Radiology is an expanding field marked by advances in imaging modalities and image-guided techniques. Both diagnostic and interventional radiology nurses are vital members of the radiology team, providing patient care during diagnostic and minimally invasive, image-guided procedures used to treat a wide array of cardiovascular, neurovascular, and peripheral vascular conditions.
What is Diagnostic Radiology?
Diagnostic radiology utilizes imaging radiologic methodologies to diagnose a disease or injury. The methodologies used in diagnostic radiology include:
- Nuclear radiology
- Diagnostic ultrasound
A number of subspecialties exist within diagnostic radiology:
- Breast imaging: Focused on the diagnostic imaging and diagnosis of breast diseases and conditions
- Cardiovascular radiology: Focused on the diagnostic imaging and diagnosis of disease of the heart and vascular and circulatory systems, including the blood and lymphatic vessels
- Chest radiology: Focused on the diagnostic imaging and diagnosis of diseases of the chest, including the heart and lungs
- Emergency radiology: Focused on the diagnostic imaging and diagnosis of trauma and non-traumatic emergency conditions
- Gastrointestinal radiology: Focused on the diagnostic imaging and diagnosis of the gastrointestinal tract and abdomen, including the stomach and intestines
- Genitourinary radiology: Focused on the diagnosis and treatment of the reproductive organs and urinary system
- Head and neck radiology: Focused on the diagnostic imaging and diagnosis of disease of the head and neck
- Neuroradiology: Focused on the diagnostic imaging and diagnosis of the brain and nervous system, and the head, neck, and spine
- Pediatric radiology: Focused on the diagnostic imaging and diagnosis of disease of children
- Nuclear radiology: Focused on the imaging and diagnosis of patients using trace doses of radioactive material; includes imaging of the heart, skeletal system, and most organs of the body
- Radiation oncology: Devoted to the treatment of cancer using radiation
What is Interventional Radiology?
To fully understand the job of an interventional radiology nurse, it is important to first understand interventional radiology and its value in today’s technologically driven medical field.
Interventional radiology, often known as the operating room of the radiology department or the special procedures division, involves using imaging guidance (fluoroscopy, CTs, ultrasounds, x-rays, and MRIs) to guide tiny catheters and wires throughout the body’s vascular system. Unlike traditional (imaging) radiology, which is typically used in a diagnostic/screening capacity, interventional radiology delivers therapeutic procedures, often after other diagnostic testing has been performed.
The American Board of Medical Specialties recognizes interventional radiology as a medical specialty. Interventional radiologists are board-certified physicians with additional advanced training in minimally invasive treatments using imaging guidance. Board certification for these physicians includes Diagnostic Radiology and Vascular and Interventional Radiology, both through the American Board of Radiology.
Interventional radiologists treat conditions of the blood vessels (narrowing of the arteries, aneurysms, hemorrhaging) and veins (blood clots, varicose veins, block veins). They also provide non-vascular interventions, which include:
- Treating tumors/cancer (called ablation or embolization)
- Treating uterine fibroids
- Draining fluid or pus in the chest or abdomen
- Placing feeding tubes (gastrostomy)
- Treating collapsed spinal bones (vertebroplasty)
- Treating kidney stones (nephrostomy)
- Treating gull stones
According to the Society of Interventional Radiology, the most commonly performed procedures in interventional radiology include:
- Central venous access
- Stenting and grafting
- Fallopian tube catheterization
- Hemodialysis access maintenance
- Radiofrequency ablation
- Transjugular intrahepatic portosystemic shunt (TIPS)
- Uterine fibroid embolization
A number of specialties also exist within interventional radiology:
Interventional radiology is involved in all aspects of cancer care. Interventional radiology procedures may be used for diagnostic purposes, for providing palliative care for cancer-related end-of-life symptoms, and for performing minimally invasive procedures, such as:
- Chemo embolization
- Insertion/removal of chemotherapy ports
- Insertion/removal of chemotherapy catheters
- Radiofrequency ablation
- Internal radiation therapy
Neurointerventional radiology involves interventional radiology techniques used to treat stroke, cerebral aneurysm, and other conditions of the central nervous system through endovascular approaches. Procedures in neurointerventional radiology include:
- Embolization for brain AVs and dural fistulas
- Stenting of carotid artery disease in the neck and brain
- Coiling and other treatments for brain aneurysms
- Tumor embolization
What are the Job Duties and Responsibilities of Diagnostic and Interventional Radiology Nurses?
The main goal of radiology nurses is patient safety. They monitor and assess patients, ensuring the provision of safe and effective care.
The job duties of diagnostic and interventional radiology nurses include (but are not limited to):
- Preparing patients for procedures: Includes checking and verifying vital signs, meds, NPO status, lab results, and medical history
- Providing education to the patient and family members: Includes ensuring the patient and family members understand the procedure and plan of care before signing procedural consent and providing them with discharge planning/instructions
- Inserting and removing intravenous lines
- Administering conscious sedation drugs and other drugs
- Monitoring patient patterns and vital signs during the procedure
- Overseeing the safety and comfort of patients before, during, and after procedures
- Providing post-procedure monitoring: Includes observing for signs and symptoms of complications, such as bleeding from the puncture site, pain, and/or changes in mental status or vital signs
How to Become a Radiology Nurse
Radiology nurses possess an RN and additional training in radiology nursing. Many nurses entering the field have previous experience working in critical care units or in labs that perform therapeutic and diagnostic imaging procedures.
Many nurses in radiology are also advanced practice registered nurses (APRNs), achieving a Master of Science in Nursing (MSN) as a nurse practitioner or clinical nurse specialist. Within the MSN program, students may complete additional coursework in radiological sciences and clinical rotations in radiology and interventional radiology. A number of institutions also offer post-master’s certificate programs in radiological sciences.
Master’s-level courses related to radiological sciences often include:
- Advanced radiation physics
- Advanced radiation protection and biology
- Case studies in medical imaging
- Radiology management
- Advanced imaging modalities
Most employers require diagnostic and interventional radiologists to possess Basic Life Support (BLS) and Advanced Critical Care Life Support (ACLS) certification.
MSN Program Options
Candidates for traditional MSN programs must typically possess a Bachelor of Science in Nursing (BSN) and a valid RN license. In addition, most institutions require students to possess a minimum undergraduate GPA, minimum GRE scores, and clinical nursing experience, and also submit admissions essays and letters of recommendation.
Many institutions have also begun offering MSN programs in a partially or fully online format, thus appealing to busy working RNs. These programs allow students to complete most or all of the didactic components of their MSN program through interactive, online courses and then complete their clinical requirements at partner sites close to home.
Further, a number of institutions have also begun offering MSN programs for RNs that possess different educational backgrounds:
- RN-to-MSN Programs: Many colleges and universities offering MSN programs also provide an alternative MSN program for RNs with an associate degree. RN-to-MSN programs allow students to complete the components of both the BSN and the MSN in one, streamlined format.
- Direct-Entry MSN Programs: Direct-entry MSN programs are designed specifically for candidates that possess a bachelor’s degree in a major other than nursing. These programs allow students to transfer a number of their undergraduate credits and then complete both their RN and MSN throughout the course of the program.
Professional Certification Opportunities for Diagnostic and Interventional Radiologists
Although not required to become a diagnostic or interventional radiologist, many nurses in the radiology field earn voluntary professional certification. The Radiologic Nursing Certification Board, accredited by the Accreditation Board for Specialty Nursing certification, offers the Certified Radiology Nurse (CRN) credential.
To qualify to take the CRN exam and become a certified radiology nurse, candidates must possess the following:
- An active RN license
- At least 2,000 hours of radiology nursing in the past 3 years
- At least 30 contact hours of continuing education in nursing care of radiology patients in the past 24 months – at least 15 of the 30 contact hours must be related to imaging nursing
Candidates who have met the eligibility requirements must take and pass the CRN exam, which is administered in May and October every year and at the Association of Radiologic and Imaging Nursing annual convention. The exam consists of 175 questions related to:
- Assesing patient and plan care
- Administering, monitoring, and evaluting therapetuic interventions
- Teaching patients and families and providing a supportive environment
- Providing a safe environment and managing emergency situations
- Participating in interdisciplinary and professional practice activities
- Diagnostic imaging, fluorscopy, and breast health
- CT and MRI
- Interventional radiology
- Ultrasound/vascular ultrasound
- Nuclear medicine, PET, and radiation therapy
The CRN credential must be renewed every 4 years. At the time of recertification, certificaition holders must show evidence of:
- Current RN license
- At least 2,000 hours of practice as a radiology nurse in the past 4 years
- Currently practicing as a radiology nurse an average of 8 hours per week
Certification holders who have not met the above recertification requirements may also recertify by retaking the CRN exam or by completing at least 60 continuing education contact hours in the last 4 years. At least 30 of the 60 contact hours must be related to radiology nursing.
Salary Expectations for Radiology Nurses
Although no clear statistics exist for interventional and diagnostic radiology nurse salaries, recent job listings (sourced in May 2016) reveal the following salaries:
- Registered Nurse – Interventional Radiology: Department of Veterans Affairs: $50,805-$94,361
- Registered Nurse – Interventional Radiology: Duluth, MN: $64,480
- Interventional Radiology Nurse – Trenton, NJ: $93,600
- Vascular Interventional Radiology Nurse – Fairfield County, CT: $80,000-$100,000
- Registered Nurse, Recovery and Procedure – Encino, CA: $83,200-$93,600
- Registered Nurse, Vascular Center – Jacksonville, FL: $60,000
- Radiology Nurse – El Centro, CA: $62,400