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Serving kindness through in-service

Nov. 1, 1996
Albert Einstein ... Mother Teresa ... Christopher Columbus ... Mozart ... Leonardo DaVinci ... Henry Ford ... Abraham Lincoln ... Martin Luther King Jr. ... Joan of Arc ... Charles Darwin. How often in the past has just one person impacted the entire course of history? One thought - acted upon or shared with others to carry forth - can change the course of humanity. For better or for worse, one man or woman can literally change the world.

Albert Einstein ... Mother Teresa ... Christopher Columbus ... Mozart ... Leonardo DaVinci ... Henry Ford ... Abraham Lincoln ... Martin Luther King Jr. ... Joan of Arc ... Charles Darwin. How often in the past has just one person impacted the entire course of history? One thought - acted upon or shared with others to carry forth - can change the course of humanity. For better or for worse, one man or woman can literally change the world.

Cathy Terhune Alty and

Kathy Olson

As dental hygienists, we may not win the "big prizes" our society bestows on individuals: the Nobel, the Oscar, team captain, or gold medals. But what we are given is one moment in time - an opportunity to impact our little piece of the world through our involvement, our passion, our existence. No excuses, no putting it off for another day, no waiting for someone else to step in and do it first. The power of one: one person touching another person`s life in a personal, profound way. It happens every day.

RDHs know more about dental health than any health profession. We know how valuable that knowledge is and that many people will benefit from our sharing it with them. Each one of us as an individual can make a difference by stepping out of our comfort zone just a little bit and sharing the message of dental health.

The problem for many of us is we don`t know where to start. Kathryn Olson, RDH, dental services coordinator for Swedish American Hospital in Rockford, Ill., suggests dental hygienists could begin by walking in the door of the nearest nursing home or extended care facility (ECF) and offer in-service training to the staff.

"We already have all the skill and knowledge needed to provide this valuable service," Olson said. "We must only adapt our knowledge to correlate with the needs of these special needs patients."

Olson offers specific information for dental hygienists who would like to try in-service training at their local ECF.

Your dental IQ versus ECF employees

In most ECFs, staff are required to attend in-service training. The reverse is also true. ECFs are required to provide this training on various topics annually, including oral health.

When providing in-service training to staff who are caregivers in extended care facilities, it is advisable to understand your audience. Caregivers in ECFs usually work very hard for minimum wage or a little more. They do not generally have a high level of education. It is important not to talk down to your audience. It is equally important not to speak over their heads.

Observing the audience will help determine if you are speaking at an appropriate level. This is not too complicated. If everyone is looking at you as if they are totally lost, back up and explain your ideas in easier terms. After years of providing in-service training, Olson said she still occasionally fails to notice listeners` confusion.

"For example, I always include a little information about smokeless tobacco and its hazards at the conclusion of my in-service," she said. "After one such in-service recently, one of the participants asked me what smokeless tobacco was. Don`t assume your audience knows too much."

Some staff members are anxious and willing to improve their knowledge and skills by attending these in-services. Others wish only to put in the required time and be done with it.

Making your in-service interesting can help involve those less interested listeners. Your attitude and enthusiasm about your subject will directly affect the audience. We can certainly remember those teachers in school in whose classes it was difficult to stay awake. If you choose to simply read facts, don`t expect interest and enthusiasm in response. If you, on the other hand, display genuine enthusiasm and a positive attitude about what you are teaching them, the feedback you receive will reflect that.

"I always try to involve my audience," Olson suggested. "On occasion, I will ask for audience response to specific questions, and throw out toothbrushes for correct answers. That really wakes up a crowd! In all of my in-services, participants are encouraged to ask questions and make comments during the presentation. I feel this type of format puts everyone more at ease, including me, and promotes interest and participation."

The main point of the lesson

As for the content of the in-service, Olson uses the "KISS method - keep it super simple." She tries to keep all in-services to a maximum of 30 minutes of instruction and an additional 15 minutes of answering questions. A time limit of 30 minutes does not allow for much detail. Most ECFs cannot have caregivers away from their patient care areas for long periods of time. Olson also notes that when "I begin to go over the 30-minute time limit the audience`s attention begins to wane. Some of them will be ending their shift and are anxious to leave. I have had people actually get up and walk out while I was still speaking. Never be rattled by uninterested participants."

Since time is so short, prioritize the content of the in-service. Choose a few critical points to convey and always stress one main point right at the beginning of every in-service: The key belief that daily oral care is not simply a personal hygiene issue but rather a medical issue. Daily oral care can be compared with daily wound care or medicine regimes. This point is intended to get the staff to view oral care as a critical part of total patient care. You can explain that leaving bacteria in the oral cavity by not brushing or not effectively brushing directly affects a person`s overall health.

"If my audience leaves with nothing more than an understanding of this one concept, I feel as though I have been successful," Olson said.

Try to include information in the in-service that participants will find useful and interesting for themselves as well as for their patients. Olson said it has been her experience that caregivers will attach the same importance to their patients` oral care as they do to their own. So, by improving the caregiver`s own dental IQ, hygienists help the special-needs patients.

Do not get into detailed discussions of toothbrushing techniques, and do not include flossing. It is very unrealistic to expect that staff or caregivers will floss a resident`s teeth. The goal is to convince them to brush their patients` teeth once or twice a day. If you have not spent time in an ECF, you may think that this level of daily oral care surely exists. It does not in many, many places.

Hygienists providing training are also asked to do in-services on more specific subjects - for example, nutrition, cancer patients` oral needs, oral care for the difficult patient, and abnormal oral findings.

"When I get a request, and since I`m not an expert on these subjects, I research the topic using as many sources as possible," Olson said. "Another good source of information is colleagues: dentists, hygienists, physicians, nurses, and other health-care professionals who are in the trenches on a daily basis. You also have vast knowledge from your own experience. Use that knowledge as a base and expand it using outside resources."

An expert`s confidence

Olson`s most important advice for interested hygienists is don`t be afraid to "just do it."

"When you walk into a room to do an in-service in an ECF, you are the expert," she said. "You already possess far more dental knowledge than anyone there. I recently gave a lunch-and-learn presentation of all interested employees in the hospital. This group included several different health care professionals, office staff, housekeeping staff, and administrators.

"The half-hour presentation was titled, `Taking Care of Those Pearly Whites.` The information was simple: What kind of brush to use, what kind of toothpaste, storage of toothbrushes to prevent spread of germs, the effects of poor oral health on your general health, common dental problems and what to do about them, and a little about smokeless tobacco. All of these subject matters are very familiar to us as dental hygienists. The feedback at the end of the presentation was overwhelmingly positive. I know anyone reading this article could have presented the same information with only a little review."

If you are asked a question you can`t answer, which seems to be the biggest hurdle for some people, simply say, "I can`t answer that, but I will try to find you the answer." This happens many times, according to Olson, and "I always try to find an answer and get back to the person."

Your confidence level speaks loud and clear to your audience. If you are tentative and unconvincing about what you are saying, your audience will tune you out. On the other hand, if your voice and body language convey assertiveness and confidence, your audience will receive what you say as expert information.

"I hope this gives you some ideas and the incentive to try inservicing in an ECF near you," Olson said. "I know that you will find it a very rewarding experience and that your services in this area are desperately needed. It is a great way to provide a community service using the skills you already possess."

"Since we have become a visual society, I use slides and other visual aids when presenting," Olson said.

Visual aids can be obtained from many sources, or you can create your own with the help of a photographer. (Note: Be sure to get the necessary photographic releases from people who may appear in your slides.) Olson often passes around a partial and a denture because many people have never seen or held a prosthetic appliance. She also uses a large typodont and toothbrush for demonstrating brushing.

Visual aids can be an important teaching tool, but be careful not to overload your presentation with too many different types of visual aids. This will become cumbersome and distracting. Also, remember to always be prepared to go on without the help of electronic devices.

"I have had slide projector bulbs blow out and missing equipment which meant doing the presentation with no visual aids," Olson said. "Don`t be rattled - just do without!"

In summary, an interviewer once questioned Mother Teresa about the near futility of her tireless work with the people of Calcutta.The interviewer said, "All the people in the world who need help could be compared to a huge net full of fish. What is the difference if one fish is pulled from the net and set free?"

Mother Teresa answered, "It would be all the difference in the world to that one fish."

We all need to find those fish and set out to release them, one by one. As Kathryn Olson says, just do it!

Cathleen Terhune Alty, RDH, is a consulting editor to RDH who has contributed many articles to the magazine. Kathryn Olson, RDH, is a 1976 graduate from the Marquette University School of Dental Hygiene. She has taught in-service programs throughout Illinois for the past nine years and serves on the national board of the Academy of Dentistry for Persons with Disabilities. She can be contacted at (815) 391-7510 or (815) 562-8000 (home).

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Kathy Olson