Nursing in IR department

jajajody · Jun 23, 2012

I'd like to get some feedback from any IR or cath lab nurses who are managed by a radiology tech. What is the normal hierarchy for these departments? Do you have a nurse to answer to? Also, are you a secondary part of the department (like an afterthought) or are you an equal with the rad techs? I am trying to affect some change in my department and I'd like to know if I'm just going to spin my wheels since these departments (or possibly just mine) are so tech oriented.

I work at a teaching facility where the lead IR technologist is the board runner/leader of the department. Nurses are not treated as afterthoughts. Some nurses have had a problem with a rad tech directing them. My thought is we are all an essential part of the team and each has their role--the lead tech's role is to ensure that needed equip is available, staff is assigned to cases and the flow remains constant. He never tells a nurse how to nurse just like I don't tell him how to do his job. We do have a patient care coordinator (charge nurse) who supervises nurses in IR, MRI, CT, Nuc med, ultrasound.

Radnurse54 · Jul 10, 2012

While some of us have managers of deparments such as IR or CT MRI that are technologists, there must be nursing oversight by some member of the administrative team. If you do not have a charge nurse or other nursing manager, make sure who your line of responsibility goes to, non nurses cannot oversee nurses. They do not have the education or knowledge base to evaluate nursing practice or patient care under nursing.

mermom46 · Aug 30, 2012

As an RN in a medical imaging dept managed by a rad tech, this has been my great & ongoing frustration! I have had a million questions (regarding nursing issues) which fall on deaf ears. For example, What is the policy regarding low GFR and CT contrast? There was none when I started in my rural facility, and I have had to battle against great odds to get one. Technologists in general are very task oriented, and don't understand why a nurse cares to ask the critical thinking questions.I was met with so much resistance, I finally went to the director of nurses and quality director for support. I was paid lip service re: my concerns. My manager continued to write up disciplinary actions against me for minor offenses (after 30 years as an ER nurse with NO disciplinary actions). I have been treated as an "enemy" simply for trying to effect changes that improve patient care and safety. I have had techs try to countermand my nursing decisions in certain situations, because in their mind, the lead tech has the higher authority over nursing. Everyone in Radiology assumes everyone else is doing the right thing. The radiologists think the hospital has policies in place; the hospital thinks it is the radiologists' responsibility. The nurse is the only one who sees (or cares) that in actuality NO ONE is assuming responsibility for the patients' well-being. Good luck in your efforts.

"Been there, doing that"

ahawki01 · Sep 9, 2012

Hello all! I am a nurse in charge of our Radiology department who presently do all CT/MRI injections. Do your facilities have techs or RN's do the injections? I understand that techs performing the injections is the go forward trend but how do you all feel about it? Techs do not see the big picture, as RN's do, in my opinion, and I have concern for my nurses having a responsibility taken away from them, as do they. Any input?

Radnurse54 · Sep 10, 2012

By injections do you mean the contrast? Or do you mean other medication injections? We do MRE's and Urogram's in MRI that require IV and IM injections. For those of course I would say definately not....but for IV contrast? That would require an enormous amount of nursing staff.

ahawki01 · Sep 11, 2012

Hey Radnurse54! Yes, I do mean IV contrast injections - gadolidium for MRI and Omnipaque/ Visipaque for our CT's.

Flyboy17 · Sep 12, 2012

I am currently working in a Cath Lab and Interventional Radiology with our hospital. In the Cath Lab we do have a Chief Tech for the technologists but also have a nursing clinical coordinator and a director that is an RN. In IR we have an RT VI as our coordinator and and RT® as our director. We do however have a charge nurse every day and have a nursing director that oversees all nursing aspects with in the radiology departments.

Hope that gives some insight

Jonathan RN

RNJohnny23 · Sep 14, 2012

I did IR for a couple of years and had these same issues arise. Even though we had a charge nurse, the director was a Rad Tech. Nothing wrong with that, except they don't understand nursing and try to just send one of the nurses--charge or otherwise--to meetings of the other nurse managers. Or Surgery is supposed to manage this specialty, but spends almost no time in the area. It seems that as far as IR goes, it is an ignored middle child. I'm out of IR and into ICU now. I prefer to be in an area that is more nursing focused. I miss procedures, but not enough to go back.

Wjcostel · Oct 25, 2017

Oh my gosh do we work together?

BexnRN · Oct 27, 2017

This is why I gave up on IR. It is a FANTASTIC specialty, and I loved it. But I will NOT work for a radiology tech ever again. I had never had the amount of disciplinary actions (write ups) taken against me in my entire nursing career of 13 years as a nurse as I did in IR. And I attribute it directly to working for rad techs. They simply do not have the scope, experience, context, or relativity to govern, question, oversee, or evaluate nurses. I had a "nurse supervisor" in a large teaching trauma facility, but she didn't do my yearly evaluations. I had a "dotted line to nursing" in a small facility (I was the only radiology nurse) who was an RN supervisor in pre-op/GI lab whom I never saw. I don't understand the disconnect between Cath Lab and IR. They're rock stars and IR is the weird cousin lol. You might consider contacting your state board of nursing or Joint Commission. I did due to the fact that nurses filled out consent forms in my last facility, not the MD doing the procedure. I hope they got ripped a new one. I'm still considering writing the CNO of my last facility to plead for actual nurse oversight in that IR department. Sorry this is so long, but IR has left a terrible taste in my mouth. Good luck and don't give up. YOU have a responsibility for the safety of those patients. It's why you're there. They deserve it :)