Dental nurses should wear their qualification badges with pride.
The health minister, Ann Keen, recently announced that general medical nurses will need to have a university degree to enter the profession after 2013, a move that has been both hailed and criticised simultaneously. It could be argued that dental nurses have had to face a similar upheaval with the introduction of mandatory registration by the General Dental Council in 2008 requiring new registrants to pass a recognised national qualification to be eligible.
The medical nurse unions, Unison and Unite, have stated that there is no ‘compelling evidence’ that degrees for nurses have improved patient treatment. Looking back at the early days of mandatory dental nursing registration, I wonder whether dental patients are receiving better care as a result of registration?
Dental nursing is a very hands-on profession. It is important to have the knowledge of how to perform the tasks undertaken and an understanding as to why, but it cannot be assumed that by having passed an exam that knowledge is present. It is all too easy for some more academically suited individuals to achieve the exam requirements whilst still not being good nurses at a practical level, although of course this could apply equally to other healthcare professionals, doctors and dentists included.
Dental nursing requires the skills to pass the right instrument and know how to mix materials correctly and also how to talk to patients in a calm and reassuring manner. This ability to communicate, whilst always being aware of the dentist’s needs, cannot be taught in a classroom. Is it really essential for a dental nurse to know the different cranial nerves as taught on some diploma courses when they will not be administering the anaesthetic?
What is required by a dentist is a confident individual who can provide him or her with support but not duplicate his or her role. A good nurse must be able to put patients at ease, visually monitor their vital signs, anticipate the dentist’s every move and maintain strict infection control measures.
One of the consequences of registration is the loss to the profession of many experienced dental nurses who provided invaluable cover for practices up and down the country in times of sickness and emergencies. The impact of a whole raft of capable, competent nurses being removed in one fell swoop is still being felt today. The single-handed practitioner may need the availability of three registrant nurses to cover for holidays and sickness absences, but with ever rising costs facing the profession and the wider economy as a whole, this is difficult to achieve.
With the introduction of registration, nurses’ salaries have soared in some areas as the demand for qualified nurses increases. Clearly, this is how it should be for dedicated staff who, prior to registration, were often poorly paid. Nevertheless, it still represents an increasing cost for dentists to cope with in these financially constrained times.
And what about the man or woman in midlife, who wants to change jobs and take on the role of the dental nurse? They may have changed jobs several times in their working lives, and can easily acquire the skills necessary to be a dental nurse, with the added benefits of maturity and the ability to put patients at ease in an environment that is uncomfortable or stressful for some. However, it could be a lifetime since these individuals finished their formal education or sat an exam, so it would be daunting and discouraging for them to go back to ‘school’ with others half their age, only to fail at the final hurdle despite having the potential to be excellent dental nurses where it matters most - by the patients’ side. But such essential skills – such as making patients comfortable – cannot be taught as easily as they can be learned through a lifetime of experience.
On the other hand, we need to appreciate that registration has brought opportunities and well-deserved recognition for dental nurses, whether they acquired registration through grandparenting arrangements or by formal examinations. The latter can be especially hard going, juggling the demands of study, work and often parenting responsibilities, all for a qualification which until recently was not obligatory. But they choose to do it the hard way by reading the books, completing the coursework and taking the exam, often in their own time and outside of work.
I can only think that nurses take the difficult route as they take pride in their profession (and indeed deserve to wear their dental nurse qualification badge with pride) and the crucial role they play in keeping the most important person happy – the patient. For me, I am lucky as I have such a dental nurse by my side every day.