Notes

1. Your name:
Joel Christopher Lorenzo
2. Facility at which the observation occurred:
My clinical observation took place at CHI Health Saint Elizabeth in Lincoln, NE.
3. Name, phone number and email address of facility contact:
I was able to schedule my observation hours thanks to the lead dosimetrist Nicole Lafleur, who may be contacted at (402) 219-7930.
4. The length of observation
My observation was from 7am to 12pm.
5. Treatments, simulations and other procedures observed. 6. Types of patients (diagnosis, male/female, adult/pediatric, inpatient/outpatient etc).
During this time, I was able to see the equipment, patient care and tasks the therapists were involved in. I was able to observe a variety of treatments. The patients I observed for treatment were all adult outpatients. The exams were as follow:
• Male, Bilateral Knee for palliative care
• Male, Pelvis
• Male, Prostate x2 for prostate cancer
• Female, Breast x3 for breast cancer
• Male, CT simulation

7. Discuss at least 5 duties which therapists perform on a daily basis:
Some of the duties I noticed were:
1) Upon arrival one of the technologists began the daily quality assurance tests going through a checklist that ranged from heating up the linac at various MeV levels to checking field size, laser alignment and automatic table positioning.
2) Communicating with the patient and family, answering any questions or concerns they may have or help accommodate their schedule.
3) Watch the patient closely during treatment and assess the patients condition and positioning before beginning therapy
4) Create molds and immobilization devices or lead blocks to use during treatment.
5)

8. Explain how the therapy team ensures accurate delivery of radiation treatments.
The accuracy of the radiation treatment is ensured by following the dosage and delineation plan set by the oncologist and dosimetrist. While the patient is receiving treatment, immobilization devices are used to keep the patient in the same position during treatment. Tattoos or marks left on the skin during initial simulations are also used as landmarks for laser alignment and some exams require prior imaging for positioning accuracy before the treatment begins. A big part of accuracy also has to do with checking that the machines are functioning correctly.

9. Discuss the role of advanced technology in the field of radiation therapy; how is the field different compared to 10-15 years ago.
From what I have researched online and discussed with the technologists, IGRT and IMRT with mult-ileaf collimation along with CyberKnife are great improvements in the field that help reduce exposure to surrounding tissue while allowing for higher and more effective radiation dosages to be administered. The dosimetrist also gave me a brief explanation on the use of the CyberKnife unit at their facility and how they perform brachytherapy.

10. Explain how radiation safety is maintained for patients and the therapists.
Radiation safety is demonstrated in the department through the use of proper communication with the patient and cameras to view the patient during treatment in case of any movement and exposure to areas that were not delineated for treatment. The patient is also placed in a separate room with walls built to certain specifications so there is no risk of exposure to therapists.

11. After observing the duties and work environment of a radiation therapist, do you feel you have the physical capabilities to perform these tasks on a routine basis?
12. Explain your personal reaction to the observation experience
I had an enjoyable experience during my observation. The staff and patients alike treated me as if they had worked with me in the past. I do believe I have the physical capabilities to perform all tasks the radiation therapists encounter on a daily basis and would love my career to go in the direction of radiation therapy.