Radiography and the covid-19 response

Vicky Ballard, Lead Advanced Practitioner, Radiography, and Darren Sander Lead for MRI and Paediatrics, Radiography are part of a team who are often the first to diagnose patients with COVID-19, Radiographers are at the front door in their PPE standing next to the nurses and doctors 24 hours a day, 365 days a year.
Here are their profiles…
How has your role and that of your team changed with the COVID-19 response?
Radiographers provide imaging services 24/7 for the Emergency Department and all in-patient areas both in department and mobile x-rays.
As part of the COVID-19 response, all patients attending the hospital with suspected or confirmed COVID-19 will see a radiographer as part of their pathway with the radiographer often the first person to know that a patient has COVID-19 based on their imaging findings. Due to the significant number of asymptomatic patients we have also been the ones identifying unsuspected cases allowing quick isolation and appropriate management.
I have taken on a more operational role to support the Covid-19 response for imaging on the acute floor at RSCH. This has taken me away from some of my reporting sessions for which my team have stepped up to cover. The chest x-ray (CXR) reporting team have prioritised hot reporting for all ED red zone patients to assist clinician decision making.
How did you prepare for the changes in the lead-up?
We attended several trust planning exercises in the lead up and looked at what changes may be required. As the acute floor set up moved to red and green zones we re-designated our CT and XR services into red and green to support this change.
The rota has evolved in stages to increase the numbers of radiographers working overnight and to accommodate staffing of the red and green zones. We have been in involved in developing new pathways and we have also ensured risk assessments for all at risk staff, FIT testing and PPE training.
What has been challenging and what have you been proud of?
Planning for the unknown was challenging as we didn’t know what the impact on our staffing levels or the patient numbers would be.
I am proud of how the acute floor imaging team have pulled together and supported each other. We responded early to changing demands on the service and ensured that our staffing levels out of hours provided a safe and efficient service, making our team feel supported and cared for during a potentially stressful time.
How has your role and that of your team changed with the COVID-19 response?
The news throughout the pandemic has focused on nurses and doctors and not so much on allied health professions such as Radiographers yet every COVID-19 patient is seen by a Radiographer for either a chest x ray or CT scan.
To prepare for the response we cancelled all routine imaging and provided only an emergency and urgent imaging service. Radiographers working in specialist areas such as MRI were asked to work on the acute floor again carrying out x rays instead of MRI – for some staff a massive challenge considering they have not taken an x ray for 10 years! Staff working patterns and hours totally changed, weekends didn’t exist. A big difference for staff has also been the wearing of PPE for all patients.
How did you prepare for the changes in the lead-up?
We wrote new imaging pathways, almost daily at the start, and split the acute imaging floor into red and green areas. We carried out risk assessments for at risk staff groups and attended trust planning exercise. We wrote, and then re-wrote, staff rotas almost daily to ensure we had more members of staff on the acute floor and to take into account staff who were unwell and isolating. We also wrote competency documents to support staff working in new areas.
What has been challenging?
Changing my role has been challenging, before COVID-19 it was about getting as many patients through imaging as quickly and safely as possible and ensuring no breaches of waiting time targets. It has been hard throughout this to see the backlog of imaging building up with nothing I can do. It has also been difficult at times to reassure staff and answer their questions when the situation was so unknown.
What have been the achievements and things you are most proud of?
The main achievements have been seeing all staff stepping up and supporting each other and going the extra mile and covering last minute shifts with little notice. Also staff who have not taken an x ray in years working on the acute floor and staff who have not done nights in a long time back on the night rota to support the service.
Radiographers are at the front door in our PPE standing next to the nurses and doctors 24 hours a day, 365 days a year and I am very proud to be part of that team.