By Beth Allen
We have all heard the horror stories about the tragedy that can occur when our MRI safety program fails. Whether it is due to human error, equipment malfunction, misinformation, or negligence, one event is too many. There are rules in place to try to keep our team members as well as our patients safe. We have policies and procedures, strict screening practices, physician, team member and patient ongoing education but we are still at risk.
There are many things that can cause an MRI technologist anxiety. There are more and more implanted devices every day. It takes time to research these devices to ensure the patient is safe to scan. Is the patient completely cleared or is the device considered conditional? If it is conditional, can we safely meet all those conditions?
There is always the scare that the patient forgot to tell us something. Patients may think a significant detail is irrelevant.
It is important to follow the ACR MRI Zones and adhere to the safety recommendations for those spaces. The MRI team is the gatekeeper to Zones III and IV. There is a lot of multitasking going on while being the gatekeeper. This and anxious patients may be the biggest MRI safety hazards that we don’t often consider.
Throughout the work shift, it may become chaotic. It would be wonderful if each MRI control area was in a constant state of Zen; allowing a peaceful experience for the MRI team to only do one thing at a time. No phones, no physicians, no TEAMs messages, no implant research to be done, no schedules to review or questions to answer. Picture a spa like experience with calming music, soothing sounds and lavender scents. Plenty of time to do each patient. No patients show up late. None are anxious, claustrophobic or angry about the parking situation outside.
This scanning utopia is not likely to happen. However, we have technologists with different levels of skill prioritizing tasks and remaining calm. Some come by it naturally and others can be taught. A training program can be part of a strategic plan so that we can work to improve our work environment. We can set some goals around stress and time management. By finding solutions to controlling the chaos, it shows our teams that we understand how crazy it can be and we will find a way to help.
The primary focus should be the patient on the table. Two patient identifiers are used to make sure we have the correct patient. The order is reviewed. Thorough screening is performed and verified. Once the patient is on the table, we need to make sure that the accurate sequences are being acquired and the patient has our full attention. We need to check in and update the patient on the progress of the scan and encourage them to continue to be cooperative. Every effort is made for the patient to feel safe and that together we are a team.
The other distractions that may take place can wait. Nothing is more important than the patient in front of us. As long as we can continue to focus on the current patient, other tasks can still be accomplished during the scan acquisition. This is where the teaching may come in since not everyone has this skill set. We need to think ahead and anticipate what we are doing in order to get enough time to accomplish all the tasks that need to happen each day.
Take ownership of your workspace.
Plan the day.
Identify the most efficient way to complete the schedule review or implant clearance lists.
Do not do redundant work.
Eliminate any unnecessary steps.
Control any interruption. It is OK to ask someone to wait for attention as long as it is not our patient.
It is OK to delegate certain work to assistants or reach out to a manager or another technologist for help if necessary.
It is definitely OK to stop for a second and regroup. The most important skill in a chaotic environment is self-awareness.
The anxious patient is also a hazard since they can be unpredictable, but as long as we are controlling our own environment, we can give those frightened, worried, stressed humans our full attention and ease them through the experience.
There will always be stressful days. Some more than others, of course. We need to control what we can control and keep everyone safe.
Thanks for all you do!
Beth Allen, RT(R)(CT), CRA, is the director, clinical operations at Banner Imaging.