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60 min, 2 quad SRP

So I do fill-in 3-4 days a week at different offices. Some weeks its just at one office those 4 days, or some weeks its a different office every day. But I’m seeing that at a lot of these offices they are scheduling 60 minute, 2 quad SRP appointments with a patient booked immediately afterwards and I am having a lot of difficulty with these. At some offices, the patient is late, or they keep them up front a few extra minutes to get things verified so I don’t even get that!

I am in a state where the dentist does the anesthetic, so sometimes that takes 10-15 min depending on how long I have to wait for them and how much chatting they do, and if they need to go give additional injections afterwards because the patient still has feeling.

I do not feel nearly skilled enough to do 2 quads in like 40 minutes, subtracting the time the patient to get seated, review changes/med history, get anesthetic done, and the time at the end to turn that room over. I know with some of these patients who have a ton of build up that I’m not able to get everything and I hate it.

But because I’m filling in and this isn’t my office, and all this is pre-determined before I get there, theres not a lot I can do about it. I just do what I can in that time. I took a bitewing the other day after a patient who had 7-8 mm pockets and just huge chunks of black sub-gingival calculus coming out from every tooth and I was really disheartened to see what was left on the xray, but I just didn’t have the time to get everything.

Is this just the nature of the game here? Just try my best? Ugh.

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Author Note:
Wanted to add that I work with an agency that schedules me.

2 Answers

I feel that 40 minutes (and even 60 minutes) to complete two quads of SRP simply isn’t enough time, no matter how skilled you are. In my opinion, 40 minutes for a prophy isn’t even enough time, let alone 2 quads of SRP! Offices that don’t provide adequate time for treatment tend to be production and money focused instead of patient focused, which is wrong on so many levels. Unfortunately, some offices are like this, but not all – there are good offices out there where the patient is their first priority. The way I see it, you have 3 choices here.
First option: You could continue temping/filling in at these offices and doing your best. The problem with this option is that you are doing a disservice to the patient and you will continue to feel crummy about it. If the patient’s tissue heals around residual calculus, there runs a risk of a perio abscess. This can cause real problems if the patient decides to file suit against the doctor and even name you in the suit as the hygienist.
You could have a chat with the doctor and office manager at these offices about the time they provide for treatment explaining the risk of not having enough time to remove deposits thoroughly. You would want to do this in a way that shows concern for patient care and concern for the dentist’s (and your) licence. The risk with doing this is that the office may not want you back because you essentially called them out on poor patient care. However, I think they need to hear it.
The last option is to tell the agency that you are not comfortable working at such and such offices and ask that you not be sent there. I would explain that they are putting you in a horrible position to provide less than thorough treatment due to the time they allow for treatment and you are concerned about the risk to your license not to mention patient care.
I would definitely tell the agency regardless of which option you choose which offices are not giving adequate time. I would hope they wouldn’t want to be sending temps in to a situation where the hygienists feel defeated at the end of the day because they can’t do their job properly, are set up to fail right from the get-go, and are risking their licenses.
This is a horrible situation to be in and I’m so sorry you are dealing with this! Please don’t think that you aren’t a skilled hygienist! You are being asked to do the impossible here and its just not right – to you or the patients. I wish you the best of luck!

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Why are you taking responsibility for this inept office? From scheduling, to check-in, to time management on the dentists part, it sounds like the office is a complete disaster! You’re a skilled, knowledgable hygienists. If you weren’t, you wouldn’t have written your post.
Stop doubting yourself and protect your license, your sanity and your patients. I would definitely bring this to the dentist’s attention. If the dentist (I’m assuming s/he owns the practice) doesn’t take steps to correct the problem, you should refuse to temp there. I’m sure that reporting the dentist has crossed your mind. Maybe it’s time for a wake up call to all of these dentists and office managers who perpetuate patient neglect.

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