11 August 2009
Q. I am an associate working in a small practice. In the past, if a dental nurse was off sick the practice manager (who worked as a dental nurse for many years) would work with me, however, she is not registered with the GDC. If the situation arises again, should I refuse to see any patients (and cancel their appointments) in the absence of a registered nurse?
The requirement for all dental nurses to be registered with the General Dental Council has created practical difficulties in the day to day running of a general practice. However, in the event of your registered dental nurse being unwell, anyone standing in for her would either need to be registered with the GDC or in training for a registerable qualification. The GDC's publication Principles of Dental Team Working states "When treating patients make sure there is someone else-preferably a registered team member-present in the room, who is trained to deal with medical emergencies." This might well mean cancelling patients; if for example, you are unable to treat your patients safely and effectively without a nurse and a registered agency nurse could not be employed at short notice.
If you needed to see a patient with an acute emergency in order to provide essential treatment it is advisable to have a third party present, just as there would when seeing a patient outside of normal surgery hours. However if this is the case you as the dentist are responsible for assessing the possible risk to the patient of continuing with treatment in the absence of a trained person.
It may be sensible to have a contingency plan in place for this type of situation. The law states that it is illegal for a non registered person to be involved in the actual practise of dentistry and the GDC have been quite clear that to allow a non-registered person to assist in the surgery, could lead to an investigation into your fitness to practise.
You can read about the indemnity needs for agency-based dental nurses here in question 8.