Sink or Swim?

Would you ever throw your child into a lake without a life preserver? I think that's the way we often treat new technologists. Sink or swim. Do or die. Baptism by fire. Send her to the ER by herself and leave her until she either quits or begs for help. Then when she does ask for help, humiliate her by telling her that maybe she's not "cut out" for this kind of work. Far fetched? Believe me when I tell you this happens where I work. It seems like they want to see you fail instead of succeed.

And then there's the OR. Every hospital has one or two surgeons that seem to take out their frustrations on the circulating nurse, the OR tech or the x-ray tech. After working in x-ray for fifteen years, there are still occasions I am subjected to verbal abuse by a surgeon. This happened again recently and this time I took my complaint as far as it would go. Now, a month later I still don't know what was done about it or if anything will change. Where's the support from management?

I've seen so many good people bail out of x-ray because of both these issues. Why? What happened to helping each other, team building and moral support? It's no wonder that techs get so hardened and end up hating their work. There's the attitude that "I had to pay my dues (I got screwed) and so do the new people." Now then, would you throw a poor swimmer into a lake and hope they'd make it back to shore? Or would you throw them a line?

Grand Tour

I gave a tour through the hospital for all the new radiography students the other day. I first took them down to the huge x-ray archives in the basement. Of course it's locked, which brings to mind the increased importance of patient privacy laws. The archives are also thinning down as each year passes since we went to PACS. This shows real change made by our use of technology. But the fact that struck me was how the x-rays that we take are part of a patient's record and in some cases (legal, for example) are not "ever" destroyed. An x-ray that you took several years ago may be pulled for reinterpretation. Your best and worst work doesn't really disappear after they are first read by a radiologist. I'm not sure if the typical seventh year (now they are purging 1999) will be applied to PACS. What do you think?

CAUTION: TECHNOLOGY TRENDS

A cautionary tale about buying merchandise from a website… I ordered a video camera from Fotoconnection.com and three days later, instead of receiving the camera, I got a call from an aggressive and obnoxious salesman who made me suspicious of this company. When I got off the long phone call with this individual who didn’t know the meaning of “No, I only want the camera”, I googled them – and went to a website that rated online electronics retailers. On a scale of one to five they got only ones from dozens of unhappy customers with similar stories and worse—not receiving the merchandise promised. Immediately, I called Fotoconnection back to cancel my order. They refused to cancel it, even though the camera had not yet been shipped! Now I am in the process of disputing the hefty charge through my credit card company. I should have checked this company out first! Ultimately, I purchased the camera from a well known retailer with a website—no problems. As a side note, I discovered that this camera and so many others are not available in stores. I’m passing this on to those in Radiology because so many of us have to keep up with the technology at work and school. Our “hobbies” like photography can be an enjoyable way to help us stay current.

What I Learned

What I learned from writing a book:
1) How inexact my knowledge was of the things I saw every day in the ER or the OR, like the names of drugs, medical conditions or equipment
2) That writing is a very inexpensive hobby—maybe the cheapest of all!
3) That writing helps your thinking—it’s entertaining, adds to your vocabulary and brings situations into focus
4) It can broaden your knowledge of current events and technology
5) That if going to write a book you better write something that you enjoy reading because you’re going to read it at least five times.
6) Find someone to help you (P.S. thanks to Carolyn and Yonathan)
7) And that it feels really good when you know that you’ve done the very best you could

How to talk to your Clinical Instructor

1) Ask only one question at a time. Listen for the complete answer before jumping to the next.

2) Try not to preface your question too much with things like “I always thought that…” Get to the point.

3) Wait to ask a question when the individual really is able to answer it. Consider timing.

4) Speak up! Make eye contact. Stay in one place.

By the way, there’s so much knowledge and experience that doctors and nurses have. I continue to ask them questions myself. Hope you do too. Good Luck, Tim.

Don't Forget Your History

A radiologist called into a radio show I was listening to. He expressed concern over the limited history information he would get before he had to dictate an exam. Whether it be an MR, CT, sonogram or radiographs, he implied that technologists need to do more at pinpointing patient symptoms while in the exam room. Sometimes, he said, that’s all the radiologist will have to work with.

The guest on the show (not the caller) was Dr. Jay Grupman (sp?). He talked about his new book How Doctors Think. I haven’t read it, but from the interview, it sounds interesting. He focused on what a patient should do when symptoms don’t go away and he referred to a sort of cascading diagnosis that sometimes happens as people latch on to a diagnosis too soon. This can happen very quickly in an emergency room setting when everyone is in a rush with a lot of distractions.

I have a list of pertinent histories that are appropriate for chest x-rays, abdomen series etc. I show these to the x-ray students. I have to admit, however, that when I got this list from the radiologists, it seemed to me the emphasis was on coding and reimbursement rather than on narrowing down a patient’s condition. Now I try to place emphasis on just communicating with the patient to find out exactly what they’re problem is. Maybe chest pain is a little vague? And how long have they been S.O.B.?

Art and Artifact

My book is now available through LULU.COM, Amazon.com and Borders, ($12.99) just go to http://www.lulu.com and search by my name "Timothy Kerr" or "Art & Artifact" and your copy will be mailed to you. Read on.

Behind the lead-lined doors of the Radiology Department of All Saints Hospital, most x-ray technologists toil to provide the best possible patient care and patient imaging. Most, that is, but not all.

Coming from half a world away, Tesfaye Ababa feels every mile of it while he strives to fit in. But fitting in becomes secondary to just getting through a workday as a new x-ray tech. From impatient surgeons to hysterical patients, each day brings new challenges.

Follow Tesfaye through the chaotic corridors of All Saints Emergency Department during a crisis that strains everyone’s capabilities – but especially the Radiology staff.

Look over Tesfaye’s shoulders as he positions patients, reveals anatomy and uncovers secret CT scans. Now he faces questions more ancient than his homeland of Ethiopia. When do you accept what goes on around you? When do you simply walk away? And when do you do all that you can to stop the mistreatment of others?