H.S.100-Lesson 8.doc

39
Lesson 8 Clinical Laboratory Technologists and Technicians MEDICAL TECHNOLOGISTS, GENERAL INFORMATION The practice of modern medicine would be impossible without the tests performed in the clinical laboratory. A medical team of pathologists, specialists, technologists, and technicians works together to determine the presence, extent, or absence of disease and to provide data needed to evaluate the effectiveness of treatment. Physicians order laboratory work for a wide variety of reasons: Test results may be used to establish values against which future measurements can be compared; To monitor treatment, as with tests for drug levels in the blood that can indicate whether a patient is adhering to a prescribed drug regimen; To reassure patients that a disease is absent or under control; or To assess the status of a patient's health, as with cholesterol measurements. Although physicians depend on laboratory results, they do not ordinarily perform the tests themselves. That is the job of clinical laboratory personnel. Working Conditions Clinical laboratory testing plays a crucial role in the detection, diagnosis, and treatment of disease. Clinical laboratory technologists and technicians, also known as medical technologists and technicians, perform most of these tests.

description

 

Transcript of H.S.100-Lesson 8.doc

Page 1: H.S.100-Lesson 8.doc

Lesson 8

Clinical Laboratory Technologists and Technicians

MEDICAL TECHNOLOGISTS, GENERAL INFORMATION

The practice of modern medicine would be impossible without the tests performed in the clinical laboratory. A medical team of pathologists, specialists, technologists, and technicians works together to determine the presence, extent, or absence of disease and to provide data needed to evaluate the effectiveness of treatment.

Physicians order laboratory work for a wide variety of reasons:

Test results may be used to establish values against which future measurements can be compared;

To monitor treatment, as with tests for drug levels in the blood that can indicate whether a patient is adhering to a prescribed drug regimen;

To reassure patients that a disease is absent or under control; or

To assess the status of a patient's health, as with cholesterol measurements.

Although physicians depend on laboratory results, they do not ordinarily perform the tests themselves. That is the job of clinical laboratory personnel.

Working Conditions

Clinical laboratory testing plays a crucial role in the detection, diagnosis, and treatment of disease. Clinical laboratory technologists and technicians, also known as medical technologists and technicians, perform most of these tests.

Clinical laboratory personnel examine and analyze body fluids, tissues, and cells. They look for bacteria, parasites, or other microorganism; analyze the chemical content of fluids; match blood for transfusions, and test for drug levels in the blood to show how a patient is responding to treatment. They prepare specimens for examination, count cells, and look for abnormal cells. They use automated equipment and instruments that perform a number of tests simultaneously, as well as microscopes, cell counters, and other kinds of sophisticated laboratory equipment to perform tests. Then they analyze the results and relay them to physicians.

The complexity of tests performed, the level of judgment needed, and the amount of responsibility workers assume depend largely on the amount of education and experience they have.

Medical technologists generally have a bachelor's degree in medical technology or in one of the life sciences, or have a combination of formal training and work experience. They perform complex chemical, biological, hematological, immunologic, microscopic, and bacteriological tests. Technologists microscopically examine blood, tissue, and other body substances; make cultures of body fluid or tissue samples to determine the presence of bacteria, fungi, parasites, or

Page 2: H.S.100-Lesson 8.doc

other microorganism; analyze samples for chemical content or reaction; and determine blood glucose or cholesterol levels. They type and cross-match blood samples for transfusions.

They may evaluate the effects a patient's condition has on test results, develop and modify procedures, and establish and monitor programs to insure the accuracy of tests. Some medical technologists supervise medical laboratory technicians.

Technologists in small laboratories perform many types of tests, while those in specialty laboratories or large laboratories generally specialize. Technologists who prepare specimens and analyze the chemical and hormonal contents of body fluids are clinical chemistry technologists. Those who examine and identify bacteria and other microorganism are known as microbiology technologist. Blood bank technologists collect, type, and prepare blood and its components for transfusions; immunology technologists examine elements and responses of the human immune system to foreign bodies. Cytotechnologists, who have specialized training, prepare slides of body cells and microscopically examine these cells for abnormalities which may signal the beginning of a cancerous growth.

Medical laboratory technicians generally have an associate degree from a community or junior college, or a diploma or certificate from a vocational or technical school. They perform routine tests and laboratory procedures. Technicians may prepare specimens and operate automatic analyzers or they may perform manual tests following detailed instructions. Like technologists, they may work in several areas of the clinical laboratory or specialize in just one. Histology technicians cut and stain tissue specimens for microscopic examination by pathologists and phlebotomists draw and test blood. They usually work under the supervision of medical technologists or laboratory managers.

Hours and other working conditions vary according to the size and type of employment setting. In large hospitals or in independent laboratories that operate continuously, personnel usually work the day, evening, or night shift, and may work weekends and holidays. Laboratory personnel in small facilities may work on rotating shifts rather than on a regular shift. In some facilities, laboratory personnel are on call (available in case of an emergency) several nights a week or on weekends.

Clinical laboratory personnel are trained to work with infectious specimens. With proper methods of infection control and sterilization are followed, few hazards exist.

Laboratories generally are well lighted and clean; however, specimens, solutions, and reagents used in the laboratory sometimes produce odors. Laboratory workers may spend a great deal of time on their feet.

EMPLOYMENT OPPORTUNITIES

Clinical laboratory technologists and technicians hold about 268,000 jobs. More than one-half work in hospitals. Most others work in medical laboratories and offices and clinics of physicians. Some work in blood banks, research and testing laboratories, and in the Federal government in such agencies as the Department of Veterans Affairs hospitals and the U.S. Public Health Service. TRAINING, OTHER QUALIFICATIONS, AND ADVANCEMENT

The usual requirement for an entry-level position as a medical technologist is a bachelor's degree with a major in medical technology or in one of the life sciences. Universities and hospitals offer

Page 3: H.S.100-Lesson 8.doc

medical technology programs. It is possible to qualify through a combination of on-the-job and specialized training. Bachelors' degree programs in medical technology include courses in chemistry, biological sciences, microbiology, and mathematics, and specialized courses devoted to knowledge and skills used in the clinical laboratory. Many programs offer or require courses in management, business, and computer applications.Masters' degrees in medical technology and related clinical laboratory sciences provide training for specialized areas of laboratory work or teaching, administration, or research. Two universities offer doctorates in clinical laboratory technology.

Medical laboratory technician training is offered in community and junior colleges, hospitals, vocational and technical schools, and in the Armed Forces. A few technicians learn on-the-job. Community and junior college programs last two years and lead to an associate degree. Others are shorter and lead to a certificate in medical laboratory technology.

Nationally recognized accrediting agencies in the allied health field include the American Medical Association's Committee on Allied Health Education and Accreditation (CAHEA), and the Accrediting Bureau of Health Education Schools (ABHES). CAHEA accredits more than 800 programs that provide education for medical technologists, cytotechnologists, histologic technicians, specialists in blood bank technology, and medical laboratory technicians. ABHES accredit training programs for medical laboratory technicians.

Licensor and certification are methods of assuring the skill and competence of workers. Licensor refers to the process by which a government agency authorizes individuals to engage in a given occupation and use a particular job title. Some States require laboratory personnel to be licensed or registered. Information on licensor is available from State departments of health, boards of occupation licensing, or occupational information coordinating committees.

Certification is a voluntary process by which a non-governmental organization such as a professional society or certifying agency grants recognition to an individual whose professional competence meets prescribed standards. Widely accepted by employers in the health industry, certification is a prerequisite for most jobs and often is necessary for advancement. Agencies that certify medical laboratory technologists and technicians include the Board of Registry of the American Society of Clinical Pathologists, the American Medical Technologists, the National Certification Agency for Medical Laboratory Personnel, and the Credentialing Commission of the International Society for Clinical Laboratory Technology. These agencies have different requirements for certification and different organizational sponsors.

Clinical laboratory personnel need analytical judgment and the ability to work under pressure. Close attention to detail is essential because small differences or change in test substances or numerical readouts can be crucial for patient care. Manual dexterity and normal color vision are highly desirable. With the widespread use of automated laboratory equipment, computer skills are important. In addition, technologists are expected to be good at problem solving and to have strong interpersonal and communication skills.

Technologists may advance to supervisory positions in laboratory work or become chief medical technologists or laboratory managers in hospitals. Graduate education in medical technology, one of the biological sciences, chemistry, management, or educations usually speeds advancement. A doctorate is needed to become a laboratory director. Technicians may become technologists through additional education and experience.

JOB OUTLOOK

Page 4: H.S.100-Lesson 8.doc

As in most occupations, replacement needs will be the main source of job openings. Employment of clinical laboratory workers is expected to grow about as fast as the average for all occupations through the year 2010 creating additional job openings. The rapidly growing older population will spur demand, since older people generally have more medical problems. Technological changes will have two opposite effects on employment. New, more powerful diagnostic tests will encourage more testing and spur employment. However, advances in laboratory automation and simpler tests, which make it possible for each worker to perform more tests, should slow growth. Research and development efforts are targeted at simplifying routine testing procedures so that non-laboratory personnel--physicians and patients in particular--can perform tests now done in laboratories. Also, robots may prepare specimens, a job now done by technologists and technicians.

Fastest growth is expected in independent medical laboratories, as hospitals continue to send them a greater share of their testing. Rapid growth is expected in offices and clinics of physicians. Slower growth is expected in hospitals.

EARNINGS

Median annual earnings of clinical laboratory technologists and technicians are about $33,000. The middle 50 percent earn between $24,970 and $39,810. The lowest 10 percent earn less than $19,380 and the highest 10 percent earn more than $48,290 a year. Median annual earnings in the industries employing the largest numbers of medical and clinical laboratory technologists are about:

Offices and clinics of medical doctors $40,300Federal government 39,600Hospitals 36,500Medical and dental laboratories 35,600

Median annual earnings in the industries employing the largest numbers of medical and clinical laboratory technicians are about:

Hospitals $26,600Offices and clinics of medical doctors 25,500Medical and dental laboratories 24,800Health and allied services not elsewhere classified 22,400

Questions:

In what ways do Clinical Laboratory Technicians play a role in medicine?

Generally, what degree do Medical Technologists hold?

What degree to Medical Laboratory Technicians have?

How many jobs do Clinical Laboratory Technicians hold in the United States?

Page 5: H.S.100-Lesson 8.doc

Under what agency is the accrediting of Medical Technologists?

What are the special qualities needed to become a Medical Laboratory Technician?

What will be the main source of future Medical Laboratory Technician openings?

Where do most Medical Technologists find jobs?

What are the median annual earnings of Medical Laboratory Technicians?

Page 6: H.S.100-Lesson 8.doc

OTHER RELATED OCCUPATIONS

Clinical laboratory technologists and technicians analyze body fluids, tissue, and other substances using a variety of tests. Similar or related procedures are performed by analytical, water purification, and other chemists; science technicians; crime laboratory analysts; food testers; and veterinary laboratory technicians.

ADDITIONAL INFORMATION

Career and certification information is available from:

American Society of Clinical Pathologists, Board of Registry, P.O. Box 12277, Chicago, IL 60612.

American Medical Technologists, 710 Higgins Rd., Park Ridge, IL 60068

American Society of Cytopathology, 400 W. 9th St., Suite 201, Wilmington, DE 19801

International Society for Clinical Laboratory Technology, 917 Locust St., Suite 1100, St. Louis, MO 63101-1413

American Association of Blood Banks, 8101 Glenbrook Rd., Bethesda, MD 20814-2749

For a list of accredited and approved educational programs for clinical laboratory personnel, write to: National Accrediting Agency for Clinical Laboratory Sciences, 8410 W. Brn Mawr Ave., Suite 670, Chicago, IL 60631For a list of training programs for medical and clinical laboratory technicians accredited by the Accrediting Bureau of Health Education Schools, write to: Accrediting Bureau of Health Education Schools, 803 West Broad St., Suite 730, Falls Church, VA 22046

Radiological Technologists

WORK DESCRIPTION

Perhaps the most familiar use of the x-ray is the diagnosis of broken bones. However, medical uses of radiation go far beyond that. Radiation is used not only to produce images of the interior of the body, but to treat cancer as well. At the same time, the use of imaging techniques that do not involve x-rays such as ultrasound and magnetic resonance scans is growing rapidly. The term diagnostic imaging embraces these procedures as well as the familiar x-ray.

Radiographers produce x-ray diagnostic pictures of parts of the human body for use in diagnosing medical problems. They prepare patients for radiological examinations by explaining the procedure, removing articles such as jewelry, through which x-rays cannot pass, and positioning patients so that the correct parts of the body can be radiographed. To prevent unnecessary radiation exposure, technologists surround the exposed area with radiation protection devices such as lead shields, or limit the size of the x-ray beam. Radiographers position radiographic

Page 7: H.S.100-Lesson 8.doc

equipment at the correct angle and height over the appropriate area of a patient's body. Using instruments similar to a measuring tape, technologists may measure the thickness of the section to be radiographed and set controls on the machine to produce radiographs of the appropriate density, detail, and contrast. They place the x-ray film under the part of the patient's body to be examined and make the exposure. They then remove the film and develop it.

Experienced radiographers may perform more complex imaging tests. For fluoroscopy, radiographers prepare a solution of contrast medium for the patient to drink, allowing the radiologist, a physician who interprets x-rays, to see soft tissues in the body. Some radiographers operate computed tomography scanners to produce cross-sectional views of patients and may be called CT technologists. Others operate machines using giant magnets and radio waves rather than radiation to create an image and may be called magnetic resonance imaging (MRI) technologists.

Radiation therapy technologists, also known as radiation therapists, prepare cancer patients for treatment and administer prescribed doses of ionizing radiation to specific body parts. They operate many kinds of equipment, including high-energy linear accelerators with electron capabilities. They position patients under the equipment with absolute accuracy in order to expose affected body parts to treatment while protecting the rest of the body from radiation. They check the patient's reactions for radiation side effects such as nausea, hair loss, and skin irritation. They give instructions and explanations to patients who are likely to be very ill and may be dying. Radiation therapists, in contrast to other radiological technologists, are likely to see the same patient a number of times during the course of treatment.

Sonographers, also known as ultrasound technologists, use high-frequency sound waves and send them into areas of the patient's body to view internal structures. The equipment can collect reflected echoes to form the images of these structures. The image is viewed on a screen and may be recorded on a printout strip or photographed for interpretation and diagnosis by physicians. Sonographers explain the procedure, record additional medical history, and then position the patient for testing. Viewing the screen as the scan takes place, sonographers look for subtle differences between healthy and pathological areas, and judge if the images are satisfactory for diagnostic purposes. Sonographers may specialize in neurosonography (the brain), vascular (blood flows), echocardiography (the heart), abdominal (the liver, kidneys, spleen, and pancreas), obstetrics/gynecology (the female reproductive system and fetus), and ophthalmology (the eye). Radiological technologists follow precisely physicians' instructions and regulations concerning use of radiation to insure that they, patients and co-workers, are protected from overexposure. In addition to preparing patients and operating equipment, radiological technologists keep patient records and adjust and maintain equipment. They may prepare work schedules, evaluate equipment purchases, or manage a radiology department.

WORKING CONDITIONS

Most full-time radiological technologists work about 40 hours a week; they may have evening and weekend or on-call hours. Technologists are on their feet for long periods and may lift or turn disabled patients. They work at radiological machines but may do some procedures at patients' bedsides. Some radiological technologists travel to patients in large vans equipped with sophisticated diagnostic equipment. Radiation therapists are prone to emotional burnout since they regularly treat extremely ill and dying patients on a daily basis. Although potential radiation hazards exist in this occupation, they have been minimized by the use of lead aprons, gloves, and other shielding devices, as well as by instruments that measure radiation exposure. Technologists

Page 8: H.S.100-Lesson 8.doc

wear badges that measure radiation levels in the radiation area, and detailed records are kept on their cumulative lifetime dose.

EMPLOYMENT OPPORTUNITIES

Radiological technologists hold about 170,000 jobs. Most technologists are radiographers. Some are sonographers and radiation therapists. About one in five radiological technologists work part-time. About 75 percent work in the hospital setting. The rest are in physicians' offices and clinics, including diagnostic imaging centers.

TRAINING, OTHER QUALIFICATIONS, AND ADVANCEMENT

Preparation for this profession is offered in hospitals, colleges and universities, vocational-technical institutes, and the Armed Forces. Hospitals, which employ most radiological technologists, prefer to hire those with formal training. Formal training is offered in radiography, radiation therapy, and diagnostic medical sonography (ultrasound). Programs range in length from one to four years and lead to a certificate, associate degree, or bachelor's degree. Two-year programs are most prevalent.

Some one-year certificate programs are for individuals from other health occupations such as medical technologists and registered nurses who want to change fields or experienced radiographers who want to specialize in radiation therapy technology or sonography. A bachelor's or master's degree in one of the radiological technologies is desirable for supervisory, administrative, or teaching positions..The Committee on Allied Health Education and Accreditation (CAHEA) accredits most formal training programs for this field. CAHEA accredited 687 radiography programs, 120 radiation therapy programs, and 52 diagnostic medical sonography programs in 1998.

Radiography programs require, at a minimum, a high school diploma or the equivalent. High school courses in mathematics, physics, chemistry, and biology are helpful. The programs provide both classroom and clinical instruction in anatomy and physiology, patient care procedures, radiation physics, radiation protection, principles of imaging, medical terminology, positioning of patients, medical ethics, radiobiology, and pathology.

For training programs in radiation therapy and diagnostic medical sonography, applicants with a background in science, or experience in one of the health professions, generally are preferred. Some programs consider applicants with liberal arts backgrounds, however, as well as high school graduates with courses in math and science.Radiographers and radiation therapists are covered by provisions of the Consumer-Patient Radiation Health and Safety Act of 1981, which aims to protect the public from the hazards of unnecessary exposure to medical and dental radiation by ensuring operators of radiological equipment, are properly trained. The Act requires the Federal government to set standards that the States, in turn, may use for accrediting training programs and certifying individuals who engage in medical or dental radiography.

About 26 States require radiographers to be licensed, and 23 require radiation therapists to be licensed. Puerto Rico requires a license for the practice of either specialty. One State, Utah, licenses diagnostic medical sonographers.

Page 9: H.S.100-Lesson 8.doc

Voluntary registration is offered by the American Registry of Radiological Technologists (ARRT) in both radiography and radiation therapy. The American Registry of Diagnostic Medical Sonographers (ARDMS) certifies the competence of sonographers. To become registered, technologists must be graduates of a CAHEA-accredited program or meet other prerequisites and have passed an examination. Many employers prefer to hire registered technologists.

With experience and additional training, staff technologists may become specialists, performing CT scanning, ultrasound, angiography, and magnetic resonance imaging. Experienced technologists may be promoted to supervisor, chief radiological technologist, and, ultimately, department administrator or director. Depending on the institution, courses or a master's degree in business or health administration may be necessary for the director's position. Some technologists progress by becoming instructors or directors in radiological technology programs; others take jobs as sales representatives or instructors with equipment manufacturers.

With additional education available at major cancer centers, radiation therapy technologists can specialize as medical radiation dosimetrists. Dosimetrists work with health physicists and oncologists, physicians who specialize in the study and treatment of tumors, to develop treatment plans.

JOB OUTLOOK

Employment for radiological technologists is expected to grow much faster than the average for all occupations through 2010, as the health care industries grow, and because of the vast clinical potential of diagnostic imaging and therapeutic technology. Current as well as new uses of imaging equipment are virtually certain to sharply increase demand for radiological technologists.

Technology will continue to evolve. New generations of diagnostic imaging equipment are expected to give even better information to physicians and be used more widely. Since ultrasound is non-invasive, it is less risky and uncomfortable for the patient then exploratory surgery.

Radiation therapy will continue to be used alone or in combination with surgery or chemotherapy, to treat cancer. More treatment of cancer is anticipated due to the aging of the population, educational efforts aimed at early detection, and improved ability to detect malignancies through radiological procedures such as mammography.

Although physicians are enthusiastic about the clinical benefits of new technologies, the extent to which they are adopted depends largely on cost and reimbursement considerations. Some promising new technologies may not come into widespread use because they are too expensive and third-party payers may not be willing to pay for their use. But on the whole, it appears that radiological procedures will be used more widely.

Hospitals will remain the principal employers of radiological technologists. However, employment is expected to grow most rapidly in offices and clinics of physicians, including diagnostic imaging centers. Health facilities such as these are expected to grow very rapidly through 2010 due to the strong shift toward outpatient care, encouraged by third-party payers and made possible by technological advances that permit more procedures to be performed outside the hospital. Some jobs will come from the need to replace technologists who leave the occupation.

Page 10: H.S.100-Lesson 8.doc

EARNINGS

The median annual earnings for radiological technologists who work year-round and full-time are about $28,000. The middle 50 percent earn between $22,932 and $33,748 a week; 10 percent earn less than $19,708 a week; and 10 percent earn more than $40,456.

According to a University of Texas Medical Branch national survey of hospitals and medical centers, the median annual salary for radiation technologists, based on a 40-hour week and excluding shift or area differentials, is $26,615. The average minimum salary is $21,250 and the average maximum is $32,553. For radiation therapy technologists the median is $34,278 and for ultrasound technologists, $32,219.

Questions:

What are some of the uses for radiation technology?

What is the job description for most Radiological Technologists?

What do Radiation Therapy Technicians do?

How many hours a week do most Radiological Technologists work?

In what type of institution are most Radiological Technologists trained?

What are the program requirements for entrance into a professional Radiological Technology Program?

Under what type of Consumer Protection Act are Radiological Technicians covered?

Page 11: H.S.100-Lesson 8.doc

What additional training can be received by those who have Radiological Technology degrees?

How are job opportunities for Radiological Technicians expected to grow?

In what types of facilities do most Radiological Technicians work?

What are the median annual earnings for Radiological Technicians who work full-time?

Page 12: H.S.100-Lesson 8.doc

RELATED OCCUPATIONS

Radiological technologists operate sophisticated equipment to help physicians, dentists, and other health practitioners diagnose and treat patients. Workers in related occupations include nuclear medicine technologists, cardiovascular technologists and technicians, perfusionists, respiratory therapists, clinical laboratory technologists, and electroencephalographic technologists.

EEG and EKG Technologists and Technicians

WORK DESCRIPTION

Electroencephalography is a procedure that measures the electrical activity of the brain. An instrument called the electroencephalograph records this activity and produces a written tracing of the brain's electrical impulses. This record of brain waves, an electroencephalogram (EEG), can be taken while patients are at rest or asleep, while they are subjected to stimuli such as loud sounds and blinking lights, or during periods of exaggerated breathing.

The resting EEG is a basic diagnostic tool in the area of neurology. Neurologists use electroencephalograms to help diagnose the extent of injury for patients suspected of having brain tumors, strokes, metabolic thoracic disorders, or epilepsy; to measure the effects of infectious disease on the brain; and to determine whether individuals with mental or behavioral problems have an organic impairment such as Alzheimer's disease. Surgeons use them to monitor the patient's condition during major surgery. EEGs are standard in intensive care units as well, since absence of electrical activity in the brain is a basis for determining that a patient is clinically dead, or is used to assess the prospects for recovery of patients in a coma.

More sophisticated equipment is used for special EEG procedures, including ambulatory monitoring, evoked potential studies, sleep studies, and brain wave mapping. Tests such as these improve the physician's ability to detect the underlying reasons for a wide variety of troubling conditions. Ambulatory monitor is used to check the activity to the brain over a 2-hour period. Sometimes, in case where patients experience dizzy spells or sudden blackouts, brain waves may appear perfectly normal until the onset of symptoms. By monitoring such patients for an extended period of time, there is a better chance of detecting abnormal brain wave patterns. Evoked potential studies are used to aid in the evaluation of the visual, auditory, and other sensory systems of the body, and in the diagnosis of multiple sclerosis. Sleep studies have proven valuable in the treatment of sleep disorders, impotence, and, in some cases, hypertension. Brain waves involve the use of computer-generated images of brain function; it is simply an enhancement of the EEG, in which a color-coded picture or map shows the intensity of brain waves in different areas of the brain.

The people who operate electroencephalographs are called EEG technologists or technicians. The titles are used interchangeably and do not necessarily denote different skill levels. With the introduction of additional tests and machines that measure the electrical activity of the brain, a

Page 13: H.S.100-Lesson 8.doc

new job title is coming into use; neuralradiologic technologists. It may be years, however, before another term replaces AEEG technologists in standard usage.

Not only are job titles changing with the development of new ways of monitoring and evaluating the functioning of the nervous system, but job duties and skill levels are changing as well. Proficiency in operating basic EEG equipment is becoming little more than the entry-level skill for jobs in this field; additional training is necessary for personnel who perform special EEG procedures.

Before EEG technologists produce electroencephalograms, they take a short medical history and help the patient relax. Then they apply electrodes to designated spots on the patient's head and body and make sure that the instruments are working correctly. The technologist chooses the most appropriate combination of instrument controls and electrodes to produce the kind of record needed. Technologists must recognize and correct any artifacts that appear (an artifact is an electrical or mechanical wave that comes from somewhere other than the brain, such as eye movement or interference from electrical sources). Mechanical problems with the electroencephalograph are reported to the supervisor, so the machine can be repaired promptly. The first step in conducting a special procedure EEG is essentially the same as that for a resting EEG--attaching electrodes to the patient's body. However, electrodes for a resting EEG are secured at various places on the scalp, whereas a special procedures EEG may require that electrodes be secured on the chest, arm, leg, or spinal column as well, to record activity from both the central and peripheral nervous systems.

In the procedure known as ambulatory monitoring, activity of the heart as well as the brain may be monitored while the patient carries out normal activities over a 2-hour period. Once the monitoring time has elapsed, the technologist removes the small recorder fastened to the patient's side and feeds the recorded information into a special machine that transforms the digital recordings into hard copy (paper) EEG tapes. The technologist reviews the tapes, a process that can take several hours, selecting sections for the physician to examine. In order to determine which sections merit attention from the physician, the technologist must be able to distinguish between normal and abnormal brain wave patterns. Whereas ambulatory EEGs measure general brain wave activity, evoked potential testing uses a special machine to measure sensory and physical response to specific stimuli. After the electrodes have been attached properly, the technologist sets the machine for the type and intensity of the stimulus. If there is no reaction, progressively stronger stimuli are applied until the patient reacts. Once there is a reaction, the sensation level is noted. Additional stimuli are applied until the technologist decides an adequate reading has been taken. The technologist may spend anywhere from one to four hours with the patient when an evoked potential test is being run.

Increasingly, technologists are called upon to set up and monitor EEGs and evoked potential tests in the operating room. Surgical monitoring requires that technologists be well versed in anesthesia and its effect on brain waves, so that they can alert the surgical team when readings from the EEG instrument suggest an abnormal reaction.

Sleep studies and brain wave mappings are examples of other diagnostic procedures administered by specialized EEG personnel. Sleep studies require technologists to be competent in monitoring respiration and heart activity in addition to brain wave activity. Technologists must know the various stages of sleep, the average length of each stage, and the characteristic fluctuating of the neurological and cardiopulmonary systems during each stage. When all the necessary readings have been taken, the technologist coordinates readings from the various organ systems, separating them according to the various stages of sleep, and relays them to the physician. Brain wave

Page 14: H.S.100-Lesson 8.doc

mapping requires the technologist to decide which sections of the EEG should be transformed into color-coded pictures of brain wave frequency and intensity, for examination by a physician.

Technologists must know how to recognize changes in the patient's neurological, cardiac, and respiratory status. To react properly in an emergency, they must understand the kinds of medical emergencies that can occur while they are taking the EEG. For example, if a patient suffers an epileptic seizure in the EEG laboratory, the technologist must be prepared to take the proper action.

Besides conducting EEGs, technologists may have supervisory or administrative responsibilities. They may manage the EEG laboratory, arrange work schedules, keep records, schedule appointments, order supplies, establish correct treatment procedures, and provide instruction in EEG techniques.

In some hospitals, job duties are not confined to electroencephalography. EEG technologists may perform EKGs and other kinds of procedures as well. To acquire the requisite skills, technologists are cross-trained to handle several different machines. As new trends in hospital staffing, the cross-training of multi competent technicians are seen as a way of holding down labor costs.

WORKING CONDITIONS

EEG technologists usually work in clean, well-lighted surroundings, and spend about half of their time on their feet. A lot of bending is necessary as they may work with patients who are unruly or very ill and require assistance. A 5-day, 40-hour week with some overtime is normal, although some hospitals require EEG technologists to be on call after hours and on weekends and holidays. These employees generally work during the day, but those involved in sleep studies may work evenings and nights.

EMPLOYMENT OPPORTUNITIES

Electroencephalographic technologists hold nearly 7,000 jobs. Most jobs are in hospitals, but other health care settings are gaining in importance. EEG technologists work in neurology laboratories, offices of neurologists and neurosurgeons, group medical practices, HMOs, urgent care centers and clinics, and psychiatric facilities. Most technologists work full-time.

TRAINING, OTHER QUALIFICATION, AND ADVANCEMENTS

EEG technologists generally learn their skills on-the-job, although some complete formal training programs. Applicants for trainee positions in hospitals need a high school diploma, as a rule. Often, EEG trainees transfer to the neurology department from other jobs in the hospital, such as a laboratory aide or licensed practical nurse.

Formal training is offered at the post-secondary level by hospitals, medical centers, community colleges, vocational-technical institutes, and colleges and universities. In 1998, the Committee on Allied Health Education and Accreditation had approved 36 formal training programs for EEG personnel. Programs usually last from one to two years and include laboratory experience as well as classroom instruction in anatomy, neuroanatomy, physiology, neurophysiology, clinical and

Page 15: H.S.100-Lesson 8.doc

internal medicine, psychiatry, and electronics and instrumentation. Graduates receive associate degrees or certificates.

Credentials for EEG personnel are available through the American Board of Registration of Electroencephalographic Technologists, which awards the title Registered EEG Technologist to qualified applicants. This board accredits technologists in the sub specialty of evoked potential as Registered Evoked Potential Technologist. Although not generally required for entry-level jobs, registration indicates professional competence, and may be necessary for supervisory or teaching jobs.

Persons who want to enter this field should have manual dexterity, good vision, aptitude for working with electronic equipment, and the ability to work with patients as well as with other health personnel.

EEG personnel in large hospitals can advance to chief EEG technologist and take on increased responsibilities in laboratory management and in teaching basic techniques to new personnel or students from EEG training programs. A physician--an electroencephalographer, neurologist, or neurosurgeon, generally supervises chief EEG technologists.

JOB OUTLOOK

Employment of EEG technologists is expected to grow much faster than the average for all occupations through the year 2010, chiefly because of increasing application of the EEG and related neuro-diagnostic tests, and the willingness of health insurers and other third-party payers to cover such examinations. Nonetheless, most job openings will result from the need to replace workers who transfer to other occupations or leave the labor force entirely. Continued acceptance of the value of the EEG is expected to sustain demand for workers who perform these tests. Moreover, further advances in clinical neurophysiology are a virtual certainty, and these are likely to spur demand by expanding the uses of neuro-diagnostic testing.The rate at which this field expands will be governed by the willingness of third-party payers to pay for neurological testing. EEG laboratories, which offer outpatient as well as in patient testing, have become revenue centers for hospitals, as outpatient centers are currently fully reimbursed. Some hospitals have expanded their EEG laboratories, adding space and hiring additional personnel. Non-hospital providers have responded to incentives in the reimbursement system as well, expanding the range of EEG procedures they offer and creating more jobs for EEG technologists.

Because job growth through the year 2010 is expected to be very rapid in outpatient settings, including offices of neurologists, medical group practices, and HMOs, opportunities are likely to be especially favorable in those settings. Opportunities for individuals who have a background in EEG technology will be excellent. Hospitals and other employers prefer to hire individuals with some formal preparation.

EARNINGS

Starting salaries of EEG technologists employed by hospitals, medical schools, and medical centers averaged $18,664, according to a survey by the University of Texas Medical Branch. Starting salaries for registered EEG technologists are $1,000 to $2,000 higher. Salaries for experienced EEG technologists ranged as high as $25,000 a year. Positions such as EEG laboratory supervisor, special procedures instructor, or EEG training program director generally command higher salaries. EEG technologists in hospitals receive the same benefits as other

Page 16: H.S.100-Lesson 8.doc

hospital personnel, including paid vacations, sick leave, health insurance, and pensions. Some institutions provide tuition assistance, uniforms, parking, childcare, and other employee benefits.

RELATED OCCUPATIONS

Related occupations in supervised health care activities are audiometrist, electrocardiograph technician, clinical laboratory technician, occupational therapy assistant, surgical technician, physical therapy aide, and psychiatric aide.

ADDITIONAL INFORMATION

Local hospitals can supply information about employment opportunities. For general information about a career in electroencephalography as well as a list of accredited training programs, contact: American Society of Electroencephalographic Technologists, Inc., 6th at Quint, Carroll, IA 51401.

EKG Technologists and Technicians

WORK DESCRIPTION

Electrocardiograms (EKGs) are graphic tracings of heartbeats recorded by an instrument called an electrocardiograph. These tracings indicate the electrical impulses transmitted by the heart muscle during and between heartbeats. EKG technicians operate the electrocardiograph to produce the tracings for review by a physician. Physicians order electrocardiograms to help diagnose certain forms of heart disease, monitor the effect of drug therapy, and analyze changes in the condition of a patient's heart over a period of time. The test is done before most kinds of surgery, including outpatient's surgical procedures. Some physicians use electrocardiograms as a routine diagnostic procedure for persons who have reached a certain age. In many fields, electrocardiograms are required as part of preemployment physical examinations.Since the equipment is mobile, EKG technicians can record electrocardiograms in a doctor's office, in a hospital heart station (cardiology department), or at the patient's bedside. After explaining the procedure to the patient, the technician attaches 10 electrodes to the chest, arms, and legs of the patient. Normally, the technician applies a gel between the electrodes and the patient's skin to facilitate the passage of the electrical impulses. By manipulating switches on the electrocardiograph and positioning the electrodes across the chest, the technician obtains a recording of the heart's electrical action. A stylus or ink pen records the tracings on graph paper. The test is usually performed while the patient is reading or while exercising. The technician must know the anatomy of the chest and heart to select the exact locations for the chest electrodes. Electrodes placed in the wrong location result in an inaccurate reading.

After the recording is completed, the technician prepares the electrocardiogram for analysis by a physician, usually a cardiologist (heart specialist). The most advanced EKG equipment employs a computer to analyze the tracing, and the technician may need to enter information into the console using a keyboard. Technicians must be able to recognize and correct any technical errors such as crossed leads, incorrect lead placement, or electrical interference that prevent an accurate reading. They must call the doctor's attention to any significant deviations from the average normally recorded by the technique used. Physicians then review the recordings and study these and other deviations identified.

Some EKG technicians schedule appointments, type doctors' interpretations, maintain patients' EKG files, care for equipment, and perform or assist in more specialized cardiac testing.

Page 17: H.S.100-Lesson 8.doc

Cardiology is one of the most rapidly developing fields in medicine today, and new procedures for diagnosing and treating heart and circulatory problems are being introduced all the time. These have raised skill requirements and created new occupations in the areas of cardiovascular and cardiopulmonary technology. For example, recognition of the value of monitoring heart action while the patient is normally active has led to widespread use of 2-hour ambulatory monitoring, also called Holter monitoring, after the physician who developed the equipment, and exercises stress tests that record the EKG during physical activity. Technicians who perform these tests need special training. EKG technicians perform a relatively simple task and do not have skills to assist in the newer cardiac procedures unless they complete additional training.

WORKING CONDITIONS

Technicians generally work a 5-day, 40-hour week that may include Saturdays and Sundays. Those in hospitals and private clinics may work evening hours. Much time is spent walking and standing. The work can become hectic.

EMPLOYMENT OPPORTUNITIES

Electrocardiography technicians hold about 8,000 jobs. Most EKG Technicians work in cardiology departments of large hospitals. Others work part-time in small hospitals where workloads are not great enough to require full-time technicians. Some EKG technicians have jobs in cardiologists' offices, cardiac rehabilitation centers, HMOs, or clinics.

TRAINING, OTHER QUALIFICATIONS, AND ADVANCEMENT

EKG technicians are trained on-the-job or as apart of other professional training. Training is usually conducted by an EKG supervisor or a cardiologist and lasts no more than four to six weeks for the basic resting EKG. Training for specialized EKG testing is much more extensive, usually 12 to 24 months, and involves in-depth study of cardiovascular anatomy and physiology.Applicants for trainee positions generally must be high school graduates. High school courses recommended for students interested in this field include health, biology, and typing. Familiarity with medical terminology can be acquired in classes on human anatomy, physiology, or medical terminology and by studying a medical dictionary. Applicants for EKG training must be reliable and have mechanical aptitude, ability to follow detailed instructions, and presence of mind in emergencies. A pleasant, relaxed manner for putting patients at their ease is an asset.

Opportunities for advancement are good for technicians who become proficient in more complex procedures. Increasingly, experienced EKG technicians are being trained to perform or assist with a wide range of cardiac tests, enabling them to advance to positions as monitor technicians, Holter monitor technicians, stress testing technicians, or echocardiography technicians. Individuals with the requisite experience and training may eventually be upgraded to jobs as noninvasive or invasive cardiovascular technicians. Promotion to supervisory positions is possible, too. Employers generally encourage and may provide training to technicians to help them become competent in various procedures.

JOB OUTLOOK

Employment of EKG technicians is expected to grow about as fast as the average for all occupations through the year 2010 due to anticipated growth in cardiology. Demand for EKG technicians is not likely to keep pace with growth in the number of cardiac tests and procedures

Page 18: H.S.100-Lesson 8.doc

performed, however. Nor will job growth be as rapid as in the more highly skilled cardiology occupations--a consequence of productivity gains associated with new EKG equipment and efforts to streamline hospital staffing. Most job openings, therefore, will result from the need to replace technicians who transfer to other jobs or leave the labor force all together.

Use of the EKG as a standard test in the diagnosis and treatment of heart disease is expected to continue, but advances in technology and computerization of hospital departments will substantially raise EKG technicians' productivity. An EKG that used to take 15 minutes can now be performed in five minutes, thanks to new EKG equipment that records readings more quickly and relieves the technician from having to mount three separate graphs on a backboard for the physician to read. In addition, computerization has cut back dramatically on paperwork. Rather than spending time on clerical duties, technicians can use their time administering EKGs.

Employment of EKG technicians will be further constrained by hospitals' efforts to cut labor costs. The equipment used for a resting EKG is so simple that the necessary skills can be mastered quickly. Many hospitals are cutting back on EKG personnel by training registered nurses, respiratory therapists, and others to perform EKG procedures during off hours. Thus, some hospitals whose EKG departments formerly operated on a 24-hour basis have cut to eight or 12-hour coverage; emergency EKGs are handled by other hospital personnel. If this trend persists, it will dampen demand for EKG technicians in hospitals.

An increasing number of jobs will be in cardiologists' offices, cardiology clinics, HMOs, and other outpatient settings. Facilities such as these are expected to experience very rapid growth through the year 2010. Nonetheless, hospitals are likely to remain the dominant employer of EKG technicians.

Because entry requirements are minimal, the pool of prospective job seekers is very large. In some communities, individuals seeking positions as EKG technicians may find that employers prefer applicants with previous EKG experience or formal training including armed forces training. Individuals with training in Holter monitoring or stress testing in addition to basic EKGs may enjoy more favorable job prospects than those without these additional skills.

EARNINGSEKG technicians employed in hospitals, medical schools, and medical centers earn starting salaries of about $16,900. EKG technicians who perform more sophisticated tests are paid more than those who perform only basic ones. Some experienced EKG technicians earn as much as $24,800 a year. EKG technicians in hospitals receive the same fringe benefits as other hospital personnel, including health insurance, pension benefits, vacations, and sick leave. Some institutions provide tuition assistance, uniforms, and other benefits.

Questions:

What is electroencephalography?

In what areas of medicine is the resting EEG a basic diagnostic tool?

Page 19: H.S.100-Lesson 8.doc

What kinds of conditions might require an EEG?

What types of jobs might an EEG Technician do in a hospital?

How many jobs do EEG Technicians hold?

How does an EEG Technician learn their skills?

How is employment of EEG Technicians expected to grow?

What factors affect the rate of employment for EEG Technicians?

What are the starting salaries of EEG Technicians?

What is the purpose of an EKG?

How are EKG electrodes placed on the body?

Why is cardiology the fastest growing area of medicine today?

What is the employment outlook for EKG Technicians?

What are the starting average earnings for EKG technicians?

RELATED OCCUPATIONS

Page 20: H.S.100-Lesson 8.doc

Workers in other occupations requiring operation of diagnostic or therapeutic equipment include audiometrists, electroencephalographic (EEG) technologists and technicians, radiological technologists, clinical laboratory technologists and technicians, cardiovascular technologists, cardiopulmonary technologists, and electroneuro-diagnostic technicians.

ADDITIONAL INFORMATION

Local hospitals can supply information about employment opportunities. For a list of training programs in cardiovascular technology, contact: American Society of Cardiologic Technicians, 55 E. Jackson Blvd., Chicago, IL 60604

Nuclear Medicine Technologists

WORK DESCRIPTION

Nuclear medicine is the branch of radiology that uses radionuclitides, unstable atoms that emit radiation spontaneously, in the diagnosis and treatment of disease. Just as the field of radiology had its beginnings when Wilhelm Roentgen discovered X-ray, the seed for nuclear medicine was planted almost a century ago when Marie Curie discovered radium. However, it was not until after World War II and the discovery of ways to produce artificial radionuclides that doctors began to recognize the medical uses of these elements. When a radionuclide is injected into a patient or taken orally, radioactivity can be detected and monitored from outside to assess the characteristics or functioning of those tissues or organs in which it settles. Abnormal areas show up as higher or lower concentrations of radioactivity than normal.

Nuclitides capable of producing useful information about thyroid function are among the first medical uses discovered. Since then, diagnostic applications of nuclear medicine have expanded dramatically, with images of bones, brain, liver, or heart function emerging as particularly important. Nuclear medicine today commands a place alongside other highly valued diagnostic disciplines. As is generally the case in medical diagnostics, specially trained technologists perform the tests and procedures ordered by physicians, who, in turn, interpret the results.

Nuclear medicine technologists are trained to assume responsibility for the proper use of nuculearpharmaceuticals (radioactive drugs) in a variety of functional areas. They may conduct laboratory studies, do research, or develop and administer procedures for purchasing, using, and disposing of radioactive nuclides. Implementing safety procedures required by the Nuclear Regulatory Commission is another important role. Technologists generally work directly with patients performing nuclear medicine procedures that are used to diagnose and treat disease.

Nuclear medicine technologists, like radiological technologists, operate diagnostic imaging equipment. However, the equipment used in these two specialties relies on different principles, and job duties reflect this. Radiological technologists create an image by shooting a beam of radiation through the patient. In nuclear medicine, the technologist prepares a radioactive substance (radiopharmaceutical) for the patient to take, administers it, and then operates a camera that uses the radiation given off by the patient to create an image.

Page 21: H.S.100-Lesson 8.doc

Preparing the radioactive substance that the patient takes before the image is taken is a task that requires laboratory skills as well as strict adherence to safety precautions, inasmuch as the technologist is handling potentially dangerous radioactive materials.

Prior to the examination, the technologist explains the test procedure and tries to relieve any anxiety the patient may be experiencing. The amount and type of radiopharmaceutical that is used depends on the particular test being performed. The nuclear medicine technologist first calculates and prepares the correct dosage and then administers it to the patient by mouth, injection, or other means. Afterward, the technologist observes the patient carefully to make sure that is no unanticipated reaction.

Once the nuclide has had time to enter the system, the technologist is ready to perform the imaging procedure. The technologist positions the patient and then starts the Computer Assisted Tomography scanner, as these instruments are popularly called, which takes pictures of the radioisotopes as they pass through to localize in different parts of the patient's body. Once the scan has been completed, the technologist carefully examines the quality of the image for any additional information to give the physician. Some studies, such as cardiac function studies, are then processed by the technologist with the aid of a computer. Information obtained through the nuclear medicine procedure is used by the patient's doctor in arriving at a diagnosis.

In some facilities, nuclear medicine technologists perform imaging procedures in other sub specialties of radiology. Technologists may spend part of the day in the ultrasound or diagnostic radiology departments, performing ultrasound scans, fluoroscopy, or routine x-rays. The amount of time spent on a non nuclear medicine procedure depends on the size of the facility, the amount of specialization, and the organization policy within the institution. The job of the nuclear medicine technologist encompasses more than diagnostic imaging. Because nuclear medicine is effective in certain laboratory tests, technologists must be proficient in clinical laboratory procedures. In one type of test, a small quantity of a radiopharmaceutical is administered to a patient and then body specimens such as blood or urine are collected and measured for radioactivity level. In other words, laboratory testing replaces the image as the means of assessing the behavior of the radioactive substance inside the body. In another kind of test, radioactive substances are added to blood or serum in a test tube to determine levels of hormones or therapeutic drug content.

Other job responsibilities include ensuring that all workers in the nuclear medicine laboratory carefully follow radiation safety procedures and that complete and accurate records are kept. This includes patient medical records, patient procedures performed, and amounts and types of radionuclides received, used, and disposed of.

WORKING CONDITIONS

Nuclear medicine technologists generally work a 40-hour week. This may include evening or weekend hours in hospital departments that operate on an extended schedule. In addition, technologists in hospitals are required to perform on-call duty on a rotation basis. Depending on the size of the nuclear medicine department and number of technologists employed, the frequency of required on-call duty varies. The number of times a technologist is actually called into the hospital while on call depends on the size and case mix of the hospital. Opportunities for weekend, part-time, and shift work are also available.

Technologists are on their feet much of the day, and may be required to lift or turn disabled patients. Physical stamina, therefore, is important. There are potential radiation hazards in this

Page 22: H.S.100-Lesson 8.doc

field; however, these hazards have been reduced by the use of safety devices such as instruments that measure radiation exposure, shielded syringes, gloves, and other protective devices. Because of the presence of radiation and radioactive materials, technologists wear special badges that measure radiation levels while they are in the radiation area. The badge measurement rarely approaches or exceeds established safety levels because of safety programs and built-in safety devices.

EMPLOYMENT OPPORTUNITIES

Nuclear medicine technologists hold 10,000 jobs. About eight out of 10 are in hospital jobs. The rest are located in medical laboratories, physicians' offices, and outpatient clinics and imaging centers. The Federal government employs about 300 nuclear medicine technologists.

TRAINING, OTHER QUALIFICATIONS, AND ADVANCEMENT

Technologists used to be trained on-the-job, but this is no longer the case. Most employers prefer to hire individuals who have completed formal training programs. Such programs are available at the post secondary level in hospitals, medical centers, colleges and universities, and the armed forces. Programs vary in a number of respects: length of training, prerequisites, class size, and cost. Programs range in length from one to four years and lead to a certificate, associate degree, or bachelor's degree. One-year certificates and two-year associate programs are most prevalent, however.Certificate programs in nuclear medicine technology enroll individuals from a variety of backgrounds. These programs are designed for individuals who already have some post secondary education--whether in radiological technology, another allied health profession, or another health or science-related area. Among those attracted to certificate programs are radiological technologists and ultrasound technologists who seek to enhance their skills, as well as medical technologists, registered nurses, respiratory therapists, and other health professionals who wish to change fields or specialize. Individuals with three to four years of college education may choose certificate training as a means of preparing for a career in nuclear medicine technology. The second major route of entry into nuclear medicine technology is through completion of a two-year associate degree program.

Among the topics covered in programs that prepare nuclear medicine technologists are physical sciences, the biological effects of radiation exposure, protection, radiopharmaceuticals and their use on patients, and imaging techniques. Programs that grant academic degrees (associates or bachelor's) have additional requirements.

The Committee on Allied Health Education and Accreditation (CAHEA) accredits most formal training programs in this field. There are about 150 CAHEA accredited programs in nuclear medicine technology.

Nuclear medicine technologists are among the occupations covered by the Consumer Patient Radiation Health and Safety Act of 1981, which aims to protect the public from the hazards of unnecessary exposure to medical and dental radiation by making sure that personnel involved in administering radioactive drugs or operating radiological equipment are properly trained. The Act requires the Federal government to set standards that the States, in turn, may use for accrediting training programs or certifying individuals who use radioactive elements or radiation in medicine or dentistry.

Page 23: H.S.100-Lesson 8.doc

Procedures for acquiring professional credentials in nuclear medicine technology include licensor--required by law in seven states and Puerto Rico--and certification or registration, which is voluntary. Registration or certification is available from the American Registry of Radiological Technologists (ARRT) and from the Nuclear Medicine Technology Certification Board (NMTCM). Credentials from either of these accrediting bodies qualify applicants for employment in the hospital setting.

Many jobs are open only to registered or registry-eligible technologists. Hospitals generally require CAHEA accredited training plus credentials in nuclear medicine technology. Medical group practices and outpatient clinics are more likely to hire technologists without formal credentials.

Career lines in this field are short. Advancement usually involves promotion to a supervisory position, such as chief technologist or department administrator or manager. Specialization in a clinical area such as cardiology diagnostics or computer analysis offers another route for advancement. Some technologists progress by becoming instructors or directors in nuclear medicine technology programs, a step that usually requires an associate or bachelor's degree in nuclear medicine technology. Some technologists leave the occupation to take jobs as sales or training representatives with health industry equipment manufacturing firms, positions that build upon their background and experience.

JOB OUTLOOK

Employment of nuclear medicine technologists is expected to grow about as fast as the average for all occupations through the year 2010. Most job openings will come from the need to replace experienced technologists who leave the field. Conflicting forces will shape the job outlook. On the one hand, employment growth is likely to be constrained by competition from less invasive imaging method--computed tomography (CT) and magnetic resonance imaging (MRI) in particular. Developments in diagnostic imaging technology are occurring at a dramatic pace, and it is likely that some of the tests that emerge by the year 2010 will replace procedures currently performed by nuclear medicine technologists.

At the same time, advances in medical diagnostics could spur use of nuclear medicine procedures. The use of radiopharmaceuticals in combination with monoclonal antibodies is just one illustration of the enormous diagnostic potential of nuclear medicine. Monoclonal antibodies have affinity for tumors. When radioactively marked, they are easily followed by scanning equipment as they gather around otherwise invisible parts of the body. They can be used to detect cancer at far earlier stages than is customary today, and without resorting to surgery. Another illustration is the use of nuclear medicine diagnostics in cardiology. Using radionuclides injected into the bloodstream, nuclear medicine technologists can measure the percentage of the patient's blood pumped by each contraction of the heart. This procedure performed at rest and during stress examines the heart's ability to meet the body's needs. In some patients, such a test eliminates the need for cardiac catheterization, a costly and at times, risky procedure.

In the years ahead, job opportunities for nuclear medicine technologists in offices of physicians, medical laboratories, and outpatient imaging centers are expected to expand substantially. Hospitals, however, will continue to be the major employers of these workers through the year 2010. Hospitals, under considerable pressure to keep costs under control, are trying to reduce the number of tests per patient and to discourage procedures that mean revenue losses. Together with competition from other imaging methods, this thrust could curtail expansion of nuclear medicine testing, although it is not at all certain that this will be the case.

Page 24: H.S.100-Lesson 8.doc

In any event, the dominance of the hospital sector in the employment of technologists means that job prospects will be better in some localities than in others, depending on conditions in the hospital industry. In communities that experience hospital closures or mergers, for example, the number of openings for trained nuclear medicine technologists could decline precipitously. Employment opportunities for trained nuclear medicine technologists vary regionally. Competition appears to be fairly keen in large metropolitan areas, while hospitals and other employers are actively recruiting technologists in rural areas.

EARNINGS

Starting salaries for nuclear medicine technologists employed in hospitals, medical schools, and medical centers averaged $25,300 a year, according to a survey by the University of Texas Medical Branch. Experienced technologists averaged $29,600. According to a survey by the Society of Nuclear Medicine, staff technologists averaged $25,000 a year. Chief technologists earn average salaries of $36,000 a year. The average salary of nuclear medicine technologists employed by the Federal government is $29,000 a year.

Questions:

What are radionuclides?

How are they used in nuclear medicine?

What are Nuclear Medicine Technologists trained to do?

How do Nuclear Medicine Technologists use computers to do their work?

What are some safety procedures used by Nuclear Medicine Technologists?

Where do most Nuclear Medicine Technologists work?

In the United States, who accredits Nuclear Technology programs?

Page 25: H.S.100-Lesson 8.doc

What at the steps necessary to become a Nuclear Medicine Technologist?

What is the job market like for Nuclear Medicine Technologists?

What are the starting salaries for Nuclear Medicine Technologists?

RELATED OCCUPATIONS

Nuclear medicine technologists operate sophisticated equipment to help physicians and other health practitioners diagnose and treat patients. Workers in related occupations include radiological technologists, ultrasound technologists, cardiology technologists, electrocardiograph technicians, electroencephalographic technologists, clinical laboratory technologists, perfusionists, and respiratory therapists.

ADDITIONAL INFORMATION

Additional information on a career as a nuclear medicine technologist is available from: American Society of Radiological Technicians, 55 E. Jackson Blvd., Chicago, IL 60604; and the National Committee on Health Certifying Agencies, 1101 30th St. N.W., Washington, D.C. 20007

Page 26: H.S.100-Lesson 8.doc