Dear Dianne, I've practiced dental hygiene for 23 years. For the past six years, I have done fill-in-work, because I want to have the flexibility to work...
I’ve practiced dental hygiene for 23 years. For the past six years, I have done fill-in work, because I want to have the flexibility to work when it is convenient for me. My husband is semiretired, and we like to travel. I have temped in many different offices, some good and some bad.
Several months ago, I agreed to work for a hygienist who was going on maternity leave. After one week in that office, the doctor fired me. He told me I was “too slow.” This caught me totally by surprise, and I am so hurt and insulted that I don’t know if I will ever get over the pain.
The office was very busy and hectic, and I often found myself waiting several minutes for the doctor to come and check my patient. Every day, I worked 15 to 30 minutes into my lunch hour and was always the last one to leave at the end of the day. I felt stressed by the hectic pace, but I was determined to do my best to stay on schedule and cope with running late.
I take great pride in the quality of my work. Cutting corners is not an option with me, but the doctor was obviously not happy with my job performance. My question is: How can I prevent this from ever happening again? I want to keep temping, but I do not want to be unpleasantly surprised like this again.
Still Hurting in Houston
I guess the first thing that jumps out at me is your mention of having to wait on the doctor to do the hygiene check. By that, I’m assuming the doctor was not summoned until you were finished with your patient. I suppose there are some offices where that strategy would work. My experience with fast-paced, hectic practices is this: Waiting until the end of the appointment to summon the doctor is asking to be kept waiting.
A better plan is to complete all the preliminary tasks such as updating the medical history, taking the blood pressure, exposing any necessary radiographs, periodontal charting, and intra/extraoral exams. Then summon the doctor. This will give your doctor more than ample time to come and check your patient before the end of the appointment.
Years ago when my children were small, I did temp work. Temping is much more difficult than going to the same office every day. I remember how “discombobulated” I felt not knowing where anything was; not knowing how the doctor liked things done or the particular office routine; not knowing any of the other staff members or patients; not knowing how to operate unfamiliar equipment, etc.
For all of those reasons, plus the fact I did not get any fringe benefits in temp situations, I didn’t mind asking for a higher than average pay rate - not ridiculously high, but higher than the average rate. Sometimes the call would come early in the morning, and I would drop everything I had planned that day to go and work for a hygienist who was ill or who had a sick child.
Some offices were appreciative that they didn’t have to cancel nine to 11 people that day and expressed their appreciation by their friendliness and willingness to help keep me on track. A few offices were downright unfriendly and made me feel like an intruder. Those offices would only get me once. That’s the great thing about temping - you don’t have to go back if you are not treated well! My point is this: Temping is difficult at best, and, because of varying philosophies and personalities, a perfect “fit” is not always possible.
The other problem that you highlighted was your ability to stay on schedule. From working with many different offices, my experience is there are four basic speeds that correspond with quality of work for clinicians. They are:
• Slow and good.
• Slow and not good.
• Fast and good.
• Fast and not good.
Some clinicians (both hygienists and dentists) are like race horses on speed. They work quickly with their hands and often move about the office like their lab coat is on fire. It’s part of their “driven” nature. Clinicians in this category do not work well with people who are deliberate and methodical with their work speed. I suspect that may have been the case here. In a temp situation, the hygienist has to adapt (as much as possible) to the pace that has already been established. That would be very difficult for someone who, for example, is accustomed to having one hour for an adult prophylaxis but goes into an office to temp where only 40 minutes is allotted for adult prophies.
It is so unfortunate that this happened to you, but try not to let this experience bruise your ego too much. If this office’s hectic pace was stressing you out, the doctor probably did you a favor by cutting you loose.
Let’s face it. There are offices that expect hygienists to “run and gun,” and, to do that, corners have to be cut. Typically, the procedures that often get skipped are the most important, such as a thorough intra/extraoral exam and periodontal charting.
Please note that the most important thing you do for any patient in your chair is not scraping debris off his/her teeth, but rather a good, thorough examination. You do not need an inordinate amount of time for those procedures, but they take time all the same.
Also, remember that some personalities do not match well with other personalities in the workplace. Consider this experience a “mismatch” and keep on going down the road. Do your best to flex and blend in with the practice culture with the knowledge that you are enriched with each new practice experience.
Best wishes, Dianne
Rules of temping
I would advise anyone who is considering doing fill-in hygiene to follow these rules of temping:
❏ If possible, go to the office a few days ahead of time and familiarize yourself with their layout and scheduling. Even though you will not remember exactly where everything is located, having been there once will help you feel more comfortable than just walking in cold turkey and start seeing patients.
❏ Make sure your pay requirements are clearly spelled out with the doctor or office administrator beforehand. It is best to speak directly with the doctor or the office administrator about these matters. Further, it should be understood that you expect taxes to be taken out of your pay.
❏ If you have agreed to work multiple days, initiate communication at the end of the first day with the doctor about how she or he likes to have things done. Don’t be shy about asking questions, such as, “Doctor, since I am unfamiliar with your office, is there anything I am doing or not doing that we need to address? I want to make sure I am doing things as you would like.” Asking for feedback may help you know if you need to make any adjustments.
❏ You have to be flexible. Every office will not do things exactly like you would like, but it would be unwise for you to go in as a temporary hygienist and raise criticism about the office.
❏ Find out ahead of time about what they usually do for lunch.
❏ Treat the patients you see like they are royalty. Make sure you introduce yourself in the reception room area before taking the patient back to the treatment room. Extend your hand and say, “Hi, Mrs. Jones. I’m [your name]. [Regular hygienist’s name] is sick today, and I have been asked to fill in for her. We did not wish to interrupt your care, so I hope that will be all right.” Never in all my years of temping did I have a patient object to seeing me when I made the effort to break the ice and kindle the relationship with kindness.
If you follow these rules in the future, you should be able to avoid any misunderstandings.