Dually Qualified Hygienist Therapist
Question:
I was wondering if anyone else employs a dually qualified hygienist/therapist who works almost exclusively as a hygienist. In our practice (which is completely private) there are issues developing as a result and I would be grateful to find out the experience of other practices e.g. nursing support: we have a nurse working alongside the hygienist/therapist – not only is this expensive but it is quite boring for the nurse. Does anyone else employ a nurse to work with a hygienist and if so how do they manage this?
Answer:
We have 2 hygienists/therapists and 1 hygienist at our mixed practice. Having therapists did not work for us, they took a lot longer, met with more resistance from patients who felt they were getting a lower standard of treatment and generally we found the dentists were having to redo some of their work! I agree it's very boring for a nurse to work with a hygienist and apart from any new nurses who are ideal for hygiene support while they get to grips with suction etc; our hygienists very rarely have a nurse. Someone will set the surgery up and clean down at the end of the session but our main concern is cost. It is not cost effective for us to employ a nurse solely for the hygienist. We usually ask the decon nurse to pop her head in every now and again to the hygienist and this usually works ok. Our hygienists are very good and have now accepted that they don't have a nurse and we don't have a problem.
Answer:
We are a completely private practice and employ 4 hygienists altogether on a part time basis sharing two surgeries. The two employed by us are exclusively hygienists and the two self-employed are hygiene / therapists.
We have two nurses who work with them and it works well for us. The hours suit the nurses and by having a nurse to support the hygienists, allows us to see our patients for 15 minutes each.
I haven’t had any problems with this arrangement in my time here with the nurses if I’m honest as we made it clear about the role when we took on the staff and the job description suited them better as it was less stressful etc.
Answer:
The only minor problem I have encountered with Therapists is that the patients don’t want to see them. They feel they pay good money for a dentists to see them and their children and don’t want to be referred to anyone else that’s not a dentist so they don’t get to practice as a therapist with us. We are looking to create more awareness of the role of therapists through our newsletters etc, but I reckon this will take a long time to change this amongst our patients.
Answer:
Yes we do employ a nurse for the hygienist/ therapist as lone working according to our defence union and the BDA would have been an issue should anything arise. Our hygienist works in 2 other practices and this is the only place she gets a nurse.
Answer:
Our nurses work on a rota basis so no one nurse is saddled with the hygienist all the time. When the nurse is working with the hygienist she also carries out admin duties to utilise the time.
We worked out that the extra time the hygienist needed to turn the surgery around would almost cover the cost of the nurse.
Answer:
I know what you mean we have had similar issues here. We have solved it by asking a nurse to go in and help clean and decontaminate between patients. Have had to explain that this is the only way we can do it for the reasons you mention.
Answer:
We have a hygienist/ therapist, we separate her working days, Tuesday is therapy where she has a nurse and Wednesday is hygiene where she doesn't have a nurse. We have a full time hygienist and a 2 day part time hygienist, neither of them has a nurse.
Answer:
We have always employed a nurse to work with the hygienists here. We now have a dual qualified person as well now.
We have always started our trainees in this location, so that they can begin to understand the principles of cross infection, practice policies, etc.
If there are any spare sessions, once the trainee is a bit more experienced, we have them in the surgery with the head nurse to begin to learn more, ready to start the NEBDN course.
Once more experienced, my nurses are happy to swap around for a few days, to keep the nursing skills up for the 'trainee'.
Yes, it is boring, but it is the only way to learn all the aspects and you have a nurse already trained to your standard should any of your qualified nurses’ leave.
Answer:
We are a fully private practice and have a hygienist who does 2 days a week with a nurse and a therapist/hyg who worked one day a week until this month when she left due to children. She also had a nurse. The Therapist was paid about £6 per hour more than the hygienist because of her qualification but she mainly did hygiene work and the occasional filling. It can be boring working in hygiene for the nurses but we work on a rota basis and I try not to put the same nurse in for more than once a week. Our nurses quite like it as it is an easy day for them. We are not at present going to replace the therapist.
Answer:
We have 2 hygienists and they both have a nurse on a permanent basis. The nurses who are with the hygienist do tend to have an easier day but they are on a rota system of working in the same surgery for 2 weeks so every 6 weeks they get 2 weeks with the hygienist on 3 days of the week. Most of the girls dont seem to mind and they do extra jobs like checking stock etc whilst in there.
Although it is very expensive to have a nurse with the hygienist it is a good service to offer the patients and helps keep on time and aids the hygienist with the note taking, advice, charging and plaque scores and BPEs etc.
Answer:
It is tricky to manage we have the same situation, but recently have a part time nurse off on maternity leave which we have not covered. This means some sessions the nurse operates the central steri room & nurses for our hygienist/therapist. The only time this doesn't seem to work is if therapy is booked in but this is so infrequent it is not worth the cost of another nurse.
We have also used trainees in the past, but as they become more experienced they do become board.
Answer:
We have 2 hygienists and one dual qualified who works only as a hygienist. None of them have a nurse, never have had, unless a dentist is on holiday and there is absolutely nothing else that needs doing.
I made it clear at interview that we needed a hygienist. not a therapist, so there have never been any issues around what she actually does.
I am, however, aware that these dually qualified individuals are by and large under used,and complain they will loose their skills – probably true. But the hard fact is that Hygienists are in great demand, whilst as of now, Therapists aren't.
Answer:
We no longer have a Therapist working at our practice, but up until 2010 we did. As you mentioned, our Therapist also ended up doing a lot of hygiene work. I found there to be three factors for this, the first was obviously the need for the Hygiene appointments and lack of time with our ‘solely Hygienist’ available in the appointment book. It was difficult debating the decision on increasing the hygienist book but then not having enough work to fill the Therapist book.
The second being that our therapist used to work for us as a Hygienist and our long standing patients LOVED her and wanted to stay seeing her!
The third factor was that it took our dentist quite a while to get into referring treatment over (she found it hard letting go) which impacted on the time left available in the book that required filling – hence the time being used for hygiene work. This then created an issue on hourly rates as our hygiene rate was lower than our therapist rate.
Nurse wise we rotated the nurses around and all the nurses had at least one session with the hygienist, most reported back to me that it was nice to have one day that predictable and ‘easy’. We provide nurses for all of our clinicians (including the hygienists).
As I said we no longer have a Therapist as she re-located to Devon, but when she was here it did get to the point of assessing our options. I think the clinicians referring HAVE to be behind the idea otherwise they just won’t do.
May 2012
