Still Nervous about PA CHEST

robertrays · Joined: 08 Feb 2009 Posts: 2

Yes, that is how you introduce yourself. With a pleasant smile. Treating each patient like a person pays big dividends; I had a patient who was in enormous pain, yet still expressed sympathy for my student struggles my first week of rotations, and wished me luck thereafter. Treat them as you'd want to be treated, or, perhaps better, as you'd want your mother treated -- best, as you'd want the dean of your school's mother treated! -- a notion which seems to escape many professionals. Don't offer medical opinions, but sympathy is not unwelcome, while you're setting up (saving time). I've had many patients smile, thank me, shake my hand, wish me a GREAT day; and I'm not an especially charismatic person.

Have patient say name and date of birth while you eyeball the armband.

Interview questions in S.A.M.P.L.E. format -- Signs/Symptoms; Allergies; Medications; Past medical history; Last oral intake; Events leading up to this episode or appearance at your facility.

Reduce your odds of forgetting things by watching while an experienced person does it. Write a checklist for yourself if you have to, and don't pull the trigger or dismiss the patient until everything is checked.

Dismiss the patient pleasantly, with some mention of when they may expect results to reach their physician, if you know it. Tell them to take care, or something encouraging, so they don't feel like rejects from an army physical.

As you load your cassette or position the patient, tell them what you're going to tell them: "When I step over there, I'll ask you to take a deep breath, then let it out, then take another deep breath and HOLD IT, then I'll take the x-ray, OK?" Then do so. (And don't forget to have them roll shoulders forward.)

Relax and enjoy. You WILL get there.

RobertRays

robertrays · Joined: 08 Feb 2009 Posts: 2

By "ecnouraging", I don't mean give them false hope -- I mean, don't dismiss them like lab rats. They're people.

RobertRays

wvaio · Joined: 22 Sep 2007 Posts: 82

You must develop a routine. A "speech". It takes time and practice to develop, but it can be very beneficial. I will try to articulate my "speech" to give you an idea.

As soon as you address the person by their name, introduce yourself.

you:"Mr. Jones"
pt: "Thats me"
you: "Good morning, sir. My name is Johnny, I will be performing your X-rays today."
pt: "hello"
you: "Can you verify your name and date of birth for me?"
Pt: "Jerry Jones, Aug. 17th 1965"
you: "Mr. Jones, what brings you in today?"
pt: "My wife's car. Its parked out front"
you: "What kind of problems are you having?Are you having any difficulty breathing or chest pain"
pt: "Yeah I have been a little short of breath"
you:"for about how long?"
pt.:"about a week"
you:"any other problems recently?"
pt: " I pulled a muscle in my leg the other day cutting the grass"
you:"Ok sir, I am going to have you face toward this board and place your chest against it. Arms out. Roll your shoulders forward. Now hold very still."
**Walk behind the control panel**
you: "If you would sir, please take in a deep breath. Blow it all the way out. Take in another deep breath. Hold your breath."
**Expose**
you: "Breathe"
While walking toward the bucky slowly say " If you would, please turn to face toward me." At the point you say "me" you should be at the bucky, so that they can turn to face you for the lateral.
Change cassette.

you: "I am going to have you put both arms straight up in the air and take a step toward your left" If necessary..."take a baby step forward".

Run behind console.
you:"Take in a deep breath. Blow it all the way out. Take in another deep breath. Hold your breath."
***expose***
You:"Breathe. You can relax."
Walk out towards patient
you:" If you would, please have a seat in the chair right there. It will take me a couple minutes to process these images and ensure that we do not need additional images. I will be right back"
Take your cassettes and process them. If all is well go back to room
you:" We have all of the images that the doctor needs. The radiologist will take a look at them and the results will be faxed to your doctors office in about 48 hours. Do you have any other test to get today?
pt: "No"
you: " Ok. You have a good day sir. The way you came in is that way."

Speak loudly but not quite a shout when behind the console. Act as though you have been doing it for 100 years. Never give off the vibe that you are unsure. Take your time, but don't over-think it. Practice will result in competence.

Wvaio

papa · Posted: Fri Feb 13, 2009 10:58 am Post subject:

wvaio -- you missed something Wink

---- shielding -----

Sparky--

for as many people that are here at radiologyforums.com, there will be at least twice as many correct ways to perform your Chest films. as far as what your routine is? that's up to you. be yourself. there is no right or wrong way to do it, as long as you are polite and profesional.

in the 9, almost 10 years i've been in this wonderful field, i've found that everybody has their own way of doing things. they find what works for them. just find what's comfortable for you. don't worry, it'll come.
_________________
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

wvaio · Joined: 22 Sep 2007 Posts: 82

I stand corrected..

Addendum: Shield patient Very Happy

Wvaio

hjhogle · Posted: Fri Feb 13, 2009 7:02 pm Post subject:

Wvaio ~ don't feel bad, feel honored.

Your answers are so thorough and engaging (and they rival papa for length!) that you've made yourself a target.

And that's a great thing Wink

hjh, RT

papa · Posted: Fri Feb 13, 2009 11:53 pm Post subject:

but hey, it's good to be a target here Wink

i've got to keep up on my posts or else wvaio will be the new papa
_________________
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

wvaio · Joined: 22 Sep 2007 Posts: 82

I'm workin on it. This is a great forum, and I enjoy the ability to share what I have learned to better the field. It's also great practice because I plan to teach in the future.

I'm honored to be in the same sentence as papa...
Wvaio Smile

mrigirl25 · Joined: 21 Feb 2009 Posts: 9

Hey Sparky,

Just be you. As long as you have the order and it is the correct patient, go for it, you don't have to go into details with them and their life but just be courteous and mabey do a mock exam with a makebelieve patient.

I used to have a friend be the patient, I know it is nerve racking but the more you do it the more comfortable you will be. You will develop your own method and you will be great!