The Digital Shutterbug (aryx) wrote,
The Digital Shutterbug

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Damn, it really is happening all over North America.

Nurses are being allowed to order x-rays!
How come I can't order pain medication for one of my patients, then?

Simply, because I don't know, as an x-ray tech., enough about medication and drug reactions and contraindications to do such.

Likewise, I do not believe that R.N.s have the necessary knowledge to order x-rays. In fact, most of them can't even name half the bones in the body.

Secondly, there is a law somewhere in the healthcare branch that states that no one is allowed to order x-rays except the physician.

So how is America and Canada getting away with it?

Simply, a doctor has written down signs and symptoms of particular things that he/she would get x-rays of. For example, a kid comes in with a swollen and disfigured wrist. It is, more than likely, broken, so a triage nurse sees that and orders a wrist x-ray for verification. That's okay, in that case, yes, the doctor probably would order an x-ray; of the wrist. Not the whole forearm and hand and elbow...just the wrist.

It gets worse, as I don't think it matters what the reason for the swelling is anymore. I have done an x-ray of a swollen hand because of an insect bite, and another tech has taken an x-ray for a bee-sting. This is a bit extreme.

Nurses are making bad mistakes when it comes to ordering x-rays. When an x-ray tech takes a forearm x-ray, he/she must include the wrist and elbow. There is almost no point in ordering a seperate exam of the elbow or wrist. Why charge the patient for 3 exams when 1 will be plenty. Most of us know that we can take extra views (pictures) in a certain area if we see something.

I think it's time for a little more education on the part of the R.N. if they are going to continually be allowed to order x-rays.

First, x-ray is radiation! It'll fuck you up! There is still no amount that is considered safe. Yes, our technology is such that we have reduced the amount of radiation necessary for a particular exam by half in the last 15 years, but it's still radiation.

Secondly, how about some more anatomy lessons. Simple things like which bones are considered part of the foot versus the ankle.

In addition to that, radiographic anatomy, which means when I take an x-ray of the hand, what will be seen on that x-ray, including all of the fingers (so you don't have to order fingers when you order a hand) and the wrist (so there is no reason to order a wrist).

Thirdly, the types of fractures (breaks) and how they occur. Example: spiral fractures occur to a long bone when there is some sort of twisting force on that bone. There is also a patient's age to take into consideration. If a baby learning how to walk falls down, they are only falling about a foot or 2, their bones are soft, and generally, babies bounce. This isn't to say that they won't break anything, but they aren't as likely to. If an elderly person falls, whose bones are brittle, reaction time slow, and fully grown, so a fall of 4 to 6 feet, then there's a much greater chance of a break.

Perhaps if nurses would stop making bad orders, then I wouldn't care so much that they order x-rays. Of course, I still believe there's a law somewhere in the books against it. As soon as I find out for sure, and if I am right, I will be writing a few letters... newspapers, congressmen, the CEO of the hospital, etc. I just have to find it.

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