I have just read the letters in the autumn issue of Vital regarding the changes in our roles (page 4).

I work for the primary dental service which is part of the NHS system. We as a service deal with patients who are not normally seen in practice due to mental or physical problems. Our patients can be violent and being kicked is seen as part of the job. We are shouted at by some of the patients; again this is taken by the staff as part of the behaviour we can expect. For this we are treated the same as dental nurses in general practice and our pay is the same. We have not had pay increases like other NHS staff. We also do domiciliary visits and are expected to drive to these places and attend our clinics within the service. Our employers this year have insisted that to claim mileage or parking back we have to change our private car insurance; many of us have had to increase this by £30 or more. Again we have the indemnity as well as GDC registration costs to find. We have also been told these costs may increase due to the type of patients we treat.

I think that at present a large unplanned shortfall of dental nurses is developing across both the private and NHS sectors. As we now register within our own rights we need to take out expensive new policies but due to poor pay in the past our employers are not necessarily increasing wages to allow dental nurses to fulfil their obligations.

Due to the fact I do work for the NHS the only perk we do get is that we have to attend so many training sessions and staff meetings, so collecting CPD hours is not a problem. I feel very sorry for the dental nurse who needs to gain hours in practice.

Many of the new guidelines that have been brought out for the safety of patients and staff appear to be over the top with a number of them ‘forgotten’ or ‘stopped’ unless inspections are being carried out. Many of the new rules for HTM 01-05 are very costly and time consuming and thus are forgotten in the never-ending race to get the surgery ready for the next patient.

When I started dental nursing we tried to win patients over that dentists were not there for a ‘fast buck’, and showed that we cared about them and wanted to do the best we could. However, due to the pressures on dental nurses our jobs have changed to having little or no time for the patients and their concerns. We are able do very little to change the next generation's perceptions on dentistry being painful and indeed, out for a quick buck.

I know a number of very experienced nurses leaving the profession as they are no longer gaining pleasure from treating patients and financial rewards are lacking. If dental nurses do not start to be treated better, practice principals will find it hard to maintain their practices as they are being run at the moment. Many of the ‘old style’ nurses are prepared to work through lunch etc for the benefit of the patient but the new nurses have a different outlook. I wish I was one of them and didn't worry or get as stressed if I don't do a great job. I am looking for a new job as I feel this is a job rather than a profession to be proud of.

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