I Rock the OR

Week of: 2007-07-16

Abstract: An amazing first week in the OR passes in a flash. I get paid as technologist for the first time.

Mood: Somewhat tired but optimistic

What went well: I rocked in the OR. I did many cases solo.

What needs work: Speed with turning equipment over after cases. Changing the views in the rooms.

Disclaimer: Some descriptions of cases are graphic in nature and not suitable for all audiences.

Elucidation: I've had a delightful week in the OR. Something just clicked for me: I'm doing exams on my own. Crazy Uncle, the OR lead tech remarked to the visiting instructor of my program how I just go out and grab a req off the board and do it from start to finish. And how he can throw me into a room with the expectation that I will pick up where the previous tech left off. As I left on Friday, I remarked to a group of techs, “Thanks for helping me feel so successful.” One of them said, “You're doing exams on your own. Keep up the good work.” I feel so lucky to be in this program.

On Monday I did a procedure where involving a patient who's epidermis had been completely pulled away from the underlying tissue of his hand. This is called degloving. In this case, his hand had received the blunt force of a falling cinder block, sufficient to pull the skin away from the muscle, tendinous, connective, nervous, and osseous tissue of the hand.

I watched as they flushed his hand which was missing a couple of fingers. This was a difficult exam to see. But if I do say so, I maintained a clinical attitude of professionalism throughout. As one tech said, “Humpy Dumpty.” Meaning the docs would put the hand back together bit by bit. At the same time I felt my heart swell not in resonance of the pain, but in expression of kindness: seeing the true nature of the individual as a whole healthy person, seeing the person well.

I also so a degloved leg procedure. This one was more interesting, again the epidermis had been completely pulled free from an areas stretching from mid-thigh to mid tib-fib. The dermal tissue had been completely destroyed. There were muscle groups hanging loosely from a bloody mess. They had put in antibiotic beads to assist in fighting infection. To close, I'm sure they used grafted tissue to surround the enormous wound.

During my first two terms, the lead tech tried to shield us from such extreme cases. I appreciated that. I'm telling you this because this is my blog. Yo. I've kinda snuck into the last one. I need to let Crazy Uncle know that I'm sufficiently hardened to observe this type of case. I don't resonate with the pain or the injury, I resonate with viewing the patient as healthy and whole as the process I'm participating in. I see myself as a participating member of the team, headed my the physician, bring the pt back to health.

There's a counterpart program to my program that is across the State from us. They live an area of the state with a farm based economy and low population density compared to ours. We've been sharing our classes with then via internet link as I'm sure I mentioned earlier.

They've been visiting our sites this week. It was a wonderful experience because I was able to demonstrate my knowledge of the C-arm: the controls, sending images to PACS, how you line up the C-arm to the axial line of the part. If the pt is rolled up so the affected part is higher, you might need to incorporate multiple angles to achieve an AP and Lateral to adjust to the rotation of the pt, to explaining how increasing kilovoltage increases apparent brightness of an image. It was fun to meet these students.

I participated in a couple of Cystography exams. this week. One included lithotripsy and associated basketing of the stones. It was interesting following the scope up the ureters to the kidneys. Also of interest was viewing the scope feed on an LCD monitor next to the spot films of the c-arm.

For my part, it was very simple: follow the scope from the bladder to the right kidney, then from the bladder to the left kidney, as they flushed contrast into the renal tissue providing shape of those structures. They inserted a basket through the ureters to grab the stones broken up by the lithotripsy. It was wonderful to do the procedure solo all the way through. And I liked the feeling of being an integral part of the OR: providing diagnostic images for the physicians.

I worked my first paid shift as a Imaging Technologist Trainee on Saturday. I did at least six CXR portables today solo. I enjoy ports. I think there's something very calming about walking the corridors of a big county hospital as portable machine rolls noisily along. Even though I've been at the same hospital for a year I haven't spent a day doing them. It helps in learning the layout of the floors.

I like when patients talk back or ask me questions. One woman asked about the large body of water she saw from the sixth floor window. I went from floor to floor, introducing my self to nurses. I suggest playing nice with nurses; they're there to help the patient and by extension the technologist.

There were a lot of trauma cases. Nothing really to write about. Except for one fellow who was brought in from a high-speed motorcycle wreck. In a situation like this you do about 50 images. We worked quickly. But multiples take time.

Goals for next week:

Pick up prescision in lining up the C-arm with the affected body part.

Start, work and finish an ankle case.

Pick up my overall speed.