RADIATION THERAPY SPECIALIST

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The Department of Radiation Oncology Main Campus is comprised of two hospital departments and one physician group: Brigham And Women's Hospital (BWH), Dana-Farber Cancer Institute (DFCI), and the Brigham and Women's Physicians Organization (BWPO).

Under the direction of the Chief and Lead Radiation Therapists, the Staff Radiation Therapist will demonstrate essential skills of treatment modalities and protocols to accurately set-up and administer daily radiotherapy treatments. The Staff Radiation Therapist communicates effectively with patients, families, medical staff, and healthcare team.

Principal Duties and Responsibilities:

Patient Care

1. Will be expected to perform radiotherapy on site at assigned department

a. Brigham And Women's Hospital

b. Dana Farber Cancer Institute

2. Responsible for daily patient care and education.

* Appropriately involves the patient and their family in care and care decisions.
* Maintains and demonstrates respect for patient confidentiality and modesty.
* Explains the treatment procedures.
* Arranges daily radiation treatment schedule.
* Attentive to patient needs and concerns by continuous monitoring of the patient's physical and physiological response and reactions to treatment and refer patient for appropriate management as needed.

2. Administers radiation therapy treatment accurately and safely, following departmental policy and procedure.

* Monitors and reports treatment variances and inconsistencies.
* Accurately documents all treatment delivery information in the electronic medical record (EMR).

3. Positions and immobilizes patients according to the treatment plan and effectively evaluates images according to standard guidelines and assists in solving set-up issues.

4. Demonstrates the ability to care for acute Inpatients.

5. Demonstrates the ability to care for pediatric patients, including pediatric patients requiring anesthesia.

6. Demonstrates appropriate knowledge of the principles of growth and development from all life stages, ranging from infancy to geriatric. In addition, s/he must possess the ability to assess patient relative data as deemed pertinent to age-specific needs and provide care as described in the department's policy and procedure manual.

7. Demonstrates an understanding of the patient functional mobility assessment tool and mobilizes patients using appropriate mechanical assistive devices, such as ceiling lifts and lateral transfer devices, during the provision of patient care.

8. Other duties as assigned.

Knowledge and Skills

1. Rotates to other treatment areas as directed by the Chief and Lead Radiation Therapists. May be required to demonstrate basic knowledge and skills in one or more specialty areas and programs, including but not limited to:

a. Procedures

o Align RT, including tattooless workflows

o Stereotactic CNS

§ Stereotactic Radiotherapy (SRT)

§ Stereotactic Radiosurgery (SRS)

§ Complex stereo CNS cases - including Multi Met

o Stereotactic Body Radiation Therapy (SBRT)

o Cardiac SBRT

o Total Marrow Lymph Irradiation (TMLI)

o Adaptive Radiotherapy, including contouring

o Craniospinal Radiotherapy

o Extremity/Sarcoma Radiotherapy

b. Specialty Rotations, will include these additional responsibilities

o Simulation

§ Demonstrates knowledge and ability to operate CT scanner and CT scanner software.

§ Demonstrates knowledge and ability to complete tasks in the Treatment planning software (Eclipse)

§ Demonstrates knowledge and ability to operate LAP Lasers

§ Explains simulation procedure, including the administration of permanent tattoos for set up purposes.

§ Assists and interacts with all departmental Radiation Therapists , demonstrating the ability to answer all questions and details pertaining to simulation to ensure quality treatment.

§ Demonstrates the ability to create immobilization devices, bolus, and accurately document set up instructions.

§ Demonstrates knowledge and ability to perform all aspects of both treatment and simulation. Assists treatment machines with difficult set ups.

§ Participates in the IV contrast program, including; Patient Screening, Peripheral IV placement, Injection of IV contrast agents via power injector.

§ Demonstrates knowledge and proficiency in use of IV contrast Power injectors

§ Administers Oral Contrast

§ Able to navigate and enter orders in the Hospital EMR (EPIC)

§ May be asked to participate in MR Simulation procedures.

§ Assists in scheduling/rescheduling appointments, as needed.

§ Assists other areas of the department during low volume periods.

§ Demonstrates knowledge and proficiency in the use of Point of Care (POC) Testing via the i-STAT analyzer for Creatinine results.

* Radiation Therapists performing waived point of care (POC) testing. Requires at a minimum a high school diploma or equivalent as described in the Federal Register, 42 CFR, Subpart M 493.1403-1495. (addendum added 2/2019)
* Radiation Therapists are responsible for obtaining blood specimens, performing creatinine tests using the i-STAT analyzer, evaluating creatinine results as they are displayed by analyzer, downloading test results into the patients' medical record and verifying eGFR results prior to proceeding with contrast administration

o Total Body Irradiation (TBI)

§ Responsible for scheduling all BMT new start and daily treatment appointments according to BMT protocol.

§ Demonstrates knowledge of all back up procedures, including Linac based treatment delivery and Imaging.

§ Works directly with CO60, a radioactive source and has knowledge of all safety and emergency protocols.

§ Provides hospital holiday coverage if TBI cases are scheduled.

§ Assists other areas of the department during low volume periods.

o Brachytherapy

§ Demonstrates knowledge and ability to perform all brachytherapy procedures, including: GYN Brachytherapy, Surface Applicator Brachytherapy, HDR/LDR TRUS, all Brachytherapy simulations.

§ Provides coverage as needed for Brachy Procedures out of department: OR/AMIGO/MR Sim Coverage

§ Assists in prepping for anesthesia cases and room turnover, equipment changes and room cleaning.

§ Demonstrates knowledge of all brachytherapy tools and equipment.

§ Demonstrates knowledge in the operation of the HDR Microselectron.

§ Demonstrates the ability to perform, participate, and assist in Ultrasound guidance for procedures.

§ May be asked to assist with the direct preparation of radioactive sources.

§ Understands and practices protocols for sterile procedures.

§ Assists other areas of the department during low volume periods.

o MR Linac

§ Helps screen patients and equipment for MRI safety

§ Is Level II MRI certified

§ Assists in CT/ MR-LINAC simulations

§ Assists in Adaptive treatment planning including: Treatment Delivery, Air overrides, contouring.

2. Understands the function of all equipment, accessories, treatment policies, procedures, and protocols and applies knowledge appropriately.

3. Participates in some clinical instruction and evaluation of the Radiation Therapy students.

4. Other duties as assigned.

Administrative

1. Performs daily QA measures to ensure proficient operation of all imaging and treatment equipment.

2. Performs daily shutdown procedures.

3. Participate in and appropriately documents the Time Out procedure for all treatments delivery information.

4. Responsible for the safe and accurate access and use of all aspects of the EMR and Record and Verify systems.

5. Possesses knowledge of all patient scheduling and billing procedures.

6. Demonstrates ability to accurately perform all required New Start chart checks, Cone Down chart checks, and weekly chart checks.

7. Assists the Lead Radiation Therapist to develop new techniques and assist with emerging technology projects.

8. Participates in and appropriately documents the Time Out procedure for every treatment procedure.

9. Utilizes the Quality Assurance (QA) program to encompass all aspects of treatment, treatment delivery, and quality patient care.

10. Other duties as assigned.

General Duties

11. Works flexible shifts as directed by the Chief and Lead Radiation therapists, depending on patient volume and departmental needs.

* Coverage may be necessary on weekends and holidays in certain circumstances.
* Adapts to contingency plans, which are in response to variables which influence workload and/or schedule.

12. May be required to travel to network satellite clinics as directed by the Chief Radiation Therapist.

13. Maintains and demonstrates cooperation and responsiveness to all departmental staff members.

* Works professionally and collaboratively with all members of the care team, including, Physicians, nurses, physics and dosimetry staff, medical assistants, practice assistance.
* Models appropriate professional behavior, such as, but not limited to: courtesy, respect, constructive assertiveness, effective listening.
* Effectively utilizes professional problem solving and negotiation skills to manage conflict.

14. Attends regularly scheduled Therapist staff meetings.

15. Attends regularly scheduled continuing education activities.

16. Maintains active membership in professional organizations.

17. Other duties as assigned.

Basic Requirements:

High School Diploma or equivalent with certificate in Radiation Therapy or Associate's Degree in Radiation Therapy

* Valid Massachusetts State License in Radiation Therapy
* Continued employment is contingent upon obtaining valid ARRT certification within 6 months of hire date
* Valid BLS certification

Preferred: Bachelor of Science in Radiation Therapy

Skills/Abilities/Competencies Required:

1. Must have proficient technical knowledge and skill set. This includes but is not limited to demonstrating efficient knowledge of all equipment operation, tools and procedures specific to assigned area. This also includes demonstrating the ability to effectively troubleshoot issues as they arise.

2. Ability to establish and maintain effective interpersonal professional relationships with physicians, management, peers, patients, and their families.

3. Must convey a positive attitude and present a professional appearance.

4. Must have effective communication (both oral and written) skills sufficient to resolve conflicts, and relay information concisely to staff, patients, and other hospital personnel.

5. Must have sufficient organizational skills.

6. Demonstrate strong customer service skills, including the ability to use appropriate judgment, independent thinking and creativity when resolving issues and conflict.

7. Demonstrate initiative and the ability to work independently.

8. Demonstrate the ability and flexibility to effectively handle challenging and stressful situations and to balance and shift multiple priorities.

9. Must have the ability to adapt to frequent interruptions and shifting priorities in a fast-paced environment.

10. Must have interpersonal skills sufficient to interact effectively with patients who may be under physical and/or emotional stress.

11. Must have to ability to handle sensitive and confidential patient information.

12. Must be proficient in the use of the Radiation Oncology Information Systems and software and Hospital Information Systems that integrate with the Department of Radiation Oncology, including, but not limited to: ARIA, EPIC, ExacTrac, Eclipse, Align RT, Ethos.

Working Conditions:

1. Must be prepared to work overtime, holidays and weekends, as needed.

2. Must be prepared to work and excel in a stressful, complex, and demanding team environment with varying workload, necessitating varying working hours.

3. Works with ionizing radiation, radioactive isotopes, MR, computers, cancer patients, both adults and children, and their families.

4. Exposure to human waste and disease.

5. Physical demands include but not limited to:

* Lifting and repositioning patients, using mechanical assistive devices.
* Lifting and positioning immobilization devices and beam modifying devices.
* Continuous standing.

6. Subject to frequent stressful situations.

Hospital Wide Responsibilities:

Works within legal, regulatory, accreditation and ethical practice standards relevant to the position and as established by BWH/MGB; follows safe practices required for the position; complies with appropriate BWH and Partners policies and procedures; fulfills any training required by BWH and/or Partners, as appropriate; brings potential matters of non-compliance to the attention of the supervisor or other appropriate hospital staff.

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