[Intl_DxMedPhys] Tech - less cath labs

[Bob Kobistek]

I agree, and of course, I'm aware of the ODH regulations. I'm trying to discourage the site from moving in this direction, but the bean counters and management will likely not heed my warnings. Around the early 2000's, another one of my cites received a Level 1 noncompliance, a cease-and-desist letter, and a follow up inspection after an ODH inspector asked a nurse if she ever presses these buttons, and she said "yes." And knowing how some physicians think, I have no doubt that eventually they'll start asking nurses to change mag modes, etc. Also, and I verified this with ODH, the cardiologist will have to personally, with his own hand, select the protocol on the computer when the patient gets registered. And the fact that the radiology director has been asking the ODH for clarification on the rules will paint a target on our backs at inspection time.

If they continue to move in this direction, I am considering asking them to remove me as IRRP.


Robert J. Kobistek, MS, FACR, DABR, MRSE(MRSC(tm))
Medical Physicist
RJK Medical Physics, Inc.
440-463-7879

From: Joshua Johnson <jjohnson at onephysics.com>
Sent: Friday, May 22, 2026 9:07 AM
To: Bob Kobistek <bob at rjkmedphys.com>; DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu>
Subject: RE: Tech - less cath labs

You're going to need to be very careful on that. I don't see it being smooth at all. You do have the option of having nurses do minimal tasks for operation for cath only procedures. Like you said, most of the button pushing would be done by the cardiologists outside of resetting the timer and any positioning buttons. I try to avoid having the nurses do anything on the list when possible out of fear that it would expand outside the bounds. I don't like not having an RT and have had facilities getting into trouble for having incorrect staff "operating the equipment" even when it's only select procedures without an RT.
I'm sure you know this already, but the nurses can:
(1) Move or position the patient;
(2) Move or position the fluoroscopic unit; and
(3) Reset the audible signal on the cumulative radiation exposure timer.

Joshua Johnson, MS, DABR
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From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu>> On Behalf Of Bob Kobistek via Intl_dxmedphys_wd_osu_list
Sent: Friday, May 22, 2026 8:50 AM
To: DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>>
Subject: [Intl_DxMedPhys] Tech - less cath labs

Hi folks. One of my sites is planning to eliminate X-ray technologists from their cath lab staff, which necessitates having the cardiologists press all the buttons. At this site, I am the IRRP (In the Ohio language, a person like the RSO, but
Hi folks.

One of my sites is planning to eliminate X-ray technologists from their cath lab staff, which necessitates having the cardiologists press all the buttons. At this site, I am the IRRP (In the Ohio language, a person like the RSO, but for radiation-generating equipment and not RAM). Given that I have this responsibility, I'm concerned about cardiologists getting lazy and having the nurses press buttons, thereby resulting in a Level 1 violation. Have any of you ever worked with a cath lab that had no techs? If so, how'd that work out?

Thanks


Robert J. Kobistek, MS, FACR, DABR, MRSE(MRSC(tm))
Medical Physicist
RJK Medical Physics, Inc.
440-463-7879

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