Routine duties are those performed on a regular, repetitive basis. It should be recognized that what is considered as routine for some mid-level providers, because of their training and experience, may be non-routine for others. Thus, the authority to perform these duties must be specified in the Scope of Practice. Routine duties include:
1. Monitoring patients during Nuclear Medicine Stress testing and providing support to primarily to the Interventional Radiology (IR) section.
2. To prevent any misunderstanding regarding this position, the Radiology Mid-Level provider does not interpret medical imaging, create or approve medical imaging reports. Regarding Radiology IR procedures when requested by the Supervision the Radiology Mid-level assists the Radiologist during the procedures but does not perform the procedure nor make any imaging diagnosis related to the procedure.
3. The RML performs patient assessments, initial patient history/ physical examinations, documenting findings as directed by the supervising Radiologist. Medical record notes/orders/consults will be reviewed by the supervising physician who will co-sign within the specified time frame as outlined in the Medical Staff By laws.
4. Conducts patient assessment and evaluations for nuclear medicine stress testing. Reviews history/orders/notes to ensure that pre-procedure safety criteria have been met. Obtains history and informed consent for nuclear medicine stress testing. Documents in CPRS pre-stress testing H&Ps, results of EKG report review, medication review as it pertains to nuclear myocardial imaging. The RML will independently supervise and monitor treadmill exercise and pharmacological stress testing. Writes evaluations and progress notes on patients, monitors patients after testing within the scope as defined by Supervising Radiologist/Nuclear Medicine physician. Will maintain BLS and ACLS certifications. RML will perform initial assessment of patients having unexpected symptoms during stress testing, notify the supervising Nuclear Medicine Physician as soon a possible.
5. Providing and coordinating comprehensive care for assigned patients in any care setting. The RML will manage simple interventional procedural complications and educate patient regarding potential or known procedural complications. If there is a significant change in a patient's condition based on direct observation or via telephone/computer patient contact, the RML will notify the clinical supervising Radiologist and indicate in the medical record a change patient condition. A note should also be made that this was discussed with the clinical supervising physician.
6. Following SOPs in Nuclear Medicine and Radiology/IR Radiology the RML will screen patients to determine if patient meets inclusionary/exclusionary criteria for performing the requested exam/procedure. RML will manage Nuclear Medicine and Radiology/IR consults in CPRS as directed by the Supervising Radiologist.
7. The RML will administer and/or order medications under their scope of practice including enteral or IV contrast media, under the supervision of a Radiologist and in accordance with Federal and State law.
8. Obtain informed consent from patients regarding procedures and/or exams using appropriate CPRS/IMED procedures.
9. Completes chart documentation, Radiology tracking data used for scheduling and/or quality improvement or safety initiatives as directed by the clinical supervision Radiologist or Chief of Radiology. The Radiology Mid-level will have frequent direct/telephone/computer contact with patients and will be expected to contact patients by telephone to facilitate their understanding and preparation for Radiologist exams/ procedures and to monitor patients for complications or other adverse events that might alter care or planning.
10. The Radiology Mid-level will review medical records including historic Radiology reports, PACS images, Vista Imaging as they relate to the RML's duties.
11. When requested, assists Interventional Radiologists with a variety of procedures including PICC lines, central lines, fluoroscopic procedures, injections, thoracentesis, paracentesis, arthrography, ultrasound biopsies, port placement and port removal and any other procedure performed by Radiologists. The Radiology Mid-Level may have radiation exposures similar to Radiologists and therefore the RML will be required to follow all applicable Radiation Safety policies and procedures including any additional measures recommended by the facility Radiation Safety Officer (RSO). The RML will complete all elements of VA/Facility mandated Fluoroscopy Safety training.
12. Incumbent will record, track and maintain database/spreadsheet(s) for complication-efficacy tracking (designed by IR Section Chief) and track patients through CPRS and/or provider and patient contacts to determine short term/long term outcomes of complications/efficacy. He/she will produce graphs and analysis of complication-efficacy data and create reports for review by IR Section Chief/Chief of Radiology. When approved he/she will submit reports to Chief of Radiology.
13. Communication and interpersonal relations, including the ability to appropriately and courteously relate to inter and external customers.
14. Maintenance of confidentiality of patients/employee information, electronic and printed.