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If a patient cannot sit still during treatment, or prior to treatment, what would you do?

Answer examples and advice for how to answer this interview question for a Radiation Therapists interview

How to Answer

Patients may have trouble remaining still for various reasons. Shakiness, irritability or anxiety may be a symptom of their condition or medications they may be taking. You may need to physically adjust them. You also may need to know how to talk them down if they are feeling excessively anxious or nervous. You may consider answering this question with, "It depends. I ask a lot of questions of my patients when I find out they are undergoing additional treatments or medications, because I know how it can affect them. Helping them to remain calm by setting a tone of being relaxed myself typically makes a difference. I speak in a soothing voice when my patients are nervous and I remind them that I'm there to help and happy to answer questions."

If a patient cannot sit still during treatment, or prior to treatment, what would you do?

"It depends. I ask a lot of questions of my patients when I find out they are undergoing additional treatments or medications, because I know how it can affect them. Helping them to remain calm by setting a tone of being relaxed myself typically makes a difference. I speak in a soothing voice when my patients are nervous and I remind them that I'm there to help and happy to answer questions."

View user-submitted Answers

If a patient cannot sit still during treatment, or prior to treatment, what would you do?
I would use the objects available to hold the patient in position.
Make him as much comfortable to maitain the right position.
If a patient were to keep shifting around prior to or during treatment, I would utilize the different pieces of equipment available, such as the hand ring or the leg bolus to keep the patient in the correct position. To keep the patient from feeling like they were being restrained, I would also remind them about the importance of them remaining still during treatment for safety reasons.
I would explain to them the importance of sitting still and run through the safety guide lines. If necessary I would use the available equipment.
I would start by emphasizing the importance of remaining completely still during treatment for greater success overall.
I will explain to them if it is necessary for the treatment and help them trying to sit still; ask them to focus on something; an object in the room to help them sit still.
Utilize different immobilization devices that will help them to hold still such as a ring for the arms to hold on, then tell them the importance of holding still.
You try to find common ground with the patient to help calm them.
Identify what the problem is . Tal to the patient see whats causing it.
Explore possible options to make the patient more comfortable like introducing a knee fix to take pressure of the back or using foam cushions to help with the hard surface of the bed. Explain the rationale behind asking the patient to sit still. Often if the patient knows the reason why it is required they may understand the gravity of lying still and compliance might be less of an issue. I would avoid putting excess pressure on the patient as if the patient get anxious or nervous they will be less likely to sit still. Try to make them feel relaxed and comfortable if possible.
If a patient has trouble staying still for treatment, or if I can tell that even before we begin, I would constantly remind them that they are going to have to sit still for the treatment before and during. I would also explain to the patient that we need to make sure that they are still for the treatment for the treatment to be accurate and we want to make sure that the radiation will be delivered to the area we want it to be and not anywhere else. I will make sure that the patient understands this as well before going ahead with the treatment.
First ask them what is wrong, are they uncomfortable and thats why they are moving? let them know the importance of staying still during treatment and see if that can calm them down to where they will cooperate. If they still just wont stay still, I cannot give them the treatment, maybe have them talk to a nurse or doctor in case they are in pain or have anxiety and maybe its something the nurse or doctor can help with. I would move on in the meantime with treating patients and then check on them making sure they will stay still before treatment before I would begin.
I would ask if there is a specific reason why they are unable to sit still and if there is not I would inform them of the importance in sitting perfectly still while getting treatment and would ask how I could help she/he stay calm and still.
Try and reassure the patient of the treatment procedure and try to calm their nerves by giving them the opportunity to relax.
Determine whether it is a mental state, or something on their mind that is causing them to not want to sit. And then if it is not a mental state, determine if the patient is in pain or if sitting will cause pain. Perhaps call the doctor to get a second opinion.
Notify the radiation oncologist to see if immobilizers can be used or medication to be adminstered that could help.
I would ask the patient if they were uncomfortable. I would probe to see if the forms were the issue. I would also ask them if they were nervous and try to calm there anxieties by going through the procedure and what they should expect during the treatment.
Ask them the reason as to why they cant stay still, talk to them, reassure them and remind the patients the importance of staying still for radiotherapy treatment. if the patient cant stay still after talking to them, I would let my seniors aware of it.
If the patient would have to get any pain medication, I would first make sure patient got it before he enters the treatment room. Make sure I give enough time to the pain medication to work. If the patient is nervous and accordingly, he is struggling to stay still on the bed I would talk to the patient and calm him self down. I would ask him to relax and explain him the importance of staying still during the treatment. If the patient can not manage to say still at all, I would use other supporting immobilization devises to keep the patient in a stable position.
Understand why the patient feels agitated, try to resolve the initial course, explain the procedure and reassure them.
I would check and make sure that the patient was comfortable and that the equipment was not bothering them in anyway. I would also remind them that it was very important that they remain as still as possible during the treatment.
Remind them of the importance and that it is essential to remain still to gain maximum effectiveness of treatment.
Ask the patient if there is a reason for this. Explain how crucial it is that they remain still. If the patient is in pain, get a doctor to prescribe pain relief before reassessing the patients condition and then try again if they are managing better.
Give the patient time to make them feel more at ease and possibly ask the patient what we could do to make them feel more comfortable.
I would ask them what may be causing the fidgeting and suggest that they talk to the nurse to help the relax, manage their pain, or to find a way to help them hold still. I would not treat them if they were unable to hold still.
If the patient could not sit still during treatment, I would interrupt the treatment until the patient could settle and check to ensure their position was still correct for treatment. If it was before treatment, I would discuss with the patient the importance of holding still and try to discuss options that would help, such as taking pain medication if it was due to pain.
I would do my best to talk to the patient to calm them down and reassure that we are doing everything in his/her best interest. I would take my time with the patient and make sure he/she feels comfortable before proceeding to treatment.
Check if they are in pain - provide pain relief. If another issue try to find a way to resolve this perhaps with immobilisation devices or sedation. If still a problem do not treat.
Ask if they are alright and see if anything is going on. If really bad and the patient still wants treatment you may be able to take them down to the nurses station for some medication or notify the doctor if required.
This would have hopefully have been established during their initial CT sim and a optimal solution would need to be determined maybe with a alteration to the protocol with the advice for the Radiation Oncologist for further instructions. Further stabilization could be used depending on the intent and amount of fractions they are having. Straps may be able to be used. If anxiety is the reason maybe some medication can be used or even just more continual reassurance/ communication during their treatment.
I would use a mold or mask to help the patient stay in place.
Ask what the problem is. Has this been any issue since simulation?Is the doctor aware of it and has allowances been made?
I would ask why they could not sit still and see if there was anything I could do to help keep the patient still. I would also consider postponing the intervention until the patient is comfortable.
Ensure that the patient is aware of the risks of moving, and the importance of remaining still. Assess why the patient is cmoving, e. G. Pain, irritated, nervous, incompliant. Etc. And take appropriate steps to alleiviate these reasons. E. G. Pain medication, sedation, or ways to deal with stress eg. Music.
I would explain the importance of remaining in the same position but I would also try to assist them in finding out why they were unable to remain still.
I would discuss with the patient the reasons why it is necessary to remain still during treatment and ask if there is a cause behind the movement. I. E whether they are anxious, we could ask if we could help with arm supports or offer advise on how to place their hands.If they were a pelvis patient I would enquire whether their they are uncomfortable in repects to their bladder filling .
Find the reason behind the patient not being able to stay still. For example, if the patient is nervous and shaking, maybe suggesting relaxation techniques may help. In extreme situations, sedatives could be used if consent is given by the patient and the doctor prescribing it. If movement is a medical condition of the patient, they could take any medication they have to reduce movement. A general anaesthetic could also be used if the treatment was a single fraction and allowed by the oncologist. If none of the above is working, it would be safer to find an alternative method of treatment.
If they patient was already recieving treatment I would immediatly beam off and find the cause of the issue. If it was prior to beaming on, for example during set up they were having trouble maintaing position due to discomfort or pain I would suggest they see the nurse to relieve their discomfort so they can have treatment and remain in position.
Approach and let them know it is important for us that we treat the same anatomy every day but primarily for them.
Talk to them and try to calm them down. They could be anxious for which I would use my patient care and communication skills to make them feel as relaxed as possible.
First, I would make sure they understood why it is important to remain still. Then, I would ask if there was something that was hurting them that I could help with, and if I was unable to resolve the issue I would stop the treatment and report it to my lead radiation therapist.
Ask them to stay as still as possible while the treatment is occurring.
Use equipment availabe which can assist the patient to stay still as it is very important that the correct are is receiving the dose of radiation,
It depends on the situation whether the patient has problem with the starting or it occured due to the side effect of radiotherapy. If in the starting then we ll go with anesthesia or in the middle we will give a break untill the patient is fit for radiotherapy.
I would stress the importance of why it is critical to remain still, explaining that if they move healthy tissues are being damaged.
Ensure patient has been educated on importance of keeping still during treatment. As patient if there is a particular reason the are having difficulty staying still- pain, anxiety discomfort. Address issue- medication, possible change in patient position/immobilisation equipment. Possibly construct further immobilisation devices. Music for relaxation. Discuss issue with senior/RO if necessary.
I would refer back to the notes that what was taking during previous treatments. If no statement would be found, I will asked the sims tech if there was a vacloc made for the patient and go from there.
Ask the oncologist if it would be possible to change her treatment plan.
Depends on the case, theres the possibility they need to be given a mild sedative, or Ativan to help them relax, therefore would contact doctor/nurse and have them be seen.
I would first calm them down and then use extra immobilization devices to help them stay still.

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