by Joanne Iannone Sheehan, RDH
Jan Blancett, RDH, wanted less than what she was getting. Less stress from racing the clock. Less treatment limitations due to insurance and financial situations. Less of the pain in her neck and back that 30 years of private practice had awarded her. Arthritis was affecting her hands and compounding that burned out feeling.
It was at a football game that Jan ran into a dentist she had worked with in the early 1990s. For a year, they had treated patients in the state prisons on the weekends. The dentist had since become the dental director for the Arkansas Department of Correction.
"I told him how I felt about my current situation," she said. "Although I loved the dentist I worked for and all the patients, I was ready for a change. But I wasn't sure what else I could do. The dentist then told me he had a position for an administrative assistant, and asked me to call and discuss the possibility of working with him."
The decision to leave her private practice position did not come easily. But her employer understood Jan's needs and totally supported her. The office staff was equally supportive. Jan found her replacement before she left. She knew that entering this "different phase of dental hygiene" was the right thing for her. She looks back at the career move with no regrets.
Jan took the position of administrative assistant to the dental director for three days a week, and spends the other two treating patients in the prison clinics. This enables her to continue the direct patient care she loves. She also learned how to keep 11 state clinics in operation.
"The salary was comparable to that of my private practice, in addition to a huge benefits package," she said. "Health, dental, pharmacy and vision insurance, a 401-K retirement plan and 26 paid days off per year were among the immediate benefits. The more intangible benefits became apparent after a few weeks. Flexible hours, travel around the state, meeting and working with many different dentists, hygienists, and assistants as well as the prison medical staff are some of the unexpected benefits."
Working among inmates might rattle some people, but Jan insists she is working in a secure environment. All the prisons in which she practices are maximum security prisons. The "problem" inmates from the isolation cells and the maximum security inmates are escorted to the dental suite in handcuffs by prison guards. The guards stay throughout the appointment and never once leave the inmate's side. Maximum security inmates are kept in handcuffs, live in isolation cells 23 hours a day, and are escorted everywhere by a security officer. But they all have access to medical and dental care.
Inmates with a minimum security classification walk unescorted to their jobs, dining hall, and infirmary, and work in the offices as maintenance personnel.
I asked Jan if she was scared the first time she practiced in a prison in the early 1990s.
"I was somewhat nervous, but I was never alone. I was with the dental director and another hygienist. The dental director had been there for several years and was so relaxed that her attitude rubbed off on me. The patients that day were so quiet and cooperative, I forgot where we were. State prison facilities are probably the safest places on the planet, much safer than your local shopping mall parking lot after dark!"
Jan's experience in state prisons has been positive. The only incident she can recall is an inmate who insisted on calling her "baby girl."
"They always call me Ma'am or Miss Dentist Lady," she said. Because they provide a totally unique patient base, her patients supply Jan with a lot of job satisfaction.
"The most unexpected benefit of all has been the patients. They have to submit a request to have their teeth cleaned, so no one is ever brought to me against their will. They are thrilled when they realize they have been brought to the infirmary to have their teeth cleaned. The inmates are, hands down, the most appreciative and polite group of patients I have had in my 30 years of practicing," Jan said. "They are incredibly grateful to me for bringing my skills and expertise to them."
While some might feel that inmates don't deserve such conscientious dental care, Jan would disagree. As she offers quality dental care to them, a need is being met in her own professional life.
"Our prisons are full of good people who did a bad thing. My job is like getting paid to do missionary work. Most of the patients have never had any medical care, much less any dental care. They are amazed at how good their teeth look and feel when I'm finished. Sometimes, they write letters to their wardens or other administrators telling them how thankful they are that they were able to get their teeth cleaned and how nicely they were treated. You just don't get that in private practice."
The dental clinics in the Arkansas Department of Correction are one-operatory clinics. Jan said they have squeezed two units where one was meant to be, making for pretty tight quarters. When the dentist and assistant are also working, it is a logistical problem. Flexibility and creativity are a plus. The clinics have standard, modern equipment such as air driven hand pieces, ultrasonic and sonic scalers, high-speed suction, and no cuspidors. The dental clinics are located inside the prison infirmaries. There is always a prison guard outside the door in the hall. Even without someone in the room with her, Jan never feels alone. The infirmary is filled with doctors and nurses, administrators and records clerks.
"Think of our clinics just like you would a private dental office, except our room is the only dental operatory," she explained. "The other operatories are filled with nurses seeing patients, doctors seeing patients, and records clerks doing their thing at the front desk, with an officer sitting in the waiting room. We also have a pharmacy and an X-ray tech at most clinics. The inmates sit in waiting areas, and we notify the officer when we are ready for our patient to come into the dental suite."
Because Jan never expressed any fear or apprehension to her children when she worked in the clinic in the 1990s, they are "totally comfortable" with her working there full time. At ages 24 and 17, they think her job is interesting and "cool." Her boyfriend doesn't worry and her parents feel better than they once did. Jan explained to them that she would never be "...isolated with an inmate or off in the bowels of some dark prison."
I asked Jan if she treated prisoners on Death Row.
"Yes. These probably present the most poignant moments for me. I know they are on Death Row because their identification numbers are different from the general population. I am acutely aware of their situation and find myself treating them with the most dignity I can muster. I might make their last days a little healthier and more comfortable.
"I might help them live those last days with a bit more dignity. They might remember the kindness and personal respect I show them. I try to treat them as I would want one of my loved ones to be treated during their last days."
Jan lives in Little Rock, Ark. She travels daily to either the administrative office in Pine Bluff, one of three prisons there, or any one of the nine prisons around the state. She is entering her third year as a hygienist in the Arkansas Department of Correction. Jan is administrative assistant to the Regional Dental Director for Correctional Medical services, which provide medical/dental care to jails and prisons in more than 20 states. She also serves as the dental services administrator in over 11 prison dental clinics in Arkansas. She now works three days a week delivering direct patient care at six Arkansas prisons.
Jan is the dental hygienist representative on the Arkansas State Board of Dental Examiners, a position she has held since 2001. She serves as an examiner for the Southern Regional Testing Agency and is active in the Arkansas State Dental Hygienists' Association and a member of ADHA.
Jan Blancett has found a meaningful and rewarding alternative to private practice. Across the country, hygienists are filling the need for dental care in places that are less than glamorous.
Joanne Iannone Sheehan, RDH, is a 1974 graduate of SUNY in Farmingdale, N.Y. She has been licensed in five state. Winner of the grand prize in a Chicken Soup for the Dental Soul writing contest for dental professionals, she has been a frequent contributor to RDH magazine since 1997. She can be reached at [email protected].
If you are interested in a career in the Department of Correction, go to http://www.bop.gov/recruit.html or contact Correctional Medical Services at www.cmsstl.com.