Road to Radiography

Well… The first semester has finally come to a close.  I finished my final exams for my classes on Tuesday, and I don’t return to school until January 7th.  It was a tough semester and I’m definitely ready for this break.  I got A’s in all of my classes, so my 4.0 GPA is intact for now.  I certainly hope that I can maintain that for another semester.  Sometimes I wish I would just get a B in a class so the 4.0 would be gone and I wouldn’t worry so much about it, but having a perfect GPA is certainly a worthwhile goal. 

When I return to class in January, I’ll be taking the second semester (RAD-112) of my positioning class, and we’ll be starting with positioning on the cervical and thoracic spine, followed by the lumbar spine.  I’ll also have my first clinical rotation in an orthopedic office, and should be able to knock out a lot of my comps for the semester.  As of Tuesday, I’m passed off in lab on the lower extremities, so those comp opportunities should come quickly in the ortho office.  My Patient Care & Intro to Rad (RAD-110) class is over, and I’ll be starting my Rad Imaging I (RAD-121) class.  Here’s the book for that class:

…yet another $52.00 paperback book.  I’ll never cease to be amazed at the cost of college textbooks!  I’m looking forward to this class though, because I should start to learn more of the technical side of radiographic imaging.  As a photographer, my interest in this material is quite high. 

I hope everyone has a safe and happy holiday!  I’ll see you back here in January…

Tags: 1st Semester, Clinical, RAD-110, RAD-111 by John Setzler
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Our Patient Care & Intro to Radiography lab today consisted of a 3-hour round-table discussion about ethics in healthcare.  We were presented with lots of scenarios regarding ethical decisions that we will be faced with in this field.  A lot of these scenarios were based on situations where the patient asks you questions that you can’t really answer easily.  Here’s a summarized example of one of the scenarios:

Mrs. Smith shows up in the radiology department for a post-op abdominal x-ray.  She starts asking you questions like “What do you think of Dr. Jones (the surgeon) because I have heard he’s not so great and that he has a history of leaving surgical instruments inside patients?  After you do her abdominal x-ray and view the images, you see a hemostat and a couple sponges that were left behind in the patient’s abdomen.  You show these images to the radiologist and he requests lateral views to go along with the AP views you have already made.  When you return to Mrs. Smith, she wants to know why you are having to do different views and what is wrong that you are having to do that?

The first dilemma in this scenario is how to answer Mrs. Smith’s first question about performance issues with the surgeon.  It’s really a no-win situation for the tech.  Lengthy discussion about this issue didn’t really lead to a definitive answer either.  If you agree with Mrs. Smith, you are possibly guilty of slander.  You also can’t easily tell her that Dr. Jones is working in her best interest and that he’s a great surgeon.  You also can’t tell her that you saw a hemostat and sponges in her abdominal x-rays.  There are some reasonable solutions to providing a response to her second set of questions though. 

These situations are just difficult to handle.  As a tech, our ‘tongues’ should be sort of ‘tied’ here, but you can’t just ignore a patient’s questions.  Learning how to deal with this is part of the learning process…

Tags: 1st Semester, RAD-110 by John Setzler
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Well, I did not win the chili cook-off, but I ate some chili and a good time was had by all :)  Maybe next year…

We had a great lab today in our Patient Care & Intro to Rad class.  The clinical instructor from our school’s respiratory therapy program came to teach us about oxygen therapy and how to deal with patients who are on oxygen.  Rad techs often have to deal with patients who are on oxygen, so knowing how to connect and disconnect the oxygen, as well as the masks is rather important.  We don’t remove the oxygen masks and lines from a patient unless it’s absolutely necessary though.  We sometimes have patients come through the department that are on tanks that need replacing though, so being able to do that is critical.  So we learned about the various types of oxygen delivery devices and how they work, and how to install regulators on tanks.  The final item we learned is how to calculate how much time is left on a tank at a given flow rate.  I’m glad we had this instruction, and now I feel confident working with patients on oxygen. 

I’ll lose a little time in tomorrow’s clinical.  I’ll be leaving 90 minutes early because our instructors are taking us out for lunch.  I do hope to get at least one more comp tomorrow though :)

Tags: 1st Semester, RAD-110 by John Setzler
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We had a really fun lab today in our Patient Care & Intro to Rad class.  We x-rayed some phantom hands to demonstrate density maintenance and the inverse square law.  Our first test was a standard hand x-ray at a 40″ SID with the kVp set to 55 and the mAs set to 1.2.  We did the same x-ray at a mAs of 2.4 and 5.1 to demonstrate the changes in film density.  In this demonstration, the penetration of the beam did not change.  We measured the density of the films with a densitometer, and the results were what we expected.  The density approximately doubled on each consecutive exposure.  The next set of three exposures were all at a mAs of 2.4 with kVp settings of 46, 55, and then 64 (using the 15% rule.)  The results of these images were interesting.  We have studied the idea that mAs is the controlling factor of density, but we got to see here that kVp affects density as well.  In the second set of images, we did not change the mAs settings, just the kVp, yet our density readings on the three films gave us the same results as the first three where we manipulated the mAs.  Increasing the kVp increases the penetrating ability of the x-rays which, in turn, adds exposure to the film because more x-rays are penetrating the body part.  However, changing the kVp also changes the penetration of the body part, which may or may not be the desired solution. 

We did another set of three images at 20″, 40″, and 80″ to demonstrate the inverse square law.  The 80″ image was a challenge.  We had to put the image receptor on the floor because the tube would not go up 80″ above the table, and even if it would, we would have needed a ladder to get to it :)

I’m off to clinical in the morning.  I hope I can pick up some more pre-comps this week.  I have 6 clinical days left this semester and I only have one master competency so far.  I need three more to get a grade of 100 on that section of the class.  Three master comps gets me a 93 in that section, but I would prefer to get four.  Adding the humerus and shoulder girdle to my opportunities may help out, but I haven’t seen many shoulder and/or humerus exams performed during my previous clinical days.  What I see the most of that I can’t pre-comp yet is C-spine, T-spine, and L-spine exams.  We start the spinal series in January.  We’ll finish this semester with the lower limb and pelvis.  Pray for pre-comp opportunities for me tomorrow! 

Tags: 1st Semester, RAD-110 by John Setzler
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My written test in my positioning class today was a disaster.  I spent a lot of time studying for it, but apparently it wasn’t enough.  I made an 84, which is my lowest grade of the semester in any of my classes.  After taking the test, I realized that my study approach was simply not the right one, so this mistake won’t happen again.  I’ll be much better prepared for my next test.  I’m simply not good at memorizing long lists of information, which is what I really needed to do for this test.  All of the shoulder girdle positions, including the alternate and obscure, were included on this test, and I needed to know everything from patient position and central ray angulation to what the resulting radiographs look like.  I’ll do better next time…

In the RAD-110 class, we started discussing “MedicoLegal” talk.  We covered things like assault and battery and slander and libel.  Healthcare facilities and the people who work in the industry are too often targets of lawsuits, so being aware of proper procedure is very important.  If you aren’t familiar with “Res Ipsa Loquitur” you might want to look it up…  This is where innocent until proven guilty doesn’t necessarily apply…

Tags: 1st Semester, RAD-110, RAD-111 by John Setzler
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We had a test in RAD-110 (Patient Care & Intro to RAD) this morning.  The good thing is that I was, once again, over-prepared.  I don’t know my grade yet, but I’m confident that I made an A. 

Tomorrow is my last day of clinical at my current location.  We’re having our mid-semester conferences to find out how our instructors think we are progressing and review that information.  I hope to get my chest master comp done tomorrow if the opportunity arises, but we’ll just have to see how that goes.  I may or may not get a chest opportunity tomorrow before the end of my clinical day at 11:30am. 

I have 3 tests next week.  The first test will be the written test for my current unit in positioning.  That same day, we’ll be tested on positioning of the fingers, hand, wrist, forearm, and elbow.  This test will open up a new group of competencies that I can work on in clinical.  The third test will be a lab test in the patient care and intro to RAD class.  It’s gonna be a busy week…

Tags: 1st Semester, Clinical, RAD-110 by John Setzler
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Did you know that a walrus has a penis bone that is about 2 feet long?  I didn’t either, but I do now.  Just don’t ask how… lol…

Today, we spent some time in lab learning how to record patient vital signs.  We looked at several different types of thermometers, stethoscopes, and sphygmomanometers.  We also learned to count respirations while taking a patient’s pulse.  When people know you are watching them breathe, they aren’t likely to breathe normally.  For some reason, I felt a little intimidated about getting blood pressure readings.  I guess it’s just because I had never done it and didn’t know how.  I was amazed at how simple it is.  I feel like I learned something important today :)

We also practiced moving completely immobile patients from wheelchairs and stretchers onto the x-ray table.  Maybe it’s just me, but that process seems simpler than assisting partially immobile people.  Moving dead weight is a job for at least two people instead of just one.  Maybe that’s why it didn’t seem so difficult.

I’m off to clinical again in the morning and I really hope to get some chest and abdomen pre-comps knocked out…

Tags: 1st Semester, RAD-110 by John Setzler
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I had to photograph an extreme paintball event Saturday morning for the newspaper if you are wondering what sort of strange photo this is :)

As I mentioned last Wednesday, one of my instructors was absent from class and lab that day.  He returned today and had our tests that we took two weeks ago in his hand.  I’m happy to report that I made a 101 out of a possible 104 on that test.  I’m happy about that!  He was out last Wednesday though, and all of us were there at 10am just to find a note on the door that we wouldn’t be having class.  After he gave us our tests back, he dropped the bad news on us.  We have to arrive at class 15 minutes early for the next four class periods to make up that time that he missed… lol… We were THERE!  I thought it was a little obnoxious that he would ask us to do that, but I suppose it will help him maintain his schedule, and since he’s the Radiography department head, we really don’t want to piss him off :) 

In our positioning class, we started looking at the upper limb stuff today.  We didn’t get much above the wrist though.  We talked about every bone in the wrist and hand, starting with the carpals and working our way out to the distal phalanges.  Since there are 27 bones in the hand and wrist, there isn’t much left in the upper limb!  I guess the radius, ulna, and humerus are all that we have left until we hit the shoulder. 

I can’t be too sure about this until after my lab tomorrow, but I have a feeling that the positioning for the upper limb are gonna be rather simple.  I’ll report back on that tomorrow after we get started on them in lab…

Tags: 1st Semester, RAD-110, RAD-111 by John Setzler
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My Radiographic Procedures test today was not what I had hoped it to be.  I thought I was properly prepared for it, but it just wasn’t the case.  I’m going to have to find a different way to prepare myself for the next test I suppose.  I made an 89 on this test, which is lower than I’m happy with.  My grades in this class so far are 96, 91, and 89, which is a 92 average… just below the A mark.  Maybe I shouldn’t worry so much about a 4.0 GPA.  I have worked hard up to this point though, and that mark is sort of important to me.  I don’t know if it’s a realistic goal in this program, but I don’t guess there is anything wrong with trying.  As we start the new unit on Monday, I’m going to make some changes in the way I prepare myself for the tests.  I’m not exactly sure what that will be yet, but we’ll see how it goes. 

Everyone in the class thought the test was harder than we expected, so I’m not the only one.  When we reviewed the test, there was only one mistake on my part.  I knew the answer to the question and I filled in the wrong block on the scantron form.  I argued my way out of one wrong answer and the entire class got credit for it if they chose the same incorrect answer I did.  Here’s that question:

What is the BEST way to minimize the possibility of voluntary motion appearing in a KUB?

Two of the answers choices were obviously incorrect, but there were two that were correct.  I chose “reduce the length of the exposure to a minimum.”  The correct was to instruct the patient on proper breathing technique.  Our studies have included a good bit of material on increased mAs settings to reduce the length of the exposure for the purpose of minimizing motion, so she gave us credit if we chose that answer.  Whether the motion be voluntary or involuntary, a minimal exposure time would certainly reduce the chances of the motion creating problems in the image. 

One of our instructors was absent today, so we didn’t have the Rad Intro / Patient Care class or lab today…

Tags: 1st Semester, RAD-110 by John Setzler
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Today’s lecture spent some time discussing the roadmap for radiographers.  We talked about licensure, certification, and accreditations.  North Carolina is one of the remaining states that doesn’t require a specific licensure for radiographers.  Most healthcare facilities in this state do, however, require the ARRT registration, or that the tech be actively pursuing that registration within a fixed timeframe.  We also spent some time discussing extended paths of education beyond the associate degree in radiographic technology.  There are several programs available which offer a path to a bachelor’s degree in radiography, and some of them are available as online programs that can be made to fit into a working schedule.  We were also introduced to the ASRT and NCSRT organizations and recommended to become student members of both.  We didn’t get our test results from Monday today, but we were assured we would get those back this coming Monday.  I’m sure I did fine on it, but I wanna see the number :)  Our entire lab for this class was spent practicing chest and abdominal exams again, so I believe everyone is comfortable with this and ready for the testing.

In our positioning class today, we reviewed for the test we have coming on Tuesday.  We have also moved the lab test up one day, so both of those tests will happen on Tuesday now.  I’m ready to get that first lab test completed so I can start working on the competency tests for those procedures. 

I have to get started studying for Tuesday’s test tonight…

Tags: 1st Semester, RAD-110, RAD-111 by John Setzler
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