. Jobs are harder to find, benefits are drying up, wages are stagnant, and demands on workers are increasing while the time to produce is shorter and corporations are slowly wiping out solo business enterprises.
Dentistry is not unique. This litany of complaints can be applied to a long list of professions and other businesses. Here’s the good news - direct patient care can’t be outsourced to a call center thousands of miles away or delivered by a robotic computer program. Someone must treat patients from a clinical perspective. Despite the challenges, we still have a certain level of job stability.
Whether your choice is to remain in dental hygiene, take on a new challenge such as nursing, or combine the two careers, it is still your choice. There are no universal answers. The right choice is ultimately what makes you happy. RDH
ANNE NUGENT GUIGNON, RDH, MPH, CSP, provides popular programs, including topics on biofilms, power driven scaling, ergonomics, hypersensitivity, and remineralization. Recipient of the 2004 Mentor of the Year Award and the 2009 ADHA Irene Newman Award, Anne has practiced clinical dental hygiene in Houston since 1971, and can be contacted at [email protected].