“Comfortable Being Uncomfortable” – Key Lessons for Radiographers During COVID-19

As radiology, hopefully, enters a post-pandemic stage, many workflow and protocol changes will remain in place.

It’s been a long year for providers as they have worked around-the-clock to identify and care for patients who have been infected with COVID-19. The virus brought rapid and extensive changes to daily practice – many of which are likely here to stay.

In an article published this week in the Journal of Medical Imaging and Radiation Sciences, a team of investigators from Singapore General Hospital and University College Dublin School of Medicine in Ireland outlined some key lessons learned and some strategies that will remain post-pandemic. These new norms show how radiographers have pivoted to accommodate change.

“The impact of the COVID-19 pandemic on radiographers has been unprecedented. The threat of COVID-19 has underscored the importance that radiographers be nimble, resilient, and resourceful,” said the team led by Yi Xiang Tay, principal radiographer at Singapore General Hospital. “Many of the changes, while uncomfortable, have been crucial in the battle against COVID-19. The radiographers have transitioned well and have been more ‘comfortable being uncomfortable.’”

Related Content: Lessons from Singapore about COVID-19 and Radiology

Key Lessons

Teamwork: Longer shifts that offered radiographers little sleep highlighted the need for teamwork during the pandemic. Daily check-ins with team leaders not only gave radiographers the opportunity to communicate their concerns, but it also provided time to boost morale.

Communication: Clear communication about the constant changes to workflow, protocol, and patients’ infectious status, has been vital to safeguarding healthcare workers. However, with many foreign workers helping during the pandemic, reaching this goal was difficult, and it prompted radiographers to think outside-the-box. To overcome language barriers, they used body language or Google Translate, and some learned simple breathing instructions in other languages to streamline communication.

Infection control: Strict infection protocols that required equipment disinfection after every patient quickly became standard during the pandemic, as did hand hygiene and isolation measures. Singapore General Hospital now uses a Pandemic Audit Tool to monitor radiographer compliance with hand hygiene and isolation protocols, and random audits support the culture of compliance.

New Norms

As vaccination rates increase and the pandemic, hopefully, begins to abate, there are no plans to return to the pre-pandemic status quo, the team said. Many of these changes will linger as new norms.

“As the medical imaging profession moves forward, some of these new norms will remain intact as they have brought value to the current clinical practice,” they said. “These may be lessons to learn for maintained advantages after COVID-19.”

Infection Control: Mask-fitting, which was previously done at Singapore General after radiographers were working in the clinical environment, now must be completed before they begin working. Two radiographers have been trained and certified to be in-house mask fit test administrators during orientation days for all new radiographers.

In addition, a dedicated isolation team of two radiographers has been designated to operate a mobile radiography unit. They are responsible for scanning patients who have COVID-19, as well as disinfecting the equipment after every patient encounter. This strategy has proven effective in preventing cross-infection and transmission among radiographers, the team said.

Facility management: Including radiographers in the design of future X-ray facilities. For example, at Sengkang General Hospital, radiographers explored conducting chest X-rays through a glass panel in ward settings – a strategy that proved technically feasible and that saved PPE use. In addition, they said, radiographers offered ideas on using digital documentation to manage essential resources and mandatory PPE training.

“In hindsight, one would reflect that the medical imaging profession should play a contributory role in the design of our future wards,” the team said. “This could improve the radiographers’ efficiency in performing chest radiography in times of pandemic, while minimizing risk of infection.”

Mental health: Radiographer mental wellness is not a new concern, but the pandemic did offer a stark reminder of the need to recognize the warning signs of psychological distress. Efforts, such as COVID-19 care packs that can be sent to a radiographer’s home, can be integral in helping staff feel supported and encouraged, the team said. Additionally, folding a daily check-in into the daily roll call also provides an opportunity for radiographers to share their concerns or raise any issues.

Professional development: The need for social distancing gave way to teleconferencing during the pandemic, and the platform will likely remain popular, the team said. Radiographers now participate in weekly professional development programs, and several international societies now offer free online support resources for these professionals.