Sunday, November 04, 2007

My Children's Rotation

Weeks of: 2007-10-21, 2007-10-28

Abstract: My rotation through a Children's Facility

Mood: Happy

What went well: I learned a lot by observation

What needs work: Assertiveness

Elucidation: The last two weeks have been a mixed bag of my usual clinical site and the children's facility I rotated through. One day I worked in fluoro with pediatric patients. It was difficult because toilet trained children take great exception to having a catheter inserted. The VCUG (voiding cystourethrogram,) a common pediatric fluoro exam done to test for urethral reflux, has got to be one of the more challenging because of patient reaction. It wasn't the most fun I've ever had at clinical. But I learned a lot.

The tech I was with had strong skills in calming the patient and alieviating their concerns. She was successful for the most part in explaining the exam in a way that a child could understand. It's possible to over prepare a patient though.

It's often helpful to give patient and the family a pamphlet explaining the procedure. For adults this can be good because many will imagine the worst. But I can say for one eight year child, reading the pamphlet again and again caused her great duress. She was almost airborne at certain points, trying to buck off the table. Eventually she was calmed down and the contrast administered.

I can honestly say I would think long and hard before accepting a position in fluoro with pediatric patients. I love children. I have many nieces and nephews. In medical it's hard to listen to child's scream for minutes on end. The pain of child is hard to wittiness.

Another day I worked in the children's ortho clinic. It was a good experience and a reprieve after fluoro. An eleven month infant was positioned for a tib-fib and a toddler for bone length study. It was good to learn some positioning skills. You can throw out much of your ideas with adults; it's quite different. You can't position a toddler the same way you'd position an 11 year old.

The total rotation was three days. It wasn't sufficient length to start comping. I did a lot of observation which really isn't how I learn. I do best by doing.

The hospital had a lot of modern equipment. Everything is computerized and uses direct radiography. I like the visceral sense of placing a cassette into a reader is gone. But the processing time is very fast.

Back at my hospital I received two instances of feedback. After a myelogram (spine x-ray with contrast) the patient said, “Thank you for your compassion. You have an excellent team.” That felt nice as I conveyed it to the staff. I comped an arthrogram (joint x-ray with contrast.)

My clinical instructor emailed late Friday to say, “I was just stopped by a Tech who told me what a great job you did today and she saw your enthusiasm shine. She was impressed and wanted to give this feedback,” “Keep up the good work and have an excellent weekend.” I have. I'm smiling now.

I did well in my first pair of exams. I'm doing well this quarter. Stay in touch, y'all.

Goals for next week: I'm back at my hospital. I need more fluoro comps.