ADHA Access November_2013 : Page 22

T he Veterans Affairs Medical Center in Wilmington, Del. provides all aspects of dental care for veterans who qualify through a service-connected disability. The center employs two clinical dental hygienists. In 1994, Amy N. Smith, RDH , was in boot camp for the US Navy. “They told me to pick my top three choices for train-ing,” she said. “Before enlisting, I had planned on becoming a radiology technician, so I chose corpsman, which is the equivalent of a medical assistant. I had to choose three, so I added photographer’s mate and dental technician (assistant). I liked taking pictures, and I thought becoming a dental tech might help me ease or get over my own dental anxiety.” Smith worked as a dental tech in the Navy for two and a KDOI\HDUV&#1e;DIWHUUHWXUQLQJWRFLYLOLDQOLIH&#0f;VKHZRUNHGIRU¿YH more years as a dental assistant. “While assisting, I realized that I was not a fan of just helping the dentist,” Smith said. “I wanted to see my own patients and deliver my own services. I was no longer happy with just being a sidekick. I wanted to be the star of the show, but I had no desire to do operative work as a dentist. I liked that after hygiene appointments, patients could see how JUHDWWKHLUWHHWKORRNHG:KHQDFRPSRVLWH¿OOLQJLVSODFHG&#0f; it often looks the same as before the tooth was prepped. I wanted to make an immediate and positive impact, so I knew hygiene was the way for me.” Smith obtained her associate’s degree in dental hygiene from Montgomery County Community College in Blue Bell, Penn. in 2002. Starting her dental hygiene career in private practice, she eventually realized that while some aspects of her position were ideal for her, others were less so. “I was tired of having to deal with the monetary side of dentistry. I am a hygienist, not a saleswoman. I felt that, more and more, I was being asked to strongly recommend products and treatments that I did not agree with. Patients ZKRDUHVWUXJJOLQJ¿QDQFLDOO\GRQRWQHHGRUZDQWD

 WRRWKEUXVKZKHQWKH\DUHGRLQJZHOOZLWKDYHUVLRQ I wanted to work for the patients, not for the production YDOXHV,ZDQWHGWR¿QGDSRVLWLRQLQSXEOLFKHDOWK&#0f;DQG, WKRXJKWWKH9$ZRXOGEHDJUHDW¿WIRUPH´ Smith, who had worked as a contract hygienist at Naval Station Norfolk and for a state prison in North Carolina, was familiar with the VA and government employment. “So I waited until I saw a nearby open position,” she said. “I am currently working on my MSDH (from Massachu-setts College of Pharmacy and Health Studies in Boston) and plan to pursue a doctorate degree in public health after that. My ultimate goal is to help advance oral health research at the VA on a national level. Working to improve our veterans’ oral health is my way of paying them back for their service to our country.” Smith found that the biggest difference between tradi-tional clinical practice and working at the VA is the patients “ My ultimate goal is to help advance oral health research at the VA on a national level. Working to improve our veterans’ oral health is my way of paying them back for their service to our country.” —Amy N. Smith, RDH themselves. “Our patients come to us because they truly want to take care of their dental needs,” she said. “They are not motivated by dental insurance recommendations or limits, so they are able to make informed decisions about their care and not have to do only what they can afford. Our SDWLHQWVDUHFRQ¿GHQWDERXWRXUUHFRPPHQGDWLRQV&#0f;EHFDXVH they can trust that we are doing what is in their best interest and not trying to meet a production quota.” Other differences stem from the fact that most VA pa-tients have special needs. “Some patients will stay in their wheelchair for treatment, or a patient may not be able to have the dental chair reclined at all due to a neck injury,” Smith explained, adding that maintaining proper operator or SDWLHQWSRVLWLRQLQJFDQEHGLI¿FXOW³2WKHUSDWLHQWVPD\QHHG to have a chair lift used to move them into the dental chair. Besides positioning adaptations, we have to be very aware of medical conditions. The majority of our patients have medical injuries or illnesses. Luckily, we are afforded access to each patient’s medical chart and can review all conditions and medication prior to seeing the patient.” Smith is a member of the Medical Center’s Health Promo-tion/Disease Prevention committee, made up of various providers and support staff who educate and organize health initiatives within the hospital. “I also supervise senior dental hygiene students in a clinical rotation,” she said. “This is our second year, and they see patients three days a week at our clinic. Working in our clinic gives them a broader patient experience and helps them learn adaptive techniques.” For dental hygienists seeking employment outside private practice, Smith recommends being prepared to adjust the conception of the dental hygiene job description. “Supervis-ing students, presenting oral cancer screening instructions to inpatient nursing staff and serving as an Oral Health Re-VHDUFK2I¿FHUIRUP\FOLQLFDUHMXVWDIHZRIWKHMREV,GRLQ addition to clinical services,” she said. “Working in a nontra-ditional dental setting can allow you to broaden your scope of practice. I believe the future of dental hygiene is going to be in public health areas that are based on interdisciplin-ary collaboration. You have to be willing to learn new things, research what you think you already know and continue improving on your education. “Mostly, you just have to decide what direction you want \RXUFDUHHUWRJRLQ&#0f;DQGWKHQ¿QGDSRVLWLRQWKDW¿WV\RXU aspirations.” Maria E. Vandegrift, RDH , couldn’t have found a better ¿WWKDQWKH:LOPLQJWRQ9$0HGLFDO&HQWHU³,IHHOOLNH,DP IXO¿OOLQJDGHVWLQ\&#0f;DSXUSRVH&#0f;KHUHDWWKHKRVSLWDO&#0f;´VKHVDLG Vandegrift was taught young to value oral health. “Be-cause my mother fractured several of her teeth while playing with her brother at a young age, she was constantly remind-ing her six children to take care of their teeth,” she said. “I remember her never really being comfortable with her dental prosthetics. She made sure we understood how important \RXUWHHWKDUHWR\RXUZHOOEHLQJ(YHQWKRXJKLWZDVGLI¿FXOW to afford it, she had us at the dentist regularly, and I spent many years at the orthodontist.” So when it came time to select a career, Vandegrift knew VKHZDQWHGWRHQWHUDKHDOWK¿HOGRIVWXG\³,DOZD\VIHOW “Healthy mouth equals healthy body — that your mouth is a window to your overall health,” she said. “If there is disease in your mouth, you can bet it is linked to other health issues.” Vandegrift obtained her associate degree in dental hygiene from Delaware Technical and Community College in 1984 and is pursuing a bachelor’s degree in allied health at Wilmington University. ³$IWHUJUDGXDWLQJ&#0f;,ZRUNHGDWDIHZRI¿FHVXQWLO,IRXQG Michael Rosen, DDS, whom I worked with for 22 years in pri-vate practice,” Vandegrift said. “He is an excellent doctor and 22 NOV 2013 access

working

<br /> <br /> The Veterans Affairs Medical Center in Wilmington, Del. provides all aspects of dental care for veterans who qualify through a service-connected disability. The center employs two clinical dental hygienists.<br /> <br /> In 1994, Amy N. Smith, RDH, was in boot camp for the US Navy.<br /> <br /> "They told me to pick my top three choices for training," she said. "Before enlisting, I had planned on becoming a radiology technician, so I chose corpsman, which is the equivalent of a medical assistant. I had to choose three, so I added photographer's mate and dental technician (assistant). I liked taking pictures, and I thought becoming a dental tech might help me ease or get over my own dental anxiety."<br /> <br /> Smith worked as a dental tech in the Navy for two and a half years; after returning to civilian life, she worked forfive more years as a dental assistant.<br /> <br /> "While assisting, I realized that I was not a fan of just helping the dentist," Smith said. "I wanted to see my own patients and deliver my own services. I was no longer happy with just being a sidekick. I wanted to be the star of the show, but I had no desire to do operative work as a dentist. I liked that after hygiene appointments, patients could see how great their teeth looked. When a composite Ailing is placed, it often looks the same as before the tooth was prepped. I wanted to make an immediate and positive impact, so I knew hygiene was the way for me."<br /> <br /> Smith obtained her associate's degree in dental hygiene from Montgomery County Community College in Blue Bell, Penn. in 2002. Starting her dental hygiene career in private practice, she eventually realized that while some aspects of her position were ideal for her, others were less so.<br /> <br /> "I was tired of having to deal with the monetary side of dentistry. I am a hygienist, not a saleswoman. I felt that, more and more, I was being asked to strongly recommend products and treatments that I did not agree with. Patients who are struggling financially do not need or want a $100 toothbrush when they are doing well with a $4 version.<br /> <br /> I wanted to work for the patients, not for the production values. I wanted to find a position in public health, and I thought the VA would be a great fit for me."<br /> <br /> Smith, who had worked as a contract hygienist at Naval Station Norfolk and for a state prison in North Carolina, was familiar with the VA and government employment. "So I waited until I saw a nearby open position," she said. "I am currently working on my MSDH (from Massachusetts College of Pharmacy and Health Studies in Boston) and plan to pursue a doctorate degree in public health after that.<br /> <br /> My ultimate goal is to help advance oral health research at the VA on a national level. Working to improve our veterans' oral health is my way of paying them back for their service to our country."<br /> <br /> Smith found that the biggest difference between traditional clinical practice and working at the VA is the patients themselves. "Our patients come to us because they truly want to take care of their dental needs," she said. "They are not motivated by dental insurance recommendations or limits, so they are able to make informed decisions about their care and not have to do only what they can afford. Our patients are confident about our recommendations, because they can trust that we are doing what is in their best interest and not trying to meet a production quota."<br /> <br /> Other differences stem from the fact that most VA patients have special needs. "Some patients will stay in their wheelchair for treatment, or a patient may not be able to have the dental chair reclined at all due to a neck injury," Smith explained, adding that maintaining proper operator or patient positioning can be difficult. "Other patients may need to have a chair lift used to move them into the dental chair.<br /> <br /> Besides positioning adaptations, we have to be very aware of medical conditions. The majority of our patients have medical injuries or illnesses. Luckily, we are afforded access to each patient's medical chart and can review all conditions and medication prior to seeing the patient."<br /> <br /> Smith is a member of the Medical Center's Health Promotion/ Disease Prevention committee, made up of various providers and support staff who educate and organize health initiatives within the hospital. "I also supervise senior dental hygiene students in a clinical rotation," she said. "This is our second year, and they see patients three days a week at our clinic. Working in our clinic gives them a broader patient experience and helps them learn adaptive techniques."<br /> <br /> For dental hygienists seeking employment outside private practice, Smith recommends being prepared to adjust the conception of the dental hygiene job description. "Supervising students, presenting oral cancer screening instructions to inpatient nursing staff and serving as an Oral Health Research Officer for my clinic are just a few of the jobs I do in addition to clinical services," she said. "Working in a nontraditional dental setting can allow you to broaden your scope of practice. I believe the future of dental hygiene is going to be in public health areas that are based on interdisciplinary collaboration. You have to be willing to learn new things, research what you think you already know and continue improving on your education.<br /> <br /> "Mostly, you just have to decide what direction you want your career to go in, and then find a position that fits your aspirations."<br /> <br /> Maria E. Vandegrift, RDH, couldn't have found a better fit than the Wilmington VA Medical Center. "I feel like I am fulfilling a destiny, a purpose, here at the hospital," she said.<br /> <br /> Vandegrift was taught young to value oral health. "Because my mother fractured several of her teeth while playing with her brother at a young age, she was constantly reminding her six children to take care of their teeth," she said. "I remember her never really being comfortable with her dental prosthetics. She made sure we understood how important your teeth are to your well being. Even though it was difficult to afford it, she had us at the dentist regularly, and I spent many years at the orthodontist."<br /> <br /> So when it came time to select a career, Vandegrift knew she wanted to enter a health field ofstudy. "I always felt "Healthy mouth equals healthy body — that your mouth is a window to your overall health," she said. "If there is disease in your mouth, you can bet it is linked to other health issues."<br /> <br /> Vandegrift obtained her associate degree in dental hygiene from Delaware Technical and Community College in 1984 and is pursuing a bachelor's degree in allied health at Wilmington University.<br /> <br /> "After graduating, I worked at a few offices until I found Michael Rosen, DDS, whom I worked with for 22 years in private practice," Vandegrift said. "He is an excellent doctor and mentor. I feel one of the most important factors in our profession is finding the right dentist to work alongside of that you respect and allows you to grow and establish a strong clinical co-therapist background."<br /> <br /> As a student in 1984, Vandegrift did a clinical rotation at the VA Hospital. "My first week there, I saw a patient that was injured in an explosion during WWII. At the time, the prosthetics department was connected to dental. He entered our exam room and proceeded to remove his facial prosthesis, which encompassed his eye, nose and ear of one side of his face — and I proceeded to faint! I knew then that someday I wanted to work here with the veterans." In 2008, she joined the Medical Center staff.<br /> <br /> "I am in love with the mission ofthe VA hospital,"Vandegrift said. "These women and men who serve our country have given up a lot. They have sacrificed physically and mentally. The VA hospital is a lifeline for all veterans, and right now, especially, those returning home. Working in a hospital like the VA, you are working with a unique patient population."<br /> <br /> Vandegrift seconded Smith's sentiment that the VA provides optimally patient-centered care because care does not depend on what the patient can afford.<br /> <br /> "The VA also gave me the opportunity to start a new student clinical rotation here again," she added. "I like to think the veterans and my students here at the hospital benefit, but I benefit just as much — maybe more than they do. We are a strong and supportive group of health care professionals that want to make a difference in people's lives. The veterans are wonderful, grateful, giving people.<br /> <br /> It feels good to be able to give ba ck to others."<br /> <br /> When asked for advice to dental hygienists considering breaking away from private practice, Vandegrift suggested looking within. "No one can give you better advice than yourself. Your hands will follow your heart!"<br /> <br /> This edition of Working was prepared by Jean Majeski.<br /> <br /> > I believe in the profession of Dental Hygiene.<br /> <br /> > I believe I play an integral part in the health of my patients.<br /> <br /> > I believe my patients are my family, and look forward to seeing them as often as I can, for as long as they need me to, in assisting them with their oral health care needs.<br /> <br /> > I believe I am a well trained health care provider, like many ofthe health care providers I work alongside of, and like them I am trained in dealing with life-threatening situations and have used my skills when I have had to.<br /> <br /> > I believe by assisting my patients with maintaining a healthy mouth, I am also directly affecting their well-being as a whole.<br /> <br /> > I believe I am a co-therapist supporting early detection of many health issues and in this early detection can save lives.<br /> <br /> > I believe not just anyone could do what we do.<br /> <br /> > I believe my profession is just as important as any other health care profession.<br /> <br /> > I believe in the Veterans Administration Hospitals mission.<br /> <br /> > I believe I am an essential member of the hospital's health care clinical staff providing direct patient care supporting that mission.<br /> <br /> <br />

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