Bruce, a middle aged father of two, loves to ride his motorcycle. It provides him with a source of stress relief and recreation. He often looks forward to the ride home as therapy for a stressful day of work. As a Magnetic Resonance Image (MRI) technician, he frequently has to deal with very emotional situations. Although this scenario is not unique to the MRI technician, many others do not share the same caring commitment. Bruce knows that the patients can tell if there is a genuine interest in their welfare. However an apathetic sentiment is not a problem for the MRI staff. You see, MRI technicians care about their patients.
Many people think that MRI technicians are driven primarily by monetary goals. That belief troubles me because my best friend, Bruce, is an MRI technician. From that relationship, I know just how hard working, dedicated, and caring these people are. So, it was that I set off to prove MRI technicians are motivated by more that just money. I didn't disagree that money was a motivator. MRI technicians have families and bills just like the rest of us. As such, they too have a need for sufficient income to meet their families requirements. However, I was faced with the question of how to show that these dedicated professionals genuinely cared about their patients and were motived by caring for their patients. The answer to that dilemma came from interviewing two members of the MRI team and observing the team during their daily activities.
While interviewing two MRI team members, Gary and Bruce, I discovered that they average 24 hours or more per year of continuing education within the field of MRI. This easily exceeds what Illinois requires for continuing education in their field. Because these men care for their patients, both felt that it was very important to stay on top of any new or developing issues for patient safety. Bruce said that “there have been many changes in the decade that I have been working with MRI ....patient safety is the driver behind most of those changes.” Gary concurred and said “I have also seen many changes.” One example cited by Gary was that many drug patches, such as a nicotine patch, are manufactured with a foil backing. That backing can be heated by the magnetic field generated during an MRI and cause a severe burn to the patient if it isn't removed. Many patients do not even realize that they have the foil backing or mistakenly believe if the metal backing is non-ferrous that they don't need to worry. However, the truth is that any metal backing may cause a burn. Another patient safety issue Bruce mentioned was that all metal based fittings such as an aneurysm clip, must be verified by checking that it is on a list provided by the FDA before it can be deemed as safe for a patient to go through an MRI scan. The reason for this is that “some manufactures had listed devices as safe when they hadn't been properly tested and it was later found that they were not safe.” (Kendall) In some of those cases the patient died as a result. Both men expressed the desire to avoid such an incident and the preference to error on the side of safety. Although one could rightfully expect these men to maintain their continuing education requirement with Illinois, they exceed that requirement because they honestly care about their patients.
There were also two very telling events that occurred during my visits with the MRI team which illustrate my assertion that MRI technicians care about their patients very poignantly. The first example shows just how far the MRI team is willing to go to insure their patient's comfort. I had barely made my way back to the MRI area and met the team of Bruce, Gary, and Ruth when the first patient was escorted back. That patient's name was Millie. Ruth had gone out after meeting me and returned escorting her. Ruth assisted Millie very cautiously and it was apparent that she was trying to take the best care of Millie possible. The following is a brief synopsis of Ruth's pre-MRI interview with Millie:
“We have two scans, cervical and lumbar that we will be doing today. Normally they take about twenty minutes each.” Part of the discussion covered the importance of removing any metal objects that Millie may have been wearing. Ruth explained, “The MRI machine produces a strong magnetic field and, for safety, these objects must be removed before the scan can begin”. Millie seemed a bit . Ruth noticed the concern right away and asked, “Is something wrong?” Millie replied “I have several metal caps on my teeth.” Ruth apologized for the concern and said, “Don't worry about the dental crowns. They won't be a problem for the scan being run today. Let me ask you a few quick questions to verify what is on your paper work. I really don't think there will be any problems.”
After retrieving a yellow folder containing Millie's paperwork from Gary, Ruth continued with, “We just need to verify your information. Then you can ask me anything you would like. We want you to be comfortable that everything is OK.” Millie nodded yes in reply and the required screening continued by Ruth asking Millie if she had any of the following; a pacemaker, an aneurysm clip, or any metal in her eyes? Millie verified that she didn't have any of the above and the screening was complete.
Once Millie was in the MRI room, her arthritic body had problems with the position the doctor's requested scan called for. This presented the MRI team with the opportunity to care for her in a manner that demonstrated their caring nature. The following is the continuation of Millie's visit with the MRI team:
Ruth escorted Millie in to the MRI room and stated, “Please try to lie as still as possible while in the machine. Movement will cause the images to be distorted”. Millie acknowledged by a simple “OK” that she understood and Ruth helped her lie down on her side for the procedure. Once Millie was situated Ruth let her know, “l will be in the room with with you during the scan. If there is any problem just let me know and we'll take care of it.”
Fifteen minutes in to the scan there was a problem. Millie's purple socked feet were moving back and forth. Ruth inquired “Are you alright?” Millie responded “my hip is hurting honey”. Quickly, the scan was stopped and Ruth helped Millie out of the machine. Millie explained that with her arthritis, “lying on my side like that is painful”. Ruth talked to her about the pain and asked Millie to give her a minute to see if they could get the proper image from another position.
Gary, Ruth, and Bruce hurriedly had a brief meeting to talk about the scan requested. There are prescribed positions for scans based on what a doctor needs to see. Millie's scan did have an alternate but, they would need to consult with the doctor before making the change. As Bruce reviewed the manual, Gary called Millie's doctor and Ruth returned to let Millie know, “we are working on getting approval to run your scan in another position.” Ruth also stayed with Millie while awaiting final approval.
As Gary was speaking with Millie's doctors office, Bruce was resetting the MRI machine for her next scan. Ruth stayed in the room with her, the two chatting away, to keep Millie at ease. The team was concerned about Millie's hip pain and they didn't want her worrying about the next scan. They knew it would be better to keep her mind occupied on something other than the MRI procedure.
While Ruth and Millie chatted, Gary secured the doctor's approval and they were soon ready to begin the second scan. As a result of the team's efforts, Millie's demeanor stayed upbeat and she seemed relieved when told of the new position. For the next scan she would be laying on her back. A position which would be much easier on her hip. Ruth helped Millie lay back down and said, “Is everything comfortable now?” Millie responded “Yes, I am fine now.” Upon confirmation that Millie was ready, Bruce started the second scan and everything was back on schedule.
The second and even more telling event illustrates just how sensitive the MRI team is to their patient's special circumstances and their desire to help. It was this event that would cause Gary to tell me, “that is the part of the job I could do without. It is a great feeling to know you are helping someone but, discovering they have a life changing disease when they are so young is sad.” Gary's comment was made as a result of working with a young lady by the name of Gloria. Her visit was to be one of great anxiety.
Gloria, a thin bubbly nineteen year old girl, and her mother, Gina, had arrived earlier with many questions. Gina, had done most of the talking, “Gloria is having trouble with her speech and walking” she had informed the MRI team. Gary, who escorted the family back, said to Gloria “I'm sorry that you're having problems. Let's see if we can help the doctor figure out what's going on.” To which Gloria had replied, slurring ever so gently, “I hope so, I just want things to be normal again.” Unfortunately, that wish was not going to be granted.
Although she did not know it yet, Gloria has Multiple Sclerosis (MS). “Multiple Sclerosis (or MS) is a chronic, often disabling disease that attacks the central nervous system (CNS), which is made up of the brain, spinal cord, and optic nerves. Symptoms may be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. The progress, severity, and specific symptoms of MS are predictable and vary from one person to another.” (nationalmssociety.org) That news would have been bad enough but, the way it would be delivered only served make matters worse.
When the first image was complete, the MRI team knew what was causing Gloria's problems. Years of experience have given them a wealth of prior knowledge and with each scan the evidence continued to mount. Gary Evans says, “Multiple Sclerosis has a very recognizable pattern.... it would be difficult to miss.” Once the final scan was completed, Gary called Gloria's doctor to inform him of the findings and the team began to assist Gloria out of the MRI room.
The team had begun to say their goodbyes to Gloria and her mother when Gina's phone rang. It was Gloria's doctor. Instead of waiting for them to see him in person, he was calling to let them know that Gloria had Multiple Sclerosis. In an instant the mood changed to a quiet shock and despair. Gloria leaned against the wall and stared off down the hall, pensively gazing in to the distance. Gina began to sob, crying out loud. The scene had been transformed totally. The MRI team tried to comfort them but, even the MRI staff, possessing years of experience, struggled to provide comfort.
Eventually, the MRI team was able to secure a room for Gloria and Gina to recover in. A place where they could gather themselves in privacy. As Bruce would later comment, “we like to provide a positive experience for all of our patients but, this type of situation is difficult.” This was not a crisis of their making but, the MRI team handled it well.
Because MRI technicians care about their patients, they exceed their continuing educational requirements and error on the side of patient safety when there is any doubt about any aspect of a MRI scan. Because MRI technicians care about their patients, Ruth took the time to ensure Millie understood what would happen with the MRI machine. Because MRI technicians care about their patients, Ruth made sure Millie was OK with the scan procedure before beginning the process. Because MRI technicians care about their patients the MRI team quickly worked together and found a more comfortable position for Millie's scan. Because the MRI technicians care about their patients they avoid using a contrast agent when it isn't truly needed. Because MRI technicians care about their patients, the team secured a room for Gloria and Gina to recover in with privacy. And yes, even though they may need some stress relief at the end of the day, because MRI technicians care about their patients Ruth, Bruce, and Gary always treat their patients with care and respect, even when others don't.
Works Cited
Evans, Gary. Telephone Interview. 30 June. 2009
Kendall, Bruce. Telephone Interview. 30 June. 2009
nationalmssociety.org: About MS. What is MS. 2009.
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