Patient Care and Management
●​ Care is collaborative and coordinated and goes beyond physical well-being to include
emotional, social, and financial aspects of a patient's situation.
●​ Patients should always be in complete control when it comes to making decisions about
their own care and treatment.
●​ By taking a comprehensive approach to patient care,healthcare providers can better
support patients in achieving optimal health outcomes and improving their overall quality
of life.
Comprehensive Approach to Patient Care
●​ Treating the whole patient, not just the illness. It focuses on all aspects of well-being for
better health outcomes.
Physical Health
Managing diseases, symptoms, and preventive care.
Mental & Emotional Well-being
Addressing stress, mental health, and emotional support.
Social and Cultural Factors
Understanding patients' backgrounds, beliels, and access to resources.
Preventive Care and Education
Promoting healthy lifestyles and disease prevention.
Collaboration
Involving doctors, nurses, therapists, and social workers lor well-rounded care.
The Healthcare Community
Patients are the most important people in the healthcare community.
They come to us for help in preserving health and solving health-related problems, and all
the efforts of the health care team should be directed toward meeting these needs.
The Healthcare Team
Physician
●​ A doctor of medicine. They often specialize in a specific area of practice and, following
licensing, are to prescribe and supervise the medical care of the patient.
Registered Nurses
●​ Provide home healthcare and case management, educate; act as a patient advocate;
administer medications and treatments as ordered by physicians; monitor the patient's
health status;and coordinate and facilitate all patient care when the patient is
hospitalized.
Vocational Nurses
●​ Work with patients under the supervision of a registered nurse.
Occupational and Physical Therapist
●​ Work in the rehabilitative area of healthcare.
Pharmacist
●​ Preparesand dispenses medications and oversees the patient's drug therapy.
Respiratory Therapist
●​ Maintains and improves the patient's respiratory status.
Laboratory Technologists
●​ Analyzes laboratory specimens for pathologic conditions.
Social Workers
●​ Counsel patients and refer them for assistance to appropriate agencies.
Radiologic Technologists
●​ Specialized in diagnosis by imaging patient's disease or illness.
Abbreviated Table of Medical Specialties
●​ Anesthesiologist - Administers anesthetics and monitors the patient during surgery.
●​ Dermatologist - Diagnoses and treats conditions and diseases of the skin.
●​ Emergency Department Physician - Specializes in trauma and emergency situations; a
triage expert in disaster situations.
●​ Family Practice Physician - Treats individuals and families in the context of daily life.
●​ Gastroenterologist - Diagnoses and treats diseases of the gastrointestinal tract.
●​ Geriatrician - Specializes in problems and diseases of elderly persons.
●​ Gynecologist - Treats problems and diseases of the female reproductive system.
●​ Hospitalist - Specialist, often an internist, who treats patients in the hospital setting.
●​ Intensivist - Specialist, often a pulmonologist, who treats patients in the intensive care
unit.
●​ Internist - Specializes in diseases of the internal organs.
●​ Neurologist - Specializes in functions and disorders of the nervous system.
●​ Obstetrician - Specializes in pregnancy, labor, delivery, and immediate postpartum care.
●​ Oncologist - Specializes in tumor identification and treatment.
●​ Ophthalmologist - Diagnoses and treats problems and diseases of the eye.
●​ Otorhinolaryngologist - Specializes in conditions of the ear, nose, and throat.
●​ Pathologist - Specializes in the scientific study of the alterations in the body caused by
disease and death.
●​ Pediatrician - Specializes in the care, diagnosis, and treatment of diseases affecting
children.
●​ Pulmonologist - Specializes in diagnosis and treatment of diseases of the lungs.
●​ Psychiatrist - Specializes in diagnosis, treatment, and prevention of mental illness.
●​ Radiologist - Specializes in diagnosis by means of medical imaging.
Surgeons:
●​ Abdominal - Specializes in surgery of the abdominal cavity.
●​ Plastic - Restores or improves the appearance and function of exposed body parts.
●​ Neurologic - Specializes in surgery of the brain, spinal cord, and peripheral nervous
system.
●​ Orthopedic - Diagnoses and treats problems of the musculoskeletal system.
●​ Thoracic - Specializes in problems of the chest.
●​ Urologist - Diagnoses and treats problems of the urinary tract and the male reproductive
system.
Perform Diagnostic Radiographic Procedures
●​ Confirm / verify patient's clinical history with the procedure, assuring information is
documented and available for use by a Doctor.
●​ Prepare patients for procedures; provide instructions to obtain desired results, gain
cooperation and minimize anxiety.
●​ Selects and operates radiography equipment.
●​ Position patients to best demonstrate anatomic area of Interest, respecting patient ability
and comfort.
●​ Immobilizes patients as required for appropriate examination.
●​ Determines radiographic techniques or exposure factors.
●​ Applies principles of Radiation Protection to minimize exposure to patient, self and
others.
●​ Evaluate radiographs or Images for technical quality and assuring proper identification is
recorded.
●​ Assumes responsibility for provisions of physical and physiological needs of patient
during the procedure.
●​ Practice Aseptic Techniques as necessary.
Provides Patient Education
Importance of Patient Education
●​ Enhances patient cooperation and comfort.
●​ Promotes autonomy and compliance with care.
●​ Reduces anxiety about procedures and radiation exposure.
Before the Procedure
●​ Explain what to expect.
●​ A description of the preparation necessary prior to the procedure if correct preparation is
essential.
●​ A description of the purpose of the test or examination, the mechanics, the procedure
and what will be expected of the patient, for instance, frequent position changes or
medication to be taken or to be injected.
●​ The approximate amount of time that the procedure will take.
●​ An explanation of any unusual equipment that will be used during the examination.
During the Procedure
●​ Address concerns, provide reassurance.
After the Procedure
●​ Provide follow-up care guidance.
Patient Assessment and Communication
Communication
●​ Act or process of using words, sounds, and signs to express or exchange Information or
to express your ideas, thoughts, and feelings to someone else.
●​ To communicate means to convey Information accurately, to express oneself clearly, and
to have an interchange of ideas and information with others.
●​ Accurate communication is essential for both immediate and ongoing patient care.
Issues of Cultural Diversity
●​ Culture has profound effects on our attitudes and on the ways in which we communicate
and perceive others.
●​ When cultural differences are not recognized and respected, relationships suffer, and
communication becomes much less effective.
Past vs. Present
1900:
●​ U.S. communities were culturally homogeneous;
●​ 1 in 8 Americans was non-white.
Today:
●​ Cultural diversity has increased significantly. 1 in 4 Americans is non-white.
Future (2070)
●​ Half of Americans will be African American, Hispanic, Native American, or Asian/Pacific
Islander.
Impact of Cultural Diversity
Challenges:
●​ Language barriers, cultural differences, and misunderstandings
●​ Social integration and acceptance issues.
Opportunities:
●​ Diversity fosters creativity, innovalion, and a richer society.
●​ Exposure to different perspectives improves problem-solving and collaboration.
Cultural Diversity in Health Care
Health Disparities:
●​ Studies show that race and ethnicity affect health care outcomes.
●​ Minority groups often experience less access to quality care.
Legislative Action:
●​ Laws are being introduced to reduce racial and ethnic disparities in healthcare.
Role of Hospitals & Staff:
●​ Plan for better transcultural care.
●​ Train stall to develop cultural competence (understanding and respecting different
cultures)
Cultural Variations
●​ RT must be aware of cultural differences in verbal and nonverbal communication.
●​ Consider cultural differences in regards to distance and respect for personal space.
●​ If there is doubt in appropriateness, do not use
●​ humor.
Patients Requiring a Greater Use of Communication Skills
●​ Seriously ill or Injured Patients
●​ Traumatized Patients
●​ Patients with Impaired Vislon, Hearing, or Speech
●​ Infants and Children
●​ Foreign Language speaking Patients
●​ Elderly and infirm patients
●​ Physically Impaired Patients
●​ Mentally Impaired Patients Alcohol and Drug Abusers
Classifications of Communication
Verbal Communication
●​ spoken rather than written
●​ involves what is being said
●​ must involve personalization and respect
●​ paralanguage
●​ radiogropher's vocal volume, fluency and pattern
●​ involves the tone and rate of speech.
●​ loud, rapid speech is very uncomfortable for the sick patient. Use a well-modulated tone.
Nonverbal Communication
●​ Non-spoken, through actions and gestures.
●​ Radiographer must face the patient and make eye contact when communicating.
Nonverbal communication involves:
●​ facial expression
●​ professional appearance
●​ orderliness of the x-ray room, the preparation and efficiency of the radiographer.
Nonverbal Communication in Healthcare
1.​ Importance of Nonverbal Communication
●​ Conveys emotions and attitudes beyond words.
●​ Influenced by cultural backgrounds and learned behaviors.
●​ Examples:
●​ Frowns, clenched lists - Anger or disapproval.
●​ Avoiding eye contact - Submission or rejection.
●​ Leaning forward- Interest and engagement.
2.​ Eye Contact and Touch
●​ Eye Contact:
●​ In the U.S., it signals honesty and interest.
●​ Some cultures find direct eye contact disrespectful.
Touch:
●​ Can convey comfort, support, or authority.
●​ Must consider cultural and personal boundaries.
●​ Always inform the patient before touching to avoid discomfort.
3.​ Appearance and Professionalism
●​ Professional dress builds patient confidence.
●​ 'A clean, organized environment shows respect for patients.
VERBAL COMMUNICATION IN HEALTHCARE
1. Effective Verbal SkilIl
●​ Speak clearly and adjust language based on the listener's background.
●​ Use lace-to-lace communication for better understanding.
2. Attitude and Assertiveness
●​ Messages are influenced more by tone and body language than words.
●​ Assertiveness (not aggression) helps in professional and patient interactions.
3. Validating Communication
●​ Confirm understanding by asking for a response.
●​ Example: "Did you read the consent form? What did it say?"
Therapeutic Communication
●​ Techniques to help build trust, comfort, and cooperation between healthcare providers
and patients.
1. Reducing distance
●​ Maintaining an appropriate but comfortable physical distance to avoid intimidation while
ensuring a supportive presence.
2. Responding to the Underlying Message
●​ Paying attention to what the patient truly means rather than just their words.
●​ Example: If a patient says, "I just want to go home," they may be feeling anxious or
hopeless about their condition.
3. Restating the main idea
●​ Repeating or paraphrasing the patient's statements to confirm understanding.
●​ Example:
●​ Patient: "I feel like no one is listening to me."
●​ "Radiographer: "You feel like your concerns are not being heard?
4. Reflecting the Main Idea
●​ Encouraging the patient to explore their thoughts by directing the statement back to
them. Example:
●​ Patient: "I don't know if I should take this test
●​ Radiographer: "What are your concerns about taking the least?"
5. Using Listening
●​ Actively listening without interrupting, using verbal and non-verbal cues (nodding, eye
contact, "I see," "Go on").
6. Establish Guidelines
●​ Setting clear expectations to help the patient feel secure.
●​ Example: "I'll explain each step of the procedure before we begin."
7. Seeking and Providing Clarification
●​ Asking questions to ensure understanding.
●​ Example: "Can you tell me more about where you feel the pain?"
8. Making Observations
●​ Noticing and commenting on the patient's behavior.
●​ Example: "You seem anxious. Would you like to talk about it?"
9. Validating
●​ Confirming what the patient says to ensure accuracy and understanding.
●​ Example: "So, you've been feeling dizzy since yesterday?"
●​ Focusing
●​ Directing the conversation to important details.
●​ Example: "You mentioned having pain. Can you describe where exactly it hurts?"
Nontherapeutic Communication
●​ These behaviors can harm patient trust, increase anxiety, and lead to poor
communication.
1.​ Disagreeing with the Patient.
Contradicting or arguing with the patient's feelings or beliefs, which may make them
defensive.
2.​ Expressing Disapproval
Judging or making negative comments about the patient's feelings or choices.
Example: "You shouldn't feel that way."
3.​ Defending
Protecting someone or something (like a hospital policy) instead of acknowledging the
patient's concerns.
4.​ Changing the Topic
Avoiding or shifting away from what the patient is trying to discuss.
Patient. "I'm worried about my test results."
Radiographer: "How was your weekend?"
5.​ Giving unsolicited advice
Offering solutions without the patient asking, which can make them feel powerless.
Example: "If I were you, I would just relax."
6.​ Rejection
Ignoring or dismissing the patient's concerns.
7.​ False Assurance
Giving unrealistic or overly optimistic statements.
Example: "Don't worry, everything will be fine," when the outcome is uncertain.
Effective Communication with Patients
1. Addressing the Patient
●​ First contact should be professional and respectful (e.g.,"Good morning, Mr. Torres. I'm
Lynn Smith, the radiographer.").
●​ Avoid using terms like "honey" or "sweetie," as they may feel impersonal or demeaning.
●​ Some facilities prefer using first names in public areas for confidentiality.
●​ Always verify a patient's full name and date of birth using two identifiers.
2. Providing Valid Choices
●​ Involve patients in their care by offering real choices, not false ones (e.g., "Would you
like a blanket?" instead of "Would you like to come for your X-ray now?").
●​ Small choices empower patients, making them feel involved and respected.
3. Avoiding Assumptions
●​ Never assume a patient understands instructions-ask them to explain back.
●​ Patients may have additional medical conditions affecting their ability to follow directions
or complete procedures.
●​ Clarify preparation steps to ensure compliance.
4. Assessment Through Communication
●​ Observe patients to assess their cognitive and physical abilities.
●​ Look for signs of confusion, hearing difficulties, or language barriers.
●​ Effective communication builds trust, improves cooperation, and enhances patient care.
Age-Specific Care and Communication
1. Neonates and Infants (0-1 year)
●​ Reflexive behavior; respond to voice, face, and touch.
●​ Keep infants warm; involve parents to reduce anxiety.
●​ Hold infants when parents are absent.
●​ Recognize separation anxiety at 9 months.
2. Toddlers (1-3 years)
●​ Limited communication; use short, simple instructions.
●​ Allow choices, when possible, to reduce resistance.
●​ Use a friendly but firm approach; keep familiar objects nearby.
●​ Demonstrate instead of verbal instructions.
3. Preschoolers (3-5 years)
●​ Growing independence but fear loss of control
●​ Give simple choices to promote cooperation.
●​ Avoid negative phrasing (e.g.."This won't hurt)
●​ Use demonstrations for better understanding
●​ Praise and reward good behavior.
4. School Age (6-12 years)
●​ Think logically; need clear, concrete explanations.
●​ Be honest about pain or discomfort
●​ Use demonstrations or models to explain procedures.
5. Adolescents (13-18 years)
●​ Use proper medical terminology and involve them in decisions.
●​ Establish rapport by discussing hobbies and interests.
6. Young Adults (19-30 years)
●​ Think logically, and need clear, concrete explanations.
●​ Be honest about pain or discomfort.
●​ Use demonstrations or models to explain procedures.
7. Middle Adults (40-65 years)
●​ Experiencing physical and cognitive changes.
●​ Allow choices, be mindful of sensory impairments.
8. Late and Old Adults (65+ years)
●​ Avold ageism; assess each patient individually.
●​ Accommodate sensory deficits (hearing aids, glasses, lighting)
●​ Speak slowly, use low-pitched tones, and provide extra time.
●​ Ensure safety -assist with movement and avoid rushing them.
Death with Dignity
Resuscitation and Do Not Resuscitate (DNR) Orders
●​ Resuscitation is standard when recovery is possible.
●​ DNR (Do Not Resuscitate): No resuscitation if death is imminent.
●​ DNR/DNI (Do Not Intubate): No mechanical ventilation or life support.
●​ Orders are documented in the patient's medical chart.
Advance Directives and Durable Power of Attorney
●​ Advance Directive: A legal document outlining a patient's medical care preferences.
Durable Power of Attorney for Healthcare
●​ Appoints a trusted person to make medical decisions if the patient is unable.
●​ Families should be informed to avoid confusion or disputes.
DEALING WITH DEATH AND LOSS
Role of Radiologic Technologist
●​ Provide emotional support for grieving families while awaiting physician updates.
●​
Avoid volunteering opinions or discussing medical staff actions.
●​ Be aware of legal sensitivities in cases of sudden or unexpected death.
Phases of Grief
by Doctor Elizabeth Kubler-Ross (1969)
Phase 1: DENIAL
●​ The patient who is facing imminent death or loss often responds by not accepting the
truth.
Phase 2: ANGER
●​ The patient may become angry preceding death or disfigurement
Phase 3: BARGAINING
●​ The patient feels that if he becomes the "good and submissive patient" he may be
spared or miraculously cured.
Phase 4: DEPRESSION
●​ The patient accepts the impending loss and begins to mourn for his or her pastlife and
all that will be lost.
●​ The depressed person is often acquiescent, quiet, and withdrawn, and may cry easily.
●​ Support is the best response of the health worker during this period.
Phase 5: ACCEPTANCE
●​ The person accepts the loss or impending death and deals with life and relationships on
a more realistic, day-to-day basis.
PATIENT ASSESSMENT
●​ Many patients feel intimidated in medical settings, which may prevent them from
expressing concerns about pain or discomfort.
●​ When patients feel heard and reassured, they become more cooperative and receptive
to medical instructions.
●​ Radiographers play a key role in gathering patient history and reporting observations to
the radiologist.
TAKING A PATIENT HISTORY
●​ Radiologists rely on radiographers to gather relevant patient history.
●​ Helps in diagnosing conditions and customizing the imaging study.
●​ Builds connection with the patient and improves cooperation.
DATA COLLECTION
●​ Subjective Data - anything said by the patient
●​ Objective Data -anything that RT sees, hears, smells, feel or reads on the patient's chat
DATA ANALYSIS
●​ Listing all subjective and objective data and analyzing it, relevant data are listed in order
of their priority.
OBTAINING PATIENT'S HISTORY
Rules to follow to complete a successful patient history are:
●​ Provide atmosphere that is private
●​ Establish rapport with the patient by approaching in a nice manner.
●​ Ask how they would like to be addressed (e.g. Mr, Mrs, Ms)
●​ Inform patient why information is needed
●​ Tell patient that everything is confidential and only be shared with medical staff involved
in her/his care.
●​ Use open-ended and closed-ended questions if necessary.
COMPLETE PATIENT HISTORY HAVE THE FOLLOWING:
●​ Location of the problem (area of pain)
●​ Onset (when did the problem begin)
●​ Chronology (when and for how long the problem has been present)
●​ Quality (how severe is the problem or pain)
●​ Aggravating or alleviating (what factor makes the pain worse or better?)
●​ Associated manifestations (what else happens during the pain episodes)
If the request is for:
CHEST X-RAY (cxr)
QUESTIONS TO ASK:
1. Ask if the patient has cough, cold and fever.
2. Ask if the patient has hypertension and diabetes mellitus. If the patient is unsure ask if they
have a maintenance for both.
3. If the patient has cough and fever or either of
the 2 ask for:
-​
how long their cough has been present
-​
chest pain
-​
difficulty of breathing
-​
(if they have been coughing for two weeks or longer) ask if there is blood in their phlegm
SKULL PROCEDURES
QUESTIONS TO ASK:
1. Ask what happened
-​
If vehicular accident px ask the ff:
-​
Place of incident (POI) where did the incident happened.
-​
Date of incident (DOI) when did the incident happened.
-​
Time of incident (TOI) what time did the incident happened.
BODY MECHANICS
●​ It is a term used to describe the ways we move as we go about our daily lives.
●​ It includes how we hold our bodies when we sit, stand, lift, carry, bend, and sleep.
●​ Poor body mechanics are often the cause of back problems.
Muscle Strain
●​ Muscle strain occurs when muscle fibers are overstretched or torn, typically due to
excessive force, overuse, or improper use.
●​ Symptoms often include pain, swelling, bruising, and limited movement.
●​ These are common among hospital workers.
●​ The most common injury reported by the Radiologic Technologists.
CORRECT UPRIGHT POSTURE
Stand with feet 4-8" apart;
Head erect,chin in;
Abdomen up, buttocks in;
Chest out, stomach in;
Knees slightly bent
VERTEBRAL CURVATURES
●​ The vertebral column has four curves that arch anteriorly and posteriorly from the
midcoronal plane of the body.
●​ When viewed posteriorly, the normal lumbar curve can correctly be referred to as
"concave posteriorly."
●​ Whether the curve is described as "convex anteriorly" or "concave posteriorly,"
●​ The cervical and lumbar curves, which are convex anteriorly, are called lordotic
curves
●​ The thoracic and pelvic curves are concave anteriorly and are called kyphotic curves
Cervical and Lumbar Curvature
●​ Convex & anteriorly concave posteriorly
●​ Secondary/compensatory curve: develop after birth
●​ Cervical: when baby starts holding the head
●​ Lumbar: when baby learns to walk
Thoracic and Pelvic Curvature
●​ Convex posterior & concave anteriorly
●​ Primary curve: present at birth
ABNORMAL CURVATURES
LORDOSIS
●​ Exaggerated of the spine lumbar curvature
●​ "Swayback”
●​
Increase anterior convexity or posterior concavity
BODY MECHANISM
The principle of proper body alignment, movement and balance
Three concepts:
Base of support (BOS)
-​
the portion of the body in contact with the floor.
Center of Gravity (COG)
-​
The point at which the body's weight is evenly distributed and balanced.
-​
Usually located in the midportion of the pelvis or lower abdomen, depending on body
build.
-​
Any object your hold adds to the weight on the base of support affecting the location of
your center of gravity.
Line of Gravity (LOG)
-​
Imaginary vertical line passing through the center of gravity.
-​
Falls through the COG and within the BOS
-​
When the line of gravity is aligned properly, the body is in a stable and balanced position.
ABNORMAL CURVATURES
KYPHOSIS
●​ Exaggerated thoracic curvature
●​ Humpback or hunchback
●​ Increase anterior concavity or posterior convexity
SCOLIOSIS
●​ Lateral curvature
●​ S-shaped
●​ This condition also causes the vertebrae to rotate toward the concavity.
●​ The develops vertebral column second compensatory curve in the opposite direction to
keep the head centered over the feet.
BODY MECHANICS
Reasons for use:
1.​ Muscles work best when used correctly
2.​ Makes lifting, pulling, and pushing easier
3.​ Prevents unnecessary fatigue & strain & saves energy
4.​ Prevents injury to self or others
RULES OF BODY MECHANICS
1.​ Provide a broad base of support
2.​ Work at a comfortable height.
3.​ When lifting, bend at the hips & knees and keep your back straight.
4.​ 4. Keep your load well balanced and close to your body
5.​ 5. Roll or push a heavy object.
Avoid pulling or lifting.
BODY POSITIONS
SUPINE - Patient is flat on his back
PRONE - Patient lies face down
SIMS POSITION
- Semi-prone position
- To aid in the rectal catheterization
FOWLER'S
Seated in a semi-sitting position and may have knees either bent or straight.
Head is higher than the feet.
For px with respiratory distress.
TRENDELENBURG
The bed is inclined with the patient's head lower than the rest of the body. (15-30 degree)
Helpful in the treatment of patients suffering from shock.
LITHOTOMY POSITION
It is a common position for surgical procedures and medical examinations involving the pelvis
and lower abdomen, as well as a common position for childbirth.