BAS 425 Educational Narrative
[Name redacted; Identifying information altered throughout document]
Over the past 15, I have had the privilege to help diagnose illness through the use of radiographic imaging. I have worked as an xray technologist in several fields of radiology: plain x ray, OR xray, Nuclear Medicine, Special Procedures, Computerized Tomography, and Vascular Intervention. My work experience has led me to amazing opportunities and to my current career today as a clinical support and education specialist for Thomas Healthcare. The use of technology to help diagnose and treat disease is a real passion of mine. It requires knowledge and understanding of all products and equipment being used. However, it also requires implementing safety and evaluating your surroundings to be sure you are complying with strict standards to prevent accidents, over exposure to radiation, and to ensure a safe and effective experience for the patient. It is my hope that my years of experience working in a hospital setting, an outpatient lab, and operating room environment will allow me the opportunity to challenge this course as I pursue my Bachelor’s Degree in Applied Science.
- Do you have any of the certifications that count as course equivalency? If so, please provide documentation in your ePortfolio, and Congratulations! You’ve earned this course credit. If not, please answer the questions below.
- Describe the basis for the OSH Act, the OSHA inspection process, standards, and reporting of workers compensation records and statistics.
The OSH Act was implemented so that everyone could work in a hazard free environment.
Not all hazards are correctable by this act but there is a standard for assessing risks. In healthcare, we deal with OSHA standards daily and are required to learn and review yearly the updates to safety policies. The OSHA inspection process is usually performed unannounced. The OSHA compliance officer will do a review of the site’s history then they will visit the site and hold a meeting to explain what will happen and why they are there. They will then perform an inspection of the site. During the inspection, they will interview employees, point out and document potential work hazards, check documentation and maintenance records of major equipment, and document their findings. Afterwards, they hold a closing meeting where they will report their findings and issue any fines if necessary. Under OSHA, employee records have to be held for 5 years and any injuries or illness claimed on the job must be included in these records. Also the compensation an employee receives as a result of a work related injury.
Currently I work for Thomas Healthcare of North America as a Clinical Specialist in their Image Guided Therapies Division. This division provides products and education to physicians performing Vascular Surgery. In my day to day, I have a strict standard of safety that must be adhered to when helping physicians in these procedures. My job is to educate them on the proper use and safe handling of the product. I am also with them in person for case support during live cases. This starts with rigorous training to us as the educators. It is required that we go through a class on each new product we will be selling, We must memorize the Information For Use booklet included with each product, and test out on that product before we are eligible for case support in the field. This certification is included in our employee files for the duration of our employment. We are also required to take additional classes throughout the year to refresh our knowledge and keep us up to date.
During this training, we learn areas of the body each of the products may be used in, under what disease morphology they will be effective in, how to troubleshoot the device in case it malfunctions inside the body, and how to evaluate it for proper working condition before use. For example, in a recent case I had a physician want to use one of my products to access a specific artery. He was performing the case endovascularly. He had a wire down the leg but it was not in the true lumen of the vessel. One of my products allows you to visualize the artery under ultrasound. It has a needle attached to it that you can deploy once you are in the proper position. We opened the package and I guided the technologist scrubbed into the procedure on how to prep the product. Part of sterile preparation is to make sure the need can be deployed and retracted properly, and that all components are lubricated with sterile saline. There is a component of the device that must be plugged into the ultrasound machine. This is a computer piece. When I plugged the device in, an error occurred on the screen. Upon further inspection, we discovered that the electrical component was wet. We quickly unplugged the machine from the wall to ensure electrical safety. We then removed the device from the sterile table, dried everything off, and sent the product back to the company for inspection. The company followed up with me about the circumstances and this was documented. We avoided an electrical fire due to quick evaluation of the situation.
Our training is not limited to product use. We do procedures in hospitals, outpatient labs, and surgical centers. Each of these locations requires a different level of safety training with the hospital systems being the strictest. To be allowed to perform cases in the hospital, we must go through a Vendor Credentialing system like Parallon, Vendormate, or Intellicentrics. Our company has us attend safety training over aseptic technique, blood borne pathogens, electrical safety, fire safety, HIPAA, waste and abuse, National Patient Safety Goals, OR protocols, and radiation safety/ personal monitoring. These are required through OSHA to ensure we are well trained and educated in these areas so we will provide a safe environment for ourselves and the people we serve.
- Tell a story from your experience of an unsafe work condition or workplace accident and how you were part of the process to change the conditions to follow a culture of safety. What have been the effects or impacts of the changes you made?
When I worked in Nuclear Medicine, there was an incident where I accidentally spilled a low dose nuclear tracer on the floor in a patient care area. This was the result of a loose syringe shield that would not lock the syringe in place properly. The syringe holder is made of lead and has a locking mechanism. It is used to protect your hands from being exposed directly to the tracer.This was not in proper working order, so when I went to place it in the shield, it slipped and fell out on the floor.
The first part of our process was to remove people from the area. Then we contained the spill. We did this by placing a towel over the tracer so it would not spread and marked off the area. We then referred to our Policies and Procedure Manual on how to properly clean the nuclear spill. After reviewing this, gathering supplies, and properly dressing in gowns, gloves, and protective eyewear, we got to work cleaning up the area. We placed the towel that soaked up the nuclear tracer in a lead lined container and documented the time and date. We then recorded this on the container so we would know what day to check the towel to ensure the radiation had decayed. We then measured the amount of radiation being emitted with a Geiger- Muller counter and then documented dose along with date and time.
Next, we began to wash the area with a gentle detergent being careful not to spread the radiation or get it on ourselves. Once this process was completed, all cleaning items, gloves, and protective clothing were placed in lead boxes and labelled with time and date of incident. Then we re-checked the area with a Geiger-Muller counter to document the amount of radiation that was being emitted after clean-up. Finally, we covered the area with lead blocks and checked the location twice daily with Geiger-Muller counter.
We recorded our findings and reported all of this to our Radiation Safety Officer. He was responsible for reporting this as a medical incident, documenting our actions, and monitoring the situation. Due to our knowledge of proper safety protocols when handling nuclear tracers we were able to avoid an inspection. We corrected the syringe holder situation by removing it from our inventory and buying a new one. We reported this in our documentation.
This may seem like a minor incident and it was, however, this could have been a more dangerous occurrence. The amount of radiation I spilled was small and it decayed completely in seven days. Some of the tracers used in Nuclear Medicine have a high radiation dose. If this event would have happened with a larger dose or would have landed on a person, it could have been considered malpractice. OSHA requires that we as employees have all the equipment necessary to safely perform our jobs. In this instance, we as a team dropped the ball on providing ourselves and our patients with proper protection. I learned from this situation that these rules are in place for good reason, especially when you are working with liquids that can be considered harmful or dangerous. We performed a thorough inspection of all the syringe shields immediately to make sure they were working properly. My supervisor implemented a quarterly equipment inspection to guarantee that we were being safe. Under this inspection, we would document our findings and use this information as leverage in case something broke in the future. By having detailed information on the items in our lab, we were able to get broken or worn items replaced in a more timely manner by our Director. This allowed our department to run more efficiently and effectively.
- Describe the role of safety and health professionals in the workplace. In your experience, how is a safety and health professional part of a culture of safety in the workplace?
I believe a safety and health professionals role in the workplace is simply to help a company provide a culture of safety. They can do this by creating safe work plans, monitoring the work environment, assessing areas for potential risks and hazards, documenting the work environment, educating staff and management on safety in the workplace, and preventing workplace incidents. My interactions with safety and health professionals have been in the form of training and education on what is considered safe and unsafe. I worked under and also acted as a Radiation Safety Officer.
During my time in this role it was my job to monitor the radiation badges worn during procedures, hold radiation safety classes annually, check the equipment used for radiation protection like lead aprons, lead glasses, and lead shields to make sure they were in good working order and had no cracks, keep up with dosimetry reports for all employees exposed to radiation, ensure the x ray equipment had regular preventative maintenance by an engineer from the manufacturer to prove proper performance, and keep regular records for documentation. My Radiation Safety Officer provided us with the knowledge necessary to perform our jobs safely for ourselves and our patients. I was able to pass the knowledge learned from him to my next place of employment.
Another experience I had was helping our safety compliance officer set up fake fire drills at the hospital I worked at. We would go around with a clipboard and a red floor mat that said FIRE. These drills were unannounced. We would pick different departments or floors of the hospital to perform them in. He would then ask me to pull the fire alarm and we would document things like the number of people that came to put out the fire and their response time, how they contained the fire, the equipment they brought with them, if it was in a patient care area we would document the safe removal or lack of removal of the patients, the working order of the alarms and doors, and how long it took for the fire to be announced over head. The fire alarms were set to do two things when activated. They would send a signal to the operator in the hospital who would announce the fire overhead and contact fire department. The alarms also triggered the magnetic devices on the doors to release so they would close to help contain the fire immediately before someone got to it. He also would inspect each alarm and fire extinguisher to make sure it was working properly. I would help him document these inspections when we were slow. I found this to be a very interesting process and learned a lot about fire safety and things to look out for in my work area. He taught our staff to watch out for water in electrical areas, frayed wiring, patients smoking around oxygen, overheated equipment, and faulty equipment. Even though I was not a safety officer, helping in this format gave me valuable insight on his job duties and the value of a safe work environment.
- What changes have you seen in occupational safety and health issues during your work experience? How do you view safety differently now than you did earlier in your experience? Use Kolb’s cycle to outline the stages of your learning across your work experience–name each stage and describe what you did at each of the 4 stages step by step in your answer.
I think the biggest change i’ve seen to occupational safety and health issues is the shift from focusing on physical work hazards and the dangers of overworking, to include topics like mental health, harassment, and workplace bullying. Within all the companies I have worked for over the years, HR has been aggressive in addressing these issues through online training and in person meetings. About four years ago, I attended my first training involving workplace bullying. The training went over things like our language to one another, how to recognize the signs of bullying, how to report bullying if you see it happening, and how to evaluate if we as an individual were being the bully. During that training I observed what was considered bullying. Our trainer then gave us some time to reflect on our actions and conversations.
In the operating room, the language and conversation can be a little vulgar. I had never really thought about how my language might be affecting an individual or the environment as a whole. Even if we were all laughing at crude jokes, there could be someone in the room that was offended but was too embarrassed to speak up. This could be considered workplace bullying or harassment. The next day, I was in a case and someone made an inappropriate comment. This led to a pretty detailed conversation about a subject that should not be discussed in mixed company. Remembering the training, I looked around the room and saw there was a young woman pretty new to our practice sitting at a computer. She was looking down and her face was a little flushed. I could tell the conversation was making her uncomfortable. I changed the subject to something more light hearted and the rest of the conversation went on fine without any inappropriate comments made. I was able to catch this through reflective observation. Later she thanked me and said she just wasn’t used to that kind of talk. After thinking about the situation (abstract conceptualization), it made me realize that she shouldn’t have to be and that maybe I shouldn’t be used to it either. Later, I actively experimented and followed the proper channels for speaking to my HR representative about what happened that day. Through my concrete experience, the issue was resolved and a more professional environment was established.
In my current position, we have recently undergone training that focuses on mental health. Medical device sales can be very stressful. It is a highly competitive environment. Many sales representatives in this market tend to turn to unhealthy avenues to cope with stress, especially if they are underperforming. This was the case with a coworker of mine. I worked very closely with him. His role was to sell and mine was to educate and train. He was going through some personal things and it was affecting his job performance. Instead of going to our manager with his problems, he began to self medicate with alcohol. I think at first it started with one drink a night after work. Later on it worsened and I actively observed that it was becoming a more common place for him. Sometimes he would not show up to work or answer his phone. I became concerned. During the abstract conceptualisation phase, I remembered some of the signs and symptoms of alcoholism from our mental health training, so I reached out to my manager. He stepped in and gently addressed the situation. This active experimentation into our company’s policies on being healthy led to our manager being able to get his worker the help he needed. Our company enrolled my partner in a program to help with alcoholism and teach him healthy ways to manage stress. It greatly improved. About a year later he decided to switch careers and left sales. I believe this was a result of the training he underwent. He was able to make a healthy decision for himself. This concrete experience taught me to be careful and cognizant of what I’m turning to manage my own stress.
I am very thankful for the shift in focus to some of these other issues. Workplace safety isn’t just about the physical wellbeing of an individual but includes their mental and spiritual wellbeing also. Learning about this from an observational standpoint through online training and seminars helped me to become more aware of myself and my coworkers. When I saw the warning signs, I was able to act in a gentle manner. This in turn helped to create a safer work environment.