By Estela I. Prieto, CRA, MS, RT (R)
“To give real service you must add something which cannot be bought or measured with money, and that is sincerity and integrity.” –Douglas Adams
November 2009 — I do not have scientific data on the subject, but I can say with a high degree of certainty that the technologists that have worked with me and under my leadership have little or no knowledge of the American Society of Radiologic Technologists (ASRT)/American Registry of Radiologic Technologists (ARRT) code of ethics’ relevance in their day to day work.
Ethical professional conduct is expected of every member of ASRT and every individual registered by ARRT. As a guide, ASRT and ARRT have issued a code of ethics for their members and registrants. By following the principles embodied in this code, radiologic technologists will protect the integrity of the profession and enhance the delivery of patient care.1
I personally use the code of ethics in the new supervisors’, students’, and technologists’ orientation. It has been my desire in the last 10 years to make certain that from the students doing their clinical rotation in the department to all of the new hired technologists, all become familiar with the code of ethics and also to show them how this document is relevant to their day to day performance as technologists.
It is understood that some technologists in the department are not registered by ARRT, but instead RDMS or CMNT. But the content and the professional conduct and performance expected from all staff is the same.
Following is a review of each of the standards in the code of ethics and an explanation of the application and relevance in the delivery of patient care.
Code of Ethics1
1. The radiologic technologist conducts herself or himself in a professional manner, responds to patient needs, and supports colleagues and associates in providing quality patient care.
Professionalism and respect is not given to us freely; it has to be earned by the way we conduct ourselves, the way we communicate, and by the confidence and excellence we demonstrate in the performance of our work. When we display a professional behavior in all aspects of the care we give our patients, we secure our place in the healthcare team.
2. The radiologic technologist acts to advance the principal objective of the profession to provide services to humanity with full respect for the dignity of mankind.
This standard builds on the first one; we advance the principal and objectives of the profession by our conduct, performance, and continuous growth in knowledge and education. We must perform the best exam or procedure to the best of our ability and we must preserve the patient’s dignity and privacy during the encounter with us.
3. The radiologic technologist delivers patient care and service unrestricted by concerns of personal attributes or the nature of the disease or illness, and without discrimination on the basis of sex, race, creed, religion, or socioeconomic status.
We must show respect to every patient regardless of how they enter our system(s), or where they come from; we need to care for the patients by performing the exam or procedure completely and consistently with the best service we can give.
4. The radiologic technologist practices technology founded upon theoretical knowledge and concepts, uses equipment and accessories consistent with the purpose for which they were designed, and employs procedures and techniques appropriately.
Radiology is a science and our equipment and procedures are based on proven scientific knowledge. With the knowledge acquired during our education and training, and the applications received on a particular piece of equipment, we provide our patients with high quality and safe services that in turn will help diagnose or treat the problem or disease.
5. The radiologic technologist assesses situations; exercises care, discretion, and judgment; assumes responsibility for professional decisions; and acts in the best interest of the patient.
For every patient, we need to look at the exam requested, the patient’s history, the reason why the patient is having a particular exam, and the medication history. Armed with that knowledge, we need to fit the requested exam to the patient’s medical needs. Do not forget to assess emotional needs. Many times, these needs are unspoken. Fear and anxiety can manifest in the patient’s negative or disruptive behavior. Talk to your patient, explain the procedure to gain confidence and alleviate fears; take time to listen to your patient. If there is any doubt on what the patient’s needs are, seek direction from your supervisor or physician.
6. The radiologic technologist acts as an agent through observation and communication to obtain pertinent information for the physician to aid in the diagnosis and treatment of the patient and recognizes that interpretation and diagnosis are outside the scope of practice for the profession.
We, as agents for the physician, are the eyes and ears of the physician, who is not in the room with the patient. Take a complete history, a history that is relevant to the question that needs to be answered by the exam ordered, and document completely and accurately. Excellent patient history, documentation, as well as the exam itself, are our responsibility; diagnosis belongs only to the physician.
7. The radiologic technologist uses equipment and accessories, employs techniques and procedures, performs services in accordance with an accepted standard of practice, and demonstrates expertise in minimizing radiation exposure to the patient, self, and other members of the healthcare team.
This standard builds on standard #4 and reiterates that the equipment must be used according to the manufacturer’s recommendations, parameters, policies, procedures, and established protocols. In addition, it points out our responsibilities toward patients, the public, and ourselves, to keep the exposures to radiation as low as reasonable achievable (ALARA), and to always use the principles of radiation safety: time, distance, and shielding.
8. The radiologic technologist practices ethical conduct appropriate to the profession and protects the patient’s right to quality radiologic technology care.
Protecting the patient’s right to quality radiology technology care is of the essence. We must ensure that the exam is complete and of the highest quality, the markers are in place, the image collimated, and with proper identification, the exposures optimal, and the positioning correct to give the radiologist the best possible images. Together with the complete patient’s history, the most accurate diagnosis can be made. This is what is expected, this is what the patient is paying for; nothing less will do.
9. The radiologic technologist respects confidences entrusted in the course of professional practice, respects the patient’s right to privacy, and reveals confidential information only as required by law or to protect the welfare of the individual or the community.
This standard is covered in great detail with HIPPA laws and requirements; every institution has in place the policies and procedures to protect patient confidentiality. Violation of these policies can be very costly to the institution as well as to the staff.
10. The radiologic technologist continually strives to improve knowledge and skills by participating in continuing education and professional activities, sharing knowledge with colleagues, and investigating new aspects of professional practice.
Continuous education is the way we grow in knowledge and keep abreast of the changes in professional practice. Continuous education is mandatory in order to keep our registry in good standard. We should seek knowledge by reading journals, participating in society meetings and conferences, and by going to specific Web sites that deal with the imaging (and all of the subspecialties) issues and trends. There is a world of information at your finger tips. Never stop learning!
As leaders in medical imaging departments, we must teach and mentor our employees; orientation to the department is the perfect starting point to set expectations. What better way than to make certain our technologists know and live their code of ethics?
1 American Society of Radiologic Technologists and the American Registry of Radiologic Technologists. Code of Ethics. February 2003. Albuquerque, NM. Available at: https://www.asrt.org/media/pdf/codeofethics.pdf. Accessed August 23, 2009.
Estela I. Prieto, CRA, MS, RT (R) is the imaging services director at Sibley Memorial Hospital in Washington, DC. She can be reached at EPrieto@sibley.org.