Caring for the Caregivers to Improve Patient Outcomes
Dr. Nardine Bekhit, OCA member and chiropractor practising at Healthcare House in Ottawa, has been collaborating with other health care professionals to help improve her patients’ care and provide “care for the caregivers.” Since beginning her practice, she’s also been delivering successful presentations locally and internationally to health care professionals such as dentists and surgeons on ergonomics in the workplace to help them deliver patient care without sacrificing their muscle and joint health in the process.
Sharing a clinic with a family physician, Dr. Bekhit has particular interest in pediatric and prenatal populations and caring for health care professionals.
Read below to learn how Dr. Bekhit has supported medical doctors such as dentists and ear, nose and throat (ENT) surgeons.
Helping Dentists Keep Their Bodies Healthy to Maximize Productivity and Career Longevity
“During my second year of chiropractic school, I was getting orthodontic work done, and as I looked around the room of the open-concept orthodontic clinic, I saw all the hygienists hunched over their patients,” says Dr. Bekhit. “That’s when I realized there’s a huge gap in this population that we as chiropractors can help.”
Shortly after, Dr. Bekhit made a commitment to use her training and education to help dental professionals manage and prevent neck, low back, hand, and wrist pain, all common within the profession. Gathering the best evidence available, she crafted a one-hour ergonomics workshop that delivers this information in a digestible way. She also uses Instagram as an adjunct to her in-person presentations to educate and demonstrate exercises to more than 3,000 followers, while building relationships in the dental community locally and worldwide. Most recently, she’s teamed up with a dentist (who is also a yoga teacher) to deliver a four-week “yoga and learn” program for dental professionals, which provides education on ergonomics followed by a yoga flow relating to the theme (body area) of that week.
“There are many interventions that dentists can do that don’t require a complete overhaul of their equipment, which can get expensive,” says Dr. Bekhit. “It’s mostly about making lifestyle changes and incorporating varying postures in their day. I want people to feel informed and empowered to make daily decisions that support their spinal health.”
Dr. Bekhit also recommends “movement snacks” or exercises that can be done in between busy clinic times and procedures, such as while waiting for bonding or anesthetic to settle for a patient.
Helpful Stretches for Dentists and Dental Professionals
Figure 1: Breugger’s Relief Position
This can be done seated or standing. Tilt pelvis forward, open the chest, rotate the arms so that palms are facing the ceiling. Squeeze shoulder blades back and down, and tuck chin in. Hold for a few deep breaths then relax.
Figure 2: Posterior and lateral neck
Place one hand behind you and tilt your head to the opposite side. Let gravity pull on your head until you feel a gentle stretch in the side of your neck. Hold for 20 seconds, then let your head drop forward as if you’re bringing your ear towards your armpit. You should feel a stretch in the back of your neck.
Figure 3: Low back
With your legs in tripod position, bend to one side, resting your elbow on your knee. Raise opposite arm overhead and look up at the ceiling.
Supporting ENT Surgeons for Better Clinical Outcomes
Dr. Bekhit has also delivered successful virtual ergonomics workshops for surgeons, including a grand rounds presentation for the Department of Otolaryngology at the University of Ottawa. For this group, one message that she hoped to get across is the importance of caring for their own physical and mental health for better clinical outcomes.
“Health care professionals are so focused on providing excellent patient care that they often overlook the importance of caring for themselves,” says Dr. Bekhit. “Once you start to take care of yourself, you’re more well-rested and in a better position to care for your patients. Studies have shown that pain has an adverse effect on sleep, which can take a toll on your cognition, which increases the likelihood of errors. As a health care professional, taking care of yourself is part of delivering patient-centered care.”
Practical Tips to Prevent Postural Strain in ENT Surgeons and Dentists
“Many people hold on to the idea that keeping our backs straight is the only “ergonomic” position to be in,” says Dr. Bekhit. “The reality is our bodies are dynamic and crave a variety of movement, which means that any posture for too long (no matter how “perfect” it looks) will make you feel sore. The best posture is your next posture.”
Take microbreaks: The ideal microbreak for surgeons is a 1.5- to 2-minute break with intentional stretches at medically convenient 20- to 40-minute intervals that can be carried out in the operating room without breaking the sterile field. Microbreaks are more effective when they are taken before you feel you need them.
Consider a saddle stool: Contrary to popular belief, sitting with your hips and knees at 90-degree angles (thighs parallel to the floor)) is not the best practice as it’s challenging to maintain a neutral spine for long periods of time. For most people, a better posture is sitting with a more open angle at the hips with thighs slanted 45 degrees towards the floor. This allows you to slide closer to your patient while creating more engagement at the quads, which are powerful muscles that can endure the stress of a long workday. Your core is also more actively engaged and protects your low back, making it easier to maintain a neutral spine.
“Again, movement is key, so look for opportunities to alternate between working seated and standing,” says Dr. Bekhit.
Advice for Chiropractors Interested in this Type of Work
“Pick a niche that aligns with your passion, interests, and personality,” says Dr. Bekhit. “Learn how to ‘speak their language’ and understand their pain points so you can better connect with your target population. I encourage my colleagues to get creative and think outside the box with how you build these connections. It’s worth carving your own path for yourself to find how your unique voice adds to the many reasons why every Canadian should have a chiropractor on their health care team.”
If you’d like to learn more about Dr. Bekhit’s work or get in touch, visit @curlychiro on Instagram or email at firstname.lastname@example.org.