The impact of the Covid-19 pandemic on the mental health and work morale of radiographers within a conventional X-ray department

INTRODUCTION

There is a plethora of literature that has described the negative impact of the COVID-19 pandemic on the mental health of healthcare staff worldwide. Our aim was to investigate the physical and mental demands of mobile x-ray imaging on radiographers during the first wave of the COVID-19 pandemic, within a local NHS Trust.

METHODS

A total of 16 participants from 1 NHS Trust took part within this study. Both quantitative and qualitative data was obtained through an online survey. Statistical data was obtained via the Trust Radiology Information System (RIS). Data was gathered for the thirteen weeks from 23rd March to 21st June 2020 (the first wave); direct comparison was made to the same period in 2019.

RESULTS

Three key themes emerged from the data. These include mental health challenges/work morale in Radiology, demand of mobile imaging and departmental and Trust-wide mental health support. Results indicate a high demand in mobile imaging which has made a significant difference in the working life of some radiographers.

CONCLUSION

The COVID-19 pandemic has significantly affected the mental health of a proportion of radiographers at this Trust. Results indicate high workload and demand in mobile imaging has made a significant difference to the working life of radiographers, specifically the ones who were relatively newly qualified.

IMPLICATIONS FOR PRACTICE

Two key interventions are proposed from this study. The first one is to provide and promote mental health support within radiology departments. The second is to encourage dual working on mobile x-ray examinations to help manage the emotional and physical burden.

The role of the assistant practitioner in the clinical setting: a focus group study

Background

Assistant practitioners have knowledge and skills beyond the level of traditional support workers, and work in many clinical settings. However, some assistant practitioners lack a clearly defined role and may be under-used due to issues around accountability and uncertainty about their purpose. This paper explores the assistant practitioner role from the perspectives of assistant practitioners and registered nurses.

Methods

This study aimed to explore the role of the assistant practitioner from the perspectives of assistant practitioners and registered nurses in two NHS hospital trusts in Oxfordshire, United Kingdom. Six qualitative focus groups were undertaken between February–March 2017. Ethical approval was obtained (FREC 2016/05) and written consent was provided by participants. Data was analysed thematically analysed using the Framework method.

Results

Nineteen participants (assistant practitioners, n = 12; registered nurses, n = 7) were recruited using convenience sampling. Emerging themes related to ‘fluctuating roles and responsibilities of assistant practitioners’, ‘role differences between registered nurses and assistant practitioners’, ‘working relationships’, ‘supervision’ and ‘redefining nursing pathways’.

The Results and Discussion sections highlight a lack of role clarity and blurring of boundaries between the roles of assistant practitioners and registered nurses, with many tasks undertaken by both. This lack of ownership of ‘nurse-specific’ roles by registered nurses was evident and clear differences were only encountered with regard to accountability. The development of the Nursing Associate role provides managers with the opportunity to redefine staff banding hierarchies to ensure that clinical staff are aware of their role capabilities and limitations and are practicing safely, whilst promoting career development and progression pathways.

Conclusion

Addressing issues around role clarity can benefit professional development, satisfaction, role identity and ownership for registered nurses and assistant practitioners, by recognising the individual and collective value they bring to the clinical team. The findings can help inform the development of the Nursing Associate role.

Assistant radiographer practitioners: Creating capacity or challenging professional boundaries?

INTRODUCTION

Over the last 2 decades the assistant radiographer practitioner (ARP) role has been introduced into NHS diagnostic imaging departments as a strategy to expand the workforce and create capacity. This skill mix initiative has not been implemented in a standardised way and there is limited knowledge of the current role scope within general radiography (X-Ray).

METHOD

An electronic survey of ARPs working within UK diagnostic imaging departments was conducted. Both open and closed questions sought information regarding basic demographic data (age category; gender; geographic region), scope of practice (patient groups; anatomical regions; imaging outside of the diagnostic imaging department), limitations placed on practice, supervision and additional roles.

RESULTS

A total of 108 responses, including 13 trainees, were received. Most sites employ three or less ARPs in general radiography (n = 43/66; 65.2%), although 11 sites have five (range 1-15). The majority undertake imaging of both adults and children (n = 85/108; 78.7%), although limitations on age were described. Their scope of practice covers a broad anatomical range and included some non-ambulant patients. The level of supervision varied with some sites empowering ARPs to check the referral prior to examination (n = 25) or images post acquisition (n = 32) (both n = 20/66; χ² = 16.003; 1df; p = 0.000).

CONCLUSION

ARPs are helping to maintain capacity in imaging departments but we suggest there is further scope for expansion. The practice described by the post holders suggests that many are working beyond the scope envisaged by the radiography professional body.

Supporting those who work and learn: A phenomenological research study

AIM

With a shift in the United Kingdom's National Health Service to organisational learning and the local introduction of the Assistant Practitioner role to support the nursing workforce there was a broad need to understand the lived experiences of those who work and learn.

METHOD

Hermeneutic phenomenology was the chosen methodology. A purposive sample of eight trainee assistant practitioners, four matrons, seven mentors and the practice development nurse participated in conversational interviews at intermittent points in the journey.

RESULTS

A stepped process of analysis produced three over-arching super-ordinate themes which indicated that the transition to assistant practitioner is non-linear and complex necessitating a change in knowledge and behaviour and the workplace culture must enable learning and role development. This paper focuses on supporting the journey which encompassed learning at university and learning in the workplace.

CONCLUSION

Participants' stories demonstrated the presence of knowledgeable mentors and a learning culture enabled new roles to be supported.

Assistant practitioners: essential support in a climate of austerity

In Britain the last decade has witnessed the growth of the assistant practitioner (AP), a higher-level support worker role situated at band 4 of the NHS career framework, just below registered nurse. Various factors are given for the role's development but little analysis is provided as to the economic reasons for its implementation. With reference to the period since the economic crisis of 2007-08, this article proposes that the AP's implementation and function is influenced by the needs of the economy. With the UK Coalition Government refusing to increase public expenditure as it is thought detrimental to economic growth, emphasising instead the need to reduce public debt, an expansion of registered nurses is unlikely despite growing service user demand. As a result, the AP has become an important economic development in an attempt to maintain standards of nursing care in the present economic climate.