If you are like most dentists, you are back, at least part time, with your staff in your office. But things are definitely not the same as they were at the beginning of the year. We’ve experienced (and continue to experience) a profound upheaval, which has affected us all.
You may have noticed that some of your employees seem glad to be back at work, while others might seem distracted or “off” in some way. This can be a serious concern, particularly if you are considering selling a dental practice and are focused on re-establishing internal stability.
You and your staff, like all members of our society, have been significantly affected by the pandemic. Most people know someone who became sick, most have family and friends who have been economically impacted, and some have even lost loved ones. There is uncertainty about the safety of returning to work, which creates fear. There may be concerns about how to find safe and reliable childcare. The current state of society affects everyone, regardless of their occupation.
For those in the dental industry, however, the risk can be particularly great. In a recent study of occupations with the highest risk for contracting COVID-19 at work, dental hygienists were identified as having the greatest risk out of any profession, with a risk score of 99.7 out of a possible 100. Dental assistants and dentists were in the top five (with scores of 92.5 and 92.1, respectively). This extraordinarily high risk of infection may also create anxiety for your staff about coming back to work.
As a healthcare professional, you are concerned about the safety and wellbeing of your patients and staff. Many practices have spent hours of time and thousands of dollars on equipment and supplies. The CDC, ADA, and local dental associations are providing guidance and information on how to protect your practice, and every person who walks through your door. While we can be prepared to meet the challenge of the virus, we must be equally prepared to meet the psychological challenge of working in a high risk environment.
Bernadette Melnyk, dean of the College of Nursing and chief wellness officer at Ohio State, said, “Physical and mental health are closely intertwined. While you practice good hygiene and physical distancing in the office, you should also practice stress-reduction.” Also, “uncertainty and unpredictability can really create an unhealthy amount of fear and stress, especially when it’s sustained over such a long period of time,” says Dr. K. Luan Phan, chair of the Department of Psychiatry and Behavioral Health at Ohio State Wexner Medical Center. Once dental practices started opening, even just to provide emergency care, clinicians were reporting profuse sweating, headaches, and fatigue. Doctors who normally enjoy and love treating their patients began to worry about the toll the new conditions are taking.
Truly, fear and anxiety about the coronavirus and the complications it has created can feel overwhelming. It’s a new kind of stress that we need to take seriously and address proactively. In this article, we aim to help you recognize the signs of stress—in your staff and in yourself—and offer some tips on how to manage it so we all come out safe and well on the other side.
It’s ok to admit that we are afraid and be honest with ourselves. However, we cannot let the fear guide our decisions. Instead, we have an opportunity to look to our education, training, and resources to find solutions to care for ourselves, and those in our circle of responsibility.
The Issue
Under normal circumstances, modern life itself can be very stressful. Our work is often a source of that stress. Yet, what we are experiencing right now is a different magnitude altogether simply due to its vast impact across all sectors. In addition to those “normal” stressors, people are also experience additional stress due to:
- Concern about being exposed to COVID-19 while at work
- Managing additional family burdens from schools and daycares closing
- Being separated from family
- Having to adjust to a different workload with new, unfamiliar tasks
- Not having all of the tools and equipment to properly to their job
- Feeling like their efforts aren’t making a difference on large scale
- Uncertainty about the future of their workplace or their job
A survey recently conducted among dental office workers who returned to work using PPEs reported experiencing symptoms such as dry eyes, sore throat, rash, runny nose, pressure blister on nose bridge, coughing at night, TMJ discomfort, eyestrain, tight chest, chapped lips, ear pressure, occlusion changes, clogged ears, bloating, itchy tingling skin, bloody nose, intermittent PVCs, facial muscle twitches, and sleep apnea. Over 40% of respondents reported dizziness or feeling light-headed, shortness of breath, and dry mouth. Over 50% reported exhaustion and profuse sweating. Over 60% reported weekly or daily headaches, dehydration, and mental fatigue.
We say this not to reinforce the fear, but to speak openly about an issue in our industry that is very real and very present. Even if you aren’t experiencing any difficulty, the chances are that members of your staff probably are, and it is important for dentists to be watchful for such issues in their practice. In addition to being mindful of your staff’s physical health and safety, you need to help create a calm and confident staff to keep your office running smoothly and ensure your patients’ safety. While this is always important, for those we are working with who are considering selling a dental practice, creating stability for the incoming buyer is even more pressing.
So the first step is to simply watch and be aware of what may be happening, and assess the toll the pandemic has taken on your staff so you can address it.
What to Look For
Chances are you’ve worked with your staff for years. You know them, how they behave, their general attitude. If you are sensing a change in a staff member’s demeanor, this is a good indicator they may be struggling with the return to work. This doesn’t mean they don’t want to be back, but people can have conflicting feelings about difficult situations. Some signs to look for include:
- Changes in performance and productivity
- Missing deadlines
- Calling in sick frequently or otherwise missing work
- Irritability and anger
- Difficulty concentrating and making decisions
- Withdrawal from work activity
- Difficulty with work transitions or changes in routines
- Feeling uncertain, nervous, or anxious
- Lacking motivation
- Feeling tired, overwhelmed, or burned out
- Feeling sad or depressed
- Having trouble sleeping
- Having trouble concentrating
If you notice any of the above in any member of your staff that seems to be more than just a bad day or week, it’s important to take some proactive steps.
What to Do with Your Employees
If you notice any of these symptoms, or if they are reported to you by another employee, start by simply taking some time to sit down with them and check in with how they are doing. If they seem reluctant to open up, share your concerns about the pandemic with them, to show them it’s ok to be worried and to talk about it. Keep the conversation focused on identifying the problem and looking for solutions. Don’t get caught up in negative thinking or lines of discussion. Actively listen to them. Ask for their input on what will help them at work.
You may even make this part of the weekly team meeting, a short chance for everyone to check in with everyone else, and to offer each other support and encouragement.
Use your hygienists to be leaders with your staff. Hygienists are often confident, optimistic problem-solvers. Tap into that energy and get their suggestions on how to adapt the office to the new sterilization procedures, how to communicate with non-medical staff and patients, and enlist them to help implement these efforts. Also, if your hygienists are experiencing stress, find a way to help them see how they are contributing to the good of their co-workers.
In addition to the extra sterilization practices you’ve adopted, here some other measures to consider and encourage for your staff to help protect against the added stress and physical toll of wearing PPE equipment:
- Schedule hydration breaks
- Whenever you wash your hands, take several deep abdominal breaths (doing this five times and day can lower blood pressure and anxiety levels)
- Make sure everyone takes a lunch hour (including you)
- Schedule PPE breaks
- Eat a diet high in vegetables, fruits, and liquids
- Avoid salty snacks
- Practice nasal breathing
- Reduce workload if possible (If a task isn’t critical, consider whether it can be delegated or put off)
- Encourage openness in a positive, supportive environment
- Be aware of your limits
- Get adequate sleep every night
- Get exercise, even just taking a short walk outside each evening
- Take breaks from work to stretch, exercise, or check in with your supportive colleagues, coworkers, family, and friends
- Expect that a variety of emotions is normal
- Make sure that families and children are being provided for
- Do things you enjoy during non-work hours.
- Take breaks from the news, including social media – hearing about the pandemic and other social issues repeatedly can be upsetting and mentally exhausting
- Seek help if you need it – the ADA has resources available for each state
Remind your staff often that we are all in a highly unusual situation. Acknowledge that we all have limited resources and are uncertain about how the future will look. What they are feeling is to be expected and it’s ok. Remind them they are an important part of the work that you do and the only way your office gets through this is to do it together. Finally, take every opportunity to recognize their efforts to support the practice and their coworkers, even the little things, on a day-to-day basis.
What to Do for Yourself
In addition to watching out for your staff, you need to be sure to take care of yourself as well. Without you, there is no practice for your staff to work in. These extra stressors can sneak up on us. We might not know how much it is impacting us until we find ourselves doing unexpected things. Are you getting less sleep? Do you get fatigued easier? Do you find yourself feeling more irritable? Are you drinking more? Eating less? All of these are signs of stress. Take them seriously and follow any advice you give your patients and staff. All of the above listed suggestions are useful tools for managing your own stress, not just those of your staff.
Two important keys to addressing the situation are to first, accept the reality of the loss and allow yourself to grieve accordingly, and second, adjust to the current reality we live in, which is quite dynamic. The pandemic is ongoing and it continues to require significant changes in how we live and work. In truth, there isn’t anything we can do to change that. We can control how we respond. An honest assessment and intelligent response, rather than an emotional reaction, will be necessary to make our way through it with resilience and courage.
If you find yourself feeling discouraged or overwhelmed, find someone with whom you can talk. It may just be a trusted friend or family member, but if the feelings persist and are impacting your relationships or ability to work, please consider seeking professional help. Again, the ADA has resources available for each state.
DDSmatch Mid-Atlantic is Here to Help Where We Can
Here at DDSmatch Mid-Atlantic, we aren’t mental health professionals. But we are dental practice transition specialists who are deeply invested in the well being of our industry and the dentists we serve. In this unprecedented time, we are here for you to discuss the state of your practice, especially if you have been considering any dental transition in the next five years and want informed feedback on what selling a dental practice or buying a dental practice in this time may look like. We’ve worked hard in recent months to consult with trusted industry advisors and stay on top of the profession and the many changes necessitated by the response to COVID-19.
Again, if you have any questions about dental practice transitions and how the pandemic may impact your plans, please give us a call. We’re here to help.