Radiology Nursing: Interview with Ronald Gore, RN
Assisting with diagnostic and interventional procedures
Ron Gore, RN
Ronald Reagan UCLA Medical Center Dept. of Interventional Radiology
How did you become interested in the specialty of radiology nursing?
In the mid-1990s I was working registry in the ICU, CCU and ER at various local hospitals. One day I was asked if I would work in the radiology department at UCLA. I explained to them that I had never worked in any labs before, but they said I would be trained. After I arrived, I saw all the equipment and monitors suspended from the ceiling and control room. I began to think, “what did I get myself into?”
The charge nurse came over and introduced herself. She gave me an orientation of the suite, explained radiation safety rules and handed me a lead apron. She reassured me that I‘d be fine, with the instruction to just take care of the patient. I thought “no problem there.” I worked in interventional radiology at UCLA for several weeks through the registry, and one day the charge nurse offered me a staff position. I accepted and here I am 13 years later.
What is it that you like about this area of nursing?
I find the work in interventional radiology fascinating. It is a whole new world of nursing. It is much different from working on the floor where you send your patient off to surgery and when they return everything is all better. In IR, the patient comes in with a diagnosis, you see the problem on the monitor, and view the treatment live right before your eyes.
What experience or certification is required?
Here at UCLA you need to have experience in either critical care or emergency nursing, and ACLS and PALS certification. You must be able to manage patient care at all levels, from the floor patient to critical care.
How has technology impacted your work?
With the advancements in technology, treatments that once required surgical intervention can now be treated non-invasively through interventional radiology. So there is an increased demand for IR procedures which means we are seeing more patients. Also, we are now getting patients at all stages of illness, ranging from early detection to palliative care.
Keeping HIPAA in mind, is there a patient story you can share that illustrates what you do?
One case that comes to mind was a 50-year-old male who arrived to IR accompanied by several members of the stroke team and his family. After getting patient information and providing reassurance, I explained what to expect upon entering the IR suite with its two large fluoro cameras and ceiling monitors. I told him that I would be monitoring his vitals and providing oxygen via nasal cannula. After the consents were signed and no more Q&A, we directed the family to the waiting room.
The IR tech and I moved the patient onto the fluoro table and connected him to the monitors. While the tech shaved and prepped the groin area, I assessed vital signs, performed a quick physical assessment, checked IV sites, inserted a Foley cath, and pulled any medications that might be needed during the procedure, usually vasopressors, anti-anxiety, thrombolytics and something for pain.
What makes all the chaos, anxiety and hard work worth it is seeing the occluding thrombus removed and the restoration of cerebral blood flow — and later hearing that the patient fully recovered without any neurological deficits.
What are your professional goals?
I have achieved one goal, and that was to become a Certified Radiology and Imaging RN and a member of the Association for Radiologic and Imaging Nursing. Likewise 90 percent of my coworkers have accomplished the same goal. Our next plan is to provide a series of classes or lectures on the role the interventional radiology RN. Many of RNs on the floor have the misconception that all we do here is start IVs.
What advice would you give to a new grad who wished to enter this specialty?
Like any job, one should do their homework, find out the pros and cons, and if possible visit the IR department to see if IR nursing is really something they want to do.
Did You Know? Radiology Nursing
Radiology nurses practice in acute care and outpatient environments, assisting with interventional and diagnostic radiological procedures for a wide variety of patients, ranging from infants to the elderly.
Radiology nurses assist with ultrasonography, radiation oncology intervention, magnetic resonance imaging, cardiac catheterization, mammography, angiography, PET scans, fluoroscopy, vascular/ neuro interventional radiology and other procedures. The radiology nurse must provide care and comfort to the patient, provide education regarding pre- and post-intervention care, and screen patients regarding contraindications for procedures involving contrast dye and nuclear materials.
Radiology nurses provide assistance with conscious sedation, the monitoring of vital signs, intravenous access and administration, bladder catheterization, assessment and monitoring of patients before, during and after procedures, as well as administration of contrast dyes and other intravenous materials. Documentation is another important contribution of the nurse, as well as continuity of care and patient safety.
The development of policies and procedures is within the purview of the radiology nurse, including those relating to patient screening, patient care, and specific aspects of radiology intervention, such as anticoagulant complications, conscious sedation protocols, renal protection protocols, drug interactions, risk management, safety, cost containment, and rapid response protocols in the case of emergencies.
These highly-skilled nurses may be employed by hospital radiology departments, outpatient womens’ health facilities, cardiac clinics, and other facilities offering radiological intervention. They may also be utilized in endovascular clinics, wound care clinics, and other inpatient and outpatient units.
This is a technical nursing specialty requiring great attention to detail, highly-developed assessment skills, and the willingness to collaborate with radiologists, surgeons, and other specialists involved in often complex patient care. Some nurses enter the specialty from other highly-skilled nursing specialties, such as trauma, emergency medicine and critical care. Many facilities encourage nurses to pursue certification, although not all require it.
Position papers posted on the website of the American Radiological Nurses Association elucidate examples of the challenges faced by radiology nurses. For example, in working with morbidly obese patients, respiratory depression in reaction to sedatives and analgesia, positioning limitations, and other unique complications may be encountered and overcome with skill, clarity of mind and innovative thinking.
Association for Radiologic and Imaging Nursing: www.arinursing.org
Journal of Radiology Nursing: www.radiologynursing.org
Society of Interventional Radiology: www.sirweb.org
American College of Radiology: www.acr.org
The American Radiological Nurses Association promotes and advocates for this particular clinical nursing specialty. The Radiological Nursing Certification Board administers the certification exam and issues the corresponding credentials.
Initial certification is valid for a period of four years. Continued certification is achieved through a recertification exam or by fulfilling continuing education requirements set forth by the board.
Those nurses seeking certification must hold a valid RN license, and have practiced as a licensed registered nurse for a minimum of 2,000 hours in radiology nursing over the previous three-year period, and two practitioners must verify that these requirements have been met. Fifteen to 30 hours of continuing education must also have been undertaken in the previous two years, with documentation required. BLS, PALS, NALS and ACLS certification and recertification are not counted towards radiology certification and recertification. Fees for certification range between $300 (for members of ARIN) and $425 (for non-members of ARIN).
Keith Carlson, RN, BSN, is a registered nurse, coach, writer and blogger. He maintains an award-winning blog at http://digitaldoorway.blogspot.com, and offers wellness and career coaching for nurses at NurseKeith.com.