Laura Maddison qualified as a dentist last summer after years working as a dental nurse. She talks us through what she’s learnt in her first six months.
It’s been six months since I qualified as a dentist. Six months since I downed tools as a dental nurse and picked them back up as a dentist. I’m in my forth month of dental foundation training. I’d be lying if I said I didn’t scramble back for the aspirator from time to time, but I have no regrets.
For almost 12 years I worked as a dental nurse, and I loved it, but evidently I wanted more. In those 12 years I worked with some amazing dentists who quite frankly I don’t know whether to curse or praise as they made it look so easy!
I now have days when I feel like I’m digging for gold under a sweaty FFP3 mask, praying to the dental gods to just locate the canals of an upper seven, which is probably not restorable.
But, I want to be some kind of hero dentist like all those other dentists have been. So does it matter that I’m losing the will or that my nurse’s eyes have rolled to the back of her head with boredom?
Gone are the days I sat chairside scowling, banging the drawers because the dentist I worked with was running late. Now I get it, it is hard graft! I apologise for the times I used to think ‘give me that drill, I’ll do it, it can’t be that hard?!’ It is, it really is.
All jokes aside, I’ve been lucky enough to see it from both sides of the dental chair. I have walked a mile to the sterilisation unit and back in a dental nurse’s shoes and I’ve been the one to ask my dental nurse to walk a mile to the sterilisation unit and back.
From that, I have gained a lot. But the most important were the two golden nuggets of ‘please’ and ‘thank you’. It’s easy to think that just because it’s someone’s job to ‘go get that’, or ‘mix that’, that manners don’t matter. But they really do. A thank you to your dental nurse at the end of day goes along way.
I probably say thank you too much, but I guess that is probably just from my past experience. I think sometimes it was hard as a dental nurse to feel appreciated. And I don’t think that’s because any dentist means to make them feel like that.
But sometimes I think in the midst of it all it’s easy to forget what else is going on around us, so I think I just make more of an effort not to do that. After all, there is no way I could do my job without my nurse. I know what goes on inside the mind of one, as that mind was once my own!
They are so much more than the runners, the mixers or the split suckers. A second pair of hands, eyes, and ears, a second mind to utilise, and ultimately the surgery shield! The unworn armour that take the hit from the patient, who wasn’t happy to be kept waiting, but ironically will most of the time show a better attitude toward us than the dentist.
Surprisingly, I think some patients don’t even notice the dental nurse. This is bizarre as they’re the friendly, hand holding face without the forceps. For this reason I always like to introduce my nurse when I introduce myself. This is so the patient can understand that they are just as important and essential to their dental visit as I am.
On the other hand, I now appreciate how challenging it can be as a dentist. Good dental nursing support is invaluable. I encourage other dental nurses to understand this too. It’s so easy to get frustrated when the dentist is taking their time, or the alginate needs repeating again (eye roll). But a little patience goes along way.
I, like many other dentists, like to do everything to the best of my ability. I try my hardest, but sometimes things just don’t go to plan. For example, the rubber dam will tear and ping 15 times. I will embarrassingly have to ask my nurse for another, and then another.
She will patiently pass me more, even though I know inside she is thinking please just stop! Ultimately though, the only person who really matters in this ‘frustrating’ situation is the patient. That is why we are both there, to deliver good patient care.
I remember my first few weeks as a dental nurse, they were terrifying. Although not as terrifying as my first few weeks as a dentist! There was so much to remember. God forbid I give dentist X the amalgam plugger the wrong way round. Or I mix dentist Z’s alginate inadequately and the impression needs taking again. I now know this was probably never my fault – a bad dentist blames his nurse right (in my controversial opinion)?
Seen and not heard?
I also can’t believe I was ever scared of working with some dentists, a common emotion felt by other dental nurses. Imagine that? A nurse, an essential member of the dental team, scared to work with you as a dentist because of your poor attitude. Hopefully this is becoming less common.
In my first couple of weeks as a trainee dental nurse a colleague said to me: ‘The dental nurse needs to be seen and not heard.’ I mean how absurd is that! For someone who finds it difficult to ever stay quiet this was a scary thing to hear, I was shaking in my Crocs. Turns out it was a myth, and hopefully no one thinks that way.
As I became a more experienced nurse, I worked with busier dentists, setting up, checking day lists, making sure lab work was back, and back then even writing up clinicians notes… ‘Exam – NAD, TCA 6/12’. That was actually how we wrote them back then. Nothing like the essays I now write: ‘Patient sat in dental chair wearing red coat…’ I’d get quite flustered doing it, especially with a busy day list.
I remember one day the dentist said to me: ‘What do we have in next?’ I snapped through gritted teeth ‘filling UR6’. He ignored my unnecessary mood and asked me to bring the next patient through. So, off I storm flustered, running late, to the waiting room of 10+ patients and bellow ‘upper right six please’. It takes about four seconds and a room full of confused patients for me to realise what I’ve done. I retract, tail between my legs back into the surgery.
It takes two
I’ve never lived that one down, but see, dental nurses can make mistakes too, hallelujah! It’s easy to see that no matter what job role we have, we all want things to go smoothly. And the top and bottom of it is that for that to happen we have to work well together and appreciate one another.
During the COVID pandemic we continue to work towards impossible targets. In the breeding ground of COVID, obviously in correct PPE, and with ever changing rules and regulations, the world of dentistry has flipped upside down.
The introduction of fallow time and cleaning time has seen the duties of a dental nurse increase ten fold. Truly the job role is very different. I’m sure there are many dentists out there who, when they get a spare minute in between typing up notes/referral letters, like me, help out where they can.
I will never feel too big or too important to clean the floors, wipe down, or scrub my instruments. After all, we are all the dental team, and sometimes it takes two.
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