Road to Radiography

Monday, I went back to an orthopedic office for my clinical rotation. This particular ortho office is different in many ways from my previous ortho rotation. Instead of one tech and one x-ray room, this office has four techs and two x-ray rooms, and the volume of work being done is significantly higher. The actual work being done is very similar, but I’m seeing a greater variety of things being done at this site. Unlike my last ortho rotation, I’m seeing weight-bearing feet and ankle exams, and a variety of different positioning techniques.

Clinical rotations in ortho offices have advantages and disadvantages. I’m not sure that I’m really ready to call them disadvantages, but they are peculiarities that are difficult to get used to.

Advantages:

Lots of exams… it’s almost non-stop on most days.
A majority of the patients are mobile and conscious :)
You get a good opportunity to work on your speed and proficiency

Disadvantages:

There is no standard technique for a specific exam. If you are dealing with several different doctors, each of them will likely want some exams done differently.
You won’t see the overall variety of work that you see in an outpatient or hospital environment.

Since school started back in the area this week, I have seen athletes from several of the local schools in for sports-related injuries. Since I’m a sports photographer for the local newspaper, I know a lot of these kids. This is one of the reasons I’m leaning towards working in orthopedics when I graduate from this program. I plan to continue my work as a sports photographer, and I would like to work in an environment where I’m providing imaging for those athletes if at all possible. I will, of course, be at the mercy of whatever jobs are available when I get ready to graduate though.

I don’t have another special rotation until late september. I’ll be spending two weeks working a second-shift rotation in a hospital. That should provide some excellent trauma experience. When I start that rotation, I hope to blog those experiences each night after clinical…

Tags: 4th Semester, Clinical // 2 Comments »

I guess I have been getting slack on my Radiography blog. I haven’t done this intentionally. I just didn’t post much during my two-week break, and my first week back in class was very busy.

I started out my clinical this week with a three-day rotation in special procedures, which is primarily cath lab work. This rotation consisted mainly of PICC lines, left heart caths, and abdominal aortograms. I did get to watch one discogram too. That procedure intrigued me more than the others. I got the opportunity to talk to a radiologist about that exam later in the day, and he told me that he hated doing discograms. This exam is designed to create pain in the patient. It’s objective is to reproduce the pain the patient is experiencing in order to determine the exact source of the pain in the vertebral column. The radiologist will insert injection needles into multiple disk spaces where he will inject contrast. The pressure created by the contrast will help locate the source of the pain in the patient. I also watched several heart caths, one of which involved the installation of a stent. Another of those exams resulted in the recommendation of a quadruple bypass because the strictures were not stentable.

I like my schedule this semester. I’m in clinical Monday through Wednesday and have class/labs on Thursday and Friday. Hopefully my weekends will show me a little more free time this semester. I can do my studying for tests on weeknights now rather than over the weekends. THAT will be a relief!

My next four weeks of clinical are in an orthopedic office. My next special rotation this semester is two weeks of 2nd shift in a hospital, but that doesn’t start until September 22…

Tags: 4th Semester, Clinical // Add Comment »

I finished up my summer semester in clinical today. All I have left to do this semester is go to my clinical conference with my instructor tomorrow at noon, and then I get to kick back for two weeks off. Today was another one of those painfully slow days at clinical, but I did manage to collect the Simmer’s T-Spine comp. I finished the semester with 7 extra comps that roll over to my 15-comp requirement for the fall semester, so that’s a good start. I will only need 8 comps during the fall to meet the requirement for the top grade.

Tags: 3rd Semester, Clinical, RAD-131 // Add Comment »

I can’t believe I haven’t posted much here lately, but I have been rather busy. We’re almost to the end of the summer term. This is the last week of class and clinical before I get a nice long two-week break before digging back in for the fall semester. I’m busy this week preparing for my physics (RAD-131) final exam that is a combination of two tests rolled into one. We’re having the 5th test of the term and the final all on a single test, so it’s worth two separate grades. That test is at 10am on Wednesday morning. I have clinical on Tuesday and Thursday, and then my clinical conference on Friday.

Overall, clinical has gone well this semester. I have not gotten the number of comps I had hoped to get, but I still have met the requirement for the best possible grade. I’m currently six comps ahead of schedule, so that means I already have six out of the 15 I need for the fall semester. I got my Upper GI comp last Friday, but it doesn’t look like I’ll get the barium enema comp this week. I’ll have to save it for the fall semester. I know where I’m going to be for my clinicals this fall and I’m confident that the barium enema comp will come from the second of my two rotations.

I’ll post again later this week after the exams are over unless something interesting comes up in clinical…

Tags: 3rd Semester, Clinical, RAD-131 // 1 Comment »

We all left clinical early today to go to the school to welcome the new class of students who start the radiography program in the fall. There are 10 new students coming in, and we had the opportunity to meet and greet them all this afternoon. This meeting was just like the one I attended last summer as a new student entering the program. Most of them had the ‘deer in the headlights’ looks. I’ll have to admit that I did too at that time, and the information you really want to have doesn’t seem to flow as quickly as it should or could at the beginning of the program. We provided the new students with a small gift bag (we used emesis bags that we picked up at our clinical sites) with some pens, pencils, hand sanitizer, and some other miscellaneous welcome material for them.

Each of the members of my class paired up with a member of the new class for introductions. We got the chance to chit-chat for about 30 minutes or so during this time. I gave my new student a sheet of paper with my name, e-mail address, and phone number on it and told him he could call me or email me with any questions or concerns he has during his experiences in the program. That’s something I have been waiting for the opportunity to do. I wish I had the same opportunity when I got started…

Tags: Miscellaneous // 7 Comments »

I would like to propose to the powers that be, a new competency requirement for aspiring radiologic technologists during their course of study. Since I have completed this competency many times during my clinical experiences, I also want to be the first student to claim proficiency in this procedure. The title of this master competency will be Babysitting.

I wish I had a dollar for every time I have been involved in an exam where a mother or father showed up with ‘extra’ kids. As we all know, we don’t want anyone in the exam room that doesn’t have to be there for obvious reasons, especially in the case of children. At my clinical site on Tuesday, a mother brought in her one-month old son for a cystogram. We usually put a lead apron on the mother and let her stay in the room and assist whenever possible. This particular mother also brought her four-year old son along for the ride. I knew, as soon as I saw the situation, that I would not be assisting in the study in any capacity greater than sitting in the hallway with the four-year old.

In order to complete this competency, the student must show proficiency in the following:

1. Establish communications with the child by getting on your knees and introducing yourself at eye level.

2. Explain to the mother that you want to stay with her child somewhere outside of the examination room.

3. Successfully separate the child from his mother with minimal kicking and screaming (the child’s kicking and screaming should also be minimal).

4. Provide adequate entertainment for the child during his absence from his mother by finding something interesting for him to play with. (Items should not include enema tips, rubber gloves, empty contrast bottles, needles, lead markers, dosimiters, or any other items that could induce death in a small child.)

5. Allow the child to step all over your pristine white shoes without complaint.

6. Keep the child from wandering into any mammography exams.

7. When the mother returns, comfort her by telling her how much fun you had during your babysitting experience.

This comp isn’t as easy as it seems :)

Tags: 3rd Semester, Clinical // 1 Comment »

Tags: 3rd Semester, Clinical // Add Comment »

Clinical is still going very well this summer. We have about three weeks left in this semester. The only thing that bothers me about this semester is that I haven’t collected a lot of master comps. I have met the requirement for the maximum grade because I had extras from last semester that have carried over, but I have only gotten 6 comps during this summer semester so far. I expect to get 3 more at least, but I would really like to have gotten several more during this term. I’m going to miss this clinical site when I’m gone though. I really enjoy working at this one.

We’ll be welcoming in the new class of students next week. The class of 2010 has been selected and they will have their orientation day at the school next week. Like the class that greeted us when we started, we will be putting together a small goody-bag of stuff for each of the new students. I believe the new incoming class only has 8 students instead of 10 this year. I’m not 100% sure of the reasoning behind that, but I believe that it has to do with the current saturation of the job market for radiographers in this area.

I am in the process of re-working the My Goals page of this website. At this point in the program, I think I need to focus on the comps that I don’t have rather than the ones that I do have. I need 11 more of the 36 required comps and I need 6 more of the required 15 electives. 17 more comps doesn’t sound like a lot, but it really is at this point in the program. In reality, I will need a lot more than that to get the grades I want. I’ll need a total of 26 more comps to get the maximum grade, but I only need 17 to meet the minimum requirement for graduation. I should get to that point without much trouble…

Tags: 3rd Semester // Add Comment »

This is a holiday week, so my only clinical day was on Tuesday since I’m out of class on Thursday and Friday. Tuesday was a rather busy day though. I managed to comp the small bowel study, and in the process, I set my personal best time on that exam. On my first pre-comp of this exam, the patient took nearly three hours to move the barium all the way to the terminal ileum. My second patient was a bit quicker at just over one hour. The patient I had on Tuesday got it all the way through in about 10 minutes. The barium had reached the terminal ileum on my film at 10 minutes, but I still had to shoot the second film since the radiologist needs the AP and PA images to work with.

I also got my final pre-comp on the ribs exam. The next time I see a ribs exam, I’ll be able to comp it hopefully.

The cruddy part of my day was that I missed out on a humerus exam when I went to lunch. I still need one pre-comp on the humerus before I can get the procedure comped, and I’m just not lucky enough yet to see many of these exams.

Comp System Rundown

Here’s a quick rundown of how our comp system works… We have a master list that we were given at the beginning of the program that lists the mandatory comps (36 total) and elective comps (30 total). We are required to comp all 36 of the mandatory comps and 15 out of the 30 elective comps. That being the case, there are 51 comps that we are required to have before we graduate. To get the maximum available grade in our clinical class, we ultimately have to get more than this. During our first semester, we were required to get 4 comps to get a grade of 100 on that section of the grade. During the second semester, we were required to get 22 comps to get a grade of 100. During this summer semester, we need 15 comps to get the maximum grade. During the upcoming fall and spring, we need 15 each semester for the maximum grade. The good news is that if you get extra comps during one semester, they carry over to the next semester. The following list shows our required comps and the elective comps. I have completed the comps that are in bold text:

Required Comps - Need all of these

Chest (routine)
AP Chest (wheelchair or stretcher)
Thumb or Finger
Hand
Wrist
Forearm
Elbow
Shoulder
Trauma Upper Extremity (non shoulder)
Foot
Ankle
Knee
Tibia-Fibula
Femur
Trauma Lower Extremity
Cervical Spine
Thoracic Spine
Lumbar Spine
Pelvis
Hip
KUB
Decubitus or Upright Abdomen
C-Arm Procedure
Portable Chest
Portable Orthopedic
Pediatric Chest
Ribs
Humerus
Trauma Shoulder (Scapular Y, Transthoracic, or Axillary)
Skull
Paranasal Sinuses
Trauma (cross table) Cervical Spine
Cross table lateral Hip
Upper GI Series
Barium Enema
Portable Abdomen

Electives - Need 15 of these

Lateral Decubitus Chest
Clavicle
Patella
Calcaneus
ERCP
Pediatric Upper Extremity
Pediatric Lower Extremity
Pediatric Portable
Small Bowel Series
Sternum
Upper Airway (Soft Tissue Neck)
Scapula
AC Joints
Toe
Facial Bones
Orbits
Zygomatic Arches
Nasal Bones
Mandible or Panorex
Sacrum or Coccyx
Scoliosis Series
Sacroiliac Joints
IVU
Esophagus
Cystography / Cystourethrography
Myelography
Arthrography
Surgical Cholangiography
Retrograde Pyelography
Pediatric Abdomen

Anything that isn’t on these lists are something we call “Candy” comps. They are comps that don’t require any pre-comps, and there are lots of them. I have 44 comps completed so far in the program. If you click on the MY GOALS link at the top of the page, you can see the list of stuff I have completed so far… I think I need to make some revisions to that page to help me focus on what I still need rather than what I have already. As far as this summer semester is concerned, I don’t expect to get many more comps. There are three that I expect to complete. I plan to comp the Barium Enema, the Upper GI, and the Swimmer’s C/T Spine. I may be able to get the Esophagus, but that exam is a multi-textured barium swallow, and I don’t see many of those.

Tags: 3rd Semester, Clinical // Add Comment »

I got my first opportunity to work on a voiding cystourethrogram in clinical today. I was glad to get the opportunity, but the experience overall was one of the most difficult I have had so far. The male patient was just under three years old. For those of you who are in your own clinical environment, you know that children this age can be difficult, especially in fluoro exams. We made it through the fluoro portion of the exam without too much trouble, but the real problems set in when we needed to have the child completely void himself for the final empty bladder image. The child’s bladder was definitely full of contrast, but the child refused to empty it for us. The frustrating part of the situation was that the child would tell us that he needed to pee, but when we took him to the restroom and put him on the stool, he always claimed that he couldn’t go. We decided to get him to drink some to help this process along, but the success was not so great. This child drank an entire 20oz Pepsi, and a 20oz Sun Drop, and still would not go. We gave him a 12oz cup of water and got him to go just a little bit after that, but not enough to void the contrast from his bladder. This process of getting him to completely void started at about 10am this morning, and when I had to leave clinical at 2pm, he was still not voided enough for the final image in the series. By this time, the child was visibly tired and just worn out. To me, it looked like he would go to sleep at any minute. I’m not sure how this exam ended, but I’ll find out in the morning. The tech who was working with me during this exam was completely frustrated with the situation, but I had to let him have it back when I had to leave. I’m sure I’ll hear the result first thing in the morning when I go back.

On a good note, this exam does count as a pre-comp for me, and I also picked up a pre-comp I needed for a pediatric abdomen on another exam today…

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