Medical Radiation Practitioners
Operate X-ray and other radiation producing and imaging equipment for diagnostic, monitoring and treatment purposes under the direction of Radiologists and other Medical Practitioners.
An afternoon in medical imaging
You are a radiographer in a hospital imaging department, taking diagnostic images for patients sent from wards, the emergency department and clinics. It is 1pm. Requests are arriving faster than you can clear them, two machines are in use, and a nervous patient is waiting in the room. The next hour will test your judgement.
Choose what you would do. Then see what happens. There are often good reasons for each choice.
I've got a patient on his way down in a lot of pain. He'll probably struggle to get into position, but I need that image fast. Please just get it done and don't worry about it being perfect.
Take the first image you can get, since the doctor said it did not need to be perfect and time matters
The image is too unclear for the doctor to use. The patient, already in pain, has to be moved again for a second try, which is worse for them than doing it carefully the first time.
Reassure the doctor, then position the patient gently and get a useful image first go
You talk the patient through each move, support the sore limb and get a clear image. It takes a few extra minutes, but the doctor has what is needed and the patient is not hurt more.
Ask the doctor to send a nurse down to help hold the patient in position
Help arrives and the image is usable. But the nurse is pulled from other patients for twenty minutes, and you could have managed with a small support and some patience.
You've looked at the picture. Please, can you just tell me what you see? I'm so worried and I can't wait to see the doctor. Is it broken? Just give me a hint.
Explain kindly that the doctor will go through the results and say when she'll hear back
She is anxious, but she understands. Knowing who will tell her and when makes the waiting easier. You've been honest without leaving her alone with her fear.
Tell her it looks fine so she can stop worrying
You are not the person who reads the images for diagnosis, and you might be wrong. If the doctor then finds a problem, she feels misled and trust is lost.
Say you cannot say anything at all, then take her back to the waiting area and ask her to sit tight
You stay within your role, but she leaves feeling brushed off. A bit of explanation about the process would have helped a frightened person.
The form for the next patient says chest, but the patient says his shoulder is what hurts. The corridor is full and the doctor is hard to reach. Should I just take the chest, like the form says?
Tell him yes, because the form is the official instruction
The wrong area is imaged, and the patient is exposed to radiation he did not need. The doctor has to request again, and everyone loses time.
Tell him to take both, to be safe, and sort it out afterwards
The patient has more radiation than necessary because nobody checked. Extra images are not free, and playing safe in this way adds to the risk.
Show him how to confirm with the ward before taking any image, and let him make the call
He rings, learns the form was wrong and gets it corrected. The patient has the right image, and Ellis has learnt a habit that will stay with him.
How it went
The queue clears by mid-afternoon and the room goes quiet. Radiography combines technology with care for people at their most worried, and a habit of checking every time. Do you think you could stay calm and careful with a busy corridor behind you?
This is a simplified, fictional situation to help you explore. It is not professional instruction or a test of your ability.
Case study: The form that said the wrong side
A fictional case set in the medical imaging department of a fictional regional hospital.
The situation
Tariq was a radiographer on a busy afternoon in the imaging department. A request form came through from the emergency department for an x-ray of a patient's left wrist. The patient, an older man named Mr Delaney, was sitting in front of him with his right wrist swollen and held against his chest. The emergency department was busy, a queue of patients was waiting in the corridor, and the doctor who had written the form had gone to another ward. It would have been quick to simply take the image the form asked for.
What they did
Tariq stopped and checked the form against the patient. He asked Mr Delaney which wrist hurt, and confirmed it was the right. He rang the emergency department to confirm the request before taking any image, so that the patient was not exposed to radiation he did not need. A nurse confirmed the mistake and a corrected form arrived within minutes. Tariq took the right image, wrote a note in the system about the correction, and told his supervisor.
How it turned out
The correct image was taken. It cost about ten minutes and some impatience in the corridor. Tariq's supervisor thanked him and used the story at the next team meeting to remind everyone to check the patient against the form every time.
What would you do?
- Why is it worth slowing down when a queue is building?
- How would you feel about ringing a busy doctor to question their form?
- What are some ways a department could stop this mistake happening?