Compassion in radiography

This month’s blog is written by Dr. Ruth Strudwick. She is an Associate Professor and the Subject Head for Radiography and Interprofessional Learning in the School of Health and Sports Sciences at the University of Suffolk.

When asked to write this blog, I immediately accepted, as patient care has always been a subject close to my heart and as I write this, my Dad is in hospital recovering from major surgery. Often we can write the right words and say the right things, but it only when we start to experience healthcare from ‘both sides’ that we start to understand how important compassionate care is. I have to say that my Dad has been very well cared for and I have seen and experienced first-hand compassionate care, patient-centred care and values-based practice.

In her article, Hendry (2019) proposes a pedagogy for the promotion of compassionate care in radiography. She suggests that we can develop the skills to become compassionate professionals. As radiographers, this may appear to be a difficult concept, due to the history and professional culture that we are part of. The relationship that diagnostic radiographers have with their patients is quite different from the relationship between many other health care professionals and their patients (Murphy, 2006). The diagnostic radiographer spends a relatively short period of time with their patient and the interaction is task focussed, i.e. the production of a diagnostic image. This relationship is therefore transient and the radiographer does not really have the time to get to know their patients (Strudwick, 2011). The therapeutic radiographer may have more time to build up a rapport with their patient as they will attend for treatment on several occasions. However, time constraints and shift patterns (with a lack of radiographer continuity) might compromise this relationship.

The diagnostic radiographer has to both understand and use the equipment to produce a diagnostic image (product) whilst at the same time interact with the patient, in order that the image produced is useful for diagnosis (process) (Strudwick, 2011). This could also be applied to the therapeutic radiographer. As early as 1978, these two seemingly contradictory roles of the radiographer were noted by Fengler (1978), who said that the diagnostic radiographer needs to have both a technical and psychosocial ability in order to look after their patient. McKenna-Adler (1990) agrees with this notion and claims that diagnostic radiographers carry out two potentially conflicting roles, both technologist and carer. He calls this a technology-humanism dualism.

In her paper Hendry uses a definition of compassion written by Willis (2015): ‘…how care is given through relationships based on empathy, respect and dignity; it can also be described as intelligent kindness and is central to how people perceive their care’.

It is easy for radiography students to see the importance of the technical aspects of their role, in this case the use of imaging equipment and the production of a diagnostic image. However, we should not lose sight of the person who is our service user. It is equally important to build relationship by finding out about their needs and what is important to them, developing empathy, being respectful and maintaining their dignity.

Hendry uses another definition of compassion from Dewar (2011): ‘…involves noticing another person’s vulnerability, experiencing an emotional reaction to this, and acting in some way with the person, in a way that is meaningful for people.’

This suggests that compassionate care should come from an emotional response to the other person, and there should be a resulting action from this response. This is where reflection comes in, we (and our students) can reflect on our emotional responses and our actions when interacting with our service users. Refection can promote compassion though modification of our responses and our behaviours.
We should also acknowledge that service users are also educators and can provide feedback on the care that they receive and they should be partners in their own care. Shared and informed decision-making are key to compassionate and values-based care. We need to be open to learn from our service users.
Back to my Dad, his care has been compassionate and values-based. All of the staff have taken time to give clear explanations about what is happening and the possible treatment options. They have taken time to get to know him as a person and to find out what is important to him. I have also learnt from this, but by being on ‘the other side’. Every day is a day to learn.

References:

Fengler K (1978) The patient-care gap. Radiol Technol 49(5) p599-600.

Hendry J (2019) Promoting compassionate care in radiography – What might be suitable pedagogy? A discussion paper. Radiography 25 (2019) p269-273.

McKenna-Adler A (1990) High technology: miracle or malady for patient care. Radiol Technol 61; p478-481.

Murphy F J (2006) The paradox of imaging technology: A review of the literature. Radiography. 12, 169-174.

Strudwick R, Mackay S & Hicks S (2011) Is Diagnostic Radiography a Caring Profession? Synergy, June 2011, p4-7.

Willis P (2015) Raising the bar: Shape of caring: a review of the future education and training of registered nurses and care assistants. Health Education England, London.

Being Newly Qualified

shutterstock_1133546873-800x445This month we have two blogs for the price of one! Sarah Bradder and Steven Cox share their thoughts on being newly qualified in the world of radiography.

Blog Part 1: Sarah Bradder

Screen Shot 2019-09-01 at 11.14.19‘Yeah, it’s going great thanks!’ almost became my catchphrase in my first couple of weeks, I said it more times than I care to remember. But in actual fact, I was struggling immensely with the transition from student to newly qualified practitioner.

I got my partner to take a ‘Sarah’s first day!’ photo in our hallway as I was wearing my uniform for the first time. I remember being so excited and proud to finally be here. Then the nerves started to kick in before I even stepped into the building – just like the first day of school really. I started as a band 4 trainee therapeutic radiographer until my HCPC (Health and Care Professions Council) registration came through, when I automatically became a fully-fledged band 5. This helped massively to some extent and I even feel like I was almost clinging to my unregistered status like a security blanket. It gave me the ‘luxury’ of not being one of the two treating radiographers responsible and accountable for a patient’s treatment. The reality is that while my degree trained me (and very well I might add) to be a student therapeutic radiographer, being a member of staff in an unfamiliar department is a whole new ball game. The excitement and nerves gave way to feeling overwhelmed. Imposter syndrome hit me like a tonne of bricks. I felt like I couldn’t help patients because I didn’t know what department protocol was for various things. I felt like I couldn’t help the staff within my team because I didn’t know a) who anyone was, b) where anything was and c) how they used certain systems. I honestly can’t remember the last time I felt like more of a hinderance. It upset me so much because being a therapeutic radiographer is all I’ve wanted since I was 17… so to finally be here 10 years later and feel like an imposter was utterly mortifying.

Thankfully, after two weeks of pretending that I was ‘fine’ I came clean to my mentor. I learned a valuable lesson in that admitting you need help or admitting that you’re overwhelmed does not under any circumstances make you seem incompetent or incapable. It’s such a difficult time; becoming familiar with a new department, trying to find where you fit in within an established team, becoming accountable for patients and making decisions about their treatment. It’s a rollercoaster of emotions and I’ve been fortunate enough to be working with radiographers who have understood this struggle and have supported me. However, it doesn’t lessen the fact that we are still expected to ‘hit the ground running’ and when you’re working in a big, busy department this is not easy.

I’ve had discussions with experienced radiographers outside of my place of work about this transitionary period and the best way that we have been able to describe it is as follows: You go from being a third year student, being part of the team where you’ve been training for three years, you know the department and how it runs like the back of your hand. Then suddenly, you’re somewhere new. You don’t know anyone. You’ve gone from being top of your game to feeling like you’re right at the bottom. So when it’s put like that it’s almost inevitable that everything isn’t going to feel great straight away! But that doesn’t mean that I’m an imposter or that I’m not good at my job – I like to think it means I care enough to want to be the very best therapeutic radiographer that I can be for both the patients I treat, the staff I work alongside and the students that I mentor.


Blog Part 2: Steven Cox

Screen Shot 2019-09-01 at 11.12.00The transition from student to preceptee was a relatively abrupt and uneventful one; I traded in my lectures for shifts, and life went on. Despite this relatively smooth transition period, a lot has changed from my simple student placements and some of it is definitely taking its toll.

The biggest difference from being a student that hit me hard was the loneliness of being a diagnostic radiographer. Now by no means is the career actually lonely but that shift from being a student under constant supervision, where someone is always within earshot to ask questions or to get help from is gone, and it does leave you feeling insecure and alone. When the department gets busy and the conveyor belt of patients starts up you can find yourself just going from patient to patient and those casual chats and ‘debriefs’ you had from supervisors are gone it is just you left to question yourself, second guess yourself, and frankly that is the worst part of it all; the doubt.

Once I received my registration and began working independently, doubt was my arch-nemesis, the radiographer’s twitch took over and I felt myself slowing to a snail’s pace, even the simplest procedures became shrouded in doubt that what I was doing was wrong, the constant ‘what-ifs?’ It must have taken a week or so to build the confidence to know that yes, I can do the simplest procedures and yes, my previous three years of work has left me with some knowledge.

Once I was over this barrier, I overcame another stage that made life so much easier; asking for help. The expectation that I was now a professional who could do anything was huge, albeit the fact I was the only person applying this pressure. Once I realised it was okay to seek assistance with that tricky case my stress levels plummeted and frankly, I gained so much more from the experience.

The staff in my department are exceptional, the family of radiographers here have welcomed me in with open arms, I truly believe my mentor would fight to the ends of the earth to ensure I have the smoothest first steps into my career and most importantly a protected preceptee status that the whole department welcomes and understands. They recognise that by taking the time to help me now, I will become a better radiographer because of it. Rather than leaving me alone to sink repeatedly, struggling, they can take the time to set me up with a stronger base on which they can mould me into the department before I am left to go alone as a more effective member of the team.

By working in a department that understands the value of this learning experience where staff are willing to invest time into helping you settle in the department can work in a stronger more positive manner. Not only the radiographers but friendly porters, receptionists and admin teams who can show you where to find things and get set up, friendly surgical teams that helped you find your feet in difficult theatre cases and so many other health care professionals all have an impact on those first impressions of a radiographer’s career.