Task 8: Determining organisational factors influencing behaviour at work To what extent do organisational factors appear to influence health and safety behaviour positively and negatively at the surgery? Note: You should support your answer, where applicable, using relevant information from the scenario. SCENARIO You work as a dental nurse as part of a small team in a dental surgery. The surgery is privately owned and run by a dentist. You have only worked there for a few weeks, and this is your first job after qualifying as a dental nurse. Your main role is to assist the dentist as they carry out treatment, such as tooth repair and extractions, on patients. Also working at the surgery are a dental hygienist (who carries out preventive work such as teeth cleaning), the hygienist's assistant and two receptionists (who, due to its small size, also help out with daily cleaning of the surgery). The surgery is open for business from 09:00-17:00, Monday to Friday, and from 09.00 - 13.00 on a Saturday. However, only you and the dentist work on Saturdays. There have been no recorded accidents in the 10 years that the surgery has been operating. The surgery occupies a small, two-storey building. There are three car parking spaces at the rear of the surgery and two disabled parking spaces at the front. As you enter the surgery through the front door, there is a reception area to the right with a reception desk and a small waiting area, with seating for patients. Behind the reception area is the dentist's treatment room. To the left of the entrance is a stairway that leads to an upper floor, where there is a room for the hygienist and their assistant to carry out their work. Outside the hygienist's room is a small seating area for patients. There are washroom facilities upstairs and downstairs that are shared by workers and customers. While the dentist has a full diary on most days, they intentionally take time to see and speak to all workers about safe working each day. This develops trust and the workers really appreciate it. Your dental nursing qualification included modules on general health and safety. You completed the NEBOSH General Certificate as part of your studies. As a result, you developed a keen interest in health and safety, and are part way through studying the NEBOSH Diploma. When you were being interviewed for the job, the dentist had commented on your health and safety qualifications and had asked you if there was anything at the surgery that could be improved. You had started by saying that the surgery was very clean and tidy, which was good. But you had also said that although posters about dental hygiene were displayed on the walls, there was nothing displayed about health and safety - no notices, posters or policies of any kind (including for emergencies). After you have been working at the surgery for a few weeks, you have a meeting with the dentist. The dentist says that speaking to you at the interview made them realise how important health and safety is to their business. You start talking about the passion you have for health and safety. The dentist says that these were some of the reasons why they hired you. Since you joined the organisation, they have begun to really value your advice about health and safety, especially how you quickly identify issues and very often come up with workable improvements. This empowerment drives you on to work even harder. The dentist asks you about other improvements that could be made. You explain to them that they should at least have a health and safety policy, as it is the law. You outline other benefits of such policies and what they are designed to achieve. As you talk further, you ask to see the workplace risk assessment and the dentist retrieves it from a locked filing cabinet. The dentist explains that it was the best they could do in the time they had available. They downloaded an example of a dental surgery risk assessment that they found on the internet. You quickly look through it with the dentist, asking questions to clarify. You realise that some of the risks in the risk assessment are either not relevant, or not controlled in the same way in your surgery. The dentist agrees and asks you to revise the risk assessment to make it better suited to the surgery. You admit that you can do most of this. You still have only a basic understanding of some of the activities in the surgery from the short (1 hour) induction training you received when you joined. You lack experience in other areas. You therefore suggest that it would be a good idea to involve other team members in this too, but you might also need advice from an expert consultant. In the past, the dentist had occasionally used a health and safety consultant when they had not felt confident to tackle a specific health and safety issue themselves. On this occasion, the dentist telephones the consultant who confirms the need for a statement of general policy within a health IG1_IGC1-0017-ENG-OBE-QP-V1 Sept22 NEBOSH 2022 page 2 of 5 and safety management system. The consultant also adds that there are benefits in consulting and involving workers in health and safety matters like this. Following this conversation with the health and safety consultant, the dentist plans a health and safety meeting for the first time. The intention is to close the surgery for any patient treatment for a single day in about a month's time. The dentist books the date in the diary for all workers to attend. Health and safety subjects will be discussed, inviting input from all workers, when setting health and safety management objectives and specific goals for the coming year. This includes discussions on health and policy development, more specific risk assessments, and procedures. The following Saturday morning, the dentist, assisted by you, is finishing a complicated series of tooth extractions and repairs on a patient. This required anaesthetic injections to the patient's gums. The dentistry has taken much longer than anticipated and required a good deal of physical strength and concentration by the dentist for several hours. This is in addition to an already very long and busy week. The dentist finally finishes the work. The time is now well beyond 13:00. You hand the patient a plastic cup of mouth-rinse to thoroughly clean their mouth and help promote healing. You have been taught, although this is not written down, that you should monitor the patient while they rinse. This is because it can be difficult to rinse and spit out effectively while parts of the mouth are anaesthetised. Any spillages can therefore be mopped up immediately. However, on this occasion, the reception desk telephone rings and you are asked by the dentist to answer it. You go out to the reception area while the dentist updates the patient's treatment notes. After dealing with the call in the reception area, you hurriedly return to the treatment room. Unfortunately, you slip on a pool of mouth rinse that the patient had inadvertently spilled onto the floor, striking your upper arm and shoulder hard against a nearby work surface. You experience a lot of pain in your arm and shoulder. The dentist tries to get you up on your feet, but you stay in a sitting position, cradling your arm. The dentist has no idea what to do. You whisper to the dentist that they should probably call for an ambulance, as you think you may have broken your collarbone. The hospital later confirms this self-diagnosis.