A FAILURE TO COMMUNICATE EFFECTIVELY WITH THE PATIENT
Failing to communicate effectively with the patient is one of the worst errors that an
x-ray technologist can make. This is especially true when positioning the patient. If,
for example, you are preparing to palpate the patient's pelvis to find the crest of the
iIlium, you must be sure to explain to the patient what you are going to do and why.
You need to explain to the patient what kind of discomfort to expect, if any. Imagine
that you have positioned the x-ray tube, put the film in, and aligned the tube to the
film. Your next step may be to align the patient. If you fail to explain this step, it may
come as a shock to the patient, almost an aggression, when you push in really hard
on the patient's pelvis. The patient may feel stressed and quite possibly become
uncooperative and even belligerent.
Just such an incident occurred in real life, with the result that the patient in question
filed a complaint for assault and battery. The complaint led to an investigation that
revealed no substance to the allegation. But, from then on, the radiographer was
watched more closely by his supervisor. In this case, the radiographer, a man in his
50's, was about to perform a chest x-ray in accordance with deeply ingrained habits
he had picked up in the course of a long career. It was his practice to place his
hands directly below the chest on the lateral borders, at the level of the lower ribs.
He did so because he felt that this was the best way to ensure that the patient was
aligned properly at the level of the lower ribs (so that the costophrenic angles of the
lungs would not be cut off on the x-ray). Most patients don't like to be handled in this
manner unless the need for this manner of touching is explained beforehand.
Even though the radiographer's name was eventually cleared, the incident haunted
him from then on. His failure to communicate with the patient and his "history" of
incidents (one incident) caused the supervisor to be reluctant to give this
radiographer work on obstetric ultrasonography. The supervisor was concerned
about the risk of another possible incident with a female patient. Thus, the incident
continued to haunt the radiographer. It also has had adverse consequences in terms
of covering patient work load and overall morale and operation of the radiology
(1) Becoming alert to the big picture. Learn to become aware of the overall
workings of the radiology department and the hospital, as a whole, early on in your
career. Make a concerted effort to take note of potential problem areas and, if nothing
more, consider what you would do to resolve them if you were called upon to do so.
(2) Proactivity pays off. Give thought to possible solutions before you are
asked to provide them. Ask yourself, "Why is there a long wait in this room? Is it
because all of the head and chest x-rays are going to one room?" Since chest x-rays
represent the greatest number of patients, maybe they should be spread evenly over all
the rooms, instead of bottlenecking them in a single room.