The Last One

This is the last blog I will be writing as your President, and it seems like a good time to look back on the last 2 years to reflect on how things have gone. I certainly do feel that I’ve grown and hopefully developed personally and a lot has happened.

Being the BNMS President has been one of the best things I’ve ever done. But if you read these blogs from the beginning, you will know that at the start I didn’t feel too confident I could do it. In fact, those first couple of months I was pretty overwhelmed by the Imposter Syndrome – and wrote about it in my second blog. I felt very much that I wasn’t good enough – and found it hard not to compare myself to other Past Presidents and felt very inferior. The thought of writing a monthly blog was frankly terrifying. But in the end, it’s probably one of the things I’ve enjoyed the most. After attending that session at the SNMMI on the Imposter Syndrome, I realised that constantly comparing myself to other people was a fool’s game and in fact, I should focus on things I myself do well. 

It wasn’t always easy at first though, I have to admit, but instead of trying to emulate blogs written by other people, I focused on things I felt were important. I drew from my own experiences – something we can all do and from the things people would say to me, I certainly was not alone in any of it. 

You all shared my frustrations with poor communication and care experienced by my lovely mum and appreciated the importance of maintaining the dignity of people in our care – as evidenced when my father was not properly covered when he was in hospital at the end. You were all with me when I lost Mammy last February. Thank you so much for all the lovely messages you sent – they did help.

The experience we all went through as a family really focused my mind on how we need to support older people, particularly those who are suffering from cognitive impairment. I definitely think there is more we can do to support patients who have dementia when they come to our departments. As I said at the time, please remember the extraordinary ordinary person they were before this disease started to steal them away. My mum only developed dementia in the last couple of years of her life. For all the years before she was Barbara Hepplewhite, hard-working teacher and lovely friend to all who were lucky enough to know her and the best mum my sister and I could have wished for. We are so lucky to have had her for so long.

You also heard recently about my friend who was recently diagnosed with cancer. Again, this really makes you stop and think about what is important – both in how we care for our patients and in life generally in how we look after ourselves and support our loved ones. 

You also may know how passionate I am about us being inclusive. In all ways. We work in a caring profession and should care for all our patients without judgement. In fact, I feel we need to do more than not judge people – we should support people. You may already know my son is gay. He has many friends within the LGTBQ+ community, including some who are trans. I can proudly state here and now that I am and always will be, a trans ally. Because I care for people, and don’t like to see anyone being targeted as I feel they are. We have people coming into and indeed, working in, our departments who will identify in all sorts of different ways. Our business is not to judge them; it’s to care for and support them. End of. 

One thing which happened over the last couple of years has to be mentioned. It is something I consider to be a huge and terrible blot on the landscape of our history as a country. These were the riots that happened after the tragic and senseless murder of those poor young girls in Southport. Those families will never recover from what happened to their daughters – as a parent, the thought of it tears me up now as I write this. But what happened afterwards was by no means justified in any way. Outraged doesn’t even come close - I really hope we never see anything like that again. But as so often seems to be said at the moment, the world is changing, and we are looking ahead at uncertain times everywhere. All we can do is pull together and support each other and our patients as best we can. For now, I would just like to reiterate that Nuclear Medicine needs all of you and rather than the colour of your skin or your religion being something that makes you a target, I think it is something that makes you a special part of our wonderful, diverse, Nuclear Medicine community. 

Something that happened more recently was the Molybdenum shortage. This was a tough time for many of us, but we achieved something remarkable together. We managed to work together across the various borders within our country to redistribute the available activity so that patient appointments were prioritised according to clinical need in all areas. I know if was tough, but it was absolutely the right thing to do. I really feel it is something we should be proud of – and I do think it set a precedent for how this sort of shortage would be managed in the future. 

Going back to the Imposter Syndrome – if anything could hammer home that we all have our own strengths and should play to them, then this did it for me. It made me finally stop comparing myself to other people, because I do feel that this event was something I was well placed to deal with. But I couldn’t have done it without you getting on board with it. Thank you so much to you all. 

I’ve also been trying to think about what it means to be a BNMS member. Obviously, I love our Society and want everyone to join! But apart from cheaper conference rates, what is the benefit to you? So, we introduced our pre-conference members event, which went so well in Belfast that we are doing it again in Glasgow. We also introduced our monthly Research Webinars, which have been very popular. I hope we will continue these on other subjects – watch this space. 

We’re looking to see what we can do to act upon the things you told us were important to you through our members survey. Unsurprisingly, the biggest concerns related to workforce. Whilst BNMS can’t solve all the problems, we can definitely take the lead in looking at what can be done and trying to get some action taken. 

I will be handing the chain of office over at the end of the Glasgow conference to a more than worthy successor; Sabina Dizdarevic. Without Sabina, I would never have put my name forward to be BNMS President. It was she who first encouraged me. She is someone who is not only a bright shining star in the world of Nuclear Medicine, she is something even more special. She is a good friend, and someone who supports other women. 

If you aren’t already registered, please have a think about coming up to join me for my last conference as BNMS President – it really would be great to see you. 
So, as I finish this last blog, my hope is that you have all felt supported by me and by our Society. I hope that when times have been tough you have felt that BNMS is somewhere you can look to for leadership, help and advice. And when good things happen, I want BNMS to celebrate them with you, so please do share these things with us. 

But most of all, the thing I want most fervently to leave behind is the feeling that our Society belongs to you. To each and every one of you. It is a Society for us all. It is a Society where all professional groups are equally valued. 

It’s certainly been the Society for me, and it’s been the privilege of my life to have been lucky enough to act as your leader for the last two years. Thank you all so much for everything. I can’t finish this by saying until next time. So, I will just finish by signing off and saying as I’ve said many times before, always be kind. And thank you.

Dealing with a death in the Nuclear Medicine department

Now this may seem like a bit of a morbid subject, but I think it’s an important one.

Unlike many other departments in the hospital, it is unusual to have a patient die while they are in our care. Where I work, there was only one other case some years ago that anyone could remember – until about 18 months ago, when I was the most senior manager on site. When something doesn’t happen very often, it can make it more difficult to know what to do and in Nuclear Medicine, we have some very specific things which need to be considered.

I’ll start with what needs to be done as soon as it is clear there is a problem. Our patient was having a VQ scan, and what alerted our technologist was that they stopped seeing Krypton update on the ventilation scan, as the patient had stopped breathing. They called immediately for a doctor and CPR was commenced. This may seem like the right thing to do, but someone does needs to check whether there is a DNR (Do Not Resuscitate) order in place. If there is, then resuscitation shouldn’t be attempted. Accompanying ward staff should know this, but in this case, a student had been left with the patient who didn’t. When it was checked with the ward, it became clear in this case there was a DNR order in place for this gentleman, and resuscitation was stopped immediately. There had been a couple of instances just before this in Imaging where patients had been resuscitated despite having a DNR and this is viewed very dimly as it goes against the patient’s wishes.

If the patient’s study has started, they are likely to have been injected with radioactivity. In essence, the body is a radioactive source, so care must be taken with handling and transporting the body. In our case, the patient was a Muslim and so his family wanted to hold the burial within 2 days, as is tradition in their religion. Because his body was radioactive, it wasn’t going to be possible to transport it to the funeral home, so careful and sensitive explanation was necessary, mindful that not all members of his family spoke good English. The family agreed that they would wait until after the weekend to arrange the burial.

This happened on a Friday, so we needed to identify somewhere where the body could be kept over the weekend. By the time we were ready to move it from the Nuclear Medicine department, it was after 5pm, so most of the staff in the morgue had gone home. We had to consider proximity of the body to people working in the morgue over the weekend, so arrangements were made for it to be kept separately, to minimise exposure to staff. It is important to get your physicist to provide support for these arrangements. On the day in question, there were no senior physicists available, so I and the junior physicist in attendance decided to proceed on the cautious side.

Another thing to consider is what to do with any cannulas or lines. As these would be radioactive, they were removed and disposed of by the Nuclear Medicine staff.

As well as the practical considerations, is important to remember that this is a person, with a family. In one way, it being a Friday afternoon was advantageous, as the department was relatively quiet. This meant the man’s body could be kept in a separate room. The immediate family came to the department quickly and asked if others could join them. We agreed to this, but quickly the department filled up with a large number of relatives and they stayed quite some time. It did become a bit difficult for the staff and remaining patients. In the end, a senior nurse from the ward politely steered them away. That is something we felt unwilling to do, but the ability to do this comes with experience, so we were very grateful to the nurse for her support.

A key message here is to have good communication links with the ward and ask for their help on all things that don’t relate to the patient having received an administration of radioactivity.

The patient’s culture and religion must be respected. This patient was a Muslim, so there were traditions which the family wanted to observe, such as wrapping the body. We agreed to this, although asked that it wasn’t all carried out by the same family member, so that they weren’t individually spending too much time in close proximity.

it is important to look after everyone in the department who is involved with caring for the patient, including scanning, attempting to resuscitate and providing support to relatives. Asking if they are OK at the time and afterwards is important so they know that if they need to talk about it, then they can. Although no-one felt they needed it, counselling was offered. This is important – I was OK with it then, but if it had happened in those first few months after I lost mammy, I definitely would not have been.

Finally, this has to be logged as an incident and an investigation must be held with an independent investigator. This part of the process was quite hard. It felt like we were in some way being blamed for his death. It is important to release that this is not the case. Any death in the hospital must be taken seriously and it is important to question and learn from it. This man was very poorly and one question was whether, given those circumstances, he should have been moved to Nuclear Medicine for a scan at all. However, having been asked to scan him and believing a diagnosis would be of benefit, it was felt that that the decision made at the time was the right one with the information available.

After this happened, it made me think about what happens if a patient who has had a radioactive injection dies shortly afterwards when the radiation is still within their body. This could happen anywhere, not necessarily in the Nuclear Medicine department. So, guidance on how to manage that situation is needed. This is something we have started looking at in the BNMS UK MRT Consortium, since it is more likely to be a problem if the patient has had therapy.

I can’t apologise for the somewhat serious subject matter this month, as it is something that I think we should think about, even if it’s uncomfortable. On 26^th February it will be a year since I lost my lovely mum, and I feel it is so important that we, as Nuclear Medicine staff entrusted with the care of other people’s loved ones, look after them as well as we can – particularly if we are the people there at the end. Until next time.

Ms Jilly Croasdale

BNMS President

What is important to you – feedback on the BNMS survey (workforce!)

Thank you so much for those of you who managed to find time to fill it in our membership survey. I know from experience that completing these surveys can be a bit of a bind and with so many demands on our time, it’s not always our top priority. So it is wonderful to get so many responses.

Something that is important but not always done well is making sure those who complete surveys see some feedback or action, so I thought I’d try and give you a little bit of both.

Overwhelmingly the most challenging part of our jobs is staff, time, workload and budget. This is not a surprise, I’m sure. Many of us are keeping our services running in the face of staffing shortages, difficulty in recruiting and retaining staff. Covering sickness is also a big issue. Lack of time and competing demands causes stress and many of us feel under constant pressure to scan patients faster in the face of the staffing challenges so many of us face.

Some of us also find the challenges around ageing infrastructure and radiopharmaceutical supply problems add more pressure and poor management is a problem for some. The regulatory burden on us is high and keeping up with this can be difficult. Lack of statutory Technologist registration is another concern as is career progression and training.

This paints a pretty grim picture and I really want to try and do something about at least some of it. I wish I could wave a magic wand and improve things for us, but the issues are complex, are not unique to Nuclear Medicine and have been going on for some time. So difficult to fix and certainly not quick.

However, having read your feedback, I feel we have to try and do something. To this end, BNMS have set up a task force within our Council to look at our workforce issues and consider what we can do to help.

The issues aren’t the same for all professional groups, so the task force has representation from all of them. However, there will be some overlap, so working together is the right way to progress. For example, even if we improve the arrangements for training, we need to make sure potential trainees are aware of us. We are a small specialty and from my experience of going into schools to talk to students about careers, typically they know of very few outside of doctors, nurses, midwives (probably because they’ve watched Call the midwife) and physiotherapists. So, we need to market ourselves and get the information out to the right people. At the same time, we don’t need lots of applicants (although wouldn’t it be lovely to have too many?)

Apprenticeships have the potential to be helpful, but the funding model for these can work against us, since you often need a vacancy to fund an apprentice and when you have a vacancy, the remaining staff may not have much time to train an apprentice.

The Scientist Training Programme is great – I have certainly found this to be the case in Radiopharmacy and I’m sure this is the same for many of you. However, this course may not be suitable for all applicants. We need people who are practical and hands on to care directly for our patients and to make the radiopharmaceuticals for us to give to our patients. In both in Nuclear Medicine and Radiopharmacy we have big gaps in our Practitioner workforce.

We used to have more Nuclear Medicine nurses, but they are getting harder and harder to find. When you think of it, Nuclear Medicine hours are often very favourable for those with families (and for those without, to be honest!) as there may be no weekend working, for example. So, I’m often surprised there isn’t more interest in our positions when we advertise them. Maybe the radiation puts people off. If this is the case, we need to try to educate people. Because there are risks in many other jobs – try being a sea fisherman. It’s very risky! If you’ve ever watched those extreme sea fisherman documentaries, you’ll already know this. They carry a 1 in 500 risk apparently, compared to our 1 in 15,0000 risk with a 2mSv radiation exposure (according to a well-known physicist I know).

So what can we do about it? The BNMS Task Force are going to meet outside of Council to develop an action plan and we have made workforce a regular standing agenda item for Council to discuss and track its progress each time we meet. I will make sure we keep you updated on what we are discussing and how we are progressing. I’m not sure yet what the best way of doing this is, but I want to have something in place before I finish my term as President, so I will let you know what that is going to look like once I know. (Please remember we volunteer our time on top of our day jobs, but I can promise you we’ll do our best.)

One thing which we have been working on for some time is statutory Technologist registration and after a long time getting nowhere, we have recently seen some progress. Following a letter written by IPEM to the NHS guardian, both IPEM and BNMS are working together on this and BNMS have now prepared a paper to go to the DHSC, supported by the UK Health Security Agency. We have put together a strong argument and it feels like the time may be right to get somewhere on this finally.

The benefits in terms of professional standing and patient safety are significant. The role of the Nuclear Medicine Technologist has developed a lot, with many of you reporting, processing scans, administering therapy doses and consenting patients, for example. You should not be limited in what you can achieve and certainly should be of an equal standing to registered Radiographer colleagues doing similar roles.

However, it is not all bad news. There are many things you find rewarding about working in Nuclear Medicine. Being involved in research, making changes for the better, supporting colleagues and working within a team are all things you have said you enjoy. So, for those of you who manage other people, this is good to bear in mind. Whether it be getting more of your team involved in research or involving them in making changes to improve your service, being a part of positive things like this means a lot.

It was not a surprise to hear that much of your enjoyment of your job is related to helping our patients and providing a good service. We all come to work to help patients. It’s what we do and in our amazing Nuclear Medicine community we do it brilliantly. But another thing a lot of people mention as the most rewarding thing is how nice it is to be thanked. Taking the time to notice what other people are doing, to say thank you, and to mean it, is important.

So, in this festive edition, I’d like to finish by saying a big thank you to all of you. Thank you for all you do every day for your patients and for your colleagues. Thank you specifically from me for all you did to help with the recent Molybdenum shortage. We are all Nuclear Medicine’s biggest asset. Please remember that and be proud of what you achieve every day.

I hope those of you who celebrate it have a happy Christmas and those who don’t please enjoy a few days relaxation or time with friends and family. For me it will be bittersweet.  The first without mammy, but I am determined to enjoy some quality family time and to make the most of it with the people I care about. I hope you do the same. Until next time.

Ms Jilly Croasdale

BNMS President

Norwich – well worth the trip!

I’m writing this blog sitting on a train in Norwich train station, having just attended the BNMS Autumn Meeting. I’ve never been here before – it’s quite a long way from the Midlands, where I live and work. However, one of the nice things about the Autumn meetings is that it offers the opportunity to visit somewhere new, and I’m so glad I’ve had this chance to visit. Before I tell you about the fantastic meeting we’ve just had, I’d like to pass on a few facts about Norwich which I found interesting. Firstly, back in medieval times, Norwich was actually the second biggest city in the country, second only to London. Immigrants came from all over the place to work in the city’s wool and weaving industries. And it still remains the only English city to be located in a national park – for those of you who haven’t been, the Norfolk Broads is designated an Area of Outstanding Beauty. 125 miles of navigable lock-free waterways wind their way through beautiful countryside and pretty towns and villages. It’s also mentioned in David Bowie’s ‘Life on Mars’, just FYI. And who can resist anything with a link to him? (not me!)

Other claims to fame – Norwich was the first town to have a pedestrianised street (this happened back in July 1967) and was the first place to have postcodes. Another interesting fact for some may be that Norwich at one time had a pub for every day of the year x (almost) 2, so you could literally go to a different one every night for quite a long time, if you so wished. However, many were closed in the 1960s, which saw King Street go from a staggering 58 pubs to just one. This pub remains today – aptly called the Last Pub Standing.

Famous people from Norwich include Alan Partridge (OK, he’s not a real person, but bear with me), Jeremiah James Colman (better known for making a famous brand of mustard), and who can forget the great Delia Smith whose now famous half time  ‘Let’s be havin’ you’ speech in the 2005 Premier League clash against Manchester City surely had them quaking in their boots, and at the very least helped put Norwich football club on the map (although another interesting Norwich fact - Norwich FC has the oldest football song, written in 1890) . But in my book, her recipes probably outshine the football – especially the Christmas ones!

Anyway, back to the BNMS. Our meeting was held at the beautiful Norwich Assembly Rooms and was jointly organised by Cambridge and Norfolk and Norwich University Hospitals. The venue is one of the most glorious examples of Georgian assembly rooms architecture in the country. It is a grade 1 listed building, originally the site of a 13^th century hospital and secular college and church for priests. In 1544 the college closed when Henry VIII ran rampage through the country’s monasteries and the building were subsequently surrendered to the crown. Following that, much demolishing took place (he was a destructive lad, was Henry), but eventually the house was renovated and converted to ultimately become the Assembly House we were lucky enough to spend today in.

As we have started to do in recent years, we held a welcome event the evening before the meeting. This is something I really like – it is just so nice to have that little bit of extra time to spend with people who you may not have seen for a while as well as to meet new people. It also helps if you are travelling a bit further. We had a couple of speakers before dinner on a subject close to my heart – sustainability. Erika Denton, who I’m sure many of you will know of, gave an excellent talk in her capacity as National Medical Director for Transformation at NHS England and lead for The Greener NHS. She was followed by Gerry Lowe, of East and North Hertfordshire and Mark Cracknell of the Paul Strickland Scanner Centre, who gave a thought provoking talk about the carbon footprint of PET. All highlighted travel as the biggest contributor to the size of our carbon footprint, not surprisingly, but it was also interesting to hear the part played by our equipment, including when it is idle. It’s definitely worth checking whether your piece of kit needs to be on all the time - it’s not always the case. As someone working in Radiopharmacy, I do find the number of single use items a cause of concern. Of course, many things must be single use, but not everything needs to be. There are a lot of unseen factors – often upstream - which influence our overall carbon footprint.

That was followed by a lovely meal and even nicer company. Not a bad way to spend a Monday evening.

The next day was the meeting proper and there really was a great varied menu to choose from. For our first Plenary session, we had what can only be described as a stunning talk from an esteemed Professor of Medical Oncology at the University of Groningen in the Netherlands, Elisabeth De Vries. Elisabeth spoke about the role that molecular imaging can play in supporting drug development and patient selection for cancer medicines. One of the slides in particular was very thought provoking – it was around breast cancers which may not be visualised using the usual imaging routes, but which can be seen with some types of PET imaging (non FDG).

As many of you will be aware, a subject close to my heart is dementia and we had a wonderful talk about PET amyloid imaging in Alzheimer’s. This highlighted how key early diagnosis is, although currently not all treatments have approval. I know first-hand how challenging it can be to get any investigations at all for a loved one who you suspect may be developing dementia. My sister was asked what we hoped to achieve by getting a dementia diagnosis by my mum’s GP, for goodness sake. Needless to say, he didn’t remain her GP for much longer. So anything which helps people early on in their journey, especially if it leads to something which could slow down the progression of their disease is important.

Another aspect I enjoyed were the talks from healthcare professionals outside of the immediate world of Nuclear Medicine, such as the talk from a Medical Oncologist about radionuclide therapy which added another perspective to this important subject.

I never cease to be impressed by the problem-solving brains of our physicists and the talk on Pituitary Phantom and Optimisation of PET by Daniel Gillet from Cambridge was no exception. Unfortunately, this clashed with the presentation by Rita Pereira and Deborah Burgess on their Technologist-led Stress service, which is a shame as extended roles for Technologists and Radiographers is something I am a keen advocate of.  I also have to mention Busola Ade-Ojo’s talk on challenges in Radiopharmacy. As a Radiopharmacist myself, I was pleased to see this given a focus in the meeting.

Our final Plenary session was delivered by our very own John Buscombe as he took us with him on a Theranostics journey from Saul Hertz to PSMA like no-one else can. He is a great story teller, and really brought the subject to life. He ended with a slide showing photos of a number of pioneers of Theranostics. I noticed that his picture was not included (something commented on by someone else too, and why he typically brushed aside), but having worked with John many years ago, I know for a fact that many Nuclear Medicine departments and their patients across the world owe a lot to him as a supporter and advocate for Theranostics and Molecular Radiotherapy as he helped them set up their services.

So, as you can hopefully see, there was a little something for everyone and it’s been an absolutely great day. If you can, please try to join us in Glasgow for the Spring meeting from 19^th – 21^st May next year, or the next Autumn meeting, which will be held in London (details to be confirmed).

I have to finish by saying a few words of thanks. The local organising committees always put so much into making this a great day for all, and we owe our sincere appreciation to Clare Beadsmoore, Luigi Aloj, Ferdia Gallagher and Matthew Gray and the rest of the organising committee below for all the hard work they have put into this event.  Until next time.

Ms Jilly Croasdale

BNMS President

Organising Committee:

Norfolk and Norwich University Hospitals NHS Foundation Trust:

Clare Beadsmoore, Radiologist

Matthew Gray, Clinical Scientist

Cambridge University Hospitals NHs Foundation Trust:

Luigi Aloj, Physician

HK Cheow, Physician

Ferdia Gallagher, Radiologist

Daniel Gillett, Clinical Scientist

Ines Harper, Radiologist

Sarah Heard, Clinical Scientist

Helen Mason, Radiographer

Iosif Mendichovszky, Radiologist

Busola Ade-Ojo, Radiopharmacist

Hope and our Nuclear Medicine community

Following on from the statement I made earlier this month on the effects the riots in this country may be having on some of our colleagues, I wanted to say how gratifying it was to receive messages of support from so many of you across the country. Not support for me, but support for each other. It reminded me again of one of the things I love about working in Nuclear Medicine: our community. We support each other, and we are a team.

I want to say to anyone directly affected by what happened that I hope you’re OK. I’m not going to talk too much more about the riots – I think those people have had enough of our attention. Instead in this month’s blog I want to focus on hope and on our Nuclear Medicine community.

After the riots a couple of things in particular made me feel hopeful. One was a story about members of a Mosque who, after waiting inside for things to ease off, went out and offered food to the rioters. They had conversations with them and came to the conclusion that the people who were rioting had never spoken properly themselves with a person of the Muslim faith. In the end, they felt there was more understanding and the violence dissipated. This may not have permanently changed these people minds, or fundamentally made them feel differently – I suspect that once they are among other people with a similar mindset again or interacting on social media with all those poisonous influences, those people may well have reverted to type. Old habits die hard. But it did make me think about education and talking to other people, and the part this could play in changing things in the future. It gave me a tiny bit of hope.

The other thing which brought me hope was when the anti-fascist demonstrators took to the streets in those places where they had heard the far right were intending to riot and literally outnumbered them. There is power in numbers, and that so many felt brave enough to do it and that it seemed to work, is a beautiful thing. It was a community standing together.

In stark contrast to all that was going on at home, the Olympics were taking place in Paris. I love the Olympics – I think it represents the best of us. Effort, pride, rewards, striving to be the best you can, supporting each other and working as a team and representing your country. It couldn’t get any different, right? Keeping tally of our medals and seeing our heroes pushing themselves to be world beaters is inspiring. As was the grace we saw in defeat where athletes would congratulate the winners, despite their own disappointment. But behind every medal winner is a team. They don’t achieve any of this on their own and this is where I would make comparisons with us all in our everyday life (see - I got there in the end!)

In Nuclear Medicine, we strive as a team to do the best we can for our patients every day. These are our gold medals and for everyone we see we want to get it exactly right. I’ve talked before about Harm free Care and GIRFT – Getting It Right First Time. The right diagnosis, for sure. But also, the right experience in every way. I’ve said before how important each and every member of our teams are and it is so true. Many of our roles are flexible, I know, but generally speaking.

Without our doctors, whether Nuclear Medicine Physician or Radiologist, our patients wouldn’t have their report and therefore their diagnosis. Those referred for it would not receive the treatment they need. These are often our clinical leaders, and without them we may not be developing our clinical services. We also may not have the same connections with the rest of the hospital. We need our doctors, for sure.

But without our nurses, or where we don’t have them, our support workers, Radiographers and Technologists, our patients would not be as well cared for while they are with us and as a result, may not be confident we’re in good hands.

Without our Radiographers or Technologists, no patient scans would happen. There is that and often Radiographers and Technologists fulfil multiple roles - there are too many to list here. Again, without them these things could not happen.

Without our Physicists, we could not image our patients satisfactorily, we would not be maintaining our cameras in optimum condition to help patients, dosimetry definitely would not happen (I always find it amusing to see the dreamy look some of them get in their eyes when you get them started on dosimetry. You know who you are!) and we would not be protecting our staff so well from potentially harmful radiation. Again, they have their fingers in many many pies!

Without the Radiopharmacy team, nothing would happen. I’m not saying that Radiopharmacists are the most important (honestly, I’m not – even though I am one, as you know). But you all also know how it feels when there are problems with supply – it’s pretty fundamental to our services to our patients to have the good stuff to give to them!

Without our receptionist and administrative staff, the appointments would not get made, so no patients would turn up and then we’d all be out of a job. See what I’m saying?

The most important member of our team? Our patients. Let’s never forget that.

So please let us focus on hope. On staying positive. On our wonderful Nuclear Medicine community, where everyone, irrespective of the colour of their skin or their faith, has an equally important and valued role to play. On looking out for each other and on pride in ourselves of the good variety. Pride that celebrates the best of us all, rather than excludes people.

In Nuclear Medicine, we have a lot to be proud of. I feel proud to represent all of you, in whatever way I can. I think you’re all amazing, so thank you to each of you for everything you do.

So, let’s continue to do what we do best: working together to get on with the job in hand, being there for our patients and for each other. Until next time.

Ms Jilly Croasdale

BNMS President