Covid-19 crisis – dental nurses on the frontline: a report
The coronavirus has devastated the world and thrown a global curve ball to healthcare everywhere – and dentistry is no exception.
As routine dental care ended throughout the UK, news spread of the need to redeploy members of the dental team to help in the fight against Covid-19.
In England, volunteers have been asked to respond to an NHS survey in a bid to boost numbers coping with the devastating effects, whilst some dentists and teams have already stepped forward to help with local urgent and emergency care.
Here, we invite two dental nurses to share their experiences on the frontline.
Amanda Hunter works as a dental nurse on the paediatric department at London’s King's College Hospital. She qualified as a dental nurse in 1992 and subsequently gained additional qualifications in radiography, inhalation and intravenous sedation, oral health education and implantology.
Amanda is now on the frontline against coronavirus. On St Patrick’s Day, just six days before the Prime Minister imposed the UK lockdown, she had her call up.
She says: ‘I was asked about the additional skills I had that could be used in the main hospital to help during this period of Covid-19. I left the form blank but mentioned that, when I was in my 20s, I worked as a health care assistant.’
One day later, she was asked if she would be happy to be redeployed across to the main hospital to help the nurses burdened with the growing number of patients receiving treatment for the virus. She says: ‘I, of course, agreed.’
But Amanda was not prepared for what she experienced – and, after a long day, left for home feeling shell-shocked. She says: ‘To see someone struggle badly for breath will stay with me for a very long time.
‘I helped the nurse bathe one patient and helped changed the bed. I remained calm and put the oxygen mask back on the patient while reminding them to take “nice calm breaths”.
I heard the doctor asking for Midazolam and, of course, realised that this patient was going on a ventilator. They were then transferred to the respiratory ward. I thought this was just a bad flu virus and was mad at myself for not finding out more about it.’
Amanda left that evening overcome with emotions and felt she wanted to share her experience.
The following day, however, Amanda was back on the wards – but this time with a plan.
She says: ‘I explained I was a dental nurse and undertaking cannulation or phlebotomy was not part of my scope of practice, but that I could work alongside a nurse and support them.
‘I then spoke with the ward matron and asked if I should change my hours to start at 7.30am for shift handover, so that I knew who has been admitted and why. I also asked if I could have more up-to-date information on coronavirus – information that, as we know, can change daily.’
So committed was she that Amanda immediately volunteered to help at the newly built NHS Nightingale Hospital at London’s ExCeL Centre in the Docklands that is offering care to the huge number of patients receiving treatment for Covid-19.
She explains: ‘I have been told I will get information soon. In the meantime, I now work on the wards with the nurses and doctors on a shift pattern and will help as much as I can. My duties include observations – blood pressure, respiratory breaths, temperature and blood sugar – giving bed baths, changing beds, helping to feed patients, dealing with dressings and responding to alarms, such as telling the nurse what fluids are running out on a drip.’
Amanda adds: ‘They are finding new things about this virus every day and I have learnt a lot about reliable resources – Public Health England, for example, has a poster called When to use a surgical face mask or FFP3 respirator, which is really helpful.
‘We need to know and have access to essential PPE. Covid-19 lives on skin and clothes for up to 15 minutes, although we do not yet know exactly how long it lives on hard surfaces.
‘We also all need to be mindful to act sensibly – for example, keeping our distance from others, washing hands regularly, using alcohol gel and then moisturising to stop the skin from breaking and taking our mobile out of its case and wiping with a soapy cloth. There are so many things we can all do to help.
‘As dental nurses, we can help. This is such a difficult and scary time but if we could all just pull together and help each other, we can and we will get through this. If people have a better understanding, then we are all better prepared.’
Dental nurse Cherie Walker trained in general practice and has been working in community dental service in Wales for 10 years.
Cherie works with Dr David Johnson, a community dental officer and a member of the British Society of Paediatric Dentistry’s executive committee.
She is nursing for him as he provides dental treatment in what he describes as a ‘hot clinic’, based at his usual community dental clinic in South Wales and now a dental facility dedicated to patients who might need aerosol-generating procedures and/or who might have coronavirus.
He says: ‘The role of the CDS is to care for vulnerable patients. We regard anyone with coronavirus symptoms as vulnerable.’
Cherie’s work involves working with adults and children with additional needs and includes treatment under sedation, theatre assistance, the domiciliary service, and working on a mobile dental unit based at a forensic mental health hospital and another at school for children with special needs.
She says: ‘It’s a very anxious time for everyone working on the frontline and it looks like the way of working in dentistry could change for some time to come.
‘I think it is important more now than ever that we look out for each other be considerate of each other’s needs and safety.’
The triaging system is managed by the health board in conjunction with 111.
Cherie says: ‘I have been fit tested to ensure no aerosols permeate through and we are currently waiting on our FFP3 masks to be delivered.
‘I would say to other dental nurses who might be redeployed or asked to work in similar circumstances that it is okay to feel anxious – you’re going to be working in a new team in unfamiliar working environment.’
She advises: ‘Should you find yourself having to train to work at a “hot clinic”, don’t be afraid to ask questions – there are no wrong ones. Walk though procedures and have dry runs until your 100% happy. It’s going to be a very different way of working and my advice would be to prepare for everything before the patient arrives so there’s no surprises to ensure safety for yourself and the rest of the team.
Fiona Ellwood is patron of the Society of British Dental Nurses, which has set up a 24/7 helpline for dental nurses concerned about the effects of the Covid-19 crisis and its wider issues.
She says: ‘We have been involved in calls, written responses to papers and key decisions and are battling every day on key issues for dental nurses. We asked very early on for the GDC to waiver the ECPD deadlines and look at the ARF and opened up the helpline when this all started – and it is open round the clock.
‘We know things are difficult at this moment in time and, although we cannot fix it, we promise dental nurses that they do not have to face these times alone.’
The SBDN is continuing to stay in touch with the GDC, the BDA, LDCs, FGDP(UK) and the All-Wales Faculty for Dental Care Professionals.
Additionally, for DCPs in Wales, there is support at the All-Wales Faculty for Dental Care Professionals at https://awfdcp.ac.uk/covid-19/faqs.
The SBDN helpline is available 24/7 on 07437 481182.
To help stop the spread of coronavirus, you should only leave the house for 1 of 4 reasons:
- Shopping for basic necessities, for example food and medicine, which must be as infrequent as possible
- One form of exercise a day, for example a run, walk, or cycle – alone or with members of your household
- Any medical need, or to provide care or to help a vulnerable person
- Travelling to and from work, but only where this absolutely cannot be done from home.
Author: Julie Bissett