Every therapeutic use of radiation has an inherent risk. Awareness of the risk is essential for all staff who have to obtain informed consent from their patients (Picano [57]). A survey of patients and family members of patients receiving radioactive iodine found that many experienced psychological distress and few received adequate help (Fitch and McGrath [20]). Therefore, careful preparation of the patient before the administration of unsealed source therapy is essential.

Patients and relatives should be educated (Skalla et al. [61]) about the principles of radiation protection and the procedures with which the patient must comply while in isolation; this is part of the consent process. Psychosocial and physical needs must be addressed, requiring a collaborative approach between patients and nurses (Stajduhar et al. [62]). It is important to identify potential anxieties before administration while the nurse can reassure the patient and is unconstrained by time limits. Fully prepared, knowledgeable patients and visitors are the key to radiation safety and contamination control (Stajduhar et al. [62], Thompson [69]). Incidents and accidents are less likely to occur if the patient fully understands the reasons for the restrictions. The name and telephone number of the ‘key worker’, usually a clinical nurse specialist, is essential for patients before, during and after treatment (DH [15], NICE [50]).

All patients are required to sign a consent form agreeing to treatment, following a full explanation from the treating clinician. This is to comply with medical, ethical and legal requirements and local hospital policy. Consent is usually obtained in the outpatient clinic before ordering the radioactive material. The patient must also agree to stay in hospital until the medical physics department advises that the level of radioactivity permits discharge (ICRP [32]).