Sorry I took so long to answer, but I just found your message.
I have been an "Lone Ranger" since 1999, and have been in a hospital/outpatient department since 2004. Like you, we have CT, MRI, xray, Nuc Med, Ultrasound, and a mobile PET scanner. We also do not do conscious sedation (although I've been trained on it), and I end up repeatedly telling JCAHO personnel that, "No, we do not do conscious sedation in our department". They act like they do not believe me, but it is true. The key to a lone RN working in a radiology department is to respect the education, knowledge, and experience that the techs have and learn as much as you can. Then teach the nurses throughout the hospital what the techs do and teach the techs what the nurses do...be a liason between both groups. But most of all give good nursing care and be a patient advocate. The techs will be watching you and learning from you, even if your don't say a word. :spin:
Get your director to get you a membership in ARNA (American Radiology Nurses Association) at arna.net because they have alot of help for you. One thing they have is a "Lone Ranger" support area where you can ask your questions. While you are waiting for that, go to ana.org and obtain a copy (see if the department can reimburse you) of "Radiology Nursing, Scope & Standards of Practice".
There is a wealth of information on the internet to help you understand the various departments (most nurses only have vague ideas of what goes on in the radiology department). That's not egotistical on my part. I also knew little of what went on in radiology myself. When I first came here, I asked the techs what they'd like the nurses to know, got the approval of the rads and director and sent it out to the nurses. It really helped. I also encourage the techs to talk to the individual patient's nurse. Some do, some don't. I've had to teach the nurses that if a patient cannot lie flat or lie still, we probably won't be able to do MRI, CT, or Nuc Med. I've had to advise them that a patient, on NRB or venti mask at max flow, who desats if you lie them down, will not be able to do the exam.
I did not have an area to get the patients ready for biopsies, drainages, and aspirations, so I worked out an arrangement for the single day unit to prep and recover the patients. It has worked out very well.
Since my director is of a radiology tech education background, we worked it out that the director of the single day unit (an RN) to be a part of my annual evaluation. She starts it and my director completes it, then I meet with both of them. (I am fortunate that my current director worked as a nursing tech before going into radiology school).
I also cover for an outpatient facility in the building next-door (starting IV's, monitoring patients with mild allergic reactions, and checking extravasations). We only do mild sedation in MRI at the hospital, not the outpatient facility. The single day or emergency department nurses help cover in my department when I go to the outpatient facility.
When the main CT scanner goes down, we have to transport patients to the outpatient department. If they can go by wheelchair, I do as many as I can, but the floor nurses need to do some also. If they need to go by stretcher, they go by ambulance, for safety reasons.
Getting patients ready for invasive procedures is another aspect of my job. By making sure everything is in place before the patient comes down, I've taught the floor nurses how to get a patient ready. It helps now that alot of the forms are on our hospital intranet.
ICU transport is also part of my job. My director supports this and the ICU nurses appreciate it. In the process I've taught the nurses there what goes on in radiology and how to get a patient ready for an exam or interventional procedure. I have an ICU background and know how hard it is to have to go off the unit with a patient while your other patient(s) also need your care. Even though someone else is watching them, sometimes they don't have the time to do the ongoing care the patient needs and you have to play "catch-up" when you get back.
I also do chart audits, but that has had to take a back seat as the radiology department takes up too much time to do that.
Updating radiology department policies and procedures is part of my job. Use nursing standards of care to help you in knowing what to include or leave out.
We have gotten the hospital to use the Purple Power PICC made by Bard. It can be used with CT/MRI at up to 5 ml/sec and up to 300 psi. It has made it so much better for both patients and techs alike.
I have been proactive in obtaining a nurse to cover me on my days off and sometimes when I need sick time. It was in my favor to find a nurse interested in working in the department. Then I could train them to the department. Of course, I got my director's permission to use them.
Currently I am working on getting an MRI compatible IV pump. The one I want has a ceramic motor that is not affected by the MRI magnet, nor does it affect the MRI magnet. It is part of my long-term goal to have anesthesia in MRI for claustrophobic patients, patients that cannot lie still for the exam (confused, tremors, etc), and ICU patients on drips. We cover a broad regional area that can support this and I am collecting data to prove this.
Whatever you do, don't get discouraged. There are answers out there and there are nurses to help you. You can do it. :smiletea2: