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‘My years of experience in all aspects of dentistry affords me incredible autonomy in the practice’

BDJ Team volume 5, Article number: 18104 (2018) | Download Citation

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Experienced dental nurse, tutor and mum of two Karen Robinson, 54, tells BDJ Team exactly what it's like to walk a mile in her shoes…

I was born into a ‘dental’ family in the idyllic, picturesque harbour town of Burry Port in South West Wales. My late father was a dental technician and my brother, eight years my senior, was a dentist. It was always presumed that I would follow in the footsteps of my brother and become a dentist too… I, however, had other ideas!

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My brother was the golden boy, graduating from Bristol winning the gold medal. I really did not fancy the idea of spending my time in university studying and living in his shadow. Little did I know there was an alternative. Half way through sixth form in an all girls’ grammar school I took it upon myself to switch from the sciences to the arts. You can imagine the furore that created at home!

Fast forward a few years: I did not manage to escape the dental grasp in the end. Taking a year's sabbatical following my A Levels to work in my brother's dental practice, I ended up staying. He did not give up trying to make me do dentistry, so I married his associate instead. A half-way-house compromise, I guess.

I qualified as a dental nurse in 1984 and worked with my brother and consequently my husband. I was always keen on helping patients improve their oral health knowledge and skills. Both my husband and brother were quite ahead of their time, as back in the eighties, most dentists regarded their ‘assistants’ (as we were known then) to be silent suckers and cleaner-uppers! My brother and husband believed a nurse's role should be far more integrated – talking to patients, giving instructions and dishing out oral health advice. To them and to me a nervous patient is far more likely to listen to a nurse who is not about to pick up a needle or carry out a procedure that might be uncomfortable. Plus, the patient could be given the advice while sitting up, not laying in a very vulnerable supine position – hardly a position conducive to taking on board important information.

So, here I am in 2018. I am 54 years old going on 18, with two married children: Joshua, a post-doctoral biomedical engineer at Oxford University, and Louisa, who is a television assistant at the British Film Institute in London and has almost completed her Master's Degree in Creative Writing.

Since 2005, I have worked in a busy, three-surgery NHS/Private practice in Pontarddulais, on the outskirts of Swansea, as the senior nurse/oral health educator. It always brings a smile to my face to read patients’ notes from the 60s, when writing dental records was succinct, shall we say? ‘Recall, NAD, 6/12’ sufficed! The General Dental Council would have a field day in 2018.

We have two dentists: David, a specialist in prosthodontics, and Anne, who has a special interest in oral surgery. There's a hygienist, a part-time practice manager, three qualified nurses, one trainee nurse and two receptionists. We are a dental foundation (DF) training practice, so enjoy the challenges that brings. I work with the DF trainee on Wednesday and Thursdays. I love this part of my job very much – seeing them develop and grow in confidence and, of course, bringing them around to allow the nurse to take more responsibility.

I have gained almost all of the extended duties and was thrilled to achieve the prestigious Stafford Miller Award for the most outstanding candidate for the Certificate in Oral Health Education. I recently retired from the part-time post of dental nurse tutor in Cardiff University and returned to work in the practice on a full-time basis.

In 2000, I changed my marital status from that of being a dentist's wife to being married to a dental technician! Kevin owns a busy laboratory so is up and out of the house before six, which means I am an early bird, too. Consequently, I am normally the first member of staff in the practice and like to check on everything before the official working day begins.

I go through the day list, planning everything, to ensure we run smoothly and to time; checking the laboratory work is there and switching on the central sterilising unit and validating the machines. David is the dentist I work with the most, and because of his specialism, we get a fair share of very rewarding cases. He is a meticulous planner and can estimate to the second how long each appointment will take and is always correct.

We have two emergency slots each day, which are usually filled. My years of experience in all aspects of dentistry affords me incredible autonomy in the practice. I am the triage nurse, entrusted with establishing the possible cause of an emergency and can arrange the appropriate appointment. If a patient calls in with a fractured denture, I will decide if an impression is required, or if it can be taken straight down to the laboratory. If an impression is needed, I can take it, saving the dentist's time. It is also very helpful when working with the DF as again, I can be relied upon to give constructive advice. However, my knowledge also gives me the ability to know when to call a halt to the proceedings and call for the trainer to intervene, if the DF hasn’t already.

Having worked there for so long, I feel I have developed a very good rapport with the patients, so much so, when I began working in the University, David threatened to have his scrubs embroidered with the words ‘She's in Cardiff today’, as he was sick of answering the questions – ‘Where is she then?’ ‘Where's your sidekick?’.

Having had years of experience as a tutor, and loving every second, it is down to me to organise staff training and the continual professional development (CPD) sessions. I will deliver some sessions myself. I firmly believe that knowledge is the key and if we want to be taken seriously and treated as vital members of the team, we must possess the underpinning knowledge to accompany our clinical skills so we can be allowed to have more responsibility and trust. I feel quite honoured when the dentist turns to me for my opinion or advice on a treatment plan, or looking at a radiograph – but I couldn’t do this without years of continual clinical development.

Lunch times, the staff sit together and discuss the day. It is during our lunch break that we have a practice meeting, or a CPD session. We work well as a team, all helping each other when we can. Over the years, there have been dramas, as in all establishments where there are several employees. Some days, it almost feels like I am a social worker rather than a dental nurse, with other members of staff crying on my shoulder, or indeed patients confiding the most intimate problems. I have been nick-named ‘Mummy Karen’ on more than one occasion!

I believe our profession is a true vocation, a calling and not a job that entails clocking in and out at the exact second. The patients come first and it makes me so cross at five o’clock when I see nurses strutting around the practice taking out the clinical waste bags, or worse, congregating around the reception, impatiently waiting for the last patient to come out of the surgery. The last patient of the day is just as important as the first. How awful must that person feel if the nurse is busying him/herself closing down the surgery as the dentist or hygienist completes the treatment.

The role of the dental nurse is, of course, to facilitate the clinician, but more importantly, we are there to ensure the patient is supported and cared for. By our attitudes and encouraging words, we can be completely instrumental in transforming initially terrified people, whose fear can manifest in them being belligerent, taciturn and even sometimes quite aggressive people, and whose names we dread to see on the day list, into our favourite patients. This transformation takes skill, which only comes with knowledge, experience and highly trained staff. We have to be chameleons, changing our colours to suit each patient. I use humour to break the ice, but it has to be professional and appropriate. I try to encourage the other nurses in the team to follow suit.

Being part of a dental practice is being part of a team and is very much give and take. David and Anne are very generous in repaying the team for their hard work and regularly organise meals out or trips. We have been to London and Disneyland Paris for weekend breaks. At the end of June we are going to Tenby for a well-earned rest and some team building fun!

Do I regret not going to dental school? Well, hindsight always comes with twenty-twenty vision. If I had taken that route, my life would be different, but not necessarily better.

Interview by David Westgarth

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https://doi.org/10.1038/bdjteam.2018.104

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