Overnight Radiologists: Providing Patient Care Around the Clock

Tina Rosenbaum, MD, has been an emergency room physician at MedStar Washington Hospital Center for 12 years – and for much of that time, there was a gap in medical imaging as part of patient care in the middle of the night. “[But] now, we get our answers immediately,” Dr. Rosenbaum says.

The reason? Our overnight radiologists who provide immediate coverage at the Hospital Center, as well as several other MedStar facilities.

Radiology chairman James Jelinek, MD, says the program was the idea of Arnold Raizon, MD. Prior to instituting dedicated teams to cover the overnight hours, radiologists would generally work their normal daytime schedules and then trade off night-time shifts. In addition, MedStar hospitals were previously covered by five different groups, all using different computer systems.

This approach didn’t make for the best patient care experience.

The Rising Need for Overnight Radiology Coverage

Laurie Abrams, MD, notes, however, that the need for dedicated overnight coverage wasn’t always necessary. Smaller radiology practices – which were the norm 20 years ago – didn’t lend themselves to dedicated teams to work the overnight hours. But as practices consolidated and grew larger, small teams of overnight radiologists became a more practical solution.

Also, the technology changed. “Reliance on imaging technology is much greater than it used be,” Dr. Abrams says.

Imaging tests can be used to diagnose an ever-increasing number of conditions. For example, head scans were previously considered to be a rare event, but now a busy hospital might find it necessary to conduct four or five head scans in a single hour. So having an overnight radiologist on-hand to offer advice, and interpret scans and films, can make a huge difference.

Bridging Gaps, Provide Better Patient Care

Thanks to the institutionalizing of the overnight radiologists at MedStar Washington Hospital Center and other facilities, many patients can be sent home quickly and safely. And when they need to be sent to the operating room, that too happens more efficiently.

That’s not to say there aren’t challenges to working overnight.

From the moment they log into the Radiology platform, they have a worklist that generally keeps them busy for the entire shift – and that’s on a normal night. On nights when there are multiple trauma cases, the need for both speed and accuracy becomes enormous.

“Your brain is always on. There is no downtime,” Gabe Schneider, MD, points out.

But that is one of the very reasons why this group takes such pleasure in their work. All radiologists are integral to patient care, says Dr. Taner, but overnight, “you are often the decision point. You can make the most difference.”

For instance, Dr. Rosenbaum says it’s not uncommon for the radiologist to take the initiative and inform the surgical teams when it is apparent that surgery will be necessary: “They will link together all the different teams and keep the lines of communication open. That helps everyone.”

For Dr. Raizon, that type of teamwork is the entire key to what they do. “The technical staff has always had dedicated people who work at night. It makes sense that the physicians do, too. This way, we all get to know each other, which leads to better patient care.”

It’s About People

Even with spending their evenings and late nights intimately involved with some of the technologically sophisticated aspects of medicine, all four overnight radiologists stress that the personal relationships they have developed are the single best part of the job.

Dr. Raizon, who has been there from the beginning, intends to work in this capacity for the remainder of his career. “I really like the people I work with at night,” he says. “It’s not just about reading X-rays. So much of medicine is about the people."

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A Shining Example of Devoted and Compassionate Care

Patients often tell us that remarkable care is what sets a healthcare institution apart. Here’s a snapshot of some of the people at our hospital who are providing phenomenal comfort and care to our patients, especially when they need it the most. Above, President John Sullivan presented the President's Award to two nurses, Maite Corbin and Sarah McLaughlin, for remarkable care and compassion to their patient and the patient’s family.  

(Pictured: 2H Nursing Director Maraki Endale, 2H Medical Director Dr. Brian Lee, President John Sullivan, recipient Maite Corbin, recipient Sarah McLaughlin, Chief Nursing Executive Sue Eckert, and 2H nurse Jessica Patterson)

Recognition from Peers

This President’s Award nomination was submitted by Jessica Patterson, RN, BSN, CCRN, 2H Neurosciences Intensive Care Unit, on behalf of her nurse colleagues Maite Corbin and Sarah McLaughlin for their exemplary display of our SPIRIT Values – Service, Patient First, Integrity, Respect, Innovation and Teamwork

Dear President Sullivan,

It is not often that I truly feel the need to recognize outstanding nursing care, but this past weekend I experienced just that. I myself am a Clinical Nurse II at MedStar Washington Hospital Center and work on 2H, the Neurosciences Intensive Care Unit. Recently, our unit received a patient with a devastating diagnosis. A teen girl, walking home from work, was struck by a motor vehicle and brought to MWHC for treatment. Although she underwent extensive surgery, by the time she arrived to our unit, her prognosis was very poor. However, the outstanding team of physicians I work with on both the Surgical Intensive Care Unit and Neurosurgical teams promised her family that they would do everything within their power to medically manage her and give her the best chance possible. To add to the family’s grief, the patient is currently here on a student visa and her mother still resides in El Salvador.

Despite our best efforts, by two weeks after the accident, no significant improvement in her brain functionality had been made. Originally, her mother’s application for a visa to the United States had been denied. This is where the amazing group of nurses I work with come in. Sarah McLaughlin's advocacy for this patient and her mother played a key role in assisting this parent to have the opportunity to see her child while she was still alive. I was the nurse caring for this patient the night her mother arrived. I should also mention that the patient’s mother and many of her family members are Spanish-speaking only. This was her mother’s first time in the United States.

The next night, prior to the day we were going to withdraw care of the patient, I cared for the young girl again and her mother had not left the hospital. My other coworker and nurse, Maite Corbin, is fluent in Spanish. She suggested a plan of care to me that I had not even thought of which was to ask the mother if she would like to assist in bathing the patient in what would likely be the last time. This was such a personal process that while a translator phone was available, Maite offered to help me and the mother bathe the patient so that the mother would feel comfortable and could easily receive instructions and guidance during the process in her native language from Maite. During the bath, the mother was able to kiss, touch, and be with her child during these final hours. When we were done bathing the patient Maite pulled the side rail of the bed down and pulled a chair next to the patient’s bed to allow the patient and her mother to be as close as possible together. She then proceeded to ask the mother questions about the patient-her hobbies, interests, school performance. The mother was then able to both talk about her daughter, expressing how she always wished for a better life for her in the United States. This also gave her the opportunity to grieve. By time the night was over, all three of us were in tears. The next day, Sarah assumed care for the patient.

Both of these nurses continue to work at the bedside while attending graduate school and being full-time moms themselves. I cannot express enough the gratitude I have to be working with such incredible women. They are advocates for their patients, their patient’s families, and their fellow nurses. They continuously provide the type of courageous and compassionate care I have described in this letter on a daily basis. I am blessed to have the privilege of calling them my coworkers and they deserve to be recognized for the type of care they provided.

Making a Difference

Congratulations, Maite Corbin and Sarah McLaughlin, for being recognized for the outstanding work you do and embodying the guiding principles for patient care we uphold at MedStar Washington Hospital Center. It is an honor to work with people as deserving of the President’s Award as you both.

Know someone going above and beyond?

This is just one of the wonderful stories of our associates who are providing exemplary care to our patients. Do you have others to share? Email them to [email protected]

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