It’s no secret that things have been much harder in the dental industry since the pandemic. There has been a significant increase in the workload, with extra infection control duties, more demanding patients, and higher targets to be met. This is all after the redeployment scheme saw dental nurses become one the largest group of registrants – but without any of the benefits. With rising dissatisfaction in the job, and many dental nurses leaving the profession altogether, it’s time to look more closely at what can be done to improve working conditions for dental nurses across the country.
The lack of recognition is something already noticed by the BADN, who have been exploring the ways in which dental nurses have been ignored despite their efforts during the pandemic. The immediate past president of the BADN, Jacqui Elsden, has expressed in a recent article that the NHS has failed its dental nurses by refusing to acknowledge the help they gave in redeployment, and by not recognising them as key workers – which led to many workers having no access to the necessary childcare and supermarket early-access needed to be able to undertake their job.
Dental nurses also felt it was unfair that the GDC still required full registration fees despite many dental nurses being out of work from March to July. There were – as reported by GDPUK – a recorded 3826 dental nurses who chose not to re-register come the end of July 2021. The increased work demand, lack of recognition, poor pay and lack of rewards for some nurses led to many throwing in the face mask for a job that was less stressful and less demanding and that expected them to make fewer out-of-pocket payments just to be able to work. This has in turn caused an increased demand for dental nurses at many practices, and what seems like a national – yet still unrecognised – shortage in the profession. The problems persist and are still going unaddressed.
If you are one of the many dental nurses who are unhappy in their current roles, and you feel that leaving the industry is the only step left to take, then hold fire on your decisions – there’s still a chance that you can make the change you need to be able to continue in dentistry. This may involve being open and honest with your employer, or seeking a job at another practice – but there are things you can do to improve your circumstances and still stay in the job you once loved and can love again.
Your employer
First off, let’s address the fact that most employers will not undertake any form of training prior to taking on a team of staff. They may complete team-leading CPD and practice management courses, but there is no set qualification for running your own practice and keeping your team happy – and that, of course, is where you come in. By working with your employer and developing an open and honest relationship, you can help them to see how a happy team with good morale can aid business growth and profitability and can increase patient satisfaction by providing positive experiences during appointments.
You
Now let’s take a look at you and your role as a dental nurse – what things are there that you can do to improve how you feel about your work?
To start with, it’s important that you can reflect on your performance and be honest with yourself about what you do well, but also acknowledge the areas in which you need to improve. Knowing what your weak points are can help you to better plan your CPD, but also shows that you are open to improvement and growth – something all employers appreciate. This then can lead to you finding new interests in dentistry that will lead you to much more job satisfaction than before.
Another thing to consider is your teamwork – are you a good team player? Do you think you and your colleagues are committed to your team and to your practice? Working well with others in your practice is a short-stop way to increase job satisfaction. It’s much better to come into a positive and happy workplace with colleagues you get on well with rather than enter a negative space where you aren’t there for each other. If you feel that there are barriers between you and your colleagues – something that negatively affects staff morale – then it could be worth exploring things such as team-building days or staff outings to help create a better bond between you all.
And how about your CPD, or further training? Have you taken steps to keep your interest for the role alive and, if not, then what could you do to increase your job satisfaction? A well-planned PDP can help you find the right courses to undertake to optimise your skillset and to keep you enthusiastic about your work. With good time-keeping – a well-known essential skill for all dental nurses – you can find time to develop interests outside of your standard duties and also bring a new skill to the practice table.
Start the conversation
It can be daunting to have to approach your employer with issues you have at work. However, they are there to listen, take on board your feedback and see if there is a way they can work with you to regain the satisfaction you once gained from your job. Therefore, the first thing to do is to make a list of the things that are making you unhappy.
Some items on this list may have more importance for you than others. We’ll address a few common issues below, but the main thing is that you know what is making you unhappy so that you can develop an idea of how to resolve it in-house.
Recognition
Dental nurses are some of the most invisible workers around. They are largely unnoticed and forgotten by patients (unless they’re doing the suction, of course!) and are rarely thanked for the work they do. This can make the job feel very thankless and unrecognised. This is not helped by situations such as the NHS failing to thank dental nurses for the work they did to help out during the pandemic; this highlighted and exacerbated the issues already present in the industry. Whilst there is not much we can do to gain the NHS’s respect for what we do, there is something we can do in relation to an employer who fails to recognise the efforts of their staff members.
If you feel like this, and have noticed that your employers rarely, or never, say thank you even after you’ve had a long and difficult day, then bring this up in your discussion. With so much to focus on to ensure the practice runs well, employers are bound to miss some things – and this could be one of them. If you explain that you would welcome verbal thanks more often to make you feel appreciated, your employer will be able to see an immediate and effective way to improve staff morale. This will also open up the door for more conversations in the future, as it will help to develop a positive relationship between your employer and their team. It may seem like something very small, but a thank you goes a long way to brightening someone’s day, and it is worth reminding people of this.
Pay
Rates of pay are one of the biggest sources of complaints from dental nurses, some of whom have come to ‘accept’ that the dental nursing profession is simply not one that pays well, despite the requirement of a qualification, regular CPD, indemnity insurance, and GDC registration. However, you should not have to settle for pay that does not reflect the value of what you do, and if you feel you aren’t appropriately paid, then it’s time to talk to your employer.
Start by listing things such as what you contribute to the practice, what roles you undertake, and any extra duties or responsibilities you may have. Each thing you list is a reason for a better pay scheme, because it shows you care about your job, go above and beyond for the practice and patients, and give your all every day. It can even help to point out a few different times that you have done something a little ‘extra’ to help reach a target or goal.
Next, look at the going rate in your local area. With the cost of living on the rise and changes in prices occurring depending on where you live, it’s important that you try and match the expectations of the current market. This means that you should not settle for a rate of pay that is below the living wage. Be sure to consider increases that you need to cover in your personal bills and, most importantly, do not ask for a rate that a nurse in London would be paid if you live in Tamworth. You need to give this careful thought and be realistic about your expectations; you are then more likely to be taken seriously.
Reward
There are dental nurses who are given a great rate of pay that they are happy with, but they find that this is where the recognition ends. It could be that your practice has no type of reward system, and you feel that implementing one will not only drive staff productivity and grow the practice morale, but will also give you an indication of when you have done a good job.
Rewards come in many forms, and it could be helpful to consider different options depending on what the practice is able to offer you. Remember that bonuses, particularly for large teams or start-up practices, are not always feasible, but other things could be made available, such as:
- performance bonuses, paid only if certain targets are met;
- employee of the month gift cards;
- team days out to celebrate when staff achieve milestones or meet targets;
- extra days of leave granted after a specified length of service;
- birthdays off.
These are just a few ideas, and you may well have your own that you’d like to have implemented. It is worth bringing this up with your employer and starting the discussion. Other types of benefits include discount schemes (such as cycle to work or technology through employer schemes), free treatment at the practice, or having your GDC registration, indemnity and CPD paid for by your employer.
Time
Perhaps the most difficult but pressing issue of all is time. How often do you work through your clinic and end up run ragged, with no time for a toilet break … but that’s okay, because you’ve had no time for a drink either? How often do you wish you had help or feel sore and tired because you haven’t stopped all day?
Whilst time management is a key skill in the role, it is also one of the most difficult things to implement effectively. You cannot create more time in the day to be able to keep on top of decontamination, but what you can do is request that long appointments, such as treatments, have an extra five minutes added to their end to give you time to sufficiently clean down and run decon, rather than having no time at all and ending up with too many instruments to put through. Lack of time can be a huge stress factor, and by recognising your difficulties and supporting you to be compliant through the provision of a little extra time now and then, such stress can be greatly reduced.
And if all this doesn’t work …
There is every chance that you will take all of your concerns to your employer and they will listen and make changes to ensure your happiness and job satisfaction. However, there is also a chance that, for whatever reason, they cannot or do not make the changes needed. If this means you’ll still be unhappy, then perhaps it is time for a move.
While it can be difficult to leave a practice, especially one you may have been at for a number of years, there may well be a point, if your concerns are ignored, when you are left with no choice. Other practices will be able to see your experience and worth, and you will be able to bargain for better pay. You can also pick and choose which practice best suits your needs and interests, and it may well be that such a move not only answers your prayers for better working conditions, but also reignites your passion for your job.
To end
The issues above, as well as others, have been present for dental nurses for a very long time, and they have been highlighted by the pandemic in a way that has led many to feel like they have no choice but to abandon the profession altogether. However, it is important that you remember how powerful you and your voice can be – if you want to make a change in your practice, then speak up and address it with your employer. Without your feedback, they won’t know that there is an issue. If you raise your concerns and they don’t listen to what you have to say, then consider whether it is time to find somewhere that will. With practices crying out for qualified and experienced staff, it is a great time to look for an employer who values their employees and recognises their hard work.
It's also important that you continue to reflect on your working conditions – don’t make this a one-time thing; make it a habit that helps you to see when you are being underpaid, or how to tackle dips in job satisfaction. You are your own best advocate, and speaking up at your yearly appraisals, or starting a conversation with your employer to show them where things may be going wrong, will go a long way to turning what seems like a short-term solution into something more long-term. You can help your employer to learn what really goes into keeping their team happy at work and to gain understanding of how integral positive staff morale – which they have direct influence over – is to their business success.
You have your bargaining chips – now go and use them.
Written by Natasha Garthwaite BSc, RDN
References
C. Tapper, GDPUK Article, 18th August 2021 https://www.gdpuk.com/news/latest-news/4027-gdc-registration-report-reveals-significant-drop-in-dental-nurse-numbers#:~:text=The%20GDC's%20figures%20show%20that,at%20the%20end%20of%20July
BADN Article, 23rd February 2023 https://www.badn.org.uk/NewPublic/News/BADN-calls-for-recognition-of-Dental-Nurses--contribution-to-dentistry.aspx
