Radiology is a broad field that involves the use of radiologic medical technology to diagnose, manage, and treat a variety of conditions and diseases. A radiology nurse is involved with the assessment, planning, and care of patients who undergo diagnostic, interventional, and therapeutic procedures. As such, a radiology nurse, often referred to as a radiological nurse, must have a high level of technical expertise and knowledge of radiologic science.
Although radiology nurses are often hired at the RN level, it is the advanced practice radiology nurse who holds key positions within the field of radiology. Imaging and interventional radiologists often call upon nurse practitioners and clinical nurse specialists to serve as mid-level providers within radiology departments and laboratories.
Radiology nurses often receive their clinical training and education in the following areas of radiologic science:
- Computed Tomography (CT)
- Breast Imaging
- Diagnostic X-ray
- Nuclear Medicine and PET
- Magnetic Resonance Imaging (MRI)
- Interventional Radiology
- Oncology Radiology
Radiological services can be broken down into three general areas in which radiology nurses can focus their professions:
Radiology nurses within hospitals and clinics may specialize in diagnostic radiology. From basic x-rays to complex MRIs that require the administration of dye contrast, radiology nurses work to support a radiologist’s diagnostic plan while accounting for patient care, comfort, and well-being.
Radiology nurses may focus in one or more diagnostic sub-specialization, including:
- Breast Imaging is the diagnostic imaging of the breast, breast diseases and breast conditions. It may include mammography, breast ultrasound, and breast MRI.
- Cardiovascular Radiology is the diagnostic imaging of the heart and blood vessels, including the arteries and veins. This may include x-rays, CT, MRI, and ultrasound.
- Emergency Radiology is the diagnostic imaging of traumatic injuries or conditions. This may include x-rays, CT, MRI, and ultrasound.
- Chest Radiology is the diagnostic imaging of the chest, including the heart and lungs. This may include x-rays, CT, ultrasound, and MRI.
- Gastrointestinal Radiology is the diagnostic imaging of the stomach, the intestines and the abdomen. This may include CT, MRI, ultrasound, fluoroscopy, and x-rays.
- Genitourinary Radiology is the diagnostic imaging of the reproductive organs and urinary tract. This may include x-rays, CT, MRI, and ultrasound.
- Head and Neck Radiology is the diagnostic imaging of the head and neck in the event of spinal injury or suspected tumors. This may include x-rays, CT, MRI, and ultrasound.
- Musculoskeletal Radiology is the diagnostic imaging of the muscles and the skeleton. This may include x-rays, MRI, CT, and ultrasound.
- Neuroradiology is the diagnostic imaging of the brain, head, neck, and spine. This may include x-rays, CT, MRI, and ultrasound.
- Nuclear Radiology is diagnostic imaging using miniscule amounts of radioactive material. This may include PET, PET/CT, and gamma imaging.
Radiation Therapy (Oncology)
Radiological nurses in radiation therapy perform examinations and procedures under the guidance of a radiologist oncologist. Radiological nurses assist the radiologist oncologist with the implementation of a precise radiation treatment plan. The radiology nurse may also be a valuable source of care and support for the patient regarding both the physical and emotional difficulties brought on by cancer and radiation therapy. A radiation therapy nurse works with the radiologist oncologist to deliver radiation therapy through a number of delivery methods, including external-beam radiation therapy, systemic radiation therapy, and internal radiation therapy.
From decreased recovery times and decreased costs, to less pain and shorter (if any) hospital stays, interventional radiology, which uses radiological technology to perform minimally invasive interventional techniques, is revolutionizing the way many health services are delivered. Interventional radiology is often used for blood vessel procedures such as angiography, angioplasty, and stent placement; biopsy procedures; fibroid removal; and fluid and abscess drainage, just to name a few.
Interventional radiologists often employ a team of highly skilled professionals, including nurse practitioners, clinical nurse specialists, and physician assistants. Because of the demands on the interventional radiologist to perform clinical services, consultations, and rounds, mid-level practitioners, such as advanced practice nurses, often oversee the interventional radiology laboratory in the absence of the interventional radiologist. Nurse radiologists in an interventional radiology laboratory setting perform a number of procedures, such as central line placements, while also assisting the radiologist in more complex procedures. In addition, they perform a number of important tasks outside of the interventional laboratory, which may include:
- Acting as the first point of contact for referrals and patients
- Attending patient consultations
- Performing initial examinations and patient assessments
- Writing pre-procedure orders
- Making recommendations to the referring physician, the patient, and patient’s family under the guidance of the interventional radiologist
- Serving as a liaison between the patient and the nursing staff and referring physician
- Performing daily rounds and communicating patient progress to the medical staff and the radiologist
- Orchestrating patient discharge and making additional referrals for home care
- Performing follow-up visits
Many nurses interested in pursuing radiology as their advanced practice specialty achieve their master’s or doctoral degree in nursing as a Family Nurse Practitioner, an Adult Nurse Practitioner, or a Clinical Nurse Specialist. They may satisfy their radiology education as either part of their graduate degree program’s clinical component in which they may perform radiological services, or in a post-master’s certificate program specific to radiology. Employers seeking advanced practice radiology nurses generally require that they hold a master’s degree in nursing, an advanced practice nursing license and, often times, specialty certification.
Some of the courses nurses pursue to achieve additional education in radiology include:
- Advanced Radiation Protection and Biology
- Advanced Radiation Physics
- Advanced Radiologic Quality Assurance
- Pathology Across Radiology Modalities
- Medical Imaging in the Digital Environment
- Case Studies in Medical Imaging
- Radiology Management
- Advanced Imaging Modalities
Although there is no advanced nursing certification available for radiology nurses, specialty certification through the Radiological Nursing Certification Board can be achieved to demonstrate experience and knowledge in radiological science.
The Radiologic Nursing Certification Board, through the Association for Radiologic and Imaging Nursing, offers the Certified Radiology Nurse (CRN) designation. To qualify for CRN certification, applicants must:
- Hold a current, valid RN license or an international equivalent
- Possess evidence of practicing at least 2,000 hours as an RN within the three years prior to applying
- Possess evidence of at least 30 contact hours of continuing education in the field of radiology within the two years prior to applying; at least 15 of those hours must be specifically related to radiological nursing – Acquired contact hours must be approved by any organization or educational institution that is accredited by the American Nurses Credentialing Center Commission on Accreditation (ANCC), which is the credentialing body of the American Nurses Association
The Certification Examination for Radiologic Nursing in Imaging can be taken either in May or October through a C-NET testing center. It is a written examination comprised of 200 multiple-choice questions that cover the following topics:
- Administering, Monitoring, and Evaluating Therapeutic Interventions
- Teaching Patients and Families/Providing a Supportive Environment
- Providing a Safe Environment/Managing Emergency Situations
- Participating in QA/CQI Interdisciplinary Activities, and Professional Practice Activities
- Diagnostic Imaging, Fluoroscopy, and Breast Health
- CT and MRI, including PET
- Interventional Radiology
- Ultrasound/Vascular Ultrasound
- Nuclear Medicine and Radiation Therapy
Renewal for CRN certification is every four years, and maintenance of the certification is dependent upon maintaining an RN license and meeting specific recertification requirements.
Resources for Radiology Nurses
The Association for Radiologic and Imaging Nursing is a network of professionals who are committed to the development and growth of nurses in radiologic imaging.
The Association for Vascular Access (AVA) is an association of healthcare professionals that promotes the “emerging vascular access specialty.” The AVA promotes research and professional and public education and partners with the device manufacturing community to bring about innovations in vascular access.
The American College of Radiology is a professional membership organization made up of radiologists, medical physicists, radiation oncologists, interventional radiologists, nuclear medicine physicians and allied health professionals. The organization is devoted to making imaging safe, effective, and accessible.
The Journal of Radiology Nursing promotes patient care in diagnostic and therapeutic imaging settings.
The Radiological Society of North America is an international society of radiologists, medical physicists, and medical professionals that hosts the largest medical meeting in the world, publishes two peer-reviewed journals, and offers educational resources.
RadioGraphics is the journal of continuing medical education in radiology.
Radiology is a monthly journal devoted to clinical radiology and the allied sciences.
Advance for NPs and PAs National Salary Report for 2011 showed that the average, full-time salary for a nurse practitioner in 2011 was $90,583, while the salary for a nurse practitioner in a hospital setting was $96,124 on average. Other examples of advanced practice nurses involved in radiologic therapeutics, intervention, and imaging included nurse practitioners working in oncology clinics, where they earned an average of $90,862, those in emergency departments where the average was $103,722, and those in surgical settings where they earned an average of $91,023 in 2011.