Point one - They do indeed.

Point two - It may be the refusal is due to the radiographer following a
departmental protocol written in collaboration with the Clinical
Director, the Medical Physics Expert, the A&E Clinical Director and the
Radiography Lead in A&E. This will be informed by the RCR referral
guidelines (here is a link to the old EU version of the guidance
http://europa.eu.int/comm/environment/radprot/118/rp-118-en.pdf

Point three - To enable the IR(ME)R 2000 regulations to be met - the
radiographer usually fulfil the role of OPERATOR and therefore do not
have discretion to move outside of the guidance. The Radiologist is
fulfilling the role of PRACTITIONER and can work outside of the
protocol.

MY CONCLUSION

The radiographer MUST follow the protocol and refuse the request. The
radiologist can act as PRACTITIONER and overrule the protocol and
countersign the request - allowing it to proceed.

If the protocol ALLOWS scaphoid review within 7 days - then the opposite
is true as stated by the OP. But it is at the development of the
protocol that these battles should be ironed out - not on a one to one
basis over the individual case.

Before berating the radiographer - surely one should check the protocol
they are working to, and make sure it is current. Is it really good
practice to try to make the radiographer cave in and accept threats of
"clinical directors" and "appraisal"?

Philip







 


-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Doc Holiday
Sent: 31 August 2005 14:58
To: [log in to unmask]
Subject: Re: Sacphoids

Don't do review clinics, so will leave the main issue (this new
invention of 
"SACphoids") to the rest of y'all. However...

----Original Message Follows----
From: Martyn Hodson <[log in to unmask]>
would also be interesting to see what happens should one of these cases 
arise after a radiographer refuses to do scaphoid views

--> You seem to have a bigger problem here - this "refusing". Thought
this 
sort of thing had been done away with. Even if a radiographer wishes to
take 
on the role of the radiologist in over-seeing whether an irradiaion is 
indicated (rather than focusing on the technical equipment and procedure

which are the radiographer's primary roles) then here he/she would still

have to have a consultant radiologist decide this is indeed NOT
indicated 
and write that on the form (with a signature and date as it is
medicolegal 
data relating to the patient - I have checked this with the relevant 
authorities). Once a consultant radiologist writes ANYTHING, the ED 
consultant will always be informed and they can get involved at that
time 
and decide whether to have the X-ray anyway.

The golden rule for our docs/nurses is that, with any request, be it for

bloods, X-ray, specilaty consultation/review, they accept only one of 2 
answers:
1. "OK. I'll do it"
OR
2. An explanation of the CLINICAL reasoning as to why they had requested

something they should not have AND THAT THIS EXPLANATION CONVINCES THEM!

Otherwise they call the ED senior ANY TIME.
In other words... we refuse to be refused!
Any "refusals" by anyone are always documented and analysed during 
appraisal. If I had a refusal by a radiographer and they happen not to
have 
an appraisal process, then I would be arranging one through their
clinical 
director...

>or maybe that's just a situation that occurs when Nurses request x-rays

>from triage, and the radiogrpahers have a bee in their bonnet oabut
nurse 
>requested X-rays

--> Should we now add "oabut" to the other neologism of "sacphoids" in a

short article called "lla oabut sacphoids" ?