“So You Are Running Between”—A Qualitative Study of Nurses' Involvement With Diagnostic Imaging in South Africa

Abstract

ABSTRACT:Nurses caring for patients in radiology departments is a relatively recent phenomenon. Only a few fragmented studies appear in the literature on the interprofessional nursing domain in these departments. This paper attempts to give a more holistic picture of nurses" experiences of patient care related to diagnostic imaging and interprofessional interactions and relations with radiographers and radiologists. Focus groups were held, among others, with nurses at a district hospital and an adjacent academic hospital in South Africa. Participants were questioned about their experiences regarding referrals for diagnostic imaging, their professional roles, views on the roles of other professions, multidisciplinary interaction and radiation awareness. Three main themes emerged. (1) Patient care and communication include the sub-themes of "being there" for patients and communicating with them. (2) Scope of professional practice is divided into activities around the request form, preparation for diagnostic imaging and further education needs. (3) Interprofessional interactions relate to hierarchical-and power relations and interprofessional communication and conflict. The study illustrates the collaborative and mediating roles of nurses at various points in the health system, from referral of patients for diagnostic imaging investigations up to discharge from the healthcare facility. More studies are needed on 2 interprofessional relations between radiographers, radiologists and nurses and nurses" ability to make appropriate judgments with regard to the completion and interpretation of request forms and preparing patients for specialized investigations.

A Qualitative Study Exploring Patients' Expectations and Experiences of the Localization Event as Part of Radiation Therapy

“…This study also provided insights into the importance on aspects of communication and interactions at a particular time although a brief but temporary encounter. A review is required on who communicates with whom during the transitioning to ensure that the patient is kept in the loop and adequately prepared (Makanjee et al, 2014b). From health system perspective, the findings also provided a glimpse into aspects of the care at the particular point within cancer continuum framework.…”

“…The radiation oncology services are delivered by specified tertiary-level hospitals in the public sectors and in some private sectors within the health care system (Dreosti, 2015, Basu). Patients gain access to tertiary-level hospitals through a multilevel hierarchical referral system that commences with patients consulting at the primary health care clinic and subsequent referral to district-level and regional-level hospitals (Dickens et al, 2014, Dreosti, 2015, Makanjee et al, 2014b, van Rensburg, 2004. Patients' point of contact with the radiation oncology department in the public tertiary hospital entails a consultation with the RO, who refers the patient to the RT division for the RT localization procedure, followed by the RT treatment series.…”

Nurse Practitioners “Insider” and “Outsider” Roles and Responsibilities Enabling a Quality Managed Delivery of Contemporary Medical Imaging Services

“…The professional NPs in a study by Makanjee et al were eager to expand their scope of practice, specifically to include the interpretation of radiographs [24]. Based on their wish to provide feedback to patients who are anxious or in transition between MI and another point of contact and to compile evidence-based nursing notes.…”

“…A challenge in the immediate MI working environment could be adapting from having stable nursing care plans and routines to the frequency of changing plans when a patient is a switch between modalities. In close collaboration with multidisciplinary teams in imaging services, ensuring also that policies, guidelines, and protocols are complied with and contribute toward enhancing effective improvements [24,27,28]. For example, during the general or plain radiographic examination depending on the patient's characteristics, the competency of the radiographer and equipment ensuring the patient's comfort while in the MI examination room, the orienting and supporting the patient's immobility during the exam, interdependent on patient cooperation, such as holding breath for a while.…”