Mental health in long days

Education in dentistry has a strong focus on what the procedure is and less on how we perform it. Long appointments and indeed long days are tiresome and by the end of the day you can feel as though your attitude to your work has declined and the quality of even simple procedures is poor. One thing that you need to learn not only in rehabilitation procedures but in general day to day practice is resilience in your work. Strategies to overcome fatigue include:

-Take breaks: Break up your day with a cup of tea or some fresh air. Long appointments can be split up with a break for yourself and the patient. If you take 5 minutes for a bathroom break and a glass of water you will make up that time afterwards by being refreshed and being ready to jump back into the procedure. It may give you the clarity to solve some issues that you have been struggling with that appointment. Seeing the case with fresher eyes is always helpful. Even the 20 seconds while your dental assistant is light curing is a good opportunity to stand up, stretch your legs and take a deep breath to recover.
-Prioritise your lunch breaks:  If a patient rings in with an emergency, there is the temptation to fit them in in your lunch breaks or at the end of the day. This means more money in your pocket and less empty chairtime for the clinic. However, lunch time is an important step in the day where you can take a formalised break from the work in the morning. You may not notice the inevitable decline in mental health if you start skipping lunch breaks but you will certainly notice an improvement in your condition once you start insisting that lunch times are adhered to. Try to be less uptight about on the minute dot of appointments and take some time to relax your mind and engage in mindless chit chat about non work related things, fill your belly and be refreshed for the afternoon.
-Do one thing at a time: No one is good at multi tasking. If you try and do more than one thing at the same time then you will tire yourself out mentally very quickly. Have a defined plan of the steps that you will take during the appointment, which teeth you will work on in which order and stick to it. Obviously plans can change but you must try not to do too much at one time as you will stress yourself and your staff out.
-Discuss your problems with someone: Everyone needs someone to talk to. Having like minded colleagues you can discuss difficult cases with is important but having someone close to you outside of dentistry that you can discuss your personal struggles with is essential. Any job in health care is a demanding one and we have to be able to talk through our problems with someone who cares. Even just the acknowledgement of your problem can be the first step in resolving it.
-Leave your work at work: There is the temptation to bring the stresses of your job home with you. This can affect your mental wellbeing and interpersonal relationships. The good thing about dentistry is there are rarely jobs with after hours call outs. Ensure that all the business that you need to sort out is done before you leave the premises. Spending some time at the end of the day to finalise your notes is important and much more manageable than spending the equivalent time sorting your work matters out at home late at night. I used to finish them at home over team viewer but I would rather keep home life and work life separate these days. Instead, have a work free sanctuary at home that you can relax and unwind otherwise when there is a stressful day you will quickly find there is no where you can escape from that work mentality. Even when you love your job, it is important to have some time free from work.
-Train your dental assistant's well: Investing time in training your dental assistants well will reap the rewards for you. An efficient dental assistant will save you hours of time in the day but a poorly trained assistant will make appointments longer and more stressful. Training them to set up the surgery efficiently and anticipate items you need for a particular procedure will save valuable chair time and effort in requesting these items when needed. Good chairside assisting will improve the success rates of procedures immensely as well as improve visibility for yourself resulting in less strain on your body and eyes as well as improve comfort for the patient and their satisfaction in your work. I always say that all members of the team are equally important and a good dentist is nothing without a good dental assistant.
-Know when to call it a day: If there is a difficult case just before lunch or at the end of the day and things aren't going well you can temporise the case and try again another day. Your mental health is worth more than the time you save in reanaesthetising and retemporising another day. If you are struggling with the case then it is a good idea to stop, ask for advice and have a go another day.
-Schedule enough time for the procedure: For long, multistep procedures, there are large variations in the length of time needed. the more steps there are the more chances there are for things to go wrong and for the treatment time to be extended. If there is a complex appointment, allocate more time than you need. If you finish on time you can use the extra time to rest and recover as well as sort out lab work, clinical notes and records. If you are running late at least you have some leeway built into your appointment schedule.
-Schedule difficult appointments well: Difficult appointments may be best scheduled in the morning when you are of a fresh mind. or before a break to give you some extra leeway time so you aren't rushing for the rest of the day if you are running late.
-Plan the appointment out well: Have a plan and stick to it. Predictability in our profession is key. Experience will dictate any possible adverse outcomes and it is prudent that your staff know the difficulty of the procedure and are ready to react to any changes that need to be made to the treatment plan or day schedule. Have all the materials out and ready to go and ensure there is enough material in stock for the possibility of retakes. Ration your time well, don't be too stagnant in your work. It is very easy in long appointments to slow the pace down significantly and you need to be alert while you are performing treatment or the time can slip away from you very fast and result in further stress when the end of the appointment is approaching.