Merry Christmas!

You can download the Kindle version of my book, "Becoming a Radiologic Technologist" for FREE on Christmas Day.  Merry Christmas everyone!

Why is there a Barium Shortage?

For the last few months, our hospital has had trouble acquiring barium for our GI studies.  When I asked our suppliers why there has been such an issue, they told me that all barium was on back-order.  "Yeah right," I thought... when the heck has there ever been a problem getting barium?  I thought they might have forgotten to order some and they didn't want to own up to it.  The problem was that it kept happening!  We got to the point where we had scheduled patients, but not enough barium to complete the studies for the day.  There were several times that we used a courier to deliver supplies from one of our other hospitals within the organization, but eventually, they stopped allowing us to do that after some time because they had also run out.  Why is this happening now, and what is causing it?

Well, yesterday, I was speaking to one of our radiologists, and he informed me that there was a depletion of barite from the world's largest mines... the earth is simply running out!  I thought he was joking at first, but he encouraged me to "google" it.  I found some interesting things:

Most of my first search included headlines from news articles across the world stating things like "hospital forced to stop barium studies."  I guess I'm not the only one experiencing this.  I also ran across this letter from Bracco, the largest supplier of barium sulfate for radiology exam purposes. It goes on to list all of the produces which there is a shortage of, and also explains that they are attempting to fulfill back ordered products as soon as possible.  Among the list of products happens to be every single one my hospital uses for GI studies.  I also ran across a list of current drug shortages from the American Society of Health System Pharmacists which confirms the significance of the shortages.

Then I ran across this article, which explains that due to increased safety regulations in barite mines in China, the volume of barite production has fallen to about 25% of what it once was.  China is responsible for over 51% of the barite mining in the world.  India is the next largest supplier at about 14% The U.S. is responsible for about 9% while Morocco mines about 7%.  The rest of the world together supplies about 19% of the global supply.

The barite reduction is said to mainly be caused by increased safety regulations in China's mines.  There's also the fact that as the mines get deeper and drilling sites expand, there is increased cost for getting the barite to export ports.  If you dig deep (no pun intended) into some of the articles on google, you can find comments from people who claim to be associated with these mining companies (mainly from China and India) who are also stating that the world's supply of barite is being rapidly depleted, and propose that this is another reason for the reduction in barium sulfate production.  It is difficult, however, to find concrete sources for that information with the amount of searching I have done, but it's interesting nonetheless.  Other comments advise the world to begin looking for other materials that can perform the same job that barium sulfate currently does, which would lend some credibility to the notion that it is being depleted.

Could we be entering an era of no barium studies?  It's quite possible, although we will simply have to use another form of contrast media for the current exams we are performing with barium.  There's always water soluble contrast... and there's potentially a lot of money to be made for any manufacturer out there that can come up with a cheap and plentiful alternative to barium (I'll accept a 2% credit on all profits for giving you the idea).  I would love to hear what everyone is using as their barium runs out, along with the pros and cons of each.  Feel free to let me know in the comments!

Radiography Discussion Resources

Have you ever had a burning question about something radiography-related and didn't know where to turn?  You're not alone!  There are others like you who are interested in sharing ideas and providing information.  I have made many connections through discussion forums and websites that are strictly radiography-related, and it's important to have some resources to go to when you need some input, don't have answers to questions, or if you're willing to share your knowledge.  Here are some of the best discussion resources I have found on the web:

Aunt Minnie is a great site for anything from multi-modality news to job boards to discussion forums.  This is by far one of the largest sites with the widest range of contributors that I have come across.  If you're looking for research, a large number of technologists involved, or even CE credits, this is the place to start.

Wiki Radiography is growing, and already has many resources specific to radiography.  I like this one because you will always get a direct answer from a technologist.  There are techs from all over the world participating here including the U.S., U.K. and Australia.  Check out the many great articles and radiographic anatomy resources.

The Radiographer's Alliance is one that I have just recently browsed, but will become more involved in quickly.  With the welcoming description "the place where radiographers can really talk," I'm already feeling welcome.

                                                     

Radiopedia is another large site with literally tons of information.  You will find contributors from radiologists to every modality of imaging.  There are free lessons, tutorials, case studies, and articles posted here among the many discussion boards.  If you have a lot of brain space waiting to be occupied by radiology-specific info, start here!

Radiology Forums is a site that has recently been introduced to me... it's still growing, but I see a lot of promise here.  Any place that is willing to provide a safe environment for discussion is okay in my book.

If you are looking for answers not found on any of these resources, you can always check out Yahoo Answers.  You may run across some opinions that are rather ridiculous and misinformed, but every once in a while you'll strike gold.  I like it because those who are willing to answer questions with any integrity will provide a resource/link to support their answer.

Of course, I always like to hear from my readers and you can get involved here on my blog in the comments, or connect with me on Facebook, Twitter, Linked In, and even Pinterest.  

Radiography Employment Survey

I have spent a lot of time talking about the job market, tips for employment, and even health care politics.  I even published a book that goes into these topics in greater detail based off information and statistics from reputable sources like JRCERT (accredits radiography schools) and the U.S. Department of Labor Statistics.  Since my book has been published, I have received a lot of comments/dialogue about the job market in particular in various regions of the country - even from people who have not read my book and assume that I take a particular stance on whether or not the reader should be jumping into a career in radiography.  The comments are vast and can even be conflicting... in other words, one person would claim there are tons of jobs available if you are willing to travel, take a casual position, work nights, etc.  Others claim that there are next to zero options for them in their situation.

When I wrote my book, my goal was for it to be informative.  I discuss employment from a statistical standpoint with verifiable sources.  I realize there are some elements that quoting national statistics will simply overlook, and I have encouraged anyone purchasing my book to perform their own market research in the region they wish to work as a radiographer due to the competitive nature of jobs in our country today.  That is why I would like to conduct an informal survey.  I want to give YOU a voice as well.    

A large percentage of readers of my blog are students or new grads from the United States.  If this applies to you, I would like to encourage you to participate in this survey.  I can quote statistics until the sun goes down, and many of my readers do not have other sources for information in the health care setting.  So regardless if your experiences finding employment in radiography were positive or negative, I would love to hear about them and share them with my readers.  Below, I have six multiple choice questions and an optional essay response question that I will leave open until January 1 2013.  I wanted to make it short and sweet, but if it's still too time consuming, feel free to leave a comment to this post.  Thank you in advance for those of you who can participate.  Please be respectful of others with your comments. 

Create your free online surveys with SurveyMonkey, the world's leading questionnaire tool.

Top 5 Difficult Questions from Patients

We as technologists know the limitations to our scope of practice.  Radiography Students, while learning, should be familiar with them as well because it can be very easy to cross the line if it is not well defined.  Patients (particularly those with no formal medical background of any kind) will not always be able to determine who in a hospital is a doctor, nurse, radiologic technologist, or lab technician.  We are simply one more person in scrubs who has information about their health.  In order to stay within our scope of practice and maintain excellent standards of patient care, we must know how to handle some difficult questions with tact.  Here are 5 typical questions requiring some forethought:

What did you see on my x-rays?

This is probably the most common question, and it can also get you in the most trouble for answering.  No matter how good you are at identifying fractures, dislocations, pneumothorax, or other types of pathology, it is illegal for you to give your opinion while remaining in your scope.  You can always inform patients of this fact.  Some patients will say "I know that you know what you're looking at" in an attempt to get you to budge, but are you willing to risk your license providing information that will be provided to the patient soon by their doctor?  A good apology and encouragement that they will learn the results from their exam by the expert soon should satisfy their curiosity for the moment.  Inform them that their doctor should be the one discussing any results and a plan of care with them.  Most reasonable people will understand.  If they act frustrated, it is probably because it took them a long time to get the exam and they are expecting results soon, so don't take it personally if they vent a little bit.

Why did the doctor order this exam?

In an ideal world, every single physician would explain the reason for every exam to every patient they refer for imaging procedures.  Unfortunately, that is not the case.  The prescription should state a reason for the exam ordered, and you can acquire some information based on a good patient history.  Aside from those things, we as technologists don't really know much about the physician's reasoning.  We should, however, be willing to contact the ordering physician if the patient seems apprehensive about having a procedure without knowing why it was ordered.  We should always refer the patient back to their doctor if after explaining the exam, they are not sure they want to proceed.  Try to avoid talking them into a procedure or giving possible reasons for the exam when you do not know the facts.  It is ultimately up to the patient if they want to continue.

Why won't they let me eat or drink anything?

Sometimes outpatients have exams that require an NPO prep... these are easily explainable in that we need the stomach/intestines empty to allow our contrast to coat the lining.  It can also produce a false-positive exam if there is food mixing with contrast.  Some ER patients need to be NPO for the same reasons, or if surgery may be required based on your imaging results.  It's probably not a good idea to explain that they can't eat because there's a chance of surgery though.  There are other reasons patients can be kept NPO such as lab work.  In any case, it's a good idea to instruct the patient to discuss the reasons with their nurse or ER doctor, and that you are following the directions of the physician.  It's usually for a precautionary reason, but we aren't doing anyone justice by guessing.

How much radiation am I getting with this x-ray?

Thanks to the internet, social media, and Dr. Oz, there are many warnings about overexposure to radiation.  It is true that we need to be conscious of our radiation dose and try to prevent unnecessary testing, but for some people, being informed means becoming a hypochondriac.  You obviously cannot simply tell a patient "you will receive about 10 mRads from this exam" and consider them informed and at ease about their exam.  Most hospitals and outpatient imaging departments offer fliers explaining the risk vs. benefits for their exams.  There are even some websites that allow you to calculate your x-ray risk that can be referred to.  We can inform them that we will take every effort to keep the dose as low as possible while using collimation and shielding, or we can even ask a Radiologist to explain the risk if they want more information about the dose itself.  If a patient wants to know about whether or not the test is necessary though, that should be a conversation between the patient and the ordering physician because we know very little about complete medical history and why the exam was ordered.

What will happen if I get this x-ray and I am pregnant?

We have a responsibility to explain that with any dose of radiation, no matter how small, some risk exists.  That risk is increased when there is direct interaction with the x-rays and the fetus, especially in the first trimester, but it can be greatly reduced if the primary beam is far away from the fetus and appropriate radiation protection precautions are taken.  It also increases when a large number of exams are performed.  A radiologist should always be consulted when we perform x-rays on a pregnant patient, and they can determine whether or not a limited procedure should be performed or the exam should be avoided altogether.  Ideally, the radiologist would communicate risk to the patient.  They might decide to contact the ordering doctor to learn more about the patient's history first, and even recommend another imaging method if necessary.  Our goal is to inform the patient while reassuring them that every safety precaution is being taken.

Our patients do not always understand our scope of practice.  They might not understand the difference between a radiologic technologist and a radiologist.  Patients even ask questions that are difficult for us to answer.  We don't have to have an exact answer prepared for each patient, but we should be able to either find them answers or point them in the right direction.  We should be striving to keep them informed so they can be included in their health care decisions without providing false information or reason for alarm.  A little tact will go a long way.

Semester Kickoff Contest

To kick off the new semester, I'm giving away a 5th edition pocket radiography guide by Balinger/Frank ($40.00 value)... must have a twitter account and you may enter as many times as you want before Sunday, 8/26 at noon... visit this link for details:  http://tweetsw.in/1726/

Taping your X-Ray Markers

I have seen a few ways to tape x-ray markers, and you may even be required to tape them a particular way when in school, but this is the way I prefer to tape mine... I know, it's a basic post, but every once in a while, I find someone asking me how I tape mine, seasoned tech and new:

Supplies Needed:  Markers, tape and a credit card or hotel card (we used to use x-ray film, but these are more sturdy and x-ray film isn't just laying around these days):

Step 1:  Place strip of tape over face of marker starting at one end and stop at the other (left to right) with sticky side down.

Step 2:  Fold tape back over itself so that the sticky side is up, making sure the original sticky side down portion stays in place.

Step 3:  Wrap the marker twice with the sticky side up and tear the first piece of tape so that the edge aligns with a side border (left to right).

Step 4:  Start a new strip of tape (sticky side down) that covers the side of the marker and the colored top portion.  You want to tear the tape so that the opposite side is covered, but the bottom of the marker remains sticky.

Step 5:  Place marker on your card and repeat for your other marker.

I typically have to replace the tape about once every week or so, depending on how busy we are and how many times I am sticking and un-sticking my markers from a bucky or image receptor.  As I said, this is only my preference, and there are many ways to tape your markers... what methods do you prefer?

Top 5 Free Apps for Radiography Students

Everyone knows radiography students are on a tight budget, and some of the apps and tools available can be quite expensive.  Since we're in the season for new radiography program sessions, I thought I would chime in with some helpful tips.  Here are my top 5 FREE picks for you:

Evernote

Evernote has many features that I would consider must-haves for students.  Aside from simply taking notes with text, you can also record audio from your phone or computer, clip images and articles from websites with one click, and easily organize your notes and notebooks.  It also allows you to sync all of your devices so you can access material anywhere.  They are constantly adding new features and supplemental applications that are also free.

 

Biodigital Human

 Biodigital Human is excellent for studying.  There are may features that this powerful app utilizes like the ability to view different organ systems or combinations of organ systems while excluding others, labeling, x-ray view, pan and zoom, and notations on each piece of anatomy you are reviewing.  You can also pin and annotate selected body parts, and take a jpg snapshot of any particular area of interest to export to a report or powerpoint slide if you wish.  This is another tool that is constantly being updated with new features.

Dropbox

 Dropbox is a very simple, yet powerful app.  It allows you to store photos, videos and documents into their cloud storage so you have all your files accessible from your PC, laptop, smart phone or pad at any time.  If your computer crashes, no problem!  Dog ate your homework or your smartphone... no problem!  All files are accessible from the dropbox website so even if you don't have your own device with you, files are retrievable with internet access.  The interface is easy to use because it looks just like any old folder you would open on your computer and interacts the same way.  You don't have to email multiple files anymore; just simply share a dropbox folder with someone to give them access.  My dropbox account started with 1GB of free storage space, but has been upgraded to 20GB of storage for free.  You can also gain an additional 3GB of storage just by using their camera feature.

gFlash+ Flashcards and Tests

  I recently came about gFlash+ and wish I had it when I was in school.  It's a basic flashcard system that can operate on IOS and Android systems.  You can "create, download and manipulate" flashcards in just about any subject.  I would recommend this for classes that require memorization of new terms or lots of detail like medical terminology and radiographic positioning.

PicMonkey

 My wife actually turned me onto this resource.  PicMonkey is a web-based photo editor, similar to photoshop.  You may be interested in some of the filters like the ones on instagram, but this offers so much more.  You can annotate with tons of font variations, adjust color quality, insert objects place borders around images, and the list keeps going and going.  I would recommend using this for any reports or presentations that require you to display radiographs.  It will allow you to remove patient demographics by painting over it (if you haven't removed it already), label anatomy, magnify, and other imperative needs.  It is very simple to use and it does not require an account of any kind.  Simply visit the website and choose "upload an image" to edit, and you're on your way!

Have any additional suggestions?  I would love to hear about them.  Please feel free to comment and tell us how you use any apps for student success!

Radiograph of the Week

Taking you back a while... this radiograph was taken by me when I was a student in 1998.  It is a digital photo of a film/screen image hanging on a view box, hence the low resolution.  What still remains interesting about this xray to me is the story behind it.  This person accidentally discharged a nail gun he was carrying while walking.  The nail went in straight, but as the patient felt the nail impale him, he dropped to the ground in pain.  The nail bent along with his knee, and he was unable to straighten it.

Lesson learned:  If you ever shoot yourself in the knee with a nail-gun, don't bend your knee.

Orbits for MRI Clearance

It is still very common to receive orders for patients who need MRI exams, but require radiographic clearance to ensure there are no metal fragments in the eyes.  Routines vary from place to place, but reasons for performing this exam include metal/machine shop workers, history of foreign body removal from the eyes, or shrapnel injuries.  Our hospital only requires a water's view to include the orbits.  Here is a good example of what to look for, as well as what to do if the reading may be positive:

I didn't notice anything in the orbits at first, but when viewed on the high resolution screen of a Radiologist, you may see a small speck at the superiolateral aspect of the left orbit:

I thought this would be too far above the orbital rim to be considered a metal fragment in the eyeball, however due diligence should prevail because it may be metal regardless of where it's located.  When this happens, here's what you do:

1. Use a different cassette.  Dust and dirt may collect on the image plate and prevent light spread during processing for the affected area.
2. Clean your cassettes.  Most manufacturers recommend monthly cleaning of image plates, however, I may start cleaning them additionally before I perform any orbits for MRI clearance based on the repeat image:

As you can see on the magnified image, the white spot is no longer there, which means it was most likely dust... and the patient gets the MRI!

Radiograph of the Week

...Trauma

"Why do x-rays take so long?"

Normally, I don't speak much about too many personal things here, but I couldn't pass this story up knowing you would appreciate it.  I just put my son to bed (he's 5) and this was our conversation:

Son:  Hey Daddy... why do x-rays take so long?

Me:  They don't take that long... don't you remember when I took you for x-rays when you broke your arm?

Son:  No... I broke my arm?!

Me:  Yep.  You fell at home and I took you to the hospital I worked at and held you in my lap while someone else took x-rays of your arm.  It only took a couple of minutes.

Son:  But you're gone all day long when you take yours!  I thought you just sit in front of the thing that takes the x-rays and then you look at your bones.

Me:  Well, lots of people need x-rays every day.  Sometimes we do about 200 x-rays every day on lots of people that need them because they are hurt or sick.  That can take all day.

Son:  Oh... I thought you just take your own x-rays of yourself all day and come home.

I would hate to see me radiation badge reading if he was right!

Contest to Win Kindle Becoming a Radiologic Technologist Extended

To start off launch week for my book, Becoming a Radiologic Technologist, I will be giving away a few things throughout the week.  The first giveaway starts today - a copy of the Kindle eBook edition is up for grabs by following me @TopicsInRadiogr on Twitter and Retweeting my contest announcement tweet:

CLICK HERE TO ENTER

One winner will be randomly selected after the contest ends, which I have extended until 8:00 p.m. Pacific Standard Time on Tuesday night, July 17 and announced via Twitter.  Click here for a glance at the prize!  Don't have a Kindle reader?  That's okay... download a free Kindle app here:

Five Ways to Find Radiologic Technologist Jobs

In today's job market, it definitely helps to know people.  If you have been in the field for a while or if you are just getting out of x-ray school, you probably hear things through the rumor mill about upcoming opportunities at the local hospitals and imaging centers.  But what if you are new to an area, or you just don't happen to know many people?  Thankfully, the internet provides three great ways you can stay ahead of the game when it comes to finding work as a radiologic technologist.

Craigslist App - You can now download an app for your smart phone to browse Craigslist.  This is great for times when you're looking for cheap tools or a used car, but you can also look for local jobs on Craigslist, or specify cities that you would be willing to relocate to.  Most of the jobs you will find are in smaller facilities, private doctor's offices and stand-alone imaging clinics.  The reason I am mentioning the app instead of just the website is because you can receive regular updates with search items of your choice, and you don't even have to use the search tool.  Just open the app and view your most recent search results!

Facebook - If you aren't doing it already, you should "like" the local hospitals and imaging centers within a distance you would be willing to drive.  This gives you a way to get regular updates from their pages without having to visit several sites individually.  Just log into your Facebook news feed and scroll for updates on job listings and chat sessions with recruiters.

Google Alerts - This option is also great for anyone who is looking for news, trends, and jobs.  Simply place a search term like "radiologic technologist" into the search query, specify how often you want these results and how many results you would like to see.  Google will email you whatever new links their search engines find.  You can do this with as many terms that you like, and it's free.

Twitter - This option is great for those who are willing to relocate.  At least once a day, do a search for #radiologic or #technologist.  You will be amazed at the amount of job offers that are posted there... again, it's definitely good to follow the local hospitals on twitter, but if you're the adventurous type you can find jobs across the country and even internationally.  It's a great networking tool that many underestimate for professional value.

LinkedIn - This is more of a social media style site for professionals.  Think of it as Facebook for industry.  I know a lot of you probably already know about LinkedIn, but most people do not take advantage of the "groups" sections.  Jobs are posted on these groups multiple times per day and they are easy to forget about because you have to actively search for groups and their message boards.  Again, a great option for searching for local jobs and jobs that you would have to relocate for, but the networking capabilities are endless.  I have recently caught up with several people from my very first x-ray job on LinkedIn.

If you have any thoughts or suggestions for the job hunt, I would love to hear about them.  I also discuss the current job market in great detail in my new book Becoming a Radiologic Techologist.

Becoming a Radiologic Technologist NOW AVAILABLE

Do you have questions about radiography program admission requirements, tuition, accreditation, and other details? If you're a student, I'm sure you have had many of these questions, including what is expected of them by instructors, staff technologists and clinical affiliates. Instructors receive these questions all the time. Being an instructor myself, I know how often these questions arise; even after program orientation. In fact, it has been my number-one type of question online since starting my blog, Topics in Radiography, in 2007. Until now, I have been unable to find a single resource to address all of these common questions. What I have found is a lot of misinformation from internet marketers about how to become an “x-ray technician”. 

That’s why I decided to write a book for people interested in exploring the field of radiography that has all of the answers they need in one convenient location. It was just published this week, and I want you to have the first chance at purchasing this resource at a reduced price. Becoming a Radiologic Technologist addresses common issues for career researchers like: 

• Myths about what technologists do (we don’t just push a button) 
• Types of radiography programs available 
• How to apply for school and requirements 
• Researching proper accreditation, pass rates, employment rates and the current job market 

It also addresses some of the more common issues seen with first year students that may require additional time and attention from faculty such as: 

• Professionalism, social media and legal matters 
• Expectations for workload in the classroom and at the clinical site (the two-year job interview) 
• Skills, strategies and etiquette needed for success 

I also offer a glimpse into the future for students regarding: 

• Preparing for the ARRT registry exam and job searching 
• Career pathways and advanced educational opportunities 

Unlike many career research tools, I have included some first-hand experiences from the past 15 years to make the reading easier for students to digest without sounding like a textbook. I also published this book with the goal of an honest, straight-forward assessment of how competitive the job market is today and why our field will need to continue to grow over the next ten years. 

Becoming a Radiologic Technologist is available in paperback print and Kindle editions. I would like to offer a promotional code for the print edition, which is normally $15.99 for the Kindle price of $9.99 by typing in the coupon code, LBDZNK39 during checkout. This offer is valid for a limited time and will expire on Friday, July 20. Just visit https://www.createspace.com/3925385. 

Find more information here: http://becomingaradiologictechnologist.blogspot.com. 

Please don’t hesitate to contact me with any questions, or if you would like to learn more about affiliate opportunities. Kindle promotional offers coming soon... please subscribe to my Topics in Radiography monthly newsletter for updates:

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Becoming a Radiologic Technologist Launch

In the recent months, a lot of my efforts have been spent with the completion of my book Becoming a Radiologic Technologist.  I am pleased to say that the official launch will happen next week.  I am still proofing some versions of the book, but some are ready for release.  


I have received a lot of questions about why I am releasing a book like this now, and that's why I am giving away the first two chapters for free.  Chapter 2 will explore where the job market currently is with data and statistics, which support my opinions expressed later in the chapter.  You can sample the first two chapters here, and the first versions will be available via pdf document and amazon kindle.  To view other formats that will soon be available including hard copy print format, please visit here.


Additional information can be found at http://becomingaradiologictechnologist.blogspot.com.  As always, if you have any questions or comments, I'm happy to hear them.  


***If you're interested in partnering with me as an affiliate, please contact me.

Introducing RadTechPRO for iPhone

I'm pleased to bring you this guest-post from RadTechPRO:

Ever wondered, "What's the angle on a Towne's view?" or "How can I get 3 views on this shoulder; this lady can't even move it!"

Such is the life of a radiographer.  Sometimes we need a reminder of a certain angle, which views would complete a series, etc.

And even more stressful is the life of a radiography student.  When learning the positions, the pressure is always on.

For years, tech's would purchase small pocket booklets for quick reference; problem is, you actually had to tote it around, and

thumbing through it with a patient on the table is not only unprofessional, but only increases the stress levels!

Enter RadTechPro, iPhone app for radiology technologists and students; this app keeps the data at your fingertips, searchable

on the fly.  RadTechPro focuses on the specific position any given exam.  When you need to get the x-ray right, you're not

worrying about pathologies, etc.  And RadTechPro is only $14.99, about half the price of those pocket booklets we used to carry

around.  Every tech has had that moment of doubt, whether student or veteran tech. Now they can just reach into their iPhone and

look the data up, with RadTechPro.  We also have special orthopedic views and tips simply not found in other positioning guides.

There are other apps on the market geared toward the radiology tech, but RadTechPro is the most concise, easy to use, affordable

and practical app out there.  And the special tips make it stand out even more.  Every radiology tech with an iPhone should have

RadTechPro installed; never know when you will need it!

-RadTechPro

Website:  RadTechPro.com

Contact:  Support@RadTechPro.com

Twitter:  @radtechpro

Have something interesting to say about Radiography?  Contact me to discuss guest-post opportunities.

Cross Training

The practice of cross-training into advanced modalities is changing.  Ten years ago, you could simply express interest to train in CT or Interventional Radiology and probably be granted an opportunity within a reasonable amount of time if you have a good work ethic and show some initiative.  In fact, that's how I learned CT, Cath Lab, and Interventional Radiology.  I was at the right place at the right time, and had a willing attitude.  But if you want to cross train now, the trend is that it is becoming more difficult to do so.

Part of the reason for this is an increase in accreditation standards.  It is in the best interest of any hospital or organization providing imaging to employ technologists who are certified in their modality.  Some accreditation standards depend on this.  Another reason is the rise in number of schools that provide formal training programs in advanced modalities.  Before my time, you simply had to pay your dues to get training, which meant simply working as a general rad tech for a period of time and keep your nose clean.  


For a few years, and still some places today, you might see a job advertisement say "ARRT-eligible" or "ARRT-registered within the first 12 months of employment."  Now, depending on your location, it is more common to require ARRT credentials as a condition before getting hired.

I have always wanted to train to learn MRI.  The educational programs are typically about 2 years if you are not grandfathered in or have been lucky enough to cross train.  I'm afraid that realistically, my chances of being able to cross train in this modality are slim unless I quit my two jobs and become a full-time student... an impossible thing for me to do right now.  If I were in a more rural area with limited access to formal schools of MRI, there might be a greater chance to slide into a training position. 

Why am I talking about this?  Well, we all know that the economy and jobs in radiology are not as plentiful as they were 10 years ago.  There are more per diem jobs available today than full or part time positions.  If you plan to make radiography your career, and you are just graduating from school, it may pay off to attend school for an advanced modality now while working a casual rad tech job.  You will be more marketable when you're finished, and if you are like me, you may not have the ability to drop everything and go back to school full-time in the future.  Food for thought...

Radiograph of the Week

Needle-Nose Pliers:

Top Three Reasons the Radiography Job Market will Bounce Back

It’s no secret that being a Radiologic Technologist has been difficult in many parts of the country due to fewer available positions.  Everyone is bracing for the impact of health care reform and cuts in Medicare reimbursement, which will soon be awarded by the Government at a percentage based on patient satisfaction.  For the first time in history, the labor budget will be forced to depend on good service.  These issues have caused many hospitals to initiate patient satisfaction campaigns, and to start cutting budgets.  With the number one expense for any health care institution being labor, the jobs just aren’t plentiful right now.  I address in more detail in my book Becoming a Radiologic Technologist, this should change dramatically within the next 3-5 years:

As I have explained in a prior post (see related posts below), the Baby Boomer generation makes up the largest percentage of the work force in the United States.  As of 2011, they have begun entering the retirement age range.  We have seen a delay in this due to problems with conventional retirement savings plans being affected by the current depression in the economy.  People simply just can’t afford to retire yet, no matter how much they want to.  Eventually, the market pendulum will swing the opposite direction as it has consistently done for many decades.

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As the largest population in our work force retires, it will create two needs.  The first need I will deem the Characteristic Effect on Employment (if you’re a student and haven’t studied this yet, it will make sense soon).  First, as the Boomers retire, their current roles will need to be filled with experienced up-and-coming professionals (ejection of the k-shell electron).  I anticipate a lot of these positions to be at the supervisory or managerial level (close to the nucleus – a lot of binding energy) due to the amount of time they have spent in the work force.  The vacancies created by people filling the Boomers’ jobs will need to be filled by new grads and current employees with a few years of experience (filling of the k-shell by valence electrons).  Second, our patient population will increase.  As the percentage of employees drops, the percentage of in patients in hospitals will rise, creating a demand for nurses and allied health professionals to care for them.

Due to the high cost of keeping patients in hospitals, expect to see more ambulatory care options rising up.  

For us Radiographers, outpatient imaging centers and urgent care centers will be hiring left and right.  It costs a lot more money in labor and supplies to keep someone in the hospital for a series of tests than to have them performed as outpatient exams, requiring only the labor cost of the person performing the procedure for the amount of time the procedure takes.  It would be good business for health care institutions to invest in more outpatient facilities to handle patient procedures that do not really need to be performed as an inpatient in a hospital.  This should also help with the over-use of the Emergency Room that is widely experienced across the country fueled by one reason: convenience. 

I know it has been tough out there, and I completely understand that getting a job today can be tough, but I truly believe we are on the cusp of change.  The Bureau of Labor Statistics has predicted a 28% growth in our fieldbetween 2010 and 2020, but what they could predict is the state of the economy.  The data for their predictions have not changed, but the timing has.  It will get better soon.

Related Posts:  "Are There Too Many Radiography Grads?"

Photo downloaded from http://www.freedigitalphotos.net/ 

This post contains affiliate links, which means I receive financial compensation if you make a purchase using these links.

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Attitude is Everything: Lesson Learned

It's easy to complain about things from our past, but it is much harder to remember the positive experiences that we have about any given period in time.  I remember having a particularly rough week during my student internship when I was asked to perform yet another Barium Enema.  I knew I should have been grateful because many of my classmates were struggling to gain experience with the exams, but I already had my fill and then some.  It seemed like I was assigned every single one that walked through the door, and the staff techs would mysteriously disappear about ten minutes before the appointment time for a scheduled BE.

Late one morning, after already completing three Barium Enemas compared to my classmates' two or three chest x-rays, another requisition printed for... you guessed it - a BE!  The Lead Tech looked around the room as everyone avoided eye contact with him, and when our eyes met, I knew what was about to come out of his mouth.  The words came out in slow-motion, "Jeremy, go ahead and do the last Barium Enema for the day."  I tried not to roll my eyes.

My body language must have indicated that I was disappointed anyways because the Lead Tech pulled me into an unoccupied x-ray room and asked what the problem was.  At first I said "nothing" and just wanted to be dismissed to get the exam over with.  He persisted saying "I need to know what's bothering you before you do this exam."  Then I unleashed my frustration telling him how it wasn't fair that I'm the only one doing all the BE's and how I understood that even though I'm a student (I'm pretty certain I used the term "slave labor" somewhere in there), that even the other students weren't being asked to do them.  I told him that I felt picked on somehow.  For once, someone asked my opinion without any restrictions, so I gave it to him.

He looked at me very calmly and said "If that's how you really feel, I will assign it to someone else, but I was hoping you would do it."  I didn't understand why he wanted me to, so I inquired.  What he said to me made me feel small.  He said "You are really gentle with the patients and take a lot of time to make sure they are comfortable.  I really wanted my mother to have the best care possible, but she's uncomfortable with me performing the exam."  I shrunk.

He started to leave the room and I stopped him to tell him I would be happy to do the exam.  I apologized for the display of frustration that I expressed, and thanked him for the reassurance for the quality of patient care that I attempt to provide.  I also assured him that I would take great care of his mother.

I had never felt so awkward, embarrassed, and foolish.  After a few hours, I still felt the need to explain that I had never been complimented by anyone on my performance, so I was caught off-guard when he explained the reason behind assigning me all the BE's.  We had an understanding from that moment forward and I never questioned his assignment of tasks after that.

It is easy to feel victimized when you are a student, especially if you are not always given positive feedback
and you feel like you're doing the "grunt work."  At the end of the day, as students we are there to learn.  We practice through repetition to gain expertise in our skill set.  I should have viewed this exam as an opportunity to gain experience, and it always helps to receive a little encouragement along the way.

Radiograph of the Week

This is a scanned film/screen image from one of my fellow students when I was in school:

Applying Lean Six Sigma in Healthcare – A look At Product Development

Blog author: Helen Titus, Marketing Director, Digital Capture Solutions, Carestream

The pursuit of less waste, reduced variances and cost-effective, quality care is driving lean six sigma projects at healthcare facilities across the globe—you may be involved in your facility’s full-scale six sigma imitative or you may be applying lean principles to simply improve the productivity of your department.

Lean Six Sigma is not unique to providers. It’s impacting the whole healthcare ecosystem, including vendors like Carestream. It is extensively deployed

throughout our manufacturing organization and it is woven into the fabric of everything that happens on the manufacturing floor.

But the same lean principles that are eliminating waste on the shop floor are also being applied at our front-end to help drive innovation in product development—ensuring what hits hospital hallways has been designed through disciplined problem solving to help overcome our customer’s challenges.

One of the key tenets of Lean Six Sigma is analysis based on fact and direct customer input.  So during the very early stages of developing the DRX-Revolution, Carestream’s new entry into the DR mobile imaging market, a team of people went on more than 50 site visits where they not only spoke with rad techs but also observed them conducting mobile imaging exams.  

These weren’t just Carestream marketing and management people but rather the software, hardware and electrical engineering team that was assigned the task of developing a new way of approaching an old problem.  How do we bring the very best image quality to the sickest patients in the hospital (those in the ICU) in a way that is the most efficient and easiest for the technologist? Seeing and hearing first-hand input from the users empowered the designers to find ways to do things better.  They even videotaped them during a routine typical day and mapped out their work process. 

The engineers took note of the “waste” in the technologist’s workflow and brainstormed ways to design the product that would eliminate these non-value-added steps.  Much the same way that Lean is applied to a manufacturing process. 

And sometimes, they just listened. 

One tech frustrated by the fact that she couldn’t see driving the x-ray mobile system down the hall said, “I wish the column was made out of glass.”  The engineer took that input and although making the column out of glass was not practical, designed a collapsible column so when driving the system it simply just goes away and the tech has a clear driving view.  The result of applying the Lean principles is a truly innovative product in a market space where no one thought any further innovation could occur.

Applying Lean Six Sigma methodology is a commitment no matter where it’s deployed—from the hospital to the factory to product development labs. But ultimately applying the principles across the healthcare sphere allows us to work smarter, not harder—and provide more efficient higher quality care.     

Are you involved in an LSS project? I’d love to hear your experience. 

What is mAs?

Some "back to basics" discussion for entry-level Radiography students:

Becoming an X-Ray Tech

Coming Soon... a new resource for those interested in pursuing a career as a Radiologic Technologist.  

UPDATE:  For more information on the updated title, "Becoming a Radiologic Technologist", visit my link on Amazon.com (Prime members may borrow this book for free)

10 "Do's" and 10 "Don'ts" When it's Slow

When staff techs and students aren't performing their primary function of taking x-rays, they sometimes struggle coming up with ideas of things to do to remain productive.  You might be at a clinical site that rarely slows down long enough for you to get in trouble, but sooner or later, you will run into one of those low-volume days.  I'm not trying to say that you shouldn't take an opportunity to relax once in a while, but sooner or later, something will need to be accomplished with all the people standing around or people will probably be sent home.

What you decide to do with this time could make a big difference when it comes time to offer a student a job, or during annual evaluations as a technologist.  Here are 10 things that you can do in these moments:

1. Clean and disinfect rooms, wipe down x-ray equipment, portables and c-arms
2. Stock linens and supplies (this will help you get used to where the supplies are located)
3. Organize equipment and supplies to look presentable
4. Check supplies and medications/contrast media for expiration dates and purge expired items
5. Check the crash carts and blanket warmers 
6. Look for depleted oxygen tanks in the department and replace
7. Clean image plates if you have CR systems (have a tech show you how if you haven't done it before)
8. Make sure each room has oxygen and suction supplies ready to use
9. Make copies of any forms that are running low and check to see if printers need paper
10. Review images for quality control and practice critique

To contrast, here are 10 things that you should try to avoid when it's slow.  Don't:

1. Sit down and kick your feet up (and expect a break in 20 minutes)
2. Make a personal phone call in the department
3. Disappear without saying anything - let someone know if you need to step out
4. Engage in gossip
5. Complain about being slow
6. Have sensitive/personal conversations in common areas
7. Play video games on your smart phone or browse social media
8. Bring food into the patient care area
9. Barge into a room with an exam underway - even if you're just trying to help
10. Put KY jelly in another tech's 7-layer burrito and expect them to laugh (true story - wasn't me)

When you're not completely busy, it doesn't necessarily mean the work is finished.  I like to think down time can be somewhat of a reward for working so hard most of the time.  It's up to you to determine where to draw the line between a good reprieve between busy moments, and taking advantage of the situation.  During these moments, try to think about how an Instructor, Manager, or Director would perceive your actions and whether or not you could justify the actions they observe.

Radiograph of the Week

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