Dental nursing: dental practice or hospital?

dental-practice-or-hospitalHow to decide which career path to take

I have been a dental nurse for the past eight years, during which time I have been working in a very busy London dental hospital, Eastman Dental Hospital (EDH). For the last three years I have been teaching major CPD updates to dental nurses.

Many nurses have asked me how it feels to work in a hospital.  Quite a few nurses would like to apply for hospital jobs but are afraid that the work might differ too much from work in a dental practice. They are not sure what to expect on the interview day and how challenging it would be to work in such a big dental clinic. 

Working in a dental hospital requires good organisation and self-discipline. Every day, the nurses work with different grades of dentist and assist with different procedures. The clinicians working in a hospital range from postgraduate dental students to consultants in charge of an entire department.  Every dentist works differently, but most like to have the clinic ready for work before they attend. 

Working in a hospital is never boring. On any single day, the procedures undertaken will range from simple check-ups to extraction of the hypoplastic 6’s or surgical removal of impacted canines. Many nurses have a post-registration qualification in sedation so that they can assist with extra sedation clinics and general anaesthesia procedures. 

It is very important to follow the cross-infection procedures and medical emergencies updates in order to be able to help in emergency situations. We have to remember that working in a dental hospital can be challenging due to the medical history of many patients. Children may have any of a range of conditions from mild asthma through to autism, cerebral palsy or Down syndrome. Children who have had accidents and trauma to their teeth will most probably be seen in a hospital rather than a dental practice, so assisting a trauma patient brings another challenge to the job.

To give you some ideas about your possible new career path, I would now like to share with you my typical day in a dental hospital.

It is Friday morning and I am starting my regular day in the Paediatrics Department at EDH. It is 8.30am and I am getting ready for my 9am patient. 

I gather all the day notes assigned to my dentist and check my day schedule so that I know ahead of time what am I supposed to prepare for today.

My 9am patient will be here for an extraction of two adult permanent teeth, using local anaesthetic. At 10am there is a possible filling with inhalation sedation for a very uncooperative seven-year-old. My 11am patient will be here for a filling, and my patient at midday will be here for root canal treatment. 

Following morning clinic, my afternoon will be spent assisting with the surgical procedure of exposure and bond, and undertaking a patient review at 4pm. 

After checking my schedule I prepare my kit, put my chair down, clean all the surfaces, and set up the instruments for the first patient. I make sure notes are ready, X-rays are in place, and consent forms for treatment are signed. 

My 9am patient arrives ten minutes late, which means there is already pressure on my dentist to keep to time for the rest of the morning. The patient is happy to follow me to the surgery so that we can begin the treatment.  However, the patient has had nothing to eat that morning, so I need to assist the patient with a glucose drink. The treatment is completed at around 9.50am. I clean everything necessary and prepare for the inhalation sedation in the specially designated sedation room. 

My 10am patient arrives with both her parents, and is already unwilling to come to the surgery. After a short period of time, she is sitting in the dental chair but is still crying. Twenty minutes into the appointment, no treatment has been given, but my dentist and I are both willing to give her some time, and try once more to calm her down. Eventually we manage to introduce her to inhalation sedation, and we polish her teeth. No fillings have been managed, and she will therefore need another appointment to continue with her treatment. 

Using my regular kit, I set up again for my 11am patient. This time everything goes smoothly and we are on time for the root canal treatment at midday. But the midday patient does not turn up!

With a spare hour on my hands, I stock up the shelves and drawers with disposable materials, and also make sure that all soap and paper towel dispensers are full for the afternoon. 

Between 1pm and 2pm there is a lunch break for the whole hospital. It is time to relax, get some fresh air and catch up with friends from other departments. Lunch time is never long enough, and it seems that the minute we sit down it is time to go back and start the afternoon’s work. 

It is now 2pm. My surgical procedure is ready and I look forward to assisting with the exposure and bond procedure. We make sure that everything has been sterilised and that the surgical suction is working. We scrub and also wear gowns to eliminate the possibility of bacterial contamination.

The procedure is finished. The gold chain is attached to the tooth and the patient is discharged.

The last patient of the day needs a simple review. There is very little setting up needed for this, and I therefore have enough time to clean the surgical equipment and send it to the sterilisation unit.

At 5pm it is time to finish for the day. We are all happy to close the department and go home. 

I hope that this short introduction to my typical day as a dental nurse in a hospital shows how different and versatile the work can be. On some days I am in charge of the new patient clinic, and on others I spend the day working in general anaesthesia - each week brings new experiences. 

I can call myself lucky; I love working with children and I love the challenge of applying the many different procedures and skills I have learned during my years in EDH. Other departments are more specialised and provide treatment for adults and children in orthodontics, root canal, prosthodontics, oral surgery and oral medicine. 

The things I like the most about my job include the people I work with, the variety, and the open space. I also like the fact that I can use my skills to help in other departments if there is a shortage of staff. 

Working in a hospital can be drastically different from working in a practice. It will take a few days for a newcomer to adjust to the different rules and environment, but there is nothing to worry about. It is never too late to learn and to try a new challenge. I strongly recommend working in a hospital. However, I understand that there are not many jobs around to apply for and that some nurses are more interested in practice jobs and management.

There are  several big hospitals in London where you may be able to apply for jobs. These include Eastman Dental Hospital, Guy’s Hospital, King’s College Hospital, Chelsea and Westminster Hospital and The Royal London Hospital. 

Applications for jobs can be long and tedious, but we have to remember that they are the first big step towards getting job interviews. Do your best to complete the application with all the details requested. Make sure you include all your dental nursing qualifications and experience. It is very important to make a good first impression.  Before the interview, read up on the general rules for infection control, team work and medical emergencies. Demonstrating management skills and good communication will also help to strengthen your application. 

If you are thinking of a career change and would like to work in a dental hospital, don’t be afraid - apply as soon as jobs are available. The best link to check for this kind of jobs is NHS jobs: www.jobs.nhs.uk.

I wish you all good luck, hope my article helps a bit, and look forward to hearing about your views and experiences.

Written by Sylvia Rippl, RDN

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