Participation, Power Imbalance, and Speaking Up

Dental nurses often attend meetings with dentists, practice owners, associates, reception staff, managers, hygienists, therapists and other colleagues. Formal hierarchies can make it harder for some people to speak, especially when the chair controls rotas, pay, references or day-to-day working relationships.

Speaking up in a meeting need not be confrontational. Keep it specific, respectful and focused on patients. Useful phrases include: "Can I check something from the surgery perspective?", "I am worried this may affect patient safety", "Could we agree who is responsible for that?", and "I may have misunderstood, but I noticed this has happened more than once."

When meetings discourage participation

• One person speaks for most of the meeting.
• Questions are treated as criticism.
• Dental nurses are asked for input only after decisions are made.
• Concerns are joked about, minimised, or delayed repeatedly.
• Actions are agreed but never reviewed.

Senior dental nurses and practice nurse managers can interrupt these patterns. A fair chair slows the discussion, invites the person closest to the process to speak, and separates concerns from personalities.

For dental nurses preparing to contribute, it helps to write the key point down, state the patient or safety impact, and decide the outcome you want. If you are worried about raising it in the room, speak to the chair beforehand and ask for the item to be introduced in a structured way.

Patient-centred phrases

• "Can we look at this from the patient's point of view?"
• "I am concerned we do not have a reliable process for this yet."
• "Could we agree what should happen next time?"
• "Would it help to check the records before we decide?"

Supporting people to speak

Speaking up is more likely when meetings are structured to hear different roles, not only the loudest or most senior voice.