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Scope of Practice of Assistant Practitioners Essay

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1.1 Profession Radiographer

1.2 CPD number FORMTEXT CPD1234

2. Summary of recent work/practice My role as a radiographer practitioner comprises all the necessary information to practice my future profession. For instance, through the various lessons that I have studied so far, I have learned all the theory that a professional radiographer should know and I can link theory to practice. Moreover, I am able to work in a team and support my teammates in order to achieve better results. I worked in busy hours at the hospital and I gained the ability to manage workload.

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As a student radiographer, I became comfortable handling all the equipment in the radiology department of the hospital, which was achieved through the internship offered to us at the hospital as students. I gained wide experience in different modalities such as Mammography, Computed Tomography, Magnetic Resonance Imaging, DEXA, and Ultrasound.

I have learned to correctly position the patient for any examination they need without the help of my supervisor. I also learned to use all radiography equipment safely by following the protocols needed. I learned the importance and the usage of contrast agent in various examinations in order to provide the right images to doctors for best diagnosis. Through my practice, I have acquired the ability to work independently and without supervision. Practical experience gives me a great opportunity to be prepared and understand my role as a future radiographer but also gave me the opportunity to work and collaborate with professionals and learn from their knowledge. I can communicate with patients, colleagues, and hospital doctors, as well as managing situations involving children. I had the opportunity to deal with people of various nationalities and different religions and I know the importance of respect in our field. I am able to communicate with routine patients, seriously ill patients and the staff of the hospital.

I know all the protocols and rules of the radiology department in Cyprus. Also, through the nursing procedures lesson, I learned various and useful information in order to deal with different situations that I might face as the radiographer. Furthermore, I have learned where all the necessary equipment is placed for my own protection, but also for the patients. I know how the various trash bins in the radiology department are used such as the hazardous trash bins, as well as knowing how to properly protect myself from various illnesses that patients may have, but also how to properly clean and disinfect the area to prevent infection of other patients from infected patients. 3. Personal statement 3.1 Reflection The Gibbs Reflective Cycle is critical for our profession. It is a powerful tool for reflection after a critical incident that had significant positive or negative impact on me. Learning by practice (Gibbs, 1988) is essential for healthcare professionals and students. I use the Gibbs Cycle in order to overcome situations that generally do not have a good outcome. The chosen reflective cycle is using 5 stages that helped me to enhance my attitude and my critical thinking on quotidian activities (Clouder, 2000). Reflective cycle practically speaking is an ongoing education that is fundamental in learning process for me and for any student to build up the essential aptitudes and clinical thinking (Sladyk, 2001). Most healthcare professionals begin utilizing reflecting cycles in order to improve their skills and behavior for better results. Additionally, reflective cycle helped me to perceive my weaknesses and strengths in any circumstances and helped me to improve my knowledge in order to cope correctly in future. Reflecting cycles are very important and beneficial for my practice as they enable me to look at my practice and see what I would change and make it better in the future in order to improve my practice because my actions can benefit the patients and me (Standard 3 and 4).

Below, I will describe an incident that happened on an evening shift in Larnaca General Hospital and I realized how effective the Gibbs Reflective Cycle was for me. Gibbs reflective cycle consists of six stages, the first is the description of the incident (appendix 1). The second step is an analysis of the feelings I was shocked that the nurse did not use gloves or use alcohol prior touching the patient especially with the protocols and infection control guidelines everywhere in the department. I did not want to make her feel bad or uncomfortable but this is very important in order prevent infections. After the incident, she justified her actions by saying that she was in a rush and she forgot to do the correct procedure but she will not do that mistake again. The third step is evaluating this event was a good lesson for her in order to make her start using the protocols and guidelines and she responded positively to what my supervisor and other doctors told her. The fourth step is an analysis of the experience It is fact that hand hygiene is the most effective way to prevent infections at hospitals (Ltourneau, Alderson and Leibing, 2017).

The cornerstone of infection prevention and control practices is the hand hygiene and can distinctly diminish hospital infections. Despite that, evidence showed that medical doctors and nurses demonstrate poor conformity (Kingston et al., 2017). As indicated by late reports from the Centre for Disease Control and Prevention, healthcare staff don’t clean their hands as frequently as they ought to (CDC, 2016). The fifth step is the conclusion I understand that I need to support my colleagues even if I am not a nurse but if I see something that puts patients and us at risk I should mention it immediately in order to prevent worst situations. The sixth step is the action plan my action plan is to try to improve and develop my skills when I work with my colleagues to ensure the health and safety of the patients and I will make this a learning goal and I will discuss some strategies for how I can achieve that with my mentor. (Standard 3).

3.2 Medico-Legal Aspects Through medico-legal aspects, I realized the significance of confidentiality. It is very important in our area to have confidentiality between healthcare professionals and patients. For instance, there must be medical confidentiality and I cannot talk about, or discuss anything that has to do with a patient along with other colleagues or any other individuals. The only way this can be done is with the patients written consent or in cases of rape or abuse (Burris, 1995). I comprehend that I have legal and moral responsibility to protect the privacy of the patients unless the release of those data is required by law. Something else that is critical, is that occasionally there are patients who need medical help but they refuse it for their own reasons, for example, a justifiable reason is a religion.

It is my duty to respect it, even if this can lead to the death of the patient. Furthermore, it is my task to inform the patient about the consequences of his choice and at the end, if he/she accept the treatment, I have to take his / her written consent and then proceed. Moreover, I recognize that all patients have the same rights and I cannot behave differently for each patient (Taylor, 2000). Therefore, I have to provide, equally to everyone, the best quality of service, it doesn’t matter if someone is poor or rich. One of the principles incorporated in healthcare human rights is that healthcare must be accessible to anyone without discrimination concerning age, sex, race, disability, income or social status. Something very important in our field is that the patient must be able to make decisions about his or her health and that we cannot take decisions for them. In the economic field, it should be mentioned, that patients must be informed about the fees and charges of their treatment before accepting it and thus be able to choose what they consider to be the best for them (Hong, 2009). Medico-legal aspects are essential and must be followed for the patient’s safety, our own, but also the proper functioning of the hospital. (Standard 3 and 4).

3.3 Clinical Governance Trough clinical governance classes I realized the importance of clinical governance in healthcare areas. Clinical governance is defined as the system through which NHS organizations are accountable for continuously improving the quality of their services and safeguarding high standards of care, by creating an environment in which clinical excellence will flourish (Scally and Donaldson, 1998).

Clinical governance is very important as its role is to improve the safety and quality of the patients care. It is very important in order to achieve high standards in healthcare and this involves clinical and self-governance but also the management of resources. The components of clinical governance are very important in order to achieve what clinical governance aims to achieve. For example, some of the components of clinical governance is identifying the clinical risks of the patients and staff, also is maintaining the capacity and capability to deliver services and ensures the quality of the patients care. Through clinical governance, here are seven fields of activity which are utilized to ensure we convey the best quality healthcare to our patients and they are as following Risk Management, Staff Management, Clinical Audit, Education Training, Clinical Information, Clinical Effectiveness and Service Users, Carers General Public (Standard 3 and 4). There are many agencies that act as advisors in order to ensure clinical governance such as NICE, HCPC and SCoR, NPSA, ICRP and many other. I can say that clinical governance is applied in Larnaca General Hospital as through the two years that I am doing my training I saw many good changes in our department. For example, many times radiographers were sent to seminars about new methods of examinations that are better for patients and for us, also I know that in Larnaca General Hospital we have a very good mammography that other hospitals do not have yet. Furthermore, we have people that coming very often to check the equipment it is in a good condition and if is working correctly in order to ensure our safety but also the patient’s safety. Clinical Governance is very important and must be implemented in every hospital for the best of all, patients and staff. (Standard 3 and 4).

3.4 Manual Handling The Manual Handling Operations Regulations (MHOR) characterized the manual handling as any move or support of any onus by bodily force or by hand and this includes lifting, pushing, putting down or pulling anything (MHOR, 2016). I recognise the importance of manual handling in our sector as the failing of correct manual handling is increasing the risk of injury during a task. It is very important because poor handling and moving practice can lead to harm of individual being moved and employee, also it can lead to musculoskeletal disorders or back pain and as a final result the inability to work (Nolan et al., 2017). I recognize the importance to adhere to the right rules for our own but also the patients health. Some principles of manual handling are among others, the following, ensure that the object is sufficiently light for lifting it, heavy ought should be moved utilizing a handling aid, ensure that the route is clear of impediments, ensure there is some place to put the load down wherever you need to take it, it is also very important to be as close to the onus as possible, utilize the legs to lift anything and in a smooth movement and something else very important is to avoid twisting our body because this can cause knee or spine injuries by the years or instantly (Swiatczak, 1992) (Nolan et al., 2017). Through this lesson I learned the manual handling rules and that the dangers of incorrect manual handling are a lot. It is very important to have a good ergonomics in a workplace in order to avoid any injuries that have to do with weight lifting and it does not matter if is light or heavyweight because if it is repeated with wrong manual handling can cause problems. (Johnstone and Owen, 2017) (Standard 3).

3.5 Cardiopulmonary Resuscitation Cardiopulmonary Resuscitation (CPR) is very important in our area as cardiac arrest can happen anywhere and anytime. According to American Heart Association, nearly 52,000 cardiac arrests occur in hospitals annually in America. It is very important for us to be trained on CPR because it might happen in Radiology Department and we should know how to face such incidents in order to save someones life. Through CPR lessons and Nursing Care Procedures that I did during my studies I learned the right procedures for cardiopulmonary resuscitation in order to save someones life. The time margin to respond in such cases is very small since the brain only needs six minutes without oxygenated blood to die, and in these cases time counts. With CPR we can avoid brain injury but even death. The sooner we act, the patient has more chances to live without any problem. There are some steps before CPR, and must be followed strictly. The first step is to make sure that the scene is safe for us and then to proceed, the second step is to call 112 for assistance, the third step is to open the airway by tilting the head back in order to lift the chin, the fourth step is to check for breathing no more than 10 seconds and if there is no breathing we can start CPR. The CPR steps are as following place our hands in the middle of the chest one on top of the other and use our body weight for compressions for at least 2 inches deep and at a rate of 100/m, after the 30 chest compressions we need to deliver two rescue breaths and then we need to repeat that until a trained medical responder arrive on scene or the patient starts breathing (American Red Cross, 2017). I faced an incident were I had to make CPR in order to keep a man in life until the ambulance came. No one on the scene knew how to provide CPR and it was my first time that I did that, I was scared but I knew what to do and how to do it correct and this is very important. The only thing that went wrong is that I broke one of his ribs but I believe that is better from letting him die. This man now is alive because of me and this is a very good feeling. (Standard 3 and 4).

3.6 Mentoring Mentoring is a mutual relationship in which mentor and mentee use experiential and reflective learning methods in order develop attitudes, knowledge and new skills. Critical thinking methods and reflective thinking are created through dialogue with my mentor with whom I share knowledge and experiences of our field. The role of my mentor in those three years of studies was very important to me, she always advised me, guided me and gave me feedbacks. My mentor is very good at encouraging me to do new things and to supporting me and what I believe. She helped me several times by recommending books or other learning tools in order to help me with my personal development or in order to help me with my projects. She is a very good listener and he has a lot of patience. She is very honest and sometimes providing tough feedbacks in order to make me move forward. I would not want to change anything on my mentor, our cooperation so far has always been flawless until now and she always willing to help in what I need. 4. Summary of supporting evidence submitted.

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