another new Rad RN-in need of help/advice
0Jun 6, '06 by skiingRN99hello to all,
recently found this site after transferring to radiology from the ed. like so many others here, i am the only rn and i am responsible for getting this program started. i have lots of questions and would love any help/advice i could get. first thing is informed consent. our hospital policy states that md is to obtain consent. to date the rad techs have been explaining procedure and consenting pts before the radiologist even see the pt. does anyone else do this? i know i don't feel comfortable doing this and the rad techs have expressed the same. also would like to know do techs have to chart sl starts? no one can tell me this and there is no policy for this. i have many more questions but will wait to ask. i have been in touch with our sister hospitals but they are run completely different than the one i am at so couldn't get all that i needed. i have also purchased the core curriculum book from arna. there are many more proceudres in that book than what we do but it is helpful! would appreciate any advice/info anyone can give me. thanks.
0Jun 6, '06 by dianah, ADN Senior ModeratorWelcome to the BB and to Radiology Nursing!!
Re: informed consents. Our hospital policy (when I worked Radiology) was the same as yours: MD obtains informed consent. However, our Radiologists requested we "educate" the patient about the procedure, and then the Rads met the pt, asked if the pt had any questions, and handed the pt the form to sign WE didn't have the pt sign the consent. I suggest you contact Risk Mgmt for guidelines/help changing current practice, this is a legal issue.
Have you tried a Google or Yahoo or Vivisimo search re: informed consent? Perhaps with key words "JCAHO informed consent" or something similar. Vivisimo is an interesting search engine, which will cluster the results for you, so you may not have to wade through as much unrelated material to reach the answers you want.
Re: SL's. that's a tough one. We nurses discussed amongst ourselves how we might document the out-pt SL's (for CT, IVP, etc) but never quite came up with a plan. What are your sister hospitals doing? for that matter, see what the other area hospitals are doing (I know, conducting polls in your "spare" time is hard, but it's always enlightening). What are the requirements? What would you chart as a floor or ICU nurse? Is there a generic template the hospital uses, or, you could develop your own (through forms committee, etc) -- make it simple (I love check-boxes!).
I work exclusively Cath Lab now, so am not "up" on Radiology anymore (but it's still interesting!). I hope someone else here can help you more. Good luck! -- -- DLast edit by dianah on Jun 6, '06
0Jun 7, '06 by TNnursejaneHi! Welcome to rad nursing. As far as consents, I am very lucky because our radiologist come in to talk to our patients before the procedures and then we obtain consent and the radiologist signs it.
As far as documenting. find out what your hospital expects. The only time we document is when we have an interventional procedure or a procedure where we use contrast. We have to do an assessment for the contrast and document how much contrast we use. It's a form they have been using before I came along but it works. I'm going to revamp it.
I'd like to join ARNA and order the curriculum. I've heard it is great.
Good luck and welcome to the boards!
0Jun 8, '06 by skiingRN99i have had some luck with the informed consents. i pulled out the p&p manual for the hospital and showed the radiologist what he is required to do and i think things will go smoothly with him for a while! he has been spoiled by the rad techs, who didn't realize that the md's needed to get those consents. as for the sl charting, i called some other hospitals including my sister facilities and it seems that either the ct techs, etc. do not chart anything or the nurses start them and chart on their notes if they are going to be with the pt. otherwise nothing gets charted. i guess i have been in the er too long! the techs had to chart their sl's in our notes. as for charting contrast, the only place this gets charted is on the requisition for the test and faxed to pharmacy and the doc's chart it in the progress notes. that's it.
i am in the process of creating my own documentation forms, which has been more challenging than i thought! i have gathered many forms from my hopspital, sister hospital and others near me so i figure i will do like so many others and just chart if i am in a procedure and play it by ear for the rest. jacho is not due back for 3 yrs so i think i may have some time! wish me luck! thanks for the responses. i just love this site. so much info here.