Dental therapist Hayley Cokayne writes about her ‘alternative' career path and why having the courage to admit when something isn't working out is important for a happy future.

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©Hayley Cokayne

To be completely honest with you, the journey I went through and emotions I experienced to get to where I am today have been challenging to say the least. However, I don't regret my career path as each experience - as clichéd as it sounds - made me into the person I have become and ultimately a better clinician. I hope my story inspires others to find their passion and believe in themselves, even when times are difficult.

Growing up, I enjoyed school and was placed within middle or top sets for all key subjects. However, mid-way through secondary school, I struggled with an eating disorder and became quite withdrawn. My friends would agree that I would easily spend a day at school without having a single conversation. Unfortunately, given how busy the school was, it seemed that the students who were encouraged academically the most were either highly intelligent or very disruptive; the students who quietly just did well blended into the background. In fact, I am certain that several teachers didn't have a clue who I was despite me being in their classes for almost a year. My one support figure at school came from a male teacher who realised something was wrong after I fainted during one of his lessons. In the year that followed, he and my mum communicated closely and with their support, I was able to recover and ended up doing well in my GCSEs.

As I didn't know what I wanted to do career wise, I continued onto sixth form to study for my A levels. However, as I didn't have a goal in mind, I lacked the motivation needed to study. I would walk to school, sign the register, talk to my friends, and walk back home - usually without attending lessons. Having always managed to do well academically, I presumed I would be able to do the same for sixth form too. I felt that my time was better spent earning money at my part time job in Somerfield than sitting in a classroom; this way I could help my mum financially and afford jeans from River Island - something I hadn't been able to do before. However, an English literature teacher did threaten to ring my work to tell them to stop giving me overtime during school hours - I'm still not sure how serious he was. Exam time came and it should come as no surprise really that I did terribly. I can distinctively remember my German exam which involved a native German speaker having a conversation with me for six minutes and when I tell you I couldn't understand a single word she said, I mean it, like total gibberish. It was the most awkward six minutes of my life: even the invigilator who was recording the conversation kept giving me sympathetic smiles. When I received confirmation of my results, I felt a total failure and the reality that I had wasted a year of my life hit me hard.

The prospect of going to university had always seemed inconceivable for a variety of reasons including the financial implications, my lack of knowledge of the higher education application process and within my family, the only member to have studied past secondary school was my paternal aunt. Therefore, I just took it for granted that once I left school, I would find a job and that would be it. So, with money in mind, I chose not to retake my A levels and instead started working as a full-time receptionist at a GP surgery.

I really enjoyed working at the GP surgery and it provided me with valuable experiences. I became great at communicating, confident with my individual responsibilities and felt part of the team. Over time, medical terminology started to become fluent, and I liked learning about various health related things. I made the most of having a full-time wage by learning to drive and helping out at home. After a few years, I left the GP surgery to work as a receptionist at a dental surgery which was a similar role but different environment. It was working with young dentists that inspired me to consider further study; after all, they were the same age as me and not all of their routes into dentistry had been straightforward. I started an Access to Higher Education course which was completed at home rather than at a college. This option suited me as it meant I could study in the evenings after work. Funding wise, I paid for it myself and chose monthly repayments so I could start it straight away. The course I selected was ‘Health Professions' rather than a specific career which meant it would be suitable for a wide range of university courses and gave me time to think about what might suit me career wise. I completed the diploma early and achieved a high number of distinctions.

After thinking through possible career options, I thought that mental health nursing would be a good choice given my personal lived experiences and I had always thought mental health was a fascinating subject. I accepted a place at my first-choice university and made the move from full time employment to student within a few months. I really enjoyed the theoretical basis behind mental health nursing and excelled with assignments and on placements, but I found the practical realities of nursing difficult. I struggled with knowing how we should be able to help people and what services we should be offering but due to funding issues, they were rarely available or extremely long waiting times resulted in service users receiving suboptimal care. Similarly, I wanted to be able to spend time with service users to get to know them and earn their trust, but low staffing levels meant this was hard to do. Eventually, it became too much, and I broke down to my mum, admitting I didn't want to continue the course. I felt like I had hit rock bottom, was a massive disappointment and wouldn't ever amount to anything.

From the moment I started working within the dental environment being hands-on, I absolutely loved it.

I was offered the opportunity to undertake a dental nursing apprenticeship with the dental practice I had worked at prior to university and gladly accepted. From the moment I started working within the dental environment being hands-on, I absolutely loved it. I enjoyed being able to reassure patients and put them at ease. Throughout the apprenticeship, I passed all my exams first time and received great feedback from my assessor who encouraged me to consider a future in dental hygiene. But I was concerned that I wouldn't be able to realistically afford to return to full time education and with no local universities offering the course, I would need to either commute via train to London or face a daily drive of almost two hours there and back - both of which would be a large expense.

In January 2020, my nan passed away after a brave battle with COPD and other complications. Upon the reading of the will, I found that my nan and grandad had generously left an inheritance to each grandchild. I felt the responsibility behind this and wanted to invest it wisely, so I sent off my UCAS application, cleared off any remaining debt and kept the remainder in my savings, to be used towards general outgoings for when I could eventually study to become a dental hygienist. Amazingly, I received an unconditional offer from King's College London to start that same year and immediately accepted. I like to believe this was my nan and grandad's doing somehow and it was meant to be.

Sadly, the COVID-19 pandemic took hold around the time the course was due to start so the majority of the first year was completed online from home. I did struggle with the loneliness of it and missed being around people every day, but I persevered and got through it. I found the academic content of first year very intense and a big step up from the Access to Higher Education diploma, so I had to focus all my energy on understanding what was in front of me. Second year and final year were more patient- and clinical skills-focused which I found easier and interesting. I had the support of some great dental hygiene and therapy tutors at King's who were very encouraging and knowledgeable but able to put things in an easier to understand way.

Unfortunately, during the last few months of university, I was assaulted by a patient and received a fractured eye socket which meant my confidence took a hit.

I completed the course with an upper second-class BSc with Honours - something I am really proud of, especially given that the assault happened around exam time, so I wasn't in the best frame of mind.

I had been offered a full-time position within a dental practice as a private dental hygienist which I had planned on accepting prior to the assault. However, as my confidence had taken a knock, I didn't feel comfortable working on my own and I hadn't sat in the operator chair since the assault so didn't know how I would feel returning. Then, something amazing happened: I received an email offering me a spot on the East of England Foundation Training Scheme and I had been successful in getting my first-choice practice. Due to the applications opening a while ago, I had pretty much put it to the back of my mind and presumed I hadn't been successful. I arranged a visit the following week which went great. I explained to my Educational Supervisor what had happened, and he was very supportive, going out of his way to make me feel comfortable.

My confidence has massively improved and the clinical skill I enjoyed most at university was restorative work so being able to develop this is brilliant.

Now, at the time of typing this, I have been part of the scheme for almost a month. The first two weeks were mainly induction-related tasks, drilling extracted teeth and settling in. I am based at the practice two days a week and every Friday is a study day where all the other Foundation Therapists meet to undertake CPD or clinical skills refreshers. For us, the study days are mainly based at Addenbrooke's Hospital in Cambridge. There are a small group of us this year but that has worked out well as it means we have more 1:1 support and can get to know each other better. Clinically, I have mainly been doing restorations on my clinic days and I have already asked for my appointment times to be reduced. For the first couple of patients, I did have a little flash back when introducing myself but it's rare that happens now. If it does, I just take a breath and continue. My Educational Supervisor has an open-door policy, but it is rare for me to check anything with him - he's happy for me to take the lead. Honestly, I am the happiest I have ever been and am really pleased I opted to undertake a foundation year. My confidence has massively improved and the clinical skill I enjoyed most at university was restorative work so being able to develop this is brilliant.

I had my first ‘I've made a difference moment' this week when a patient with heavily decayed upper and lower anterior teeth attended to start treatment. She was the same age as me and I noticed her covering her mouth when she talked as she was embarrassed. My Educational Supervisor had said just to try my best and not aim for perfection, but I really wanted to help her. So, I offered to see her for a few long appointments where we could restore her teeth in stages, and she gratefully accepted. The first session, I started with a gross scale and stain removal, then completed upper 3-3 composite restorations. I felt so pleased with what I had achieved but the best moment was holding the mirror for her to see her teeth for the first time. To witness the difference I had made and how emotional it had made her was extremely rewarding. I felt like I had done something genuinely good and improved her life. In the future, I hope to eventually carry out more of these types of transformations for those who are unable to afford it.