Levi Senior 1 Diagnostic Radiographer “I use different types of machines to take different types of images. Sometimes the job is quite calm, at other times I'm under pressure with a seriously ill patient. When this happens you keep the patient's welfare uppermost and try to get the best image as quickly as possible.”

Levi qualified as a radiographer in Zimbabwe and came to the UK in 1989. He now works at a number of sites in hospitals around London working in teams of diagnostic radiographers.

Diagnostic radiographers. Are they the people who work in X-ray departments?

We take X-rays, yes, but usually, these days, we work in departments called Imaging Departments. This is because there are other ways of obtaining images of what goes on inside us. As well as X-rays, there is Magnetic Resonance Imaging (MRI) and ultrasounds. You'll probably have seen ultrasound (which uses sound waves) being used to produce images of babies growing in wombs. MRI is better than X-rays for images of the brain, muscles and cartilage for instance, because X-rays pass through them as they're soft tissue. Diagnostic radiographers can train to use all these techniques.

Do you work from your department all the time?

No. We work in a lot of places. It’s impossible for very ill patients and those who are attached to a lot of paraphernalia – like tubes, catheters, suction machines, heart monitoring machines and so on – to come to the Imaging Department, so we push our mobile X-ray or ultrasound units to the patient’s bedside. We call this 'mobile ward radiography'. We also go into the operating theatre to assist with fluoroscopy (real-time imaging on a television screen) or to take single X-ray shots. You’ll probably guess this is called theatre radiography.

The Gastroenterology department, a totally separate department from us, has fluoroscopic X-ray equipment in its rooms, which requires radiographer control when they’re used.

Then there’s the Accident and Emergency (A&E) department, which has its own theatres and most importantly crash rooms or resuscitation rooms where seriously hurt or ill patients are transferred to straight from the ambulance. These are the kind of rooms which tailor many scenes in popular medical dramas like Casualty and ER.

Is A&E work disturbing?

You see an enormous range of things in A&E. I have had disturbing incidents in my time, like if there's been a bad accident or people who survive after jumping off high buildings, but you have to be tough and remain focused – your patient comes first. It also helps that in such incidents you don’t work in isolation, many different doctors and nurses from different medical specialities are each clamouring to do the best for the patient within the golden hour.

The Golden Hour?

There is an hour after trauma when the chances of recovery, if treated, are the greatest, the hour that could determine life or death in serious trauma.

Typically, radiographers find themselves in the thick of the action setting their machine up quickly to try and provide diagnostic images as quickly as possible so that the surgeons can confirm their initial diagnosis and appreciate the extent of injuries. You have to be determined and work as a team; sometimes you find sixteen people around the patient and you have to push your way through.

Isn't that hard?

You train yourself and also your position gives you the power to muscle in as soon as the trauma surgeon calls for you. “X-rays! Out of the way please!” usually scatters nearly everyone.

You can't afford to be nervous then.

No. Because you must try to get a clear diagnostic image first time and in as short a time as possible. Doctors and nurses will be waiting. If you produce an image that's from the wrong angle or blurred you have to take another and the clock's ticking – with your patient perhaps still in pain. You keep your patient's welfare uppermost in your mind to reduce suffering and prevent too much radiation.

And you sometimes go into the operating theatre?

Yes. Radiographers are involved on a daily basis in various theatre cases - for instance in orthopaedic procedures to determine the position and angle the surgeon uses to drill in a screw when fixing a fracture. In urology theatres, radiographers help to determine the guidance of how far catheters are pushed using fluoroscopy.

What about referrals?

These vary enormously from who sends the patient to us and what the patients require X-rayed or imaged. Thoracic surgeons, GPs and oncology clinics generally refer patients for chest X-rays. GPs and A&E refer patients for general images of wrists, ankles, fingers and so on. This is often young people who have sprained them in the school playground, or it could be anyone hurt on the street or at home.

Are these quick to do?

An X-ray takes about three minutes to produce after it's been taken. But now we can also display images directly onto screens – the technology changes all the time. It's not as simple as taking a photograph though – you must always be driven by patient welfare, radiation protection and health and safety issues which go with each examination. On radiation protection for instance, you need to get the first exposure right, minimise the patient's exposure to the X-rays, ensuring the best minimum views that promote the best diagnosis.

Is this a very science based job, then?

It helps to have a science or maths at A level before you start your training. Also to have a bit of physics; people who don't have some physics are often given time to study it before they take up their training. It just makes it easy to understand the production of X-rays and how to best control them. That goes for MRI and ultrasound, the basic aspects of these ways of working and how the images are formed.

Any bits of your job you don't like?

I worked for a time at a hospital where they did a lot of forensic work – X-raying a cadaver before an autopsy. By far the most upsetting job is X-raying still-born babies – that was really upsetting.

Good bits?

How much time have you got?! The knowledge that our work is vital in determining the patient’s outcome directly or indirectly when they visit the hospital gives us great pride and a sense of purpose. Radiology affects the way every other department works. The variety of working methods, departments and above all, patients who come to us, makes it an endlessly stimulating job.