Dianne D. Glasscoe, RDH, BS
I had a very bad day recently - possibly, the "hygiene day from hell." Please allow me to describe it. You may be able to identify with this day.
How it began
To begin with, I was supposed to be off. I expected to do a little housework, read for awhile, surf the Net, cook a good supper for my family and attend my son`s wrestling match. All that ended when the phone rang at 6:15 a.m. It was our office manager, asking (with desperation in her voice!) if I could work for one of the other hygienists in our practice who had a sick child.
Now, I really did not want to work because I wanted this day for me. But, without hesitation, I replied that, sure, I`d come in. I know how it is to have sick children. I also know what a hassle it is to contact and reschedule 10 to 11 patients, especially when the schedule already is tight. Patients really do not like being canceled, and I don`t blame them. Have you ever had an appointment that you`ve planned for canceled at the last minute? My housework, my book and the Internet still would be there tomorrow. I could throw something in the crock pot for supper, and I really didn`t like wrestling anyway. Besides, I could use the extra money.
Things began to unravel in the morning huddle when I looked at the schedule. The hygiene coordinator warned me that the 10 o`clock patient, a four-year-old boy, was sometimes difficult. In addition, another unruly child that I remembered from a previous appointment was scheduled at noon. Dark clouds were gathering on the horizon ...
Let the stress begin!
The first patient was a perio-maintenance patient who needed one hour, but I was given only 40 minutes. I used my cavitron, worked really hard and was only 10 minutes over by the time I dismissed the patient. I felt pretty good about that!
The second patient was a no-show. I was frustrated that the patient didn`t at least call to cancel because I sure could have used the extra time on the first patient. People can be so inconsiderate.
The third patient was upset visibly that she was not seeing her regular hygienist. I explained as gently as possible that Lauren had a very sick child and that we did not wish to inconvenience this patient by canceling her appointment. I gushed kindness and gentle care, complimented her on how nice she looked and bent over backwards to gain her favor. I think she was OK when she left, but I was feeling the stress that only a discontented patient can give you.
Things get worse
The fourth patient was the one I had been warned about, but nothing could have prepared me for this kid. Keep in mind that this child was having his third prophy, so coming to the dentist was not a new experience for him. Almost five years old, he practically did everything bad a child can do in the office. He kicked, spit, thrashed about, refused to lay back, coughed in my face and told me he didn`t like me. His mother was no help. In fact, her presence only made things worse. No amount of pleading, promising, chastising or bribing made any difference. Sitting upright, he finally permitted me to brush his teeth with a toothbrush, but he refused to let me rinse the toothpaste off. I was a nervous wreck by the time he was out of my chair.
The fifth patient was uneventful, but I had to wait 15 extra minutes on a doctor check. So, I was running late for the next patient. If I had only known what was going to happen with the next patient, I would have slipped out the back door and ran away.
How can this day get any worse?
Remember, the fourth patient I told you about? Well, the sixth patient was a little worse, if that`s possible. This four-year-old knew one thing for certain, and that was he didn`t want to be in my chair. His dad tried everything imaginable to get little Tony to cooperate, but nothing worked. This is the kind of child who is born with a cigar in his mouth, barking orders to everyone around him! We never did get the child to even sit in the chair. I suggested to this helpless wimp of a father that possibly a referral to the local pedodontist would be in order. When they left, the kid was smiling ear-to-ear because he knew he had won that battle.
By this time, I was strung-out emotionally and physically. I sat down at the front desk to document everything in the patient chart when the phone rang. The business assistant had gone to the restroom, so I answered the phone. Just one more mistake - it was little Tony`s mother, who proceeded to chew my ear for the next 15 minutes on what a good child her little boy was and how he had such deep-seated fears about coming to see us. She went on to say that she didn`t appreciate the doctor and me making him feel like a bad boy (we said nothing of the sort!). She said she was a child psychology major and that her son had nightmares after every visit ... and on and on she went! Remember, the only treatment little Tom ever received was an exam and a toothbrush prophy. When she finally paused, I gave her the phone number of the local pedodontist.
What a headache!
By this time, I was 15 minutes into my lunch hour. Now, I didn`t have enough time to go home and check my crock pot. So, I dashed to the local fast-food restaurant for a quick burger. My head was splitting!
After I ate and took some headache medicine, I began to calm down. I was beginning to see the light at the end of this dark tunnel - I only had four more people to see.
The first patient of the afternoon was another perio-maintenance that needed an hour, but only got 40 minutes on the schedule. How could this happen two times in one day?
The second afternoon patient was a kind, elderly woman with only a few teeth - not too challenging, thank goodness. I played a little catch-up here.
The third patient was a no-show.
Before I describe my last patient, I`d like to interject that I believe God sends special people at just the right time to affirm and confirm to us that what we do is vital and appreciated. My last patient was just such a patient.
The last patient!
Mrs. Norwood was a petite, elderly widow, who never missed a dental appointment. As we made our way back to the operatory, she walked slowly but surely. I explained that Lauren had a sick child and that I was filling in for her. She patted me on the back and said that was just fine. I knew from her warm, sincere smile, she meant it. I finished her prophy and pointed out one area that was edematous. With a little more attention to this particular area with her toothbrush, I assured Mrs. Norwood it would respond nicely.
After the doctor check, Mrs. Norwood complimented me on what a good job I had done. I thanked her graciously and scheduled her next recare appointment with Lauren. (She was such a nice person, I really would have liked to have kept her for myself!)
However, the best was yet to come. After I escorted her out to the business assistant, I told her how much I enjoyed meeting her and hoped I`d see her again sometime. I went back to clean up my operatory and shut down for the day. Possibly 10 minutes had elapsed when I walked back out to the reception room to return a magazine. There, I spotted Mrs. Norwood.
It occurred to me that she probably was waiting for a ride. So I went over to her and asked if she needed a ride home. She told me she was waiting on a cab. When I realized she didn`t drive, I asked her if a cab had brought her to the appointment. Now, I don`t know what prompted me to ask that question, but her answer floored me. She told me she had walked to our office from her home in town, a distance of approximately three to four miles.
When my mouth dropped open, she laughed and said she needed the exercise. The weather had been misting rain all day. The realization that she had walked that distance in the rain to come in for her dental appointment greatly humbled me. What a terrible thing it would have been if no one had been there to do her prophy - especially when she attached such value to it! One patient had changed my whole perspective of the day. I was so glad God had allowed our paths to cross.
Dear, dear Mrs. Norwood, if you only knew how much I needed you that day!
The tangible rewards of dental hygiene are nice: good pay, professional standing and scheduling flexibility, to name a few. But no amount of money or anything else could keep me happy if I had days like this one very often. Oh sure, there are daily frustrations that we have to deal with, like staying on schedule, waiting on the doctor and having time to sharpen instruments. This just goes with the territory.
However, next time you have a stress-filled "hygiene day from hell," try not to let it get you down. Remember the intangible rewards that come with this profession: the thrill of taking a Class III or Class IV perio patient to a maintainable state of health; the joy of helping patients succeed with their home care; the opportunity to be a care-giver and a friend; the satisfaction of knowing you did your best for your team; and the sincere expression of appreciation from some of your patients.
Here`s hoping you have a few "Mrs. Norwoods" as your patients!
Dianne D. Glasscoe, RDH, BS, has been a hygienist for 20 years and currently is a practice-management consultant based out of Lexington, N.C. Her e-mail address is [email protected].