How my clinical went and other questions from a newbie

Sparky · Joined: 03 Feb 2009 Posts: 4

I need a chest radiograph pointing out all the structures in the chest / abdomen.

It would also be great if I could see radiographs that were exposed
incorrectly with an explnation with what was wrong with the image.

With emphasis on abdomen (KUB), and chest.

Furthermore, how can you tell by looking at a radiograph if it is Supine, prone, erect, recumbent, etc.

If anybody could hep me with any of this, I would be grateful. My books
show some structures, but it doesn't really explain how I know for sure if this is this and that is that. (if that makes any sense)

P.S. I tried the PA Chest by myself in clinical and I bombed. I wasn't for a grade, but I wanted to see if I could do it. I felt so uncomfortable. My mind went blank after I got her to face the bucky. I also forgot to put my markers on, and I couldn't line up the tube correctly.

I think that is what I have the most trouble with (lining up the bucky with the Central Ray, while also projecting the beam at T-7, T-8. ) It feels like rubbing your head and patting your stomach at the same time. I'm like, do I move the Central Ray, do I move the patient, do I move the bucky... what ends up happening is that I FREEZE / PANIC and start fiddling with the controls on the machine. Not only that, but I forgot to scan my image receptor. I put an IR in the bucky that wasn't even scanned! I don't think I could have messed up any worse.

The techs were very nice to me this time, but they still go so fast. They scan everything like boop, boop, bleep, bleep, ok... that's done, that's done, and that's a wrap. By the time they are finished I am still trying to figure out where my markers went. or I'm trying to get my gloves on, or I'm rehearsing my patient history. I know the patients that the patients know that I am rattled / confused, etc. That doesn't help my confidence.

I want to do good, I really do. At my clinical, I wish that I could have had time to rehearse each step before the patient came into the room. But, the dept. didn't have time for that. There was a patient coming in and out every 15 minutes.

I saw some crazy stuff too, which I am not going to repeat because of HIPPA. It kind of freaked me out, but, I think with time I could get used to it. The physical labor is at an all time high in this profession too, I've noticed. A couple of times I forgot proper body mechanics. My back was hurting for three days.

So far I am doing good in school. This program is hard. Real hard. I have a lot of respect for radiologic technologists. I kind of feel like I'm training to become a navy seal. This program crams so much stuff into a itty bitty time frame. By the time sort of grasped one procedure, they are embarking on another.

I have also found that I am all of a sudden deeply religious. I pray to God every night that I can make it through this. I'm a really good prayer.

Well, I have procrastinated way to much with this message. I must keep trucking on.

Thanks for everybody's support, and hopefully I can hold on.

~ Sparky
_________________
~first semester Rad Tech Student~

papa · Posted: Mon Feb 16, 2009 12:29 pm Post subject:

sparky, sparky, sparky....

RELAX!!! it'll come to you. everybody goes through the first film jitters. it's normal, and it will go away. my biggest thing was just pushing the button. just knowing that i was about to do something to someone that has the overall potential of hurting them...... it just freaked me out. that's what's happening to you now.

the incorrect films you're looking for? ask your professor or clinical instructor when they will be doing their "repeat film analysis". that's exactly what they do during one of those. they'll put a bunch of films on the viewboxes, and go over why that particular film was repeated.

your supine / erect question, since we don't answer homework questions for students, i'll give you a hint. think about air/fluid levels.

and here's a solution for your pa chest issues:

patient walks up to buckey
patient pushes shoulders foward
find the bottom edge corner of their scapula
center your tube between scapula at that level (move the tube)
use the spine to help center you left and right (move the parient)
center the buckey up and down (move the buckey)

just think to yourself
scapula ... tube.... spine .... buckey

you'll get it. don't worry, you'll get it
_________________
Mr. Green

papa RT(R)(CT) Mr. Green

Delusional Radiology
never meddle in the affairs of a dragon, for you are crunchy, and taste good with ketchup

mrigirl25 · Joined: 21 Feb 2009 Posts: 9

Just relax, you are not alone, when I went to school I was the same exact way. I failed my first comp on a KUB because I did not line up the tube with the bucky, but you will get it.
You can tell the orientation of upright vs supine by the bowel gas patterns. Gas and air rises up and fluid sinks. So you can see pneumonia for example on the chest xrays in the base of the lungs. I have to think back, I do MR now and havent done an X-ray in about 5 years. I really miss it. You are going to love this profession, there is so much versitality with it. X-ray is really a stepping stone for you to go wherever you decide in imaging. You will get better at reading these films for bowel obstructions. There is a really good book that I got when I was going to school and it is called Felson's Principles of Chest Roentgenology. I had it when I was in the Radiologist Assistant program and don't need it any longer. If you would like it send me your home address and I will mail it off to you. It has exactly what you are talking about. Air/fluid, what to look at, normal vs abnormal. What central lines look like for ER settings, Great book. A radiologist suggested that it would help me and it did. It is an interactive book so you can answer questions etc. Just give it time and don't worry, it will come. Yes it is hard, I don't think people give RT's the credit. We are technologists because we are educated.