Disappointment
I had a disappointing day in clinical today. I was stoked about having the opportunity to complete my master competency on the CXR. I got my final pre-comp, and immediately following that, I had the opportunity to do another for my master competency. I got my patient and made the PA and Lateral view x-rays, and then went to look at the images. I had a hypersthenic patient, so I had to shoot the PA view with the IR mounted crosswise in the bucky. That X-ray was, by far, the best image I have made on my own so far. Everything was perfectly centered, with no rotation, and everything was in place. I did NOT collimate any with this patient because of his size. When I pulled up the lateral view, I was discouraged immediately. First of all, the image was good. Everything that I needed for a good x-ray was in place, except for my marker. I had placed it too close to the edge of the image receptor. When I’m doing erect exams, I always place my marker on the outside of the board rather than directly on the image receptor. I placed this marker in the light, but apparently, it was not good enough. About 20% of my marker was cut off the edge. I also did not collimate any on the lateral view when I probably could have. Our instructors want to see visible collimation on all x-rays. With the size of this patient, I didn’t want to collimate on the PA view for fear of having to re-take it. I should have collimated on the lateral view though. During my five pre-comp exams, I collimated on every view… even if it was just a little bit, just to show collimation on the image.
What Have I Learned Today?
The main thing I learned today is that an image that I submit as a master competency image must be perfect in every way. I understand the reasoning for this and I will make it happen on my next attempt. I think part of my problem with collimation on chest x-rays is the fact that the positioning light is smaller on the patient than the size of the image receptor. The light is representative of the x-ray primary beam though. But as the beam travels closer to the image receptor, it continues to spread. Since the light I see is smaller than the image receptor, I have less confidence that I’m not going to clip something that is an important part of the view… such as the costaphrenic angles. I need to work with what I KNOW on the chest and abdomen views rather than what I see :)
Ok… I’m ready for a long weekend now. We’re out of school Monday and Tuesday, but I still have a test to study for coming up on Wednesday morning…