Dental nursing – dentistry’s ‘most devastating recruitment crisis’ in 30 years

Claire Frisby and Jayne Sproson explore the challenges within dental nursing and why dentistry is facing the ‘most devastating’ recruitment crisis in 30 years. 

A dental nurse’s point of view – Claire Frisby

After many years in dentistry, I –alongside everyone else – had been finding it more and more difficult to find good experienced dental nurses (before the pandemic hit). This made things difficult as we were constantly short staffed.

As a lead implant nurse this meant training up someone who had no experience. This would take a lot of time, whilst working and doing my own job at the same time. I would put lots of time and effort into training, for them to realise they couldn’t manage it or it wasn’t for them (where I worked we had some very good nurses. We encouraged them to grow their skills and supported them however we could).

During the initial hit of the pandemic, there were lots of grumblings in the dental nurse forums. These were from mainly unhappy dental nurses, who had time to think.

Earlier this year I had written an article and mentioned ‘dental nurses getting more recognition’. This article was very popular and I knew this subject needed more attention.

Lack of recognition

I heard a discussion on one of the Clubhouse meetings discussing how not to become too complacent with the way the dental world is at the moment. It went on to discuss how difficult it is to get a dental nurse. They were discussing how around 47% of dental nurses have not re-registered this year.

I decided to do a post on Linkedin about this. Jayne Sproson picked up on this. She asked if I would like to join her on Clubhouse ‘Dental World’ and discuss why we think dental nurses are leaving and what we can do about it. Jayne put together a great panel of people including dental nurses, dentists and even a lawyer who was known for his skills in ‘employee relations’. This was amazing as we could now start getting people to listen!

We had several dental nurses have their say and basically found that they are not recognised for what they do. The pay in a lot of places does not reflect their work. They are not always guided in their career path. They want to progress and are most of the time held back and not encouraged to use the skills they have. When they do upskill, they are not always supported.

The dental nurse role has its own career path and needs to have some structure and encouragement put in place.

Support and guidance

Personally I think the pandemic gave dental nurses time to think. They had time to train and develop and decide if they wanted to stay in a role with the stress of medical emergencies, added PPE, the worry of COVID, paying out for indemnity, keeping up to date with training and courses. And all for a similar amount of pay that someone can get working as a cleaner or working in a supermarket.

Here they would have a tea break, a full lunch break, not have extra payments to pay out for, no PPE to wear and would most of the time finish work at the time they are supposed to. Dental nurses have families they need to support too.

The discussion went on and the Clubhouse room was full with people wanting to speak and give their opinions.

We ended up having three discussions covering this subject. We came to the conclusion that we need change. The job description is out of date, the pay rate in general is out of date and the dental nurses need more support and guidance in how to approach their career advancement.

The business consultant’s view – Jayne Sproson of The Jayne Sproson Consultancy

After 30 years of being in dentistry and 20 years in aesthetics, I have yet to see such a devastating recruitment crisis that I am witnessing now in my role as a consultant and trainer to the profession.

Nurses have called time on their poor remuneration packages and the lack of career pathways (or awareness of this). And also how disrespectfully they are often treated. And before you scream: ‘I treat my team well’, then great! You really should not face the consequences of the problems other dentists are facing. As an ex-practice owner, I know I was paying my nurses more 20 years ago than some nurses receive now. That does not include all the other benefits.

Having been a practice owner, I am very aware of the issues around modelling your business and then a pandemic blowing it apart. However, we all know that as with any crisis some people will always do well out of this one. Even if they are reluctant to admit it.

The impact of this crisis means that I am witnessing practices:

1. Unable to offer previous good service levels
2. Having to spend enormous amounts of their budget on locums
3. Extra time spent on the logistics of this – time is money
4. Focus taken away from their business objectives
5. Plus, I should mention the impact on morale of the team and their resilience during the pandemic who are now suffering from burnout.

Having recruited team members for many practices, I have been able to quantify this cost for practices. We can offer a cost benefit analysis of paying properly and on boarding properly so that you have employee engagement. Or, if you are a dental nurse, then use it as a business case for a rise.

Would you apply?

Whilst we know it isn’t all about the money – a case in point is that last year I advertised for a nurse at £28 per hour with shares in the business and I had two unsuitable candidates apply. Money is still the biggest issue. Remember Maslow’s Hierarchy of Needs? Dental nursing remuneration in many practices does not even cover the basic needs – no wonder dental nurses feel undervalued.

Just imagine you were reading this job advert:

The role includes having to deal with nervous and sometimes rude members of the public whilst wearing full PPE all day.

In addition to assisting the operative in their day-to-day function, you will have responsibility for taking accurate contemporaneous notes for record keeping. These must be compliant with regulatory body guidelines and inspection. You will be responsible for the full cleaning and disinfection with high levels of cross infection control of the treatment room.

You will, on a daily basis, be in contact with hazardous substances.

Expect call outs for emergencies. You will need to stay until the last customer has left and often this means appointments have run over your contracted hours. Ditto for lunch hours. You may get time off in lieu for this at the managers discretion.

Every year you will need to produce evidence of continuous professional development but for some extra qualifications you may receive an extra 50p an hour. Sick pay will be statuary only. But we will pay for uniform which you will have to take home to wash each day. Sometimes you will have to wash and dry all the team’s uniform due to the higher levels of safety required because of COVID-19. This is part of the job role and does not attract any further remuneration.

You must be registered with the professional body. You will pay the same annual retention fee as someone else you work with. But they earn about three to four times what you ever will.

If you make a mistake this could mean your registration is in jeopardy.

Some operatives will not address you by your name but with your job title – you must not take offence.

Customers will often bring gifts for the operative – do not expect any. You can, however, be safe in the knowledge that you will, most months, be paid properly and on time.

We only want committed team players who see what a fantastic opportunity this is. We have air conditioning but presently do not have a staff room.

Forty hours a week at £9.90 per hour depending on experience.

Would you apply?

Longstanding cry

No wonder this is not attracting the calibre of applicants we need, and nurses are leaving the profession – check the register if you are curious about the numbers.

The profession is facing a simple supply and demand crisis – dental practices are going to have to up their game when it comes to pay. We discussed this is my club Dental World. The disappointing outcome was that nurses just do not believe some dentists will change.

I appreciate this is a much more complex issue than I have portrayed here. It is a longstanding cry from the dental nurse profession about pay. However I would say to nurses this: ‘Be part of the change you want to see’.

Moaning and bitching on Facebook gets you nowhere. Asking for help and a constructive way forward might just get you further. If not, then start to look elsewhere for a job. There is plenty of opportunity for you and some with a golden handshake (health alert – but please be careful what you wish for!).

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Claire Frisby can help nurses know their value and demonstrate their worth to the right employer. Get in touch with Claire for more information @theremotedentalnurse.