Q: How is it that you now work at GOSH?

A: I trained about 10 years ago in a hospital setting. The system was frustrating and I didn't feel I could do my best because of lack of time, resources and support. After about six years I became disillusioned and left to go travelling in Asia for 6 months. The experience was well worth it, but it opened up my eyes. While travelling in South Korea, I suffered a minor injury in Seoul and had to go to hospital. It was then I realised how convoluted and tricky their health care system was. When I came back from my travels, I found myself being drawn back to the NHS. I applied for a job in a community dental setting. I was involved with paediatric and domiciliary patients and even helped run a clinic for the homeless. Lack of funds and an uncertainty around the future of the community service due to competitive tendering did little to assuage my frustration at the system.

Credit: ©Peter Wheeler / Alamy Stock Photo

It was around this time an opening for dental nurse was advertised at Great Ormond Street Hospital (GOSH). I had the necessary qualifications and motivation to involve myself in change, so I applied. In all honesty, I wasn't expecting to be offered such a life changing position, but I am here now and am excited about future opportunities. GOSH has created a platform for me to get my ideas across, teach other health care professionals about what we do and explore openings for other projects, audits and presentations. If you put yourself out there, there are opportunities to be found.

Q: Tell me about a typical working day?

A: Every day has its challenges. It's unlike any other dental nurse post I have ever had over the years. The cohort of patients we see can have very rare conditions, are seriously ill or have multiple complex conditions. In addition to the typical nursing duties that we have organising and supporting clinics, we run a nurse led oral hygiene clinic, visit wards to give advice and take part in projects that promote oral health within the hospital. General anaesthetic lists for our dental patients are challenging due to complex medical needs as well as the extra challenge of young patients who have higher anxiety levels than usual.

The work is similar to most dental hospital settings, but the opportunity to learn far more about obscure medical conditions is much higher.

Q: What are your favourite parts of the job?

A: As with any job of this nature, my favourite part of the job is working with patients and their families. It's an absolute honour to be so involved with their treatment and patient experience. Some of the youngest patients we see are so inspiring and it's always a pleasure to be involved in their care in some way. I have a lot of respect for them and their families, compassion, care and patience, as well as the motivation and experience to deliver professional, up to date care for them. Sometimes their situations are very poignant, given the nature of the hospital, but I am honoured to witness some of the best aspects of human nature. This is a a major motivator for my work.

Q: You are now working on Mini Mouth Care Matters - how did this come about?

A: I was approached by consultant paediatric dentist Urshla Devalia about this project. Because of my previous interest in oral health education for general nurses, and recent work with an oral health presentation to GOSH's new intake of nurses, my drive to expand the platform was probably what drew us together for Mini Mouth Care Matters (Mini MCM).

Q: Please tell me about the programme and your part in it

A: My part in Mini MCM is to provide the dental nursing perspective to the training, information, and policy write up.

I also support project lead Urshla Devalia and have been involved with audits, correspondence with interested parties, outreach with nurses on the wards, and training and advice materials.

MiniMCM aims to create a healthcare team that is more responsive and personalised to patients.

This will include:

  • An oral health policy and tooth brushing chart, that will be fully adaptable to any hospital Trust

  • An oral health screening tool to identify patients who may be at a high risk of developing oral problems

  • A training package which will encourage all nursing, medical and health care professionals to ‘lift the lip’ and identify common oral health/dental conditions

  • A range of tools applicable to paediatric in-patients that can be used by all hospitals hoping to join Mini MCM, including posters, booklets and baseline audit tools

Q: What has the experience of being involved in Mini MCM been like?

A lot of work. When I first heard of the project I envisioned it would be an audit, a training package for nurses on how to brush their patient's teeth on their wards, and some leaflets to promote oral health. It has since snowballed into something so much bigger, simply because there is so much interest in the project. It is great to see that there is acknowledgement of the urgent need to roll out this training, and to stop overlooking the mouth and teeth of every patient and to ‘put the mouth back into the body’.

Everything about Mini MCM has been a great experience, the message it gives, the training and advice and the teamwork involved in undertaking such a project.

As with most things, the obvious single downside is lack of time. There is so much interest in this body of work, but we aim to provide the most informative and comprehensive advice and training for all hospital settings.

Q: What do you hope will be the outcome of the initiative?

A: I hope the initiative changes cultural perception of the mouth and mouth care in hospitals as well as in the wider public domain. It's shocking when I hear medical colleagues say ‘it's just teeth’ and then come running to us when they have a critically ill patient with infection risk from their teeth. It's part of basic care, but it's almost deemed optional. If a patient wasn't bathed or turned in their beds to prevent pressure ulcers, that would be a major incident. But a second thought isn't spared for the patient who hasn't brushed their teeth or maintained their oral hygiene. I hope the initiative gets people thinking and eventually becomes part of legislation. The time, money and resources saved just from oral health maintenance will surprise everyone.

Credit: ©Jeffrey Blackler / Alamy Stock Photo

Claire Fletcher is a Specialist Dental Nurse at Great Ormond Street Hospital's Maxillofacial and Dental Department. She specialise in paediatric dental nursing and has a specialist interest in conscious sedation for anxious patients.