Sunday, February 25, 2007

My First OR Rotation: Week 1

Week of: 02-19-2007

I begin my OR rotation

Cheerful, calm & quiet

What went well: I integrated many of the dynamics of the OR.

What needs work: There's still a lot to learn. Strong personalities in the department.

Imagine your favorite crazy uncle who always is cracking jokes and you have a good picture of the lead tech in the OR. He's a real hellion but a lot of fun. His first words Tuesday were, “Why don't you go to the cafeteria to get some breakfast.” Which certainly sounds tame enough. I won't describe the other things he said, yet.

My first day in OR rotation started with a feeling of trepidation. I often get the jitters during any activity that is new. What makes it different of course is that the area around and between tables is considered sterile.

It's critically important that no one other than the scrub nurse/tech and docs touch the area. I've always been some what spatially challenged. Case in point was my short football career in high school: unmitigated disaster. I've improved in this regard since my ungainly years as a youth.

So what happened? I nearly touched the field twice in one 30 second period. The tech, a woman, pulled me by my scrubs and whispered sharply, “NEVER TURN YOUR BACK TO THE STERILE FIELD.” Wow. On Thursday, the lead tech (Crazy uncle) said something similar when we walked to a room. “If you touch the sterile field your ass is grass.” He needn't have said this.

But you know it worked. From then on I'd look in the window of the suite to assess the position and best approach to bring the equipment in.

The first tech was an encyclopedia. She explained just about everything she did during a capitulum reconstruction. She talked about the controls of the C-arm, technical factors, and who all the personnel involved were.

I found it all fascinating to say the least. Looking into an open abdomen for example, really leaves a mark on a young tech. I saw a surgeon draw a strand of the tricep upward during the capitulum reconstruction.

But I must say it brought me pleasure at the end of my shift on Thursday when the lead tech said, “You did a good job today.” I smiled. I'm smiling now.

Goals for next week:

It's all very basic for now:
Just get in to the rooms and watch, observe and take notes.

Monday, February 19, 2007

No More Moaning, Well...

Week of: 02/12/2007

Abstract: My three weeks in ortho ends. I begin surgery rotation for the first time this week.

Mood: Apprehensive yet optimistic

What went well: I did well in my classroom exams. Clinical was enjoyable.

What needs work: Same as last week


Well I'm through being hard on myself. I will continue to assertive but balance that with acceptance. I'm doing the best I can and I sticking with it. What does that mean?

I got two comps last week and I'm okay with that number. I'm not going to jump down my own throat when I do badly in an exam. I'm going to chalk it up as a learning experience. Note that I not taking about negligence. I plan to get in and get out. I do like to interact with the patients if possible but not to the point of distraction.

That's one thing different about OR. No patients to chat with. I'm a newbie in the department, so I'm a little nervous. Well I'm gonna be brief and wish you all a fantastic week!

Goals for next week:

Use initiative. Get into OR Rooms and observe.

Take notes of the procedures.

Sunday, February 11, 2007

It's the Quality Not the Quantity

Week of: 2007-02-08

Abstract: Things are progressing much the same...

Mood: Uninspired, overworked, grouchy

What went well:
I internalized much of the new material and brought it to clinical

What needs work:
I need to do more mock work. Get into the labs.

No fun. Well, not exactly. I finished up my second week in ortho with only two comps. My feeling about the situation is that it's quality not the quantity that counts. The education coordinator said much the same. “You need to act like a sponge. Gain all you can from the techs.”

Class room work is somewhat overwhelming, which is okay. I just need to buckle down. I just would like more time. Blah. We've begun our second unit on spines which I'm really excited about. It's not an understatement to say that I've been waiting two years to get into this stuff.

I love the people. Which is nice to be able to say since the medical field is all about people. I think my patients sense that vibe on some level. I enjoy interacting with techs and fellow students. I find I enjoy my interactions with the docs too.

Goals for next week:
Get several comps in ortho.
Get into the labs at school.
Get some counseling on campus regarding anxiety.

Friday, February 02, 2007

More Self-Indulgent Blather

Week of: 01/29/2007

Abstract: I begin my ortho rotation; Five major assessments in seven days.

Mood: Quiet - introspective

What went well: I received an excellent grade on one of my exams and did well on others. I felt more at ease with my skills in clinical.

What needs work: I need to improve my organization before each exam: reduce retakes.

Elucidation: As I write this I'm studying for a Positioning and Related Anatomy exam slated to occur on Monday. First, before I continue I want to say, I know how lucky I am to be where I am, doing what I doing.

But golly, five big tests in seven days? It makes you wonder why the instructors couldn't get together a spread sheet calendar to show how the exams overlap. Grrrrr. Okay, now that I said it. Was it tough? You bet: I studied and worked and studied and worked some more. Everyone said the first Fall quarter is the toughest. We're taking ten didactic credits – in addition to being in clinical fifteen hours a week.

This week in ortho was fun. Although I had some family issues that provided heavy distraction, I pulled through with four comps: hand, pelvis etc. More importantly, I had a positive experience. The lead tech in orhto is very good with students. He challenges us within our abilities. For example, before assigning us an exam he'll say, which part of this exam do you feel comfortable trying to comp? I'm usually eager to do all of the projections, but I always want supervision, that is, until I double comp each one.

The problem is such supervision isn't always available. On a busy day, the techs are running around. I began a Os Calsis exam with out my usual routine to getting organized before beginning. I don't mean I didn't flash the proper size cassettes and think about technical factors, (mAs, kvp, sid, and collimation,) and positioning criteria. I did. I just didn't stop and put it all together mentally. Through this failure, I was able to see what is called for. Slow down, don't try to be a seasoned technologist after your first semester. Try to increase your speed at the things you feel confident.

Radiography is hard to learn. It's like riding a bike for the first time, while talking on the cell phone, and reading a newspaper. Don't believe me? The tech must take into consideration the girth of the pt, how rad (hot) the room is, how dense the tissue being imaged is, how much to collimate, how all the factors affect density and contrast, what is the CR angle in relationship to the IR, how will the source image distance produce a diagnostic image, what is the physician really requesting, ensure that the right pt and part are being imaged, & how does pt history affect the current exam? I could go on and fill a page, but that would be tedious.

I must somehow keep all those things organized in my mind before the exam. I don't want to appear hesitant with the patient. How do I do that? By being a sponge: asking the tech questions, imitating my role models, referring to my notes and taking notes in clinical, practicing in the lab at school. Doing everything with defined intention and attention. In short, increasing my confidence by acting like a good tech; one who pursues knowledge and skill in order to improve steadily.

Goals for next week:

Since I dropped two comps last week, I'm setting the goal to eight comps this week.
Work on all my interactions with patients, staff and fellow students.