Life Working as a temporary dental nurse.

Life Working as a temporary dental nurse.
 
During my time temping as a dental nurse I have often found myself in situations where there are infection control issues within the dental practice I am sent to for that day.
I write this as I am sure there are a lot of other dental nurses out there too that come across these issues. I have often sought the advice of a former colleague I worked with in a large hospital NHS trust who worked as an Infection Control Nurse and she has been a good source of knowledge, suggesting in situations where I am in a compromised position what I ought to do.
 
It is often the case in a dental practice that when it comes to the decontamination of instruments prior to sterilisation that I find the practice has an ultrasonic bath but does not use it. In such case there is a discoloured nail brush with worn bristles, hand soap if you are lucky that the dental nurse is expected to use.
 
Unlabelled bottles with some sort of liquid is also a familiar finding too. I have on one occasion been told " we have an ultrasonic but we do not like to use it". I went to the cupboard found the ultrasonic, plugged it in and put the nusonic solution in the bath and started it up. The dentist looked surprised but did not object.
 
The BDA advice sheet Infection Control in dentistry A12 do state in their introduction under the title Routine Procedures, "failure to employ adequate methods of cross-infection control would almost certainly render a dentist liable to a charge of serious professional misconduct".
 
It is a concern to me and others working in a temporary capacity that we are vulnerable and we must eliminate risks to our health and wellbeing at work in order to protect ourselves. Hepatitis B, Hepatitis C, HIV are just a few viruses that we are aware of and should we have an accidental needlestick injury from a dirty sharp instrument such as a probe we run the risk of potential infection.
 
Having previously worked in a large hospital NHS trust I was  fortunate to have Infection Control nurses, Health and Safety employees and a Central Sterilisation Supplies Department  that decontaminate instruments, sterilise and package them with a bar code for us to link up with the patient notes. We must consider that all patients and patients who are immunocompromised must have clean instruments.
 
Any invasive procedure such as crown lengthening surgery or periodontal treatment may potentially render a patient with a transient bacteremia which can result in mild to severe degrees of fever or transient infection.
 
Also in large hospital trusts we are fortunate to have an HR department to deal with issues that arise with members of staff, some may also have a Pastoral Care Department with Staff Support Facilitators who are there to look after our psychological wellbeing. Unfortunately for temporary dental nurses there is no such department for us to go to when we are on the receiving end of a dentist who upsets us.
 
You are lucky if the agency you work for has concerns for your wellbeing and calls to ask you if you are fine. There are laws to protect us:-
 
The Health and Safety at Work ACT 1974
The Health and Safety at Work Regulations 1992
Employment Rights Act 1996
Protection from Harassment Act 1997
Sex Discrimination Act 1975
Race Relations (Amendment) Act 2000
Disability Discrimination Act 1995
Trade Union and Labour Relations Act 1992.
Public Interest and Disclosure Act 1998
 
We must inform ourselves and I carry the BDA A12 advice sheet on Infection Control in Dentistry to quote and show dentists if I have to.
As my colleague would say "dentists can't really go against best practice guidance". Even guidance becomes law if someone is injured.
 
Julie Rolink RDN
During my time temping as a dental nurse I have often found myself in situations where there are infection control issues within the dental practice I am sent to for that day.
 
I write this as I am sure there are a lot of other dental nurses out there too that come across these issues. I have often sought the advice of a former colleague I worked with in a large hospital NHS trust who worked as an Infection Control Nurse and she has been a good source of knowledge, suggesting in situations where I am in a compromised position what I ought to do.

 It is often the case in a dental practice that when it comes to the decontamination of instruments prior to sterilisation that I find the practice has an ultrasonic bath but does not use it. In such case there is a discoloured nail brush with worn bristles, hand soap if you are lucky that the dental nurse is expected to use.

Unlabelled bottles with some sort of liquid is also a familiar finding too. I have on one occasion been told " we have an ultrasonic but we do not like to use it". I went to the cupboard found the ultrasonic, plugged it in and put the nusonic solution in the bath and started it up. The dentist looked surprised but did not object.

The BDA advice sheet Infection Control in dentistry A12 do state in their introduction under the title Routine Procedures, "failure to employ adequate methods of cross-infection control would almost certainly render a dentist liable to a charge of serious professional misconduct".

It is a concern to me and others working in a temporary capacity that we are vulnerable and we must eliminate risks to our health and wellbeing at work in order to protect ourselves. Hepatitis B, Hepatitis C, HIV are just a few viruses that we are aware of and should we have an accidental needlestick injury from a dirty sharp instrument such as a probe we run the risk of potential infection.

Having previously worked in a large hospital NHS trust I was  fortunate to have Infection Control nurses, Health and Safety employees and a Central Sterilisation Supplies Department  that decontaminate instruments, sterilise and package them with a bar code for us to link up with the patient notes. We must consider that all patients and patients who are immunocompromised must have clean instruments.

Any invasive procedure such as crown lengthening surgery or periodontal treatment may potentially render a patient with a transient bacteremia which can result in mild to severe degrees of fever or transient infection.
 
Also in large hospital trusts we are fortunate to have an HR department to deal with issues that arise with members of staff, some may also have a Pastoral Care Department with Staff Support Facilitators who are there to look after our psychological wellbeing. Unfortunately for temporary dental nurses there is no such department for us to go to when we are on the receiving end of a dentist who upsets us.
 
You are lucky if the agency you work for has concerns for your wellbeing and calls to ask you if you are fine. There are laws to protect us:-
  • The Health and Safety at Work ACT 1974
  • The Health and Safety at Work Regulations 1992
  • Employment Rights Act 1996
  • Protection from Harassment Act 1997
  • Sex Discrimination Act 1975
  • Race Relations (Amendment) Act 2000
  • Disability Discrimination Act 1995
  • Trade Union and Labour Relations Act 1992.
  • Public Interest and Disclosure Act 1998

We must inform ourselves and I carry the BDA A12 advice sheet on Infection Control in Dentistry to quote and show dentists if I have to.

As my colleague would say "dentists can't really go against best practice guidance". Even guidance becomes law if someone is injured.
 
Julie Rolink RDN
 

Comments  

 
#2 Guest 2011-04-20 12:53
do u know the responsibilitie s i have as a trainee dental nurse employee under the health and safety at work act 1974
 
 
#1 hatsepshut 2010-09-22 12:24
After having to re locate to look after my elderly mother, I had to give up my much loved job as a dental nurse working for a PCT. We had to adhere to strict cross infection procedures, and were often observed to ensure that we complied with the cross infection policies and procedures that were in place for the benefit of all concerned. Since relocating, I have worked in several practices,and have been horrified at some of the "cost cutting" practices that go on which in my view seriously compromise the cross infection ethos.. handpiece care in one practice was non existant, oil was available, but the nozzels were incorrect making any attempt at oiling totally inaffective, I was told, just to put the whole handpiece in the ultrasonic bath!!!. Needless to say, the handpieces were constantly being "peered" at disapprovingly, when they inevitably rattled and bumped their way during routine use. ..I didn't say " I told you so", but my goodness, my tongue was sore for days after!!!!
 

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