12 September 2011

Q. Please can you advise me how I should respond to a request from my employer to work alone during periods of staff sickness and staff holidays?

I assume that most of the time you are working with chairside assistance from a registered dental nurse or one in training and that the scenario you describe is likely to be of a temporary nature.

Normally a written contract between yourself and the practice owner would set out the agreement over the level of chairside support, and reference to the Contract will establish whether the situation you describe is in fact a breach of the terms of your contract.

What is perhaps more important would be the view taken by the General Dental Council if there was an incident or a medical emergency while you were working unassisted. The GDC guidance, Principles of Dental Team Working; section 3.7 makes it clear what is expected of a registrant in that there must be someone else present in the room that has been trained to deal with medical emergencies. The Guidance does not say this must be a dental nurse but suggests it would be preferable if you were assisted by a registered team member. If an incident did happen then the GDC would wish you to come up with a very good explanation as to why you were working without chairside assistance. From a risk management point of view, it would seem sensible to further discuss the GDC guidance with the practice owners.

Working single handed can certainly contribute to a reduction to your usual level of productivity. In every working hour you will be expected at some point to de-contaminate the surgery and quite possibly do the same with your instruments and this takes time. I am sure you could make a case that your profitability to the practice would be enhanced by the presence of chairside assistance at all times.

Somehow working unassisted can create a diminished perception by patients over the quality of the care and advice that they have received, even if that is not the case. If that perception is combined with a treatment that (coincidentally) takes a little longer to settle than expected it is possible that a complaint could result.

You might like to consider attending one of DPL’s communication skills workshops to ensure you optimally effective in such conversations.

Dental Protection Limited is registered in England (No. 2374160) and is a wholly owned subsidiary of The Medical Protection Society Limited (MPS) which is registered in England (No.36142). Both companies use Dental Protection as a trading name and have their registered office at 33 Cavendish Square, London W1G 0PS.

Dental Protection Limited serves and supports the dental members of MPS with access to the full range of benefits of membership, which are all discretionary, and set out in MPS’s Memorandum and Articles of Association. MPS is not an insurance company. Dental Protection® is a registered trademark of MPS.

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