I'm a medical receptionist at an OBGYN office. Within my first year of employment I took on an extra responsibility of administering bone densiometry (Dexa) scans on women when it was recommended by their doctor. Bone density scanning, also called dual-energy x-ray absorptiometry (DXA) or bone densiometry, is an enhanced form of x-ray technology that is used to measure bone loss. This is done through a series of 2 scans taking roughly 5-10 minutes per patient. When administering the test, the operator (myself) sits at a computer roughly 5 feet from the scanner beam and controls its operations. The operator must be in the room while the test is administered, and per guidelines, protective wear is not a requirement to administer the test.
When I found out I was pregnant, I researched the safety of operating this machine while pregnant. My findings were as follows: (my comments in italics) taken from rpop.iaea.org/RPOP/RPoP/Content/SpecialGroups/1_PregnantWomen/PregnancyAndRadiology.htm
"A pregnant worker can continue working in an X ray department as long as there is reasonable assurance that the foetal dose can be kept below 1 mGy during the pregnancy. (It would take roughly 100 dexa scans to reach 1mGy radiation.) In interpreting this recommendation, it is important to ensure that pregnant women are not subjected to unnecessary discrimination. There are responsibilities for both the worker and the employer. The first responsibility for the protection of the conceptus lies with the woman herself, who should declare her pregnancy to management as soon as the condition is confirmed." (I notified my work immediately of my pregnancy, and also mentioned my discomfort in performing the scans)
"When a medical radiation worker is known to be pregnant, there are three options that are often considered in medical radiation facilities: 1) no change in assigned working duties; 2) change to another area where the radiation exposure may be lower; or 3) change to a job that has essentially no radiation exposure."
"Change to a position where there is no radiation exposure is sometimes requested by pregnant workers who realize that risks may be small but do not wish to accept any increased risk. The employer may also arrange for this in order to avoid future difficulties in case the employee delivers a child with a spontaneous congenital abnormality (which occurs at a rate of about 3 in every 100 births). This approach is not required on a radiation protection basis, and it obviously depends on the facility being sufficiently large and flexibility to easily fill the vacated position." (For whatever its worth, my company is pretty small [less than 50 employees], but multiple employees have refused or declined to learn/operate this position)
Anyway, for the first portion of my pregnancy, it was not a problem for me to refuse to administer this test. I told my manager I was uncomfortable doing it, and it was never again approached, or asked of me.
...until about a week ago.
The first time I did this test while pregnant was by request of a doctor almost 2 weeks ago. My manager approached me saying "Dr Cannon wants you to do a Dexa" and that was that. I was quite upset, but did as told...after first collecting myself in the bathroom as the thought of doing the test had me in slight tears. I wasn't trying to be difficult with my work, rather was legitimately concerned about the risks to my baby. But still, I did the test.
Since that time, I have done an additional 7 or so Dexa scans. My manager approached the topic with me by telling me that the physicians viewed my refusal as "noncompliance with something within my job description". We discussed, and she told me that while she cant force me to do anything, my refusal could be viewed as a failure to perform my job duties. I listened and explained that while she was telling me that I had a choice, I really felt like I didnt. If I wanted to be on good terms with my job, I needed to do this, regardless of my health concerns for myself and my unborn baby girl.
Needless to say, I did the test. And begrudgingly am continuing to do these tests when asked. Because I need this job right now. I did, however, provide my office manager with the link I provided you, in paper form. I also talked to my midwife (who works with/for this same practice) about my concerns. She reassured me that the risks were very small, but said I shouldnt do something Im uncomfortable with. She said she would talk to my office manager about it (but I doubt thats been done yet). My office manager says that employees are in the process of being trained...but this has also been the story for the past 4 months of my pregnancy. Im not holding my breath.
Basically, I really need advice. Because I feel like I have no leg to stand on. Its complicated and I dont want to cause conflict with my job...but at the same time Im REALLY uncomfortable doing these scans. Ive been so diligent so far about this pregnancy and my health (I've stopped taking medications, stopped having caffeine in the first trimester, etc). Ive cut out things aforementioned that are "safe in moderation" for the thought process of trying to keep myself and my baby as healthy and unpolluted as possible. Yet I feel powerless over this one thing.
What do I do??
When I found out I was pregnant, I researched the safety of operating this machine while pregnant. My findings were as follows: (my comments in italics) taken from rpop.iaea.org/RPOP/RPoP/Content/SpecialGroups/1_PregnantWomen/PregnancyAndRadiology.htm
"A pregnant worker can continue working in an X ray department as long as there is reasonable assurance that the foetal dose can be kept below 1 mGy during the pregnancy. (It would take roughly 100 dexa scans to reach 1mGy radiation.) In interpreting this recommendation, it is important to ensure that pregnant women are not subjected to unnecessary discrimination. There are responsibilities for both the worker and the employer. The first responsibility for the protection of the conceptus lies with the woman herself, who should declare her pregnancy to management as soon as the condition is confirmed." (I notified my work immediately of my pregnancy, and also mentioned my discomfort in performing the scans)
"When a medical radiation worker is known to be pregnant, there are three options that are often considered in medical radiation facilities: 1) no change in assigned working duties; 2) change to another area where the radiation exposure may be lower; or 3) change to a job that has essentially no radiation exposure."
"Change to a position where there is no radiation exposure is sometimes requested by pregnant workers who realize that risks may be small but do not wish to accept any increased risk. The employer may also arrange for this in order to avoid future difficulties in case the employee delivers a child with a spontaneous congenital abnormality (which occurs at a rate of about 3 in every 100 births). This approach is not required on a radiation protection basis, and it obviously depends on the facility being sufficiently large and flexibility to easily fill the vacated position." (For whatever its worth, my company is pretty small [less than 50 employees], but multiple employees have refused or declined to learn/operate this position)
Anyway, for the first portion of my pregnancy, it was not a problem for me to refuse to administer this test. I told my manager I was uncomfortable doing it, and it was never again approached, or asked of me.
...until about a week ago.
The first time I did this test while pregnant was by request of a doctor almost 2 weeks ago. My manager approached me saying "Dr Cannon wants you to do a Dexa" and that was that. I was quite upset, but did as told...after first collecting myself in the bathroom as the thought of doing the test had me in slight tears. I wasn't trying to be difficult with my work, rather was legitimately concerned about the risks to my baby. But still, I did the test.
Since that time, I have done an additional 7 or so Dexa scans. My manager approached the topic with me by telling me that the physicians viewed my refusal as "noncompliance with something within my job description". We discussed, and she told me that while she cant force me to do anything, my refusal could be viewed as a failure to perform my job duties. I listened and explained that while she was telling me that I had a choice, I really felt like I didnt. If I wanted to be on good terms with my job, I needed to do this, regardless of my health concerns for myself and my unborn baby girl.
Needless to say, I did the test. And begrudgingly am continuing to do these tests when asked. Because I need this job right now. I did, however, provide my office manager with the link I provided you, in paper form. I also talked to my midwife (who works with/for this same practice) about my concerns. She reassured me that the risks were very small, but said I shouldnt do something Im uncomfortable with. She said she would talk to my office manager about it (but I doubt thats been done yet). My office manager says that employees are in the process of being trained...but this has also been the story for the past 4 months of my pregnancy. Im not holding my breath.
Basically, I really need advice. Because I feel like I have no leg to stand on. Its complicated and I dont want to cause conflict with my job...but at the same time Im REALLY uncomfortable doing these scans. Ive been so diligent so far about this pregnancy and my health (I've stopped taking medications, stopped having caffeine in the first trimester, etc). Ive cut out things aforementioned that are "safe in moderation" for the thought process of trying to keep myself and my baby as healthy and unpolluted as possible. Yet I feel powerless over this one thing.
What do I do??
whatever you do I hope it helps.
