Giving confidence to save lives
A DCP-led training programme has revolutionised the way medical emergencies are taught to undergraduate dental students, DCPs and NHS staff
Saving lives is not usually in the job description for your average dental professional, but for several past and present students at Glasgow Dental School, that is exactly what they have been doing.
Lezley Ann Walker, dental team tutor at the school, and her colleague Liz Webster who is dental nurse team leader in the restorative department, swell with pride when they recount the story of one current student who came to the aid of a fellow passenger on a busy commuter train at Glasgow Central Station, performing CPR and helping save his life. Liz also describes several other incidences in recent years including a third-year student helping someone at a train station in Manchester, a fourth year who assisted a police officer in attempting to resuscitate a member of the public on Great Western Road and, most recently, a dental nurse in Hamilton who found a man slumped over the wheel of his car and performed CPR.
And, for Lezley Ann and Liz, what sets these students apart are the improvements to the teaching of Basic Life Support (BLS) and medical emergencies at Glasgow which has played a major part in giving these youngsters the confidence to go out and attempt to save lives.
One of my colleagues has noticed a big difference with students from glasgow who have done this training
Ever since the publication of the Resuscitation Council’s guidance on medical emergencies in dentistry in 2006, the subject has been a key part of every dental professional’s annual CPD requirements. However, for Alex Crighton and his colleagues at Glasgow Dental School, they saw this as an opportunity to design a programme of medical emergency training that ran from first year right through to final year, becoming unique in Scotland and one of only a few similar programmes in the whole of the UK. Alex, a consultant in oral medicine and honorary senior lecturer in medicine in relation to dentistry, explained that while, in the past, students had been taught CPR as part of their studies, they now graduate being competent managing a whole range of medical emergencies that could be expected to happen in dentistry.
Iain Robertson, who is a trained medical nurse and resuscitation officer with NHS Greater Glasgow and Clyde, came on board seven years ago when the new undergraduate teaching programme was introduced. And he believes that the change in the training has made a real difference. He said: “One of my colleagues works in the Golden Jubilee and does some work with VT dentists. He has said that he has noticed a big difference with students from Glasgow specifically who have done this training. He said that when they come in it is clear that they know what they are doing and, in his words: ‘You can see that they have been well drilled’.”
Students at Glasgow now receive BLS and medical emergencies training from state-of-the-art facilities in the brand new Life Support Training Facility on level 7. The facility is part of the new Jim Rennie Suite which was opened in October last year.
The programme is mapped out from first year through to fifth and, apart from the lectures and theory from Alex, the vast majority of the teaching is carried out by DCPs Iain, Lezley Ann and Liz.
Alex said: “The training is run by the dental team for the dental team which is much better for the students as they really grasp the idea of team working and the importance of DCPs in that team.
“It is also vital that they learn this is a crucial part of their job.It is not just an additional thing that is quite nice to do. It is actually a core part of the skills to being a dental practitioner.”
And the fact that the hands-on elements are led by two dental nurses and a medical nurse sends an important message. Iain explained: “It doesn’t matter what your job title is, it is about what skills you have and what you can bring to the table.
“When you think about Liz and Lezley Ann, they have become experts because they are teaching this on a regular basis.”
Liz and Lezley Ann also teach hygienist/therapist students from Glasgow Caledonian University as well as dentist and DCP staff at Glasgow University itself. Alex said: “It is important that any member of the dental team can do any of the tasks. In the past it was seen as the dentists’ job to do the emergency management and everybody would stand back and let them get on with it.
“But now everyone here recognises that it doesn’t matter what your job, role or title is, when it comes to this, it is a skill like anything else and the person who knows what to do is the best person.”
Alex continued: “Lezley Ann and Liz are both really good role models for their fellow DCPs, because we often hear people say ‘I can’t do that because I’m a dental nurse’. No, not at all.
“If it is something that you are good at and you have an aptitude for and a desire to do it then there is no reason why a DCP can’t take the lead. Certainly in a hospital setting, but even in a practice setting, there should be someone who is a lead for different areas, and medical emergencies can be one of those and there is no reason why that can’t be a non dentist.
“It is important that it is someone who is interested and good at it rather than someone who has a fancy title.”
And Alex believes that it is good for the dental students to see dental nurses playing such an important role in teaching the subject. He said: “Hopefully they come through as practitioners and they don’t have the attitudes that were prevalent maybe 20 years ago when it wasn’t seen as appropriate for the other members to do.”
Both Lezley Ann and Liz have worked in the Dental Hospital for more than 20 years each and in that time they have worked with and taught hundreds of undergraduate dentists and DCPs. Liz said: “There used to be a wee bit of a stigma that clinicians were the only ones doing medical emergencies and we as DCPs couldn’t do it. But that has now changed.”
Lezley Ann agreed: “When you go back maybe 10 years or so, the older style clinicians probably saw us as the person who sat in the corner with the suction. We were there to fetch and assist.
“But, with the registration, it has made people look at us in a different way. We are valued members of the dental team and, without the dental nurse the dentist can’t fulfil their role. They can’t give the patient everything they need.”
Liz explained: “The whole team should be able to do this and that is what we are trying to encourage. I think what makes it easier for DCPs is that they are seeing Lezley Ann and myself doing this and it puts them at ease. So then they feel comfortable – they say ‘if Lezley Ann and Liz are doing this then why can’t I? So it gives them more confidence to try and attempt it.
“If a patient collapses, you don’t just want one person in the practice being able to help them. It might not be the dentist that is there, it might happen in the waiting room or in the corridor.
“A lot of patients also go into the canteen here so it might happen in there.”
One of the key aspects for Lezley Ann has been the development of the new Life Support Training Facility, which has given them a dedicated room complete with a dental chair and life-sized mannequin as well as a control room, seminar space and storage for all the equipment. While previously Lezley Ann had to move from room to room to teach, she said: “The new facility has given us a huge opportunity because I used to have to carry all this equipment all over the building. I would be asking ‘Where am I today?’ and I would be up and down carrying mannequins to various rooms. So the new facility is fantastic.”
And, Lezley was at pains to point out that, without their colleagues, they wouldn’t be able to provide the high-quality teaching that has set Glasgow apart over the last seven years. She said: “We probably wouldn’t have had as many opportunities if it hadn’t been for Alex and Ian, they keep pushing us and making us believe in ourselves and saying ‘You can actually do this’.
“Without their encouragement, we just wouldn’t be here.”
The new Life Support Training Facility forms part of the £225,000 Jim Rennie Suite that was opened in October last year – the other half being made up of the Clinical Research Facility (see SDM March page 41).
The facility consists of a seminar and training room where the equipment is stored. Off this are two rooms, one featuring a robotic mannequin on a dental chair where medical emergency scenarios can be simulated, connected through a one-way mirror to the control room where the mannequin is controlled and students can be monitored.
Alex Crighton and Iain Robertson were involved in the design and are delighted with how it has turned out. Iain said: “I’m thoroughly delighted with the new facility. With the mannequin in this room here we can give the students a whole variety of scenarios of patients becoming unwell and they have to manage them.”
Alex said: “It was very helpful being involved with the creation of this facility because before we had just a single dental surgery and a room which was for equipment and debriefing. But we didn’t really have the space to actually store all the equipment like we do here.
“The new facility also has a space where we can actually carry out skill training, which needs to be integrated when you are managing an actual emergency.”
Lezley Ann Walker
Dental team tutor at Glasgow Dental Hospital and School. Is responsible for teaching Basic Life Support (BLS) to undergraduate students, university and NHS staff, DCPs and general dental practitioners.
Dental nurse team leader in the restorative department at Glasgow Dental Hospital and School. As well as the daily running of the restorative clinic, Liz teaches BLS and Immediate Life Support (ILS) to students and staff.
Consultant in oral medicine and honorary senior lecturer in medicine in relation to dentistry. Alex developed the medical emergency teaching for undergraduates and, along with Iain, helped design the new Life Support Training Facility.
Resuscitation officer at NHS Greater Glasgow and Clyde. Works at the dental hospital teaching medical emergencies to undergraduate students as well as roles at the Western Infirmary and Gartnavel Royal Hospital.