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  2. 2. Job Reference Number……P/HC/45…………………………… 4. JOB PURPOSE To provide as part of Nuclear Medicine, an area wide diagnostic imaging service and to carry out any other work associated with diagnostic, research and therapeutic uses of radionuclides. 5. ORGANISATIONAL POSITION The technical staffing of Nuclear Medicine (covering Ninewells Hospital, Clinical Research Centre and Perth Royal Infirmary) consists of a Section Manager, plus a Deputy Section Manager Advanced Clinical Technologist (imaging), 2 Advanced (Lead) Clinical Technologists and 14.6 Specialist Clinical Technologist posts. There are in addition, 5 Clinical Scientists, 1 Medical Consultant, 3 Nurses and 3.5 Admin /Clerical members of staff. PRI IMAGING LABORATORY PET-CT CONSULTANT PHYSICIST SECTION MANAGER 7.1 SPECIALIST CLINICAL TECHNOLOGISTS 4 SPECIALIST CLINICAL TECHNOLOGISTS DEPUTY SECTION MANAGER 2 NURSING STAFF 2.5 ADMIN AND CLERICAL 2 SPECIALIST CLINICAL TECHNOLOGISTS 1 ADVANCED (LEAD) CLINICAL TECHNOLOGIST 1 ADVANCED (LEAD) CLINICAL TECHNOLOGIST This Post 1.5 SPECIALIST CLINICAL TECHNOLOGISTS 1 ADMIN AND CLERICAL 1 NURSING STAFF
  3. 3. Job Reference Number………………………………… 6. SCOPE AND RANGE Nuclear Medicine provides an area wide service for therapeutic and diagnostic radioisotope studies, including advice on, and supervision of the use of radioisotopes by other clinical departments. The service facility is provided for both in and out-patients. 7000 imaging studies, 1500 non-imaging studies and 200 therapies are performed each year. In addition, the unit handles all radionuclide goods coming into Ninewells Hospital, numbering approximately 600 items a year and all solid radionuclide waste leaving Ninewells and PRI, some 2000 items each year. The Department includes Nuclear Medicine imaging and laboratory in Ninewells and Perth Royal Infirmary and PET-CT in the Clinical Research Centre The post holder provides expertise by performing specialized clinical procedures on patients, handling radionuclide goods and waste, producing radio pharmaceuticals, performing monitoring for and decontamination of radionuclides, performing general health and safety duties, maintaining patient records and by participating in research and development activities.
  4. 4. Job Reference Number………………………………… 5. MAIN DUTIES/RESPONSIBILITIES Undertakes work associated with diagnostic, research and therapeutic uses of radionuclides to provide a high quality service. Mangagement (10%) • Organises the day-to-day allocation of duties to technical staff in the imaging section of PRI, taking into account potential or actual staff shortages. • Participates in the Lead technician duties of the departments in Ninewells or PET/CT if requested by Section Manager or Head Clinical Scientist. • Manages imaging technical staff in the operation of Gamma Cameras, PET/CT scanners and associated computers to ensure the production of high quality diagnostic images. • Manages imaging technical staff in the operation of other scientific instruments and equipment. • Manages the maintenance of record keeping for the unit, including the unit’s record of administered radiation dose in accordance with the Ionising Radiation (Medical Exposure) Regulations 2000. • Checks daily patient list to identify errors. • Manages private patient documentation. • Deals with equipment failure, contacting physicists and/or engineers and re-allocating scans where necessary. Clinical (65%) • Answers appointment related queries from patients and staff before the day of the procedure. • Prepares radiopharmaceuticals and equipment for administration. • Manipulates radiopharmaceuticals under non-aseptic conditions as required. • Identifies the patient and explain the procedure. • Deals with queries from patients and staff regarding procedures on a daily basis. • Assesses whether the patient is adequately prepared e.g. has fasted, been off named medications, if female is not pregnant or breastfeeding. • Administers radiopharmaceuticals and non-radioactive named drugs intravenously, intramuscularly or orally in accordance with the relevant departmental protocols, radiation protection legislation and medicines legislation. • Operates Gamma cameras, PET/CT scanners and associated computers to obtain high quality dynamic, static, whole body and tomographic diagnostic images.
  5. 5. Job Reference Number………………………………… 6. COMMUNICATIONS AND RELATIONSHIPS The post holder is required to communicate to colleagues, staff and patients, including other Trusts and suppliers in oral, written and electronic form. Communication occasionally involves contentious information when the requirement arises to cancel patient scans due to camera failure, staff shortages or heavy workload. This requires negotiating and re-assurance skills and the ability to communicate in an antagonistic, hostile and emotive atmosphere. Communication frequently involves cultural and language difficulties, dealing with patients with physical and or mental special needs, very sick patients, young children and elderly or frail patients. This frequently involves tact, persuasive skills and dealing with sensitive information e.g. many patients have cancer related illnesses and a high degree of empathy is required. When the patient presents for the procedure, the post-holder will explain what will happen, answer the patients queries and questions, identify the patient, and ask females of ages 12 to 55 to complete a declaration regarding pregnancy and breast feeding. The post holder receives condition-related information regarding patients from, and conveys similar information to clinicians, nurses, pharmacy staff and other health professionals up to consultant level. The post holder communicates practical topics to immediate colleagues such as allocating duties to technical staff, training junior staff in manual handling, familiarization of new equipment and procedures, hygiene and health and safety including radiation protection. The post holder communicates with senior technical, scientific and clinical colleagues, passing on information regarding technical difficulties encountered and receiving guidance and instruction in return. The post holder may occasionally need to communicate with engineers both within and out- with the hospital regarding equipment servicing and breakdown. Key contacts: Dr Norman Kennedy, Head of Nuclear Medicine and Deputy Director of Medical Physics Dr John Davidson, Medical Consultant in Nuclear Medicine Mr. Scot Hudson, Chief Clinical/Engineering Technologist, Medical Physics Ms Sheila Batchelor, Section Manager Specialist Clinical technologists, Imaging Ms Jacqueline Bisset, Pharmacy Technician Nursing staff within Nuclear Medicine Administration and Clerical staff within Nuclear Medicine Other scientific staff within Nuclear Medicine Non-imaging Nuclear Medicine laboratory staff Nursing and Medical staff in other departments in Ninewells Hospital Nursing and Medical staff in other Hospitals such as Perth Royal Infirmary, Royal Victoria Hospital, Dundee and Stracathro Hospital. Staff in other departments within Ninewells Hospital such as supplies department, estates department and portering Administration and Clerical staff in other departments within Ninewells Hospital and other hospitals Ambulance Planning Department Equipment engineers
  6. 6. Job Reference Number………………………………… 7. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB There is a requirement for an advanced technical knowledge across the range of work procedures, policies, protocols and practices. This must be based on a sound knowledge of the relevant theory, underpinned by extensive relevant practical experience. The post holder will possess a BSc in Clinical Technology or equivalent qualification in a science-related subject plus a minimum 7 years experience of specialised clinical investigative and therapeutic work in Nuclear Medicine. Participates in the CPD scheme run by the Institute of Physics and Engineering in Medicine and will be on the Register of Clinical Technologists run by the Health Professions’ Council. This includes the skills and training required to operate complex specialist equipment such as Gamma cameras, PET/CT scanners and associated computers. An in-depth knowledge of radiation physics, anatomy, physiology, pathology and the effect of radiation on biological systems is required. Knowledge and practical experience of patient care and health and safety are necessary. Analytical and judgment skills are required when processing complex image data therefore advanced computer skills are required. Supervisory skills are required to manage the technical staff in PRI and the imaging technical staff throughout the department in the absence of the Section Manager and Deputy Section Manager. There is a need for the continual updating of knowledge and skills through the attendance of lectures and conferences and by reading appropriate textbooks and journals. Clinical skills such as venepuncture, cannulation, intravenous and intramuscular drug administration and basic life support are required. The post holder requires radiation protection training and a thorough knowledge of the Local Rules and policies with regard to the radiation protection aspects of Nuclear Medicine. ESSENTIAL ADDITIONAL INFORMATION 8. SYSTEMS AND EQUIPMENT The post holder is required to operate sophisticated and expensive Gamma Cameras, PET/CT scanners and associated specialized computers to obtain diagnostic images and information. Other medical equipment to be operated includes ECG monitors, blood pressure monitors and infusion pumps. Equipment associated with the detection and measurement of radiation includes dose calibrators, dose rate meters and scintillation/Geiger counters. A specialized generator used to produce radioactive gas for inhalation is also used. Computers are used to assist in compiling and updating departmental protocols, for recording patient data and to obtain relevant information from the internet. All this equipment is used unsupervised on a daily basis. The staff member will perform daily quality control tests to ensure the correct working of this equipment. These tests are carried out according to written protocols. The staff member is responsible for the correct manipulation and administration of expensive radio-pharmaceuticals costing up to £1000 for a single dose. In addition they maintain systems of monitoring for radioactive contamination and radionuclide security by restricting access to controlled areas.
  7. 7. Job Reference Number………………………………… The post holder is required to liaise with engineers and maintenance staff required to repair equipment. The post holder may need to use nuclear medicine non-imaging equipment. These comprise Gamma and Beta counters, centrifuges, and a specialized semiconductor counter. RESPONSIBILITY FOR RECORDS MANAGEMENT All records created in the course of the business of NHS Tayside are corporate records and are public records under the terms of the Public Records (Scotland) Act 1937. This includes email messages and other electronic records. It is your responsibility to ensure that you keep appropriate records of your work in NHS Tayside and manage those records in keeping with the NHS Tayside Records Management Policy and with any guidance produced by NHS Tayside specific to your employment.
  8. 8. Job Reference Number………………………………… 9. PHYSICAL DEMANDS OF THE JOB Physical Skills Precision, dexterity and manipulation skills along with good hand–eye coordination are required for venepuncture, cannulation and injecting of patients. These qualities are also required for the manipulation of radiopharmaceuticals and the use of dose calibrators and contamination monitors. The ability for speed and accuracy and advanced keyboard and sensory skills are also required. Physical Effort Frequent intense physical effort is required. The post holder is required to be trained in the manual handling of loads and patients. Heavy equipment is moved daily. This typically includes pushing shielded dose trolleys (up to100kg), collimator carts (up to 300kg), camera beds (up to 370kg) and the Technegas generator (up to 180kg) are moved daily. Some patients need to be transferred to the scanning beds from wheelchairs, trolleys and beds using a variety of aids including hoists and easy slides. Elderly, frail and sick, semi- mobile patients need to be assisted to the toilet and onto the camera beds. Mental Effort There is a frequent requirement for concentration where the work pattern is unpredictable. The Gamma cameras and associated computers are extremely complicated and as such, need concentration when acquiring and processing information. Patient safety, camera failure, and complicated image processing procedures require concentration. Planned work is subject to frequent interruption throughout the day. Typical interruptions include telephone calls from patients regarding their procedures, from the staff of other departments requesting procedures or with queries, calls from ambulance planning and problems with camera and equipment failure. Technical staff frequently need advice regarding procedures and protocols. Concentration is needed when preparing work rotas. Emotional Effort Emotional effort includes frequent exposure to distressing or emotional circumstances when dealing with terminally ill, very sick, disabled or aggressive patients. Working Conditions The post holder works daily with unsealed radionuclides from which there will be an external radioactive dose. In addition the manipulation of sources carries the risk of radioactive contamination. There is also frequent exposure to hazardous airborne radioactive contamination. There is frequent exposure to unpleasant smells and substances that are a biological hazard and/or chemical hazard. The post holder is required to assist with soiled patients and bedding. Urine, blood and other body fluids are handled as part of the daily clinical work.
  9. 9. Job Reference Number………………………………… 10. DECISIONS AND JUDGEMENTS A Lead technician for PRI, the post holder is required to make decisions and judgements if unforeseen circumstances arise such as the failure of equipment, staff shortages, difficulties with IV administration, image acquisition and processing, and patient related problems. The post holder may need to decide on the level of service which can be provided. This can include deciding on whether to cancel patients who have appointments, which patients would be most suitable for canceling, prioritizing the workload and allocating duties. The post holder is responsible for the carrying out of these duties unsupervised. The post holder is responsible for the management of the allocated workload to provide a high quality service. The duties are performed to written protocols but the post holder has the discretion to make adjustments if necessary. The typical decisions the post holder is required to make include checking the appropriateness of a request, deciding on a suitable injection site, deciding on the most suitable method of imaging to get high quality images, re-arranging patient imaging times and re-allocating patients to different camera rooms if difficulties arise. The post holder is also required to decide if enough images and information has been obtained before discharging the patient. The post holder is required to analyse the patient data and make judgments as to the requirement for further imaging. They will need to decide if the patient has been adequately prepared e.g. fasted, stopped certain medication and not likely to be pregnant or breast-feeding. The post holder is required to make judgments as to the medical condition of patients and obtain medical assistance where appropriate. The post holder will require to make judgments as to the performance of the Gamma cameras, PET/CT scanner and other equipment and decide on appropriate action. The post holder will need to interpret images and data for unexpected results and then identify the causes. The post holder will be required to evaluate existing and proposed policies, protocols, working practices and patient information of the imaging section in order to suggest changes, comment on and to draft new versions.
  10. 10. Job Reference Number………………………………… 11. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB Managing the imaging technical staff of the Nuclear Medicine Unit in PRI including making difficult and contentious decisions. Acquiring and processing complex diagnostic images and data using specialised imaging equipment and computer software and deciding if further imaging is required. The post holder has a great responsibility for patient care. Day to day they carry out complex diagnostic and therapeutic procedures directly on patients, frequently dealing with adult and paediatric patients some of whom are very sick, anxious, disabled or terminally ill. In addition, monitoring equipment performance and performing quality assurance checks impact upon the quality of clinical care.