Nurses, can we please make x-rays safe for everyone involved by standing up to bosses?

[KimJJ]

Earlier today I was so angry that I could have spit nails.  Like a number of times in the past, I was told this morning to put on a lead shield and stand next to my elderly parent while she was being x-rayed in a standing position (the position that her doctor wanted her in).

And once again, as hard as it was for me to do, I stood up for my rights (and for common sense) and said no to (me) getting radiation for no good reason. 

What happened after that is the part that made me angry. The diagnostic technician said to me, "Well, we don't have a walker here."  So, I offered to go out to our SUV and get my mom's walker. (We had brought her in her wheelchair today because it's a LONG walk from parking lot to orthopedist's office.) But the tech wouldn't let me even go get the walker!  Instead, she left the room, and when she came back, she said she had talked to the doctor's medical assistant who had told her that the x-ray could be taken lying down. She also said something along the lines of "we sometimes do it that way when it's an elderly patient".  

I replied that if the orthopedist preferred for my mom to be standing up during the x-ray of her knee, then that's how the x-ray should be taken. Visibly angry, the tech told me that Mom and I could go back to the exam room then and discuss it with the doctor/staff. I replied, "fine, we're in no hurry, let's go". 

(BTW, the ending to this story is that when the doctor came back into his exam room, I explained that the x-ray didn't get taken and why. He went down the hall to talk with the diagnostic staff and came back, saying that he felt my mom's x-ray could be taken in her wheelchair with her feet down and that would give him what he needed to see.)

Now, regarding the diagnostic technician's attitude, don't get me wrong. I get it. Nurses and x-ray technicians are sick and tired of getting radiation while standing alongside a patient who is getting an x-ray, just because the doctor wants the x-ray done in a standing position while the x-ray staff considers the patient to be a possible fall risk.  The nurse/tech agrees to bite the bullet for a while but eventually--and as sanctioned by his/her boss--starts asking patients' family members to be the ones who stand up there with a lead shield. This cuts down on the amount of radiation that the nurse/tech will incur during the course of her/his employment.   

But, seriously, what's wrong with this picture?  

1. First and foremost, why should we believe that a diagnostic department's ability to safely take a (standing-up) x-ray of someone who may be a fall risk depends on someone else standing alongside the patient to support him while the x-ray is taken? 

As my dad's (very wise) neurologist once pointed out to me, there are any number of ways that a diagnostic department can ensure the safety of the patient through the use of a simple barrier or something else to properly support or protect the patient during the x-ray. But many facilities simply are choosing not to do that. Hey, apparently it's easy enough to convince a nurse or tech (or patient's family member) to stand up there wearing a lead shield, time after time, so why should they?

2.  Again, why do nurses and x-ray technicians agree to be x-rayed with their patients? This is ridiculous to me. If your boss told you that you had to jump off a cliff today, would you go running to the edge? 

BTW, if by now some of you are now ready to lecture me on how today's modern x-rays are perfectly safe, please save your typing fingers. Look online and you'll see many up-to-date articles on this topic written by doctors, researchers, and others. No one really knows for sure just how dangerous x-rays are to our health, but certainly the more x-rays we have, the more radiation risk we choose to incur. 

3. Why do patients' family members often give in to medical staff and "take one for the Gipper" when they'd rather not? 

I remember the first time this happened to me. I was with my dad, and his doctor wanted a chest x-ray that would be done in a standing position.  I was appalled when asked to put on a lead shield and stand up there, but it was my dad, you know?  Plus, it was one of those freezing-cold, windy Winter afternoons. I cringed at the thought of having to drive Dad to another facility that day and quickly caved.

But since that time, I've talked with enough medical personnel (including one diagnostic department supervisor at a local hospital), and I'm no longer as timid and docile. 

By the way, apparently not all doctors even know this stuff in the x-ray room goes on! Both the above physician today, and my dad's neurologist years ago, said they were not aware their patients' family members were sometimes being asked to take an x-ray with their loved ones. 

To me, the bottom line is this:  As long as nurses and x-ray technicians continue to let themselves be pushed around by their bosses on this issue, this issue will continue to be the nurses'/x-ray techs' problem (or that of the patient's family, should the family let it become so). 

For some perspective, here's a true story:  Back in 1995 I was the only consultant working in a small, 2-story office building, out in the plant of a large steel mill. The only toilet in the building available to staff was often not in good working order; in order to flush it, the user sometimes had to lift the lid, reach into the water and grab the chain, and re-fasten it. 

I was told by the staff who worked in this office that whenever the toilet would not flush for me, I needed to fix it, as above, instead of leaving it for someone else to do, like I'd been doing to date. When I asked why staff didn't just ask their boss to call a plumber, I was told they were all afraid to ask the boss (who wasn't aware of the problem and had his own toilet inside his private office on the 2nd floor).  

Being somewhat squeamish about putting my hand inside a toilet lid back then, I simply refused. And boy, did I ever hear about it from my fellow workers!

I finally posted a typed memo on a wall from myself to staff, sharing that I was choosing not to help fix their toilet and that if they had an issue with my attitude, they should pick up the phone and call MY boss (I included his telephone number). I wrote that although I had once or twice grabbed the plunger next to their toilet during an actual toilet emergency, this flushing issue was an entirely different matter. I was a programmer, not a plumber, and this was America, not Czechoslovakia. I still have that letter.

(BTW, when their boss was finally approached, he was actually very nice about calling a plumber, so I don't know why they were all so wimpy.)

When you make someone else's problem your problem, it stays your problem.  It's your choice. 

I've made mine. 

p.s.  I'm not a nurse. I joined this site back in 2009 while preparing to take the TEAS exam for admission to a PTA program (which I had to drop after I became my parents' primary caregiver). I've returned to this site every now and then, through the years, to read up on various topics of interest. Very best wishes to all.