And they come with no warning,
nature loves her little surprises.
Continual crisis!

Saturday, May 11, 2013

What is past is past, what is the future we cannot say

Grades are finally in for the last semester. I had a lot of troubles these past 5 months. I'm not sure how much I've shared here, but I struggled a lot to juggle the classes and 16 hours of clinical time with a 40 hour (at least) work week.

Clinicals are set up to test our knowledge and get us prepared for our new jobs. they can also be seen as a two-year job interview where you work on actual, living people, many of whom either don't want to be there or are in pain. There's a lot more variance there, but those are the main categories. Part of our clinical time is spent studying, a very little part of the time. Most of the time we are watching the other techs, assisting, and as we gain skills and "competencies", do the actual work.

Competencies, as a quick explanation, are a way to test our skills. There are a number of "procedures", and we need to show our ability to do them at a specific rate during the semester. We do things like "chest, pa and lateral", "wrist pa, lateral, oblique, navicular", things like that (every bone has at least 2 views, every joint at least 3). First we have to be exposed to the procedure in class, then we can watch/assist a tech doing it, then we "pre-comp" (where the tech can help us), and then finally we "comp" which means from beginning the patient, taking their history, positioning, setting technique (just how much radiation we're going to use), process, escort, hang the "films", and close the patient we do it all ourselves. The only time a tech is allowed to interfere is if we're about to make a major mistake, or if we need to repeat an image (both are automatic failures). Once we comp (for the most part) we can do the procedures ourselves without a tech (although a tech needs to approve all radiographs).

So, starting out I was doing good. This past Spring we needed 12 comps, 3 re-tests (redo a comp from the group of comps, like one out of the lower extremities), and 3 film critiques (where we discuss our radiographs, prove our knowledge, and critique ourselves for quality). Not to mention employment like reviews. In the first 4 weeks I knocked out 6 comps and I forget how many pre-comps. And then I couldn't find the crest of anyone's pelvis (the top of your hip) to save my life. So I was shooting high, and shooting low. And I started failing comps. So I took a few weeks off the pace I had set (class, first time I see procedure I attempted a pre-comp, and then right after I'd attempt the comp) and just worked on my basic skills. But I never got back to the pace I had set earlier (while the other 1st year with me continued to rack up comps, next to him I look like a slacker). And I Was failing with "little things" (relative term), not for my rapport with patients, or basic positioning, or setting technique, but small stuff (many of my fails were scored >90%).

I know why (because our actual classroom experience leaves out those "little things" and every tech has their own pace, patter, and positioning tricks). But it's not that much of an excuse. There was also a personality issue, but I think that one got tamped down by the end.

Then there were the two classes. For the one, it dealt most with computer and math stuff this semester, so it wasn't that hard. I was pretty confident I would get an A and I did. The other was positioning class, which was what I had scrapped by with an A last semester (94%). This semester I was sure I would get a B (was hitting right along the 94% with my tests, made the mistake of not double-checking a lab exercise the whole lab did together - 87%, and my lab practical which was an 87%). But somehow I managed to pull an A out of the air (probably 93.6% or something). For clinicals I got a B. Fortunately, clinicals was only a 2 credit hour course, and the other two added up to 7 hours. I think that gives me a 3.7 for the semester. Which brings me to 3.95 over all. So I won't get that "graduate with a 4.0" feeling (some part of me is disappointed, but not a lot).

In another week we start Summer. That's 8 weeks of 1 class and 32 hours of clinical time for the first 5 weeks, then 40 hours the last 3 weeks (class only runs 5 weeks). Plus, you know, my 40 hour a week day thing. I have my schedule worked out on paper, and it's a killer. Basically 16 and 18 hour days Monday through Saturday (hopefully I'll have my Sundays to collapse in a gelatinous mass and get the lawn mowing done). But in that 8 weeks I need 14 comps. The good news on that front is that I start with 4 in the box already. But with juggling schedules, I have a lot of evenings at the hospital, not our major productive time, also not a lot of chances for surgery, fluoro, and bone study cases. My Clinical Instructor, regular instructor, and myself believe that this will be a big disadvantage come this fall (which, BTW, has 9 hours of classwork and 24 hours of clinicals, plus the aforementioned 40 hours of work).

So, one, giving you advanced notice that I won't be posting much during those 8 weeks (watch me post every single day now). And two, I may not be alive at the end of it.If this blog goes dark by July 12th, you'll know what happened.

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