No matter how many years of experience we gain as technologists, we all know what it's like to do the "Walk of Shame." You know, the slothful downtrodden shuffle you do when you do perform an exam, go to check your films, and you realize you need to repeat. These come with the job and serve to keep us humble.
Every once in a while, it's tempting to get a little bit cocky about your skills after a streak of not having any repeats. I've heard techs say things like "ooooh, that's textbook quality" among coworkers and students. I've also heard "check out that collimation" or "you could drive a truck through that joint space" accompanied by a self-pat-on-the-back. I've been guilty of doing that myself on occasion, all in good fun of course.
But then some days you just don't have it together. I find that everyone has their particular view like a Y-view shoulder or an open-mouth odontoid that a lot of techs struggle with, but you're the go-to person if someone else is struggling with that particular view. But there are some days when you repeat that view that you are typically awesome at, and then another patient comes in for the same exam, and you end up doing a repeat on that patient. This could happen several times in one shift, and can even last for multiple days. I don't know if anyone reading is superstitious, but I equate this to a losing streak experienced by professional sports players.
This happened to me today. It wasn't with a specific exam that I can normally do better than other exams... this was worse. I had to repeat on a patient that was already upset about something. I don't know what they were upset about, but they made it very clear during my first portable chest x-ray that the did NOT want my company. After explaining what I was going to do for the first exam, a comment was made like, "let's just get this over with." Even after offering to help with anything to make the patient's experience better, I was certain that the patient just wanted me to do my job and leave.
I was writing a patient history on my requisition when out of the corner of my eye, the image slowly began to scroll across the monitor. I could already tell... clipped costophrenic angles!!! The sinking feeling set in that I was going to need to face this patient who made me feel so unwelcome once again. We've all been there. I've seen techs stand in front of the image and just stare at it for a few minutes. I can see the gears cranking in their minds; trying to rationalize a reason for not repeating the exam. But we all eventually face the fact that no matter how long we stare at the monitor, it simply won't fix it. We're just delaying the inevitable... walk of shame.
So I returned to the patient with my portable x-ray machine, and as soon as I made eye contact with him, he rolled his eyes. I knew I was in for it. He said, "what happened? Did you screw up?" I said "I missed the bottom of your lungs on the first x-ray, and the Doctor really needs to see the rest of the lungs in order to be able to provide a thorough evaluation. In other words... yes." Admitting your mistakes is one of the more difficult things to do in life, let alone to disgruntled patients. This actually payed off. His response: "that's the first straight answer I've received since I came through the doors." I opened up a dialogue with the patient leading to the explanation about why he was upset. A bunch of tests had been ordered and performed, and he wasn't really kept in the loop. I was able to chat with the Doctor and told him what the patient had expressed and he began speaking with the patient as I was wheeling out the door with my x-ray machine. Thankfully, the repeat image included the missing anatomy from the first film, and I did not need to return.
Don't get me wrong... admitting your mistakes not typically a good experience, and rarely will it result in a positive outcome, but mistakes do happen. They remind us that we're human, as well as our patients in this case. The best thing we can do when confronted with them is to act with integrity.
Every once in a while, it's tempting to get a little bit cocky about your skills after a streak of not having any repeats. I've heard techs say things like "ooooh, that's textbook quality" among coworkers and students. I've also heard "check out that collimation" or "you could drive a truck through that joint space" accompanied by a self-pat-on-the-back. I've been guilty of doing that myself on occasion, all in good fun of course.
But then some days you just don't have it together. I find that everyone has their particular view like a Y-view shoulder or an open-mouth odontoid that a lot of techs struggle with, but you're the go-to person if someone else is struggling with that particular view. But there are some days when you repeat that view that you are typically awesome at, and then another patient comes in for the same exam, and you end up doing a repeat on that patient. This could happen several times in one shift, and can even last for multiple days. I don't know if anyone reading is superstitious, but I equate this to a losing streak experienced by professional sports players.
This happened to me today. It wasn't with a specific exam that I can normally do better than other exams... this was worse. I had to repeat on a patient that was already upset about something. I don't know what they were upset about, but they made it very clear during my first portable chest x-ray that the did NOT want my company. After explaining what I was going to do for the first exam, a comment was made like, "let's just get this over with." Even after offering to help with anything to make the patient's experience better, I was certain that the patient just wanted me to do my job and leave.
I was writing a patient history on my requisition when out of the corner of my eye, the image slowly began to scroll across the monitor. I could already tell... clipped costophrenic angles!!! The sinking feeling set in that I was going to need to face this patient who made me feel so unwelcome once again. We've all been there. I've seen techs stand in front of the image and just stare at it for a few minutes. I can see the gears cranking in their minds; trying to rationalize a reason for not repeating the exam. But we all eventually face the fact that no matter how long we stare at the monitor, it simply won't fix it. We're just delaying the inevitable... walk of shame.
So I returned to the patient with my portable x-ray machine, and as soon as I made eye contact with him, he rolled his eyes. I knew I was in for it. He said, "what happened? Did you screw up?" I said "I missed the bottom of your lungs on the first x-ray, and the Doctor really needs to see the rest of the lungs in order to be able to provide a thorough evaluation. In other words... yes." Admitting your mistakes is one of the more difficult things to do in life, let alone to disgruntled patients. This actually payed off. His response: "that's the first straight answer I've received since I came through the doors." I opened up a dialogue with the patient leading to the explanation about why he was upset. A bunch of tests had been ordered and performed, and he wasn't really kept in the loop. I was able to chat with the Doctor and told him what the patient had expressed and he began speaking with the patient as I was wheeling out the door with my x-ray machine. Thankfully, the repeat image included the missing anatomy from the first film, and I did not need to return.
Don't get me wrong... admitting your mistakes not typically a good experience, and rarely will it result in a positive outcome, but mistakes do happen. They remind us that we're human, as well as our patients in this case. The best thing we can do when confronted with them is to act with integrity.
i would like to share this with my friend~ TQ
ReplyDeleteDoes your friend do the walk of shame a lot or get cocky?
ReplyDeleteHi, Grace here. You are not alone. I used to stand in front the monitor and hope some miracle will happen bring back the clipped anatomy!!!
ReplyDeleteNot to mention we have to face the patient and relative. Some time the ICU nurses will give us tough time when we told them we need to repeat the X-ray. lol
Hi, Grace here. You are not alone. I used to stand in front the monitor and hope some miracle will happen bring back the clipped anatomy!!!
ReplyDeleteNot to mention we have to face the patient and relative. Some time the ICU nurses will give us tough time when we told them we need to repeat the X-ray. lol
I know... that's horrible when the nurses lay into you. I have no issues pointing out the fact that they were reluctant to help me (if in fact they were) on my second trip when that happens... normally I don't mention things like this, but I just got home after a 17-hour day with a few experiences like that and I'm feeling snarky.
ReplyDeleteRegarding your comments, "A bunch of tests had been ordered and performed, and he wasn't really kept in the loop." I experience that response almost on a daily basis given that I work the shift which is responsible for the AM exams on ICU and Med-Surg PTs. Moreover, the stated reasons for the procedures on the exam requisitions are generally of no value since most have "Pain" as the Dx. Expecting the physicians and/or nurses to enter an adequate DX for the exams in HIS/RIS is an unrealistic expectation that I've learned in my 10 years working at various hospitals.
ReplyDeleteIt does happen a lot doesn't it? How many times can you say you have seen an order in a chart with a reason/diagnosis/symptom? Hardly ever... though it is a requirement legally. What really becomes embarrassing is when a patient asks "why did the doctor order this exam?" and you can't really give them an answer. I applaud the patients who question these things, and even hold off on these exams until their doctors come by and have a chance to explain it to them. That should be a big red flag to the Physician.
ReplyDelete