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Allowable radiation

Life in nuclear medicine

As a high school student, Tina Ash wanted to be a nurse.

“Our local hospital sponsored a nursing shadowing day for area high school students. I was assigned to shadow the oncology ward. In-patient oncology is essentially people who are very ill with cancer. It was a bit much to take in as a 16-year-old.”

As a result Ash began to consider a different career path.

“Because I didn’t think that was a good fit for me, I pursued other options in healthcare. I paged through a career booklet in the guidance counselor office at my high school. Nuclear medicine technology was listed as well as medical technology. It described both fields as needing a strength in chemistry, which at the time I really enjoyed. Nuclear medicine was described as a good mix of laboratory work along with patient care. I thought that was a nice balance.”

Ash’s title is a certified nuclear medicine technologist. She works at Scripps Green Hospital in La Jolla. The median annual wage for nuclear medicine technologists, as of 2012, was $70,180.

To obtain her title, Ash received a bachelor’s degree in nuclear medicine technology from the University of Wisconsin-La Crosse. She also completed a 12-month internship program.

“I completed my internship with Mayo Clinic in Rochester MN. Upon moving to California, [I have found that] most technologists here first become registered Xray technologists and then complete the 12-month internship. At that point they are eligible to sit for board exams for state and national registry. Other techs I’ve run into (I’ve worked with people from Nevada, Colorado, et cetera) have a bachelor’s in a general science like biology. Then, they’ve applied to the 12-month internship in order to sit for board exams. I’ve found benefits to either course. We all share the 12-month internship as a consistency amongst all technologists.”

Ash’s typical work day is a busy one.

“Almost all of our scans require an intravenous injection. So, in a typical day, we might be starting 5-12 IVs (depending on our workload). [We start] around 6:30 am or 7 am for quality control and checking in the isotopes that are delivered by an outside vendor. We usually have patients scheduled until 4 or 5pm. Once we scan a patient, we have “processing” of the images. Depending on the exam, it can be rather straightforward (just displaying the images for radiologist review and interpretation), or more in-depth by analyzing a specific area and quantifying the results.”

Ash has run into a few obstacles in her field.

“Some people have an intense fear of needles. But, I still have to start an IV. Many times it’s difficult to get a patient comfortable on the imaging table. For a good scan, they aren’t to move. So, it’s really important to make them comfortable to tolerate a 30-minute scan. Some patients are angry about a recent cancer diagnosis and they just aren’t happy to be here with us. When I worked with pediatric patients, the kids were great. The parents were a bit intense and demanding. Rightly so...it’s their child!”

Perhaps the most challenging task in her workday is the amount of paperwork she fills out.

“There are forms to be filled out for starting an IV, a signature here that you spoke to the patient, billing the patient correctly, reviewing the order from the ordering physician to make sure that’s correct—there’s a lot of stuff that needs attention to small details. And that’s not including the documentation required for administering an isotope. I’d imagine that’s about half of my day’s work.”

Ash believes the benefits of her job outweigh the negatives. “Although some patients are challenging, it really is the best part of my job. There are some really neat people who have interesting perspectives. I also like the pace of my job. Busy days go very quickly. And, I love the variety. It keeps me interested and focused. I’m not just doing the same thing over and over.”

Speaking of patients, Ash has run across some interesting ones. “We ask patients to bring their pants down once they are lying down on the imaging table, rather than changing them into gowns and tying up a prep room. I’m always surprised as to how many men don’t wear underwear. In fact, there was one patient I can think of that would routinely not wear underwear. He was very excited to point it out. Creepy.”

Since Ash works with radiation she is required to wear a body badge and a ring badge to monitor her exposure.

“We change out our badges monthly and review the results to make adjustments. The radiation exposure I’ve received over the last 18 years is still less than the allowable amount for a year. When I was pregnant with my kids, I was a little more aware of my technique. There are smaller allowable limits of exposure when you’re pregnant. But even then, I wasn’t anywhere near the limit.”

Despite the health risks involved in working with radiation, Ash is not concerned.

“My training and education is very thorough in practicing ALARA (as low as reasonably achievable), not only for myself but for the patient as well. My philosophy is that if you are concerned about radiation and your health, this isn’t the career for you. I find it very difficult to explain that there isn’t anything wrong with low levels of exposure. It isn’t always well received amongst the general public.”

Ash’s advice to others attempting to enter the field of nuclear medicine is this,

“Be sure there are jobs available for you when you graduate. Watch the trends and work with a career expert. There was a huge need followed by an over-saturation of technologists. No one is quite sure how the Affordable Care Act (Obamacare) is going to affect the business end of healthcare. Jobs might not be plentiful. My recommendation would be to explore all areas of radiology. Everyone needs an x-ray tech. CT has availability for graveyard shifts. MRI is always booked out for weeks. Ultrasound/vascular lab/echo has a huge patient volume. Nuclear med is a little more specialized and we aren’t the first level of diagnostic imaging. Meaning, someone is likely to have a chest x-ray long before they see us.”

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As a high school student, Tina Ash wanted to be a nurse.

“Our local hospital sponsored a nursing shadowing day for area high school students. I was assigned to shadow the oncology ward. In-patient oncology is essentially people who are very ill with cancer. It was a bit much to take in as a 16-year-old.”

As a result Ash began to consider a different career path.

“Because I didn’t think that was a good fit for me, I pursued other options in healthcare. I paged through a career booklet in the guidance counselor office at my high school. Nuclear medicine technology was listed as well as medical technology. It described both fields as needing a strength in chemistry, which at the time I really enjoyed. Nuclear medicine was described as a good mix of laboratory work along with patient care. I thought that was a nice balance.”

Ash’s title is a certified nuclear medicine technologist. She works at Scripps Green Hospital in La Jolla. The median annual wage for nuclear medicine technologists, as of 2012, was $70,180.

To obtain her title, Ash received a bachelor’s degree in nuclear medicine technology from the University of Wisconsin-La Crosse. She also completed a 12-month internship program.

“I completed my internship with Mayo Clinic in Rochester MN. Upon moving to California, [I have found that] most technologists here first become registered Xray technologists and then complete the 12-month internship. At that point they are eligible to sit for board exams for state and national registry. Other techs I’ve run into (I’ve worked with people from Nevada, Colorado, et cetera) have a bachelor’s in a general science like biology. Then, they’ve applied to the 12-month internship in order to sit for board exams. I’ve found benefits to either course. We all share the 12-month internship as a consistency amongst all technologists.”

Ash’s typical work day is a busy one.

“Almost all of our scans require an intravenous injection. So, in a typical day, we might be starting 5-12 IVs (depending on our workload). [We start] around 6:30 am or 7 am for quality control and checking in the isotopes that are delivered by an outside vendor. We usually have patients scheduled until 4 or 5pm. Once we scan a patient, we have “processing” of the images. Depending on the exam, it can be rather straightforward (just displaying the images for radiologist review and interpretation), or more in-depth by analyzing a specific area and quantifying the results.”

Ash has run into a few obstacles in her field.

“Some people have an intense fear of needles. But, I still have to start an IV. Many times it’s difficult to get a patient comfortable on the imaging table. For a good scan, they aren’t to move. So, it’s really important to make them comfortable to tolerate a 30-minute scan. Some patients are angry about a recent cancer diagnosis and they just aren’t happy to be here with us. When I worked with pediatric patients, the kids were great. The parents were a bit intense and demanding. Rightly so...it’s their child!”

Perhaps the most challenging task in her workday is the amount of paperwork she fills out.

“There are forms to be filled out for starting an IV, a signature here that you spoke to the patient, billing the patient correctly, reviewing the order from the ordering physician to make sure that’s correct—there’s a lot of stuff that needs attention to small details. And that’s not including the documentation required for administering an isotope. I’d imagine that’s about half of my day’s work.”

Ash believes the benefits of her job outweigh the negatives. “Although some patients are challenging, it really is the best part of my job. There are some really neat people who have interesting perspectives. I also like the pace of my job. Busy days go very quickly. And, I love the variety. It keeps me interested and focused. I’m not just doing the same thing over and over.”

Speaking of patients, Ash has run across some interesting ones. “We ask patients to bring their pants down once they are lying down on the imaging table, rather than changing them into gowns and tying up a prep room. I’m always surprised as to how many men don’t wear underwear. In fact, there was one patient I can think of that would routinely not wear underwear. He was very excited to point it out. Creepy.”

Since Ash works with radiation she is required to wear a body badge and a ring badge to monitor her exposure.

“We change out our badges monthly and review the results to make adjustments. The radiation exposure I’ve received over the last 18 years is still less than the allowable amount for a year. When I was pregnant with my kids, I was a little more aware of my technique. There are smaller allowable limits of exposure when you’re pregnant. But even then, I wasn’t anywhere near the limit.”

Despite the health risks involved in working with radiation, Ash is not concerned.

“My training and education is very thorough in practicing ALARA (as low as reasonably achievable), not only for myself but for the patient as well. My philosophy is that if you are concerned about radiation and your health, this isn’t the career for you. I find it very difficult to explain that there isn’t anything wrong with low levels of exposure. It isn’t always well received amongst the general public.”

Ash’s advice to others attempting to enter the field of nuclear medicine is this,

“Be sure there are jobs available for you when you graduate. Watch the trends and work with a career expert. There was a huge need followed by an over-saturation of technologists. No one is quite sure how the Affordable Care Act (Obamacare) is going to affect the business end of healthcare. Jobs might not be plentiful. My recommendation would be to explore all areas of radiology. Everyone needs an x-ray tech. CT has availability for graveyard shifts. MRI is always booked out for weeks. Ultrasound/vascular lab/echo has a huge patient volume. Nuclear med is a little more specialized and we aren’t the first level of diagnostic imaging. Meaning, someone is likely to have a chest x-ray long before they see us.”

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1

It isn't surprising that Ash isn't concerned about "the health risks involved in working with radiation" because the official medical training is devoid of disclosing the true facts on the toxicity of ionizing radiation. Such as that the lowest possible dose can/does cause cancer especially upon accumulation from regular x rays (discussed in: The Mammogram Myth by Rolf Hefti). It's a misleading misnomer to call a radiation dose allowable or permissible. From this profound lack of proper knowledge comes another false statement from Ash: "there isn’t anything wrong with low levels of exposure."

Aug. 1, 2014

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