Hiatal Hernia
As a working tech, I'll get to see a variety of interesting x-ray images, and I hope to collect some of them for discussion purposes. This will give me an opportunity to study them in more detail and share them with you as well.
Recently, I was working with a student on a chest x-ray when we stumbled upon this rather intriguing image. In my limited experience, I have never seen a hiatal (or hiatus) hernia this large. In this x-ray, it's very well-definied by the air-fluid level present.
What is a hiatal hernia?
Wikipedia has a nice entry on the Hiatus Hernia if you want to take a look at it there, but a hiatal hernia is a condition where a portion of the stomach protrudes into the chest cavity through the diaphragm.
Keeping up with the Markers
I stopped by the school a couple weeks ago and snagged a couple pieces of old exposed x-ray film from the lab. I cut them to about the same width and twice the length of my ID badge and poked a hole so I could attach it to my badge holder. This works really well for holding my markers and keeping the sticky tape mess off of my name badge holder. So far, this is working pretty well. My two markers with the copper backing are on the back side of this film.
I'm getting some time in the hospital in the morning. I get a 4-hour shift from 7-11, and I'll get to work that short shift again on Saturday and Sunday over the Thanksgiving weekend. I'm looking forward to this. I'll get to check out the new digital portable units the hospital purchased after my last clinical rotation...
Cell Phones in the Workplace?
The October/November 2009 issue of the ASRT Scanner magazine has an interesting article in the "Both Sides" column this month. The debate is: Should Cell Phones Be Allowed in the Workplace? I hadn't spent much time thinking about this issue until I read this debate. Under normal circumstances, I would have said NO to that question without hesitation. Then I got to thinking about the fact that I carry mine with me into work.
This debate is rather fundamental, no matter what type of work you do. Since I work in the health care industry, this particular article uses that as a focus point on the NO side of the debate. The YES side of the debate seems to be more well-crafted. There are a lot of good reasons, even though they are all personal, to have your cell phone with you at all times. It makes you easy to reach by those who might need to reach you. Nutshell review:
Pros: Friends and family can reach you whenever they need to and you can respond appropriately.
Cons: Your 'patient' (or your work in general outside the healthcare field) should have your undivided attention at all times.
The PRO side of this debate works really well as long as the cell phone user shows a little common sense. Common sense, on the other hand, is relative. Some cell phone users will know how to intelligently handle a cell phone at work while others will not. Should everyone be penalized for the stupidity of a few? In the sense of being fair to everyone, we generally have to deal with strict rules that supposedly aren't flexible to keep management from having to deal with making decisions based on judgement.
There is no real way to argue the CON side of this debate. The debater in the article simply uses the position that if you are using a cell phone, your patient is not receiving proper care or attention from you. The thought never arises that a worker might experience a little down time during the shift.
"I recommend that it become policy that all cell phones are turned off during work hours and kept in staff lockers, handbags or locked away with other personal items."
The author goes on to state that land line phones should be used for all personal emergency calls. I'm not really sure why that makes sense.
"I think technology is great; however, we really need to get back to basics."
In my humble opinion, the last quote, which is part of the closing statement of the argument, voids credibility.
I agree that your patient, customer, or whatever business you serve is entitled to your full attention. I have also never worked anywhere that didn't grant me an occasional opportunity to catch my breath, collect my thoughts, and simply take a moment on the job. Maybe it's just the environment I work in, but I work with some highly responsible and motivated people. That was, for the most part, my experience in clinicals throughout my schooling also. I'm sure that's not the case everywhere, but I'm glad it is for me...
Scrubs again
I'm still sorta settling in to this concept of being a working tech. The Landau scrubs are working out rather well, and even though they are expensive comparatively, I like them. They are well made and comfortable. I went to search for some undershirts to wear under my scrub shirts last week. I bought some simple t-shirts that I thought would work well, but the sleeves on those were longer than my scrub sleeves and that just didn't work for me. I went to look for a couple other options and found some sleeveless tshirts that should work a lot better. I wanted a crew neck tshirt, so the regular tank tops weren't gonna fit the bill. This time of year, its cool enough outside in the mornings that I need something extra to stay warm, but not cool enough that I want to wear a jacket. I also just think the scrubs look nicer with a t-shirt of some sort on underneath. I also purchased a Starter brand long-sleeved undershirt type garment that I might try out as well. I'm not exactly sure what I'm going to do for cold weather yet. It's not cold inside our facility so I'll have to find that balance...
Wrapping up my first week
I can't begin to describe how great this week has been for me. My new part-time job has been closer to full-time for my first week back in the saddle. I worked a half day on Monday and then full days on Wednesday, Thursday, and Friday. I was really worried about how rusty I might be after being out of the radiology department for over five months, but it's all coming back to me nicely. I have been keeping notes on some specific things where I need a little refresher, and I plan to do some reading and studying a little over the weekend. I haven't really seen much of a variety of exams this week though. It seems like everyone with a cough is getting chest x-rays this week, and I have probably done 20 of those, if not more. I have had a couple Upper GIs, a couple Small Bowels, and I think there is a BE on the schedule for Friday morning.
I finally got fed up with my el-cheap-o lead markers that I have been using throughout clinicals in school. They aren't really that cheap though. They are about $13 per set, which is the same price as the aluminum-backed marker set I just ordered. I got a standard pair and a second pair with copper backing for higher kVp applications.
This marker set was $26.30 from http://www.thomascorp.com (T-Model). Hopefully they will arrive in the next week or 10 days. One of my fellow techs uses these markers, and I did some experiments with them today. His markers without the copper backing held up as well as mine with the copper backing. My markers without the copper backing will simply not hold up on chest or shoulder x-rays unless I place them in the shadow of the anatomy somewhere. Using them during cross-table shots during a BE is just pointless. Hopefully these new markers will take care of business... Remind me to post an update on that... The problem markers are the ones I was told to buy as a student. We were asked to buy two sets so we would have a backup in the event of losing one, which makes sense. What makes sense NOW is to buy the two sets in the photo above since they are the same price as the ones I don't like anymore...
One of the other fun aspects of my job is that I'm working with students. When I was a student, I always told myself that if I got the chance to work with students, I would be helpful to them. I had certain techs who were not helpful to me as a student, and I simply don't want a student to EVER to back to school and complain about me the same way I heard my fellow students (and myself occasionally) complain about techs in the field. One of the students I worked with today was experiencing her very first day of clinical. She has a few fears that I'm going to attempt to relieve while I'm working with her. I'm also going to help her get her required comps for this semester completed... It should be fun :)
First Day
Well, it's finally here. I'm finally 'working' as a Radiographic Technologist. I spent several hours this morning sitting in orientation sessions, getting finger printed, getting my ID badge, and filling out paperwork. After lunch, I got to work for a half day. Under normal circumstances, my part-time job is 'very' part-time. I'll only be working from 8:00 - 4:30 on Thursdays. This week, I'm going to get some extra time because the lead tech is on vacation. I got to work 4 hours today and I'll get to work all day Wednesday, Thursday, and Friday. That should give me plenty of time to re-familiarize myself with the equipment and systems at this site. Lucikly, I spent 2 and a half days a week for 10 weeks at this location as part of my clinical education, so I'm familiar with everything here.
I still want to replace my lead markers, and I need to find a couple of decent ID badge holders too, so I'm going shopping online before I hit the sack tonight... Where is a good place to buy accessory junk like badge holders?
Tomorrow, I'm not working at all... in the X-ray job or for the newspaper, so I'm going to try to find something interesting to do!
Chasing Documentation
I'm going to be starting work soon and I have a pre-employment screening tomorrow morning. This screening is a health screening that requires some blood testing and nothing to eat for eight hours prior. I also have to take in all my immunization records, which meant I had to go gather those up again today. I had to go to the school administration building and get a copy, but I got an extra copy this time for future use. I also had to go to the health department to get a copy of my Hepatitis B vaccination record from there. This screening was rather short notice, so I had to scramble to get everything in order for it.
During my last 5 months of job hunting, I have learned something. It would be absolutely wonderful if there could be some sort of national standardization of job applications. During the last 5 months, I have filled out no less than 42 applications. What's even worse, some companies make you do it all over again if you apply for a different job within the same company. Everyone (or most) seem to be requiring online applications these days. That being the case, there should be some sort of standardization applied to the process. Most of the information collected by job applications is the same everywhere you go. They want your name, social security number, phone number, address, employment history, education history, and references. It would be so simple to standardize that data collection process, but its not happening. All of that data could be stored in a small file on my computer and I could upload it to a potential employer. It could also easily be stored on a smartcard. It could also be stored in a secured database online where I could give potential employers a single-use access key to that information. The information would be formatted in a standard way where the employer could request the info and it would fall right into place in their computer system with no hitches. I could also update the data as needed. Its so easy in a world where computers already run businesses.
Getting Started with CEs
The continuing education requirements of the ARRT (American Registry of Radiologic Technologists) seem a little funny to me. It's simple enough that you have to collect 24 continuing education credits every two years. That part doesn't seem so strange. What feels odd to me is how the 'biennium' works, and how strange it seems to me as a new graduate. I graduated in May of 2009. My birthday is in the month of March. My biennium does not start until March of 2010. So between May of 2009 and March of 2010, it is a waste of time for me to pursue any continuing education credits. If I turn any in at this time, they don't count toward my next biennium requirement. I have to actually wait until after March 1, 2010 to turn anything in. If my birthday had been in June, I would have had to wait only one month before my new biennium started, but since it's not until March, I have to wait ten months. It seems slightly counter productive to me in some way. I just spend three years back in school, so getting started working on continuing education credits right away would seem like a good idea. Strike while the iron is hot...
I joined the ASRT (American Society of Radiologic Technologists) as soon as I graduated (or within a month). The directed readings in the Radiologic Technology Journal are good sources of continuing education credits. Each issue (it comes out 6 times per year) has two directed readings with a quiz at the end. These directed readings are worth one or two continuing education credits each. The first two issues I have received each have 3.5 hours worth of continued education credits available. The simple act of joining the ASRT and using the directed readings in the journal will fulfill the continuing education requirements set forth by the ARRT. The directed readings provided in these journals are good for two years. I can turn them in for credit any time during that two year period, so I'm working through them and will just hold them until my biennium starts in March, at which time I'll turn them in for credit. That should give me a rather comfortable head start on the 24 hours I'll be required to accumulate between March of 2010 and March of 2012.
On another note, I wonder if this little issue of the delay in being able to start accumulating CEs causes techs to wait to become a member of the ASRT? I'm also curious as to what people do to collect CE credits if they aren't members of the ASRT.
Lead X-Ray Markers
As a student, I was required to purchase two sets of the markers you see above. We were required to buy two rights and two lefts so we would have extras in case we lost one. As I progressed in my program, I ordered two more sets. I wanted a pair of the markers with the copper backing, but I couldn't find them as an individual pair and had to purchase another set of 4 markers to get them, so I ended up with a total of four pairs of markers. These are the only markers I have used so far, but as you can see, I haven't lost one yet... These markers cost approximately $13 per pair or $25 for the double pair with the copper backed pair included. If you are a student and getting ready to purchase your first set of markers, I would recommend getting the double pair with one set including the copper backing unless your instructor requires something different. The copper backing helps keep the markers visible on some exams where they like to get burned out due to a high kVp or high MAS technique. Exams like chest and shoulder x-rays and some others like cross-table images in a barium enema series tend to burn out a marker rather quickly.
These markers are rather basic, but they work as well as any for the most part. I'm thinking about experimenting with some different types of markers in the near future...
These markers are just like my existing sets except they have an aluminum backing rather than the white 'carbonite' backing. I don't know the details on 'carbonite' but I'm just assuming that it's a light weight material that is radiolucent in nature. The aluminum backing on these markers might provide some additional help when trying to avoid a marker burnout. This set of four is about the same price as the original set of four mentioned earlier.
This set has the positioner beads to show which direction is up/down in the x-ray. The lead beads fall to the bottom of the circle to give a visual reference as to which way is up/down in the image regardless of how the marker is placed. I haven't found this set with the option of a copper backing, but this pair costs about $23, so they are a bit more expensive than the others. I'm not sure if I will try these or not because I developed a habit of orienting my markers so that the letters are in the correct orientation to describe up and down in the image when a patient was in an erect or a decub position. I know that habit won't translate through to a radiologist who might be reading the images, but I know for my own purposes. I usually annotate the image with an arrow and associated text to indicate anything that might not be obvious.
I don't know where the best place to buy markers might be. I have been buying mine from ThomasCorp but there might be other places that are good also. If you know of a great place to buy markers, please let me know!
My First Job
Well, it wasn't easy and it took a while, but I have finally landed a job in the field of Radiography. I graduated from my Radiography program at school in May and it took me until now (September) to find my first job. It's a part-time job, but it's a start. I consider myself very lucky to have it since the economy is in the toilet and no one seems to be hiring anywhere.
I also consider myself lucky to have been offered the job I'll be starting soon. It's an outpatient imaging center, and it was my personal favorite clinical site during my 2 years in Radiography school. The people who work there are absolutely great and I'll have all the opportunities that I had hoped for. Since I'm very interested in expanding to additional modalities, I will have the opportunities I need in this environment to make that happen if I apply myself.
I don't really know where to start. I'm waiting on information from the HR department about my orientation day that is supposed to be on October 12. I have to get that done before I can start working, and then there is supposed to be a second orientation day sometime in November. This job is technically listed as only one day per week (Thursdays) but I was told there will be some extra opportunities for work as people take vacation time, sick days, and other situations where extra help is needed. I was told I could also have some possible opportunities to do some PRN work at the hospital when needed if I was interested, so this work might be quite diverse after all.
I bought two sets of scrubs to get me started. I told myself after I graduated that I would never wear white again because our student scrub pants and lab coats were white. This job site requires the Ceil Blue scrubs, which isn't the greatest color but it's better than white! I still need a new pair of shoes that I haven't purchased yet, but I'll get those soon enough. I still have all the x-ray lead markers that I used in school. I want some different markers and it will probably also take me a while to figure out what brand and type of scrub tops and pants I like best and where to get them, but I'll figure that out soon enough I suppose.
I don't know what will be posted in this blog yet, but I can assure you that I will be posting regularly once I actually start to work in a few weeks. In the mean time I'll be adding some content on various pages here and I'll also be searching for other radiographers who have blogs...
