XrayFeet

XrayFeet

Thursday, September 16, 2010

Trust Us! We Are Professionals!!!

ME: “Ma’am, do you have any metal on that skirt you’re wearing, like a zipper?”
PT: “Yes.”
ME: “Ok, is your skirt loose enough for you to just turn the waist so that the zipper is on the side?”
PT: (As she’s turning the skirt) “Yes.”
ME: “Terrific! Now come and have a seat here on this exam table! (while motioning toward the table)”
PT: “You mean as soon as I take off everything and put on a gown?”

Heavy sigh….

ME: “Sir, I need you to remove only your trousers and (while handing him a pair of shorts) put these shorts on. Everything else, including your underwear, is fine.”
Gentleman walks out of the changing area with the shorts on the floor, still folded, wearing nothing but underwear and a gown (which he had to have dug out himself) hanging open in the front. (He even took his socks off.)
ME: “Sir, why did you take off your shirt? I said you could leave on everything BUT your pants, and just put on the shorts I gave you.”
So he jumps up, dashes back behind the curtain, and in a few moments emerges with his underwear AND SHIRT on, and the gown still on and still hanging open in the front. But he did kick the shorts out of his way.

Shaking head….

ME: “Ma’am, please remove your blouse and bra, and put on this gown (handing it to her), with the opening to the back.”
PT: “What about my jewelry?”
ME: “No, ma’am.”
PT: “But you want me to take my watch off, right?”
ME: “No, ma’am.”
PT: “What about my glasses?”
ME: “NO ma’am!”
PT: She finally emerges, lays on the exam table, and just as I am beginning to scan her, SITS UP (banging her head on the c-arm right above her) and shouts, “But I have my partial in! Let me take it out!” as she’s trying to crawl OUT FROM UNDER the bone density c-arm.
ME: “Ma’am, if I had needed your jewelry, or watch, or glasses, or dentures removed, rest assured that I WOULD HAVE ASKED YOU TO DO SO!”

(Beginning to accept defeat…)

ME: “Ma’am, I need you to lie down here on the table, on your back please.”
PT: “Why?”
ME: “Because you came in for x-rays, and I’m going to take them.”
PT: “Yeah, but I came in for x-rays of my BACK!”
ME: “Yes, ma’am, I am fully aware of that. And I’m going to take the x-rays of your lower back.”
PT: (obviously growing agitated) “And yet you want me to lay on it?!?”
ME: “Yes.”
PT: (now yelling at me) “Well that’s pretty damn stupid! How the hell you gonna take x-rays of my back IF I’M LAYIN’ ON IT??”

ME: “Ma’am, do you have any zippers or metal eyelets at your waist?”
PT: “No.”
ME: “Great, then just come sit down over here on this table.”
PT: “But I haven’t taken off all of my clothes. I have to take my clothes off!”
ME: “No, ma’am, you do not. I just need you to come sit down on this exam table.”
PT: “I have a bra on.”
ME: “Yes, I assumed you did. Now please sit down.”
PT: “But it has HOOKS in it! METAL HOOKS!”
(OMG! When did they start making BRAS with METAL HOOKS???? I NEVER KNEW!!!!)

(After positioning a patient for a bone density exam)
PT: “You DO realize that this wrist brace has a metal bar in it, DON’T YOU?”
ME: “I am fully aware of that, ma’am.”
PT: “Well it’s going to show up!”
ME: “No ma’am, it’s not. If I were examining your wrist, it would, but like I just finished telling you, we are going to take a picture of your lower SPINE and left HIP, so I am positive that your WRIST BRACE is not going to affect my images!”

ME: “Ma’am, I need you to lie down on your back so that I can x-ray your ankle.”
PT: “Well, it hurts right here. (Pointing to the medial malleolus)”
ME: “Yes, ma’am, that’s why we are x-raying it.”
PT: “You just need to take a picture of that.”
ME: “No, ma’am, I have to take 3 pictures, all of which will include that area, so please lie down on your back.”
PT: “Well my doctor didn’t tell you to take all that! He just wants to see where I hurt it.”
ME: “Ma’am, your doctor was aware of our standard protocol for ankle imaging when he wrote the order. Our Radiologist will be expecting that protocol. The order that was written intended for me to FOLLOW that protocol. Now I STILL need you to lie down on your back!”
PT: “You’re just trying to make more money!”

Kids, are any of you aware of the educational requirements to become a Radiologic Technologist? It is a 2 year Associate of Science degree. We are taught anatomy, physiology, pathology, positioning, radiation protection, radiation physics and even the mechanical operations of our equipment. We also become BLS certified (that’s BASIC LIFE SUPPORT, which is a lil' more advanced than your run-of-the-mill CPR), learn venipuncture, and how to take an extensive history.


After all of that, we take a 260 question exam covering EVERY SINGLE ONE OF THOSE TOPICS PLUS SOME just to obtain our License. Then, depending on what state you live in, you may have to take an additional exam for the state. If you specialize in any modality beyond just plain ol’ x-ray, then you have more training, more classes, and another certification exam. For instance, someone like me (who’s an RT(R)(BD)(M) ) would have taken 3 certification exams, as well as a 40hour FDA mandated course in Mammography and classes in Cross-Sectional Anatomy, Computed Tomography and done a semester or two of CT clinical rotations.

I think, just maybe – POSSIBLY – I MIGHT KNOW WHAT THE HELL I AM DOING!!!!

Radiology has very set protocols. If you go to McDonald’s and order a cheeseburger, the kid with the runny nose and acne frying it up knows the “protocol”. He knows he slaps the fried patty on the bun with EXACTLY 2 pickle slices, a 1 & ½ -second long squirt of ketchup and some re-hydrated minced onions. Radiology uses the same principle.


If a doctor orders “ankle x-rays” he and the Radiologist and the Technologist all know that means that they are expecting to see an AP (front to back, otherwise known as AnteroPosterior – hence the AP), an oblique (with both malleoli in a perpendicular plane to the imaging plate so that the Mortise Joint is nice and open), and a lateral view (taken from the Medial to the Lateral – in other words with the outside of the ankle laying on the imaging plate). There are other views, but they are “Specialized” views, that the doctor and Radiologist will ask for by name depending on what they are looking for. The same holds true for every single body part – from the skull to the orbits to the scapula to the chest to the abdomen to the patella to the wrist to the elbow and femur even down to the big fat toe (which, by the way, is the left or right 1st digit or phalange, but specifically metatarsal). Each and every part has “Routine Views”, or a “Protocol”.

So when you go in for x-rays, please please PLEASE listen carefully to what the Technologist asks you to do. We are very specific, and we do actually try not to have you remove anything that we don’t absolutely need removed for YOUR benefit, not ours. Don’t argue with us, either. We really were well trained.


You can trust us.

WE ARE PROFESSIONALS!!!


Now would you PLEASE shut up and lie down on the table?!?