Radiology Technologist II - Part Time Regular

Job Title:          Diagnostic Radiologic Technologist II

Job Code:         DART II  

Department:          Radiology

Division:         Operations                            

Salary Level:        Non-Exempt 9

Reports to:          Radiology Manager                            

Last Revised:     January 2022

Primary Function 

The Diagnostic Radiologic Technologist specializes in using medical imaging equipment to independently produce diagnostic images of patients of all ages within the framework of established policy within the Imaging Department at Cherokee Indian Hospital.  The Diagnostic Radiologic Technologist is a licensed professional technologist responsible for assessing the patient appropriately before exam and producing diagnostic images of tissues, organs, bones, and vessels; including head, spine, trunk and extremities in both X-Ray and CT. 

The technologist in this position will perform exams in Radiology and apply advanced skills appropriate for the position within assigned functional area to meet the more complex requirements of the position. Duties and tasks are varied and may be somewhat complex. Resolves most questions and problems and refers only the most complex issues to higher level. Works under minimal supervision. May assist in training, assigning and checking the work of lower level employees as well as working with students. Level II Technologist must be registered in Diagnostic Radiology and at least one additional modality (CT, U/S, MRI, Dexa or Mammography)

The purpose of this position is to perform Radiology, CT, and the additional modality examinations and apply skills appropriate for the position within assigned functional area to meet the more complex requirements of the position.   Production of high quality images for interpretation by Radiologists that meet the standards established by the CIHA Radiology Department.  This requires competence, as determined by competency assessments, in a variety of imaging equipment and technology.  Performance of other functional duties and tasks as assigned will vary and be somewhat complex to assure efficient and optimal patient care.  Incumbent will practice proper safety guidelines for themselves, support personnel, and patients. The promotion of teamwork will be implemented through effective communication. This will ensure high levels of service and quality care are given for a positive experience for every patient. Technologist will resolve most questions and problems and refers only the most complex issues to higher level. The technologist will work under minimal supervision. They will assist in the training and checking the work of lower level employees and students.  The technologist must maintain flexibility and be open to work over and be on call when necessary, work holidays, and weekends as scheduled. 

CT

This specialty modality requires specific knowledge of cross sectional human

Anatomy and its application in spiral, and/or, multi-slice computer tomography, inclusive of 3-D reconstruction scans, including angiograms (CTA). The technologist requires specific knowledge and training in the location, appearance, and function of the various major and minor body systems susceptible to radiological illumination.  The technologist will require knowledge to interpret the examination request accurately; to understand the functioning and inter-relationship of the various organs; to use the methods and techniques which will identify organs appearing on the digital display monitor and the various stages of the examination to judge the acceptability of the image and/or scan for diagnostic use and to emphasize the aspects of interest to the physician. The Technologists assignments that include performance of independent duties in this subspecialty require advanced ARRT certification in Computed Tomography (CT).

MRI

This specialty modality requires operation of a strong magnetic scanner to obtain images used in the diagnosis and treatment of patient pathologies.  This specialty uses knowledge of imaging techniques and cross-sectional anatomy to create high quality images for interpretation of the radiologist and other medical providers.  The technologist has the ability to modify technical settings and adjusts scanning parameters to enhance images and minimize artifacts caused by involuntary motion. Technologist must specific knowledge of cross-sectional anatomy, 3-D anatomy and the different imaging planes to obtain any specified requests from radiologist. The technologist must have advanced awareness of safety factors governing a magnetic environment to ensure that patients, visitors, and equipment are completely safe upon entrance of the MR suite.  Technologist must performs proper screening documentation of all patients, staff, etc. that enters suite.  This screening includes but not limited to ferrous objects and cardiac pacemakers prior to those persons entering environment of the 1.0, 1.5, and 3.0 Tesla magnetic field.  The technologist must be able to work independently and accurately optimize MR imaging equipment to obtain examinations of acceptable quality utilizing the standardized amount of Specific Absorption Rate (SAR) and has the ability to operate all ancillary equipment necessary to complete the MRI study.  The technologist will require knowledge to interpret the examination request accurately; to understand the functioning and inter-relationship of the various organs; to use the methods and techniques which will identify organs appearing on the digital display monitor and the various stages of the examination to judge the acceptability of the image and/or scan for diagnostic use and to emphasize the aspects of interest to the physician. The Technologists assignments that include performance of independent duties in this subspecialty require advanced ARRT certification in Magnetic Resonance (MR).

Mammography

Performs specialized examinations of the breast to help in the diagnosis and treatment of breast disease in Mammography.  Mammography Technologist operates specialized X-ray equipment and performs various mammography related procedures including screenings and diagnostic studies.  Evaluate the image for technical quality such as density contrast, definition, and distortion.  Mammographers must have great patient care and communications skills.  Must be able to demonstrate empathy and compassion daily.  The Technologists assignments that include performance of independent duties in this subspecialty require advanced ARRT certification in Mammography (M). 

Bone Densitometry

Bone densitometry technologists are radiology professionals who are responsible for measuring patients' bone mass to determine bone health, especially for the purpose of diagnosing osteoporosis and other bone diseases. They make sure the equipment is operating properly, utilize appropriate safety procedures, position patients, follow physicians' orders to complete scans, and record and report results. Bone Densitometry technologist create images using specialized X-ray equipment to help doctors discover issues with patients’ bone health. The Technologist assignments include performance of independent duties in this subspecialty require advanced ARRT certification in Bone Densitometry (DXA).

Ultrasound

The Ultrasound Technologist performs a wide variety of routine and complex ultrasound procedures.  The Ultrasound Technologist is expected to perform Ultrasound imaging such as cardiac, abdominal, small parts and routine vascular examinations and may perform more complex imaging such as Doppler and guided interventional procedures such as paracentesis and thoracentesis.  The Radiologist reads the ultrasound images and the results of these examinations are used to direct the course of patient care for providers. The Ultrasonographer has knowledge of the heart, abdominal, small parts, abdominal and peripheral vascular physiology, and disease. With guidance from management and team leads, the incumbent performs clinical examinations on adults, geriatric patients, adolescents, and pediatric age groups.  The technologist assignments include performance of independent duties in this subspecialty require advanced ARDMS or ARRT certification in Ultrasonography. 

Duties and Responsibilities

•    Consistently provides quality patient care in a professional atmosphere while performing radiographic, CT procedures with accuracy and professionalism as prescribed by a physician, acknowledging the special needs of patients, i.e. pregnancy, trauma, sick and/or elderly patients.

•    Consistently performs quality radiographic exams by: 

o    Determines proper technique through the selection of voltage, current and exposure time to minimize patient and staff exposure and to effect quality diagnostic images; 

o    Properly positions patients to obtain optimum views of specified area of body       as requested by physician; 

o    Properly shields to minimize radiation to patient and staff and to ensure a safe environment.

•    Consistently performs quality CT exams by:

o    Determines proper protocol according to the ordering physician and the radiologist.

o     Properly maintains proper technique according to ALARA for both adult and pediatric patients. 

•    Transports patients to and from department and assists patient from bed or gurney to exam table.

•    Assures that any required consent forms are signed prior to examination, and obtains pertinent and adequate history on all patient exams.

•    Obtains and fills out proper reaction sheets and histories as necessary for all patients; and advises physician of allergies as warranted.

•    Practices sterile techniques and cleanliness at all times to prevent cross-contamination.

•    Performs radiographic procedures in the operating rooms, emergency rooms, recovery room and patient rooms, using portable equipment in a safe, efficient atmosphere.

•    Wears film badge at all times while performing any ionizing radiation exams.

•    Performs a variety of imaging procedures in Radiology and CT, along with the additional modality technologist is registered, if not CT.  Technologist operates all equipment safely and properly including scanners, injectors and monitors, following the manufactures instructions; troubleshooting malfunctions; calling for repairs; evaluating new equipment and techniques.

•    Performs procedures as a team member, with the Radiologist and independently such as angiograms, IVP’s, Upper GI Series, Barium Swallow, Small Bowel Follow Through exams, and air contrasted Barium Enemas.  Sets up the assigned room for appropriate procedure. Assures the sterile supplies, local anesthetics, contrast materials, catheters and other required equipment are present and laid out according to protocol.  Prepares contrast material for all exams. 

•    Assists in ACR adherence by performing any QA as required in Radiology and CT.

•    Completes all exams in a timely manner, keeps work flow moving, prioritizes patients accordingly and minimizes empty table time.  

•    Maintains knowledge of physical assessment, aseptic technique, intravenous skills and universal precautions.  Assures the sterile supplies, contrast materials, catheters and other required equipment are present.  Prepares power injector, choose protocol and specific factors needed for that exam and contrast material used for injection.

•    Specific knowledge of cross sectional anatomy, physiology, pathology, pharmacology (contrast media used in CT and its effects and reactions), medical terminology and its application in spiral, and/or multi slice computer tomography.

•    Differentiates artifacts from normal or pathological processes and recognized equipment limitations.

•    Technologist will act as a resource for students and newly hired techs. 

•    Makes recommendations to department managers for implementation of such technology and policies, which would improve the operation the radiology department

Education/Experience 

•    Must be a graduate of an accredited program with a Bachelor of Science in Radiological Technology (B.S.R.T) or Radiological Sciences (B.S.R.S); or Associate of Applied Science (A.A.S) in Radiography.

•    Applicant must have an unrestricted and valid Registered Radiologic Technologist license with the state of NC or a state that is accepted as reciprocity.

•    Must be registered with the ARRT in Radiography (R).

•    Must be registered with the ARRT in one additional modality (Computed Tomography (CT), Magnetic Resonance (MR), Mammography (M), Bone Densitometry (BD), or ARDMS or ARRT in Ultrasonography (US).

•    Must have 2 or more years of experience in the additional modality. 

•    Must have 2 or more years of experience in CT.

•    Must become registered by ARRT in Computed Tomography (CT) within 18 months of hire date. 

•    Proficiency rated at 1 year to become competent at job duties and responsibilities. 

•    Must maintain continuing education credits sufficient to maintain registry (24 CE’s/2 years).

•    Current Basic Life Support (BLS) is required

•    Applicant must have a valid Driver’s License 

Other Skills and Abilities

•    Must possess critical thinking skills and work efficiently in traumatic situations

•    Must possess a personality to work with and welcome diverse cultures and backgrounds.

•    Must possess the ability to operate new technical computer and imaging equipment.

•    Must possess the ability to adapt to changes in schedule and maintain flexibility to work weekends and holidays as scheduled and be on call when necessary.

•    Must possess the ability to interact compassionately and effectively with the critically sick (physically or mentally) or traumatically injured.

•    Must possess effective communication skills.

•    Must possess the ability to adapt and perform well as a team and independently.

•    Must possess excellent troubleshooting skills.

•    Must possess Accurate, efficient, key-boarding skills

•    Must have the ability to work under pressure with multiple priorities 

•    May be assigned to other specialized modalities as per documented competencies/registries.

•    Must become competent in starting IVs with IV catheter.

•    CIHA Radiology leaders have the ability to assign, reassign, or eliminate duties and responsibilities of this job at any time.  Critical features of this job have been described; those features may be changed at any time due to reasonable accommodation or other reasons deemed appropriate.  Other duties may be assigned as deemed necessary.

Job Knowledge 

•    Knowledge and ability to independently plan, manage, and organize work in order to meet priorities, accomplish work within established time frames and work in stressful situations. 

•    Knowledge to balance the needs of the patients and staff while still performing complex scans and procedures.  

•    Knowledge of radiation protection standards, devices, and techniques including concepts of accumulated dosage and genetic changes, effects of radiation on living organisms, and the effects of x-ray techniques on patients and operator exposure in order to assure that adequate safeguards are maintained.  To understand CT system principles, operation and components, to recognize when changes of equipment or procedures might result in increased exposure and to adopt methods to prevent such exposure.

•    Knowledge of principles, practices, techniques, and procedures of professional imaging in order to plan and provide services and care in radiology to meet the physical, emotional, spiritual, and socio-cultural needs of patients of all ages, specifically Infancy (Birth-1 year), Toddler and Early Childhood (2-5 Years), Latency (6-9 years), Preadolescence (10-12 years), Early Adolescence (13-15 years), Adolescence and Early Adult (16-20 years), Adult (21-64 years), and Elderly (65 years)

•    Knowledge of pre-procedural, procedural, and post-procedural care of patients.

•    Knowledge of basic first aid and basic life support practices related to radiology. 

•    Knowledge of anatomy and physiology along with cross sectional anatomy for CT exam, e.g. the locations, appearance and function of various organs and major systems of the human body.  Skill in using this knowledge to interpret accurately the examination requested and understand the functioning and relationship of the various organs of the system; to select the best x-ray views and CT images of particular interest to the doctor; and to identify the organs appearing on the film and the various stages of the examination in order to judge the acceptability of the radiograph and CT exams for diagnostic use.

•    Knowledge of radiologic physics including the concepts of energy, electric power and types of electric circuits, the construction, function and operating limitations of various types of x-ray tubes, digital detectors, portable detector imaging equipment and the properties of x-rays in order to understand the operation of x-ray equipment.  CT imaging, post processing, computerized reconstruction and image display.

•    Knowledge of radiographic exposure techniques including how to use formulas for determining technical factors, how to control density, contrast and distortion and how to use intensifying screens, digital detectors, buckys, collimator, filters, grids and other accessories to produce radiographs of high diagnostic quality with minimum of retakes.  CT image display informatics, artifact recognition and reduction for best image quality.

•    Knowledge of CT computer operations systems; to reconstruct images, MPRs, axial, 3D, area of interest that are outside the regular CT protocol.

•    Knowledge of first aid and life support practices including emergency cardiac arrest procedures in order to assist patients until a medical team can arrive. 

•    Knowledge of contrast agents administration and adverse reactions.  

•    Knowledge of contrast agent interactions with patient’s medications and the effects on the body.

•    Knowledge of contrast and dosages in accordance to patient’s tolerance, needs, and body habitus. 

•    Knowledge of venipuncture procedures, Intravenous catheter placement and care pre and post contrast media injection.  

•    Knowledge of universal precautions. 

•    Knowledge of medical terminology.

•    Knowledge of ACR Quality Assurance protocols in X-ray and CT. 

•    Knowledge of legal and ethical aspects of radiology. 

Complexity of Duties 

While performing the duties of this job, the employee is regularly required to stand; walk; use hands to assess and identify area of interest to center patients appropriately for specific imaging;  reach with hands and arms to pull, push, and lift patients that are unable to maneuver themselves; and talk or hear. The employee is regularly required to stoop, kneel, or crouch. The employee must regularly lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. While performing the duties of this job, the employee is regularly exposed to risk of electrical shock, and risk of radiation exposure. The employee is frequently exposed to mechanical equipment stationed in department, fumes or airborne particles, and toxic or caustic chemicals. The employee is regularly exposed to patients under a wide variety of circumstances, subject to varying and unpredictable situations; and is regularly exposed to unpleasant elements (accidents, injuries and illness); in addition, the employee is frequently subjected to many interruptions and, on occasion, long, irregular hours. The noise level in the work environment is usually moderate. The employee occasionally revises non-standard positioning and equipment set up to accommodate patients who are suffering from illnesses, deformities or injuries. The Technologist must constantly evaluate and modify existing knowledge to obtain the best diagnostic image.  

Supervision Received 

Employee will work under minimal supervision of the Radiology Manager and any requested guidance of the Radiologist. The Radiology manager provides detailed instructions on new procedures and techniques, and advises on technical problems.  Work is spot checked for diagnostic value and for methods used in conduction the examinations.  Textbooks, technical manuals, research paper/journals and computer sites on Radiology are available for additional guidance.  The employee must maintain up-to-date knowledge of developments in the fields of Radiology and Computed Tomography to recommend new methods, examinations and guidelines for adoption.  Procedures change frequently due to new developments and technology in the field.

Key Competencies under minimum supervision:

•    Customer Focused

•    Empathetic and compassionate

•    Strong work ethic

•    Flexible adaptability; willingness to accept change

•    Excellent mental, visual, and auditory attention to detail in all situations

•    Exceptional communication skills both written and oral

•    Commitment to interdisciplinary teamwork and use of evidence-based protocols

Responsibility for Accuracy 

The purpose of the work is to provide diagnostic radiographic and CT images for diagnosis and treatment to patients.  The effect of the incumbent’s performance of duties directly correlates to proper diagnosis and/or treatment. Clear and accurate studies are essential to enable the physician to evaluate and treat for patient’s conditions. 

Contact with Others

Personal contacts are with patients, patient’s family, and co-workers within the department and in the hospital, Radiologist, Physicians and other professional workers.  Personal contacts are for the purpose of performing the radiologic exam ordered by the physicians.  Contacts with co-workers are to exchange information to resolve problems with equipment, procedures and rescheduling patients and to coordinate work with other technologist when working on procedures, which may require more than one technologist or a team effort.  Contact with patients are to explain the procedure to be performed, patients who are unfamiliar with radiologic/CT exam aminations and to direct patients on how to move to achieve correct positioning.  Some patients are seriously ill, injured or nervous.  This may require the technologist to provide reassurance and comfort.  Contacts with professionals outside the department are to demonstrate and explain practical problems and procedures in taking radiographic procedures.  Contact with the Radiologist, in addition to receiving instructions, are to coordinate work efforts to resolve problems.  Contacts with other health care of related disciplines within the hospital, along with outside providers, for the purpose of sharing images, confirming orders or diagnosis to ensure quality care for our patients. 

Internal professional contacts include the department directors, coworkers, governmental agencies, vendors and the public to exchange and/or provide information. Interpersonal skills are required along with tact, decorum, and professional etiquette. Incumbent will consistently demonstrates customer service skills and care to patients and internal/external customers by displaying Right Way behaviors and skills.

Confidential Data

The employee has access to highly confidential patient medical and personal information. The Privacy Act of 1974 mandates that the  employee shall maintain complete confidentiality of all administrative, medical and personnel records, and all other pertinent information that comes to his/her attention or knowledge.  The Privacy Act carries both civil and criminal penalties for unlawful disclosure of records.  Violations of such confidentiality shall be cause for adverse action.

Mental/Visual/Physical 

There are long periods of standing, walking, bending and carrying of moderately heavy items, such as detectors, lead shields, and lead aprons, positioning weights, stretchers, wheelchairs and patients.  Considerable physical efforts involved in pushing and positioning of patients who are unable to assist or cooperate and lifting of totally incapacitated patients should only be done with the help from other employees.

Close attention to detail and mental concentration for extended periods of time are required. This is a multi-tasking position, which is subject to frequent interruptions requiring varied responses. Must deal with multiple situations concurrently. Must have ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.  Must frequently use creative thinking to complete tasks or solve problems. Physical efforts require mobility, reaching, bending, manual dexterity, and visual acuity. 

Environment

The work environment is in a restricted access area. Will be exposed to moveable equipment, chemical fumes, patients with contagious diseases, electrical equipment, ionizing radiation, and contamination or infection through accidental needle puncture or exposure to blood and/or body fluids. Occasional exposures to odor, blood, chemical irritation, and a variety of constant interruption.  Area is supplied with personal protective equipment.  Area has appropriate light and is temperature controlled. Telephone and computer access are adequate for communications.  There may be occasions when overtime is required.  Will be necessary to work when Administrative leave is granted if patient care would be compromised.

Customer Service

Consistently demonstrates superior customer service skills to patients/customers by demonstrating characteristics that align with CIHA’s guiding principles and core values. Ensure excellent customer service is provided to all patients/customers by seeking out opportunities to be of service.