Alex is a nuclear medicine technologist working in a radiology department. The department is considering allowing nuclear medicine technologists to inject a small amount of radiotracer for sentinel lymph node imaging.

Is this activity within Alex’s scope of practice?

The College has approval for members to perform some/all of the restricted activities, as identified in the Medical Diagnostic and Therapeutic Technologists Profession Regulation (the Regulation).

The Regulation states that nuclear medicine technologists are authorized to perform the following restricted activity:

15(1)(d) cut a body tissue, or administer anything by an invasive procedure on body tissue below the dermis, for the purpose of administering injections or for starting an intravenous line

What training does Alex have to do in order to perform this activity?

A College-approved program is not required as no authorization is needed; it is, however, expected that Alex will have received appropriate training to perform this activity safely, ethically and competently. As this type of injection may differ from the type of injection that is typically performed by a nuclear medicine technologist, the College would encourage the employer to provide adequate training on the procedure and expectations of the technologist in these situations.

Alex should ask:

• Do I have the knowledge to perform this competently (i.e., consider clinical procedures, pharmacology, adverse events)?
• Do I have skills to perform this competently (i.e., understanding administration routes and rates, handling medications, identifying and handling adverse events)?
• Do I have the clinical reasoning abilities to perform and maintain this activity competently (i.e., how frequently must this be practiced, how many cases would be required to learn this well and competently)?

What Standards of Practice apply to this scenario?

Standard 1.1 Patient-Centred Care

To demonstrate this Standard, a regulated member will:

d. Ensure appropriate informed consent for the procedure has been obtained (e.g., explain procedure and possible implications, recognize the patient’s right to accept or refuse medical services).

f. Perform procedure in a manner that maintains the patient’s dignity.

h. Advise the patient of any preparation for the procedure and/or post-procedural care (e.g., transfer of care, release of the patient, follow-up), when applicable.

Standard 1.2 Clinical Procedures

To demonstrate this Standard, a regulated member will:

c. Ensure the patient has been assessed for contraindications to the procedure and respond appropriately (e.g., allergies, medications, conflicting treatments/examinations, medical condition, implants/devices or other items).

e. Possess the necessary competence to perform the procedure safely and ethically.

Standard 2.2 Professional Competence

To demonstrate this Standard, a regulated member will:

b. Practice within the limits of the member’s competence.

Standard 2.3 Restricted Activities/Enhanced Practice

To demonstrate this Standard, a regulated member will:

a. Perform only those restricted activities for which they have the required competence and current authorization.

b. Assess the benefits and risks associated with performing the restricted activity and ensure that a decision is appropriately undertaken on whether or not to perform the restricted activity.

c. Be responsible and accountable for safely performing the restricted activity.

d. Understand the risks associated with performing the restricted activity and ensure that measures are in place to manage any critical or unexpected events associated with performing it.

Standard 2.4 Professional Boundaries

To demonstrate this Standard, a regulated member will:

b. Explain to the patient the need for removing clothing and other items that may interfere with diagnostic or therapeutic procedures.

Code of Ethics

Principle 3 Responsibility to oneself

b. Accountability – A regulated member takes responsibility and is accountable for their professional activities.

There are many documents that help guide a regulated member’s practice. View these documents on our Resources page.