22 March 2011
Q. One of our hygienists reported that her indemnifier had told her that if she ever had a claim it would be hard to defend unless a full-time dental nurse had been present in the surgery whilst she was working on the patient. She currently works without a chaperone most of the time. Is she right in what she says?
The General Dental Council however make it clear in paragraph 3.7 of their guidance to dental teams - Principles of Dental Team Working - that every clinician should have a third party present within surgery and that third party should preferably be a registered team member who is trained to assist with medical emergencies. Generally speaking this would be regarded as being a registered dental nurse.
The reason for this is not related to chaperonage but quite simply that a third person is required should an emergency situation develop. If a patient was to collapse in the surgery then the effective management of that patient is dependant firstly on the availability of medical assistance and secondly (and perhaps crucially) on the early use of CP. There could well be criticism unless two members of the dental team had been able to respond to the emergency
Many practices have found that having a dental nurse available to all clinicians makes good economic sense as it makes the provision of treatment that much easier. It helps to ensure that appointments run on time without the hygienist having to undertake the dental nurse’s duties in-between patients.
Looking at the situation from an economic point of view, it may not be the best value to ask a hygienist to undertake a dental nurse’s job whilst paying her a hygienist’s salary.
There is an added benefit to having two people working with the patient at any given time - facts can be corroborated. Given that patients sometimes tend to be slightly economical with the truth when making allegations, the presence of a third party in the surgery can make all the difference as it is no longer the patient’s word against that of the clinician. So in that sense, the absence of a dental nurse would deprive any clinician of accessing evidence that could have supported their case. Your hygienist is right.