Are you suffering from burnout?

August 7, 2018

By Katrina M. Sanders RDH, BSDH, M.Ed, RF

Article

In a world of long hours and grueling work, it’s no surprise that many hygienists are experiencing stress and strain.

It was a cause for celebration! My sister-in-law had gone into labor, and she was preparing to deliver the much-anticipated first grandchild of the family. The whole family gathered in the labor and delivery ward of our local hospital with butterflies in our stomachs and hearts prepared to welcome a new member to the family.

What began as a beautiful day of anticipation, however, turned into a 36-hour delivery with immense stress, fear, panic and questions.

About 18 hours into labor, our proud father-to-be, Danny, joined us in the waiting room to inform the family that Bailey’s contractions were subsiding, and she had spiked a fever. Despite receiving an Oxytocin drip to increase the contractions, Bailey’s body was beginning to show signs of distress. A nurse casually advised them “not to worry” as Bailey was placed on oxygen and given Tylenol.

I sat in the hospital waiting room watching Danny search WebMD for every reason why his wife and unborn child would be experiencing this distress while three nurses casually enjoyed coffee and girl chat at the nurses’ station.

Is this how it’s supposed to be? An indifferent “not to worry” then coffee chat while the first-time parents in room 235 struggle to understand what’s happening on what should be the most beautiful day of their lives as parents?

At what point would someone empathetically tell Danny what was going on? Or is WebMD now able to provide better, clearer and more timely answers than the three nurses behind the desk?

Being the only family member who wears scrubs to work on a daily basis, I muttered the only thing I could in the moment: “I’m sure everything is fine. These nurses are highly trained for all scenarios during labor.” I soon ate those words when we found out that the “highly trained” nurses forgot to turn ON the Oxytocin drip. After more than 24 restless hours of munching ice chips, poor Bailey received her second epidural and a second “oops” from a forgetful nurse who just couldn’t seem to remember to turn ON the Oxytocin drip.

After what seemed like an eternity, Bailey’s OB-GYN presented, was shocked at the amount of stress she had endured and delivered, via C-Section, a gorgeous 7-pound and 3-ounce baby boy with a sweet dimple on his chin and a full head of hair.

Were we all overjoyed to meet the baby? Yes. Were there tears of joy? Yes. (I’m still choking them down now as I write this.) Does this story have a beautifully happy ending? Yes. However, did the providers do all they could to provide empathetic and compassionate care while instilling trust in their patients? No.

I’ll never forget the day during dental hygiene school when my dad called me with a question. “You see, Katrine, my doctor tells me I have high blood pressure and need to take a medication, what do you think?” At some point in my dad’s experience, he decided that the countless framed degrees and certifications on the walls at his physician’s office didn’t hold a candle to my expertise as a dental hygiene student of a few months who had just been cleared to use the wrist cuff in clinic.

Why did my dad trust a hungover dental hygiene student over a respected physician with years of experience? I’m confident that his physician made the right call in recommending antihypertensives for him; however, I wonder why my Baby Boomer father felt as though perhaps this recommendation wasn’t appropriate for his unique needs. Perhaps my dad didn’t fully understand high blood pressure, or perhaps he felt like he wasn’t being heard. Or, perhaps his physician just spent the better part of his week taking vital signs and prescribing the same medication to countless other noncompliant and sedentary patients with poor diets, smoking habits and a significant family history of chronic disease.

I couldn’t help but wonder: Do dental patients experience this same level of disconnect from us? In dentistry, we chalk it up to “burnout,” a combination of feeling so mentally, physically and emotionally stressed that we begin to template our treatment planning verbiage, bite our tongues, pour that extra glass of wine at the end of the evening, or, in extreme cases, begin to explore careers in other industries.

So, here’s the million-dollar question: Are we bringing these stressors upon ourselves? Moreover, are we burning ourselves out?

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As dental professionals, we treat patients who present with extreme anxiety, severe dental pain, financial hardships, fears and openly share retorts such as “No offense, but I don’t like dentists.” At what point do we become so hardened by these aspects of patient care that we stop demonstrating that we care and thereby continue the societal views of dental providers as heartless, ambivalent people? (“Little Shop of Horrors,” anyone?)

Has the status quo of the dental and medical communities trained our patients to recognize that they’ll receive care from indifferent, passive providers who are far busier with checking messages on their Apple Watch and sipping coffee?

Do patients really feel so undervalued that they actually believe our treatment planning recommendations are solely based on if our doctor needs to make his next BMW payment?

Are WE driving our patients to do their own research instead of being the content experts we should be?

In a world where patients question our judgement, we’re constantly arguing with insurance companies for coverage, and we have to overcome the rudeness patients bring with them to their appointments, it’s no wonder that we struggle to consistently bring an empathetic and compassionate energy into our work. While dentistry continues to blame “burnout” for these challenges, the medical community has begun dissecting the term “compassion fatigue” in an attempt to understand how to best support providers in their quest for empathetic patient care.

Compassion fatigue is defined as an ambivalence to charitable appeals on behalf of those who are suffering, experienced as a result of the frequency or number of such appeals. In clearer terms, it’s an indifference that has been developed by professionals who are consistently serving those in extreme tension or stress. Sounds about right, huh?

Nevertheless, it’s important for the dental community to identify and execute tangible steps to ensure we’re actively addressing the signs and symptoms of compassion fatigue. Here are five actionable steps to consider if you, too, feel the stress and strain of compassion fatigue:

1. Take a course. Nothing fills my heart more than having my course participants tell me they simply can’t wait to step back into the operatory on Monday morning and see patients. There’s something so incredibly thrilling about acquiring fresh knowledge and being able to integrate that knowledge in an eloquent way during patient care. I implore you to take a course that challenges you, inspires you to think outside the box, or simply encourages you to seek personal development. Remember that personal development is professional development.

2. Prepare your day. Make sure you show up, and by show up, I mean be present. Wake up early, enjoy a cup of coffee with the sunrise, listen to your favorite song in the shower, dab on your favorite perfume (or cologne, cheers to my guygenists!), listen to a great podcast on the way to work, prep your operatory for the day, turn on a great Pandora station, pay a compliment to your hardworking office manager, stay positive and rock your day! It’s far easier to pour wine from a full bottle rather than an empty one - Maslow taught us that.

3. Talk to your patients. Take off your mask and loupes, de-glove, and sit down at eye level with your patients. Look them in the eye and speak with honesty and clarity. Share your wealth of knowledge, enlighten them, empower them and remind them of why they entrusted their care to you.

4. Remember your practice philosophy. Back in my dental hygiene faculty days, I encouraged my students to adopt a philosophy of practice, an anthem or motto that they could integrate into every aspect of patient care. Mine is: “I treat every patient as if they’re a member of my family … that I like.” On an hourly basis, I gently place my hand on my patients’ shoulders and advise them that “If you were my sister or my best friend, I would tell you…” My patients trust me because they know I speak with honesty and integrity.

5. Reframe your mind: We spend too much time arguing with the voice in our head that tells us “He will only do what his insurance says” or worse, the terrible ways in which we question our own professional judgement. Here’s the reality: We’re in the business of serving people and their needs while bettering their quality of life. Remind yourself of all the ways your talents and skills can serve those unique needs for your patients, believe in them and speak honestly to your patients about them.

I hope these tips will serve you in improving your awareness and service to your patients. I’ve discovered that patients find it refreshing to be spoken to with integrity by a provider whose enthusiasm and passion for dentistry are executed through a humanistic communication style. In turn, it certainly makes for a far more enjoyable day when we’re able to reach our patients with honesty, gain acceptance of treatment and truly serve our patients in a deeper way.