Week One

Week One was good; two days of mandatory (pronounced mandAtery by one of the speakers) training, most of which was useful and necessary, although I’m not quite sure why we were addressed by the chaplaincy and not the resus team. I suppose the resus team were busy training people on how to save lives. I discovered during these induction days that I won’t have a proper uniform for at least 3 weeks, so it’s lucky I didn’t ceremoniously burn my student tunics in May.

I asked the IT governance person if there was a specific social media policy, but she didn’t know (!) so I’ll just try to maintain anonymity as much as possible for myself, my colleagues, and most importantly, my patients. To this end, I have renamed my employer King Trogdor’s NHS Trust, or Trogdor’s for brevity. If you know me in meatspace I would therefore ask kindly that you respect my anonymity lest I burninate your village.

So on Wednesday I was finally allowed in the department. Apparently for a while I’m going to be supernumerary (sounds nicer than “surplus to requirements”) so I’ll be shadowing people in each area til I’m adequately trained. The thing is though, everyone there seems so approachable and lovely that I doubt I’d feel unable to ask for help at any point, which is nice. The atmosphere is completely different to anything I experienced whilst on placement, and I can’t help but make comparisons as I’ve got very limited experience of working in a diagnostic imaging department.

So another comparison I can’t not make is to the equipment. Quite frankly, up until now I have been spoiled by DR systems (I’ve written a post about equipment here for non-rads) as that’s pretty much all I’ve used. Both placement sites were fully DR (including mobile equipment!) and one was even completely paperless so we didn’t even get the physical referral forms. Trogdor’s is all CR with the exception of the resus kit. This, I’ll admit, scared the crap out of me at first. The main difference for me, is that when you’re performing a difficult examination (or when you have a difficult patient) using DR equipment, repeat images are really really easy to correct.

Say you’re doing a Y-view shoulder, and after the first exposure it turns out the patient is over-rotated, you can see both the image and the patient in front of you, so you move them slightly, retake, job done. Your eyes are on them the whole time. With my current CR situation, you take the first exposure, remove the CR cassette and exit the room (leaving the patient alone) to process it. Need to move them 10 degrees? You’ll either need a photographic memory or a patient who is able to follow instructions and stay still.

I did one on Friday, and the patient was obviously in pain, so when I returned to the room to repeat the Y-view she had sat down on the other side of the room, not that I could blame her. She had fallen earlier in the week and developed a decent bruise on her upper arm; she didn’t think anything of it at the time, but the pain was keeping her awake so she went to her GP who sent her to us for imaging. She was fairly mobile and able to rotate her arm well, so I didn’t expect to see any pathology, but after staring at the axial image for a few minutes I noticed a line through the anatomical neck of the humerus. This was my first “red dot” here so I was a bit pleased with myself I’ll admit, and as there were plenty of staff around I took the patient round to A&E myself so I could see what the standard procedure was for these cases.

So the first week has definitely consisted of a steep learning curve, but not an insurmountable one, and things will no doubt become easier with time. And now I’m one week closer to pay day, which is (unfortunately) as much of a big deal to me.

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