15 September 2015
To a large extent the problems you have are a contractual matter between you and the practice and therefore very much depend upon the associate agreement you were provided with when you started work.
Assuming this is a standard associate agreement, you should find there is a clause within that agreement indicating that the practice is required to provide you with the services of a dental nurse on a day-to-day basis. The only time when this would not be the case is when exceptional circumstances exist (sudden illness, etc).
The General Dental Council’s guidance clearly indicates that all clinicians should work alongside another team member (preferably a registered dental nurse) at all times. This is not necessarily a matter of chaperonage, but in fact relates to the provision of medical emergency care to patients.
If one of your patients was taken ill during a treatment session and perhaps lost consciousness, you might find yourself facing the dilemma of either looking after the patient or going for help. You could not do both if you were working alone. If a dental nurse was working with you, this would not be the case.
It follows that if such a situation was to arise, you might have to explain perhaps to the coroner, the courts or the GDC why a dental nurse was not present with you in the surgery, in accordance with GDC guidance. This would not be easy, particularly if it could be shown that the patient had suffered harm through lack of emergency care.
You should discuss your concerns with the practice owner and practice manager and ask them what action they feel they can take to be of assistance to you. Your associate agreement likely contains a contractual obligation (to say nothing of an ethical obligation) on behalf of the practice to try to ensure a good working environment.
If the problem continues or shows no signs of resolving, you may have to consider your position at the practice.