Wednesday, April 4, 2012

Bad Clinical Experiences

For the most part, the clinical experience during school can be somewhat stressful, and definitely uncomfortable, but occasionally we run into a particular person who simply makes your life difficult. They might not purposefully mean for this to happen, but for one reason or another, you clash. I'm sure we've all had those particular Instructors or Technologists in our lives and in our education, but for some reason, we rarely speak about those individuals. Let me introduce you to the elephant in the room.

When I was in school, there was one staff Technologist in particular who made my clinical experience very difficult. Public humiliation and threats of being thrown out of the clinical site happened all too often.

I remember performing a cross-table lumbar spine for localization as a student (on film/screen). I hung up my image to place a date sticker on it and write "portable" with my sharpie. The images was slightly underexposed, but there was enough density and visualization of the anatomy to clearly make out the vertebral bodies and visualize trabeculae, as well as the spinal needle that the Surgeon wanted the Radiologist to confirm that he was cutting at the correct level.

This Technologist (with about 5 other Technologists standing in the room looking at my image) saw my image on the light box and said, "Oh my God... What the hell do we pay you for? That's unacceptable!" This was toward the end of my clinical experience, so I had gradually built up enough bravery (and stupidity) to compose my response, which I don't recommend using... I replied in a calm, collected tone, "you don't pay me." I think I actually saw steam coming out of her ears... if I only had an egg to crack on her head, I'm sure it would have cooked instantly. Infuriated, she yelled, "Go repeat that right now!"

The tech I was assigned to walked me out of the room and led me straight into the reading room. He told me he thought that I didn't really need to repeat it, but we would ask the Radiologist just in case. When the Radiologist said it wasn't necessary, he also suggested I alter my technique for the rest of the procedure once the hardware was inserted.

I thought I was through the woods until about an hour later, when I found out that she had followed up to see if I repeated the image, and began ridiculing me in front of her staff again. I don't remember her exact words, but she mentioned the word "insubordination" and "do that again and you're out of here." She knew very well that we showed the image to the Radiologist as well, and I found myself on transport duty for the next two weeks.

She liked to do this to me because the hospital was always short on transporters, and she knew I transported for a different hospital on the weekends. I was a victim of my own initiative because I was usually done with my competency evaluations for the semester early, so the school couldn't necessarily say my education was being hindered, although I still disagree. I should also mention that the dress code for male Radiography Students was slacks, dress shoes, long-sleeved shirt, tie and lab coat, so it meant two straight weeks of dripping sweat in my nice clothes and lots of laundry. For some reason, the female students were allowed to wear scrubs... never understood that.

This was just one event from one day of almost two years worth of dread. If you don't know me, I usually find it easy to get along with most people, so it goes to show that no matter what kind of personality you have, you are going to encounter someone like this in your career eventually that just seems to have it out for you. I hear of other stories similar to mine that seem to make people question whether or not they could handle their clinical rotation, as it did for me. I only got through it by constant evaluation of my progress... this person, whether she had a grudge against me, men in general, or was just really unhappy, managed to motivate me to make as few mistakes as possible. I paid attention to detail and tried to learn as much as possible as quickly as possible so that I could attend a day while flying under her radar.

I questioned whether or not to write this post because I did have plenty of good experiences during my clinical rotation, and I don't want to sound negative. There is something therapeutic when you know that others have experienced what you're going through, and have persevered through the thick of it, but it was not until many years after these experiences that I have found anyone willing to open up about it.

I would love to hear similar experiences from anyone willing to post, and please DO NOT mention names - the last thing I want to do here is call anyone out directly, so I also recommend posting anonymously. I would also be interested in hearing how you think the person in your experiences could have handled themselves differently that would have created a more valuable learning experience. No matter how much experience we all build, we still have things to learn too.

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18 comments:

  1. I must remember to revisit this page in a couple of months; I'm not sure it would be wise to contribute whilst still a student!

    That said, the tech in your story sounds like a sadist, and I really hope they were disciplined appropriately. That's really not a suitable attitude to approach students with, and I dread to think what her patient care was like!

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  2. I must remember to revisit this page in a couple of months; I'm not sure it would be wise to contribute whilst still a student!

    That said, the tech in your story sounds like a sadist, and I really hope they were disciplined appropriately. That's really not a suitable attitude to approach students with, and I dread to think what her patient care was like!

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  3. Once as a student on my final placement, I was working in an understaffed public hospital. I frequently stayed back to help them catch up on patients but my supervisor was never appreciative. When I asked her questions I was talk that I should know the answer. Once I was helping her do a morbidly obese patient who needed a pelvis and hip X-ray. We did the pelvis on the bed and it was quite under exposed. She then got called to icu for a mobile and told me transfer the patient (who was at least 3 times my weight) onto the bed and do an in Bucky pelvis by myself. I went and asked another radiographer for help and he told me that using a post processing method it wouldn't be necessary to repeat the pelvis, so we finished the exam and I wheeled the patient out just as the supervisor returned from icu. In the middle of the waiting area she yelled at me "I told you to do another picture". I told her that I had spoken to another radiographer and he said it wasn't necessary. She then yelled that it was her patient and. I should do what she said. Since I had had 6 weeks of this I replied "if it is your patient you shouldn't leave a student alone with them. Now since I am doing free overtime and clearly my help isn't wanted I am going home". Later after she gave me a terrible report, which was not even close to any of my other clinical reports, she had the nerve to ask me if I would apply for a job there. I told her that not only had I asked another radiographer to do my final report but also that I would not apply there and hoped for a job where I would actually learn something, work in a positive environment with people who respected me. They also asked for a review of their workplace and I said I would recommend the university not send any more students. It may be hard to believe but I am usually very introverted and easy going, this was one of the worst experiences of my life!!!!

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  4. @Cherry Black: A wise move... that was one drawback from this post because I don't want anyone to place themselves in a position that would cause tension, and even worse, for someone to say something that could get them thrown out of school. For everyone, please make as anonymous as possible.

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  5. @XrayVision: There is so much wrong with how your situation was handled by the staff I don't know where to begin...

    1. Staying past your set clinical hours should have never been tolerated - huge liability for the hospital as the school's insurance no longer covers you. Good intentions existed, but you put yourself at risk and the hospital should have informed you (and the school if they were aware).

    2. You should never transfer a patient by yourself - and you should always have extra help with heavier patients.

    3. The tech should never leave a student unsupervised. On an exam that was known to be difficult, and that a repeat was known to be necessary, I would argue that even indirect supervision is not appropriate - a Registered Technologist should be present for any repeat images. Students should have a 1:1 tech:student ratio (hospital's responsibility).

    4. Tech #2 needs to be educated that post-processing should not be an option... simply changing the algorithm or adjusting window-level after the initial image processing removes raw data from the initial sample. If they changed the body part completely, there are legal concerns as well. An underexposed image should be repeated because I would guess that even after post-processing, the image you took probably still had quantum mottle, especially once in the reading room under the high resolution monitors.

    It sounds like you got the short end of the stick there... it's so hard to speak up while you're a student when you know something is wrong. You run the risk of offending someone or making your life really uncomfortable for months down the road if you don't handle it tactfully. I always recommend telling someone at your school if you find yourself working with difficult personalities, and hopefully someone has taken the time to educate the staff at that facility. Thanks for posting!

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  6. I remember when I was a student how badly this technologist treated me...she even made me cry in front the others and didn't even get me a chance to use the machine. It's sad really...I think all of them had forgotten that THEY were once students too...

    P.S- Sorry if my English seems a bit weird...it's not my main language =)

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  7. I remember when I was a student how badly this technologist treated me...she even made me cry in front the others and didn't even get me a chance to use the machine. It's sad really...I think all of them had forgotten that THEY were once students too...

    P.S- Sorry if my English seems a bit weird...it's not my main language =)

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  8. @X-RayChick - your English is great... it does seem like Techs forget what it's like to be a student, or might possibly have had difficult experiences themselves, and in turn, make it difficult for those following their paths to becoming a Technologist as if it is somehow required to endure your dues. Either way, we have to challenge ourselves as Technologists who may be training students to consider what method of learning would be best for the patients while still providing the educational opportunities needed.

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  9. Wow Jeremy, I guess I should be extra thankful that I haven't had an experience quite that bad with a tech! I've of course had my share of incidents with less-than-helpful techs (I'm currently in my last semester, hallelujah!), but I've never been yelled at, threatened or "punished." I can understand that teaching isn't for everyone so not every tech is going to enjoy it, but that's no excuse for some of the harsh behavior I've heard about ....

    I should probably also be thankful that I'm being educated in the era of CR and not film, so I've never had to deal with the experience of having my films hung on the lightbox for everyone to analyze! I get nervous enough waiting for the images to pop up on the monitor for just one tech and I to look at. :)

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  10. Wow Jeremy, I guess I should be extra thankful that I haven't had an experience quite that bad with a tech! I've of course had my share of incidents with less-than-helpful techs (I'm currently in my last semester, hallelujah!), but I've never been yelled at, threatened or "punished." I can understand that teaching isn't for everyone so not every tech is going to enjoy it, but that's no excuse for some of the harsh behavior I've heard about ....

    I should probably also be thankful that I'm being educated in the era of CR and not film, so I've never had to deal with the experience of having my films hung on the lightbox for everyone to analyze! I get nervous enough waiting for the images to pop up on the monitor for just one tech and I to look at. :)

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  11. Our program had one site that was notorious for getting students kicked out of the program. Their behavior frequently crossed the line of being tough and expecting a lot to harrassment and bullying. They would always yell at us or make comments about how stupid we were, often in front of the patient. They would give us ridiculous tasks like scrubbing the walls in their department. They would give out orientation papers to students on their first day at the site and in the papers was a line that said "Do not ask us if we need your help. We do not need your help. We know how to do everything that comes through this department; you do not. You are here to learn from us...Even if you don't think you want to work here, you still have to make it through here to graduate..." At evaluation time, they would give terrible evals. In our program, bad evals took points off of your final grade so they knew if they gave enough below averages, there would be now way for the student to pass. As previously stated, it's amazing how quickly techs forget that they were once a student too. NOTHING good came from this experience except for a promise I made to myself to never treat students the way I was treated at this site. From the tech side, sure it's frustrating sometimes to work with a new student, especially when I just want to get the work done. But I always think back to my experience and realize that every tech had to start somewhere; we all had to learn from other techs. And even after working several years in the field, we STILL make mistakes and it's OK!

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  12. @sigma - I'm not sure if I would have rather learned on CR compared to film/screen... it definitely taught you confidence in forming technical factors, and it had the added benefit (some see it this way) of hanging your films in front of the Radiologist, giving a history in-person, open dialogue, and feedback on your quality of work. We miss a lot being separated from the Rads, and there seems to be a growing anti-social aspect with some docs. That being said, there's probably less repeat rate overall with CR/DR, so that's much better for the patients.

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  13. @Anonymous... wow, that's pretty intense. I wonder if the school ever saw that document and what they thought about it. Doesn't seem like a constructive learning environment at all for a facility who has been contracted to provide education to students. They shouldn't be surprised when a student graduates and does not want to work there!

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  14. I experienced similar situations as stated by the other commenters. Thankfully, I worked at six different clinical sites during the three semesters of clinicals and was afforded some relief from Staff Techs' negative attitudes.

    All but one the sites viewed students as a burden and with disdain. I recall one Lead Tech informing me, on day one at that site, that she was treated like crap during her clinicals, and I shouldn't expect anything less from her and other staff personnel. Her words rang true. Nonetheless, I learned a lot of what not to do after observing those techs' apathetic and unprofessional behavior on a daily basis.

    Sadly, I currently work with several techs who possess the same general work ethic...or more appropriately, lack of one.

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  15. I experienced similar situations as stated by the other commenters. Thankfully, I worked at six different clinical sites during the three semesters of clinicals and was afforded some relief from Staff Techs' negative attitudes.

    All but one the sites viewed students as a burden and with disdain. I recall one Lead Tech informing me, on day one at that site, that she was treated like crap during her clinicals, and I shouldn't expect anything less from her and other staff personnel. Her words rang true. Nonetheless, I learned a lot of what not to do after observing those techs' apathetic and unprofessional behavior on a daily basis.

    Sadly, I currently work with several techs who possess the same general work ethic...or more appropriately, lack of one.

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  16. @Anonymous: We have a couple of ways to view and/or treat people that we believe have wronged us. One is to move on, gain understanding and forgive if needed, and the other is to hold a grudge and act on it. I'll be the first to admit that I struggle occasionally doing the former, but if you subscribe to the latter thought process, it leads to nothing but bitterness. I know people who are bent out of shape from things that happened decades ago by people that are not even around any more, and unfortunately, the bitter resentment over these grudges can get pointed at innocent by standers. I like to think that all the negative experiences I had in school have influenced me to become more understanding and empathetic toward students. The medical field needs people who aren't walking around with chips on their shoulders.

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  17. OK, I do agree with what you said Jeremy ... I also know that I'm being way too spoiled by the widespread use of AEC (though we were discouraged from using it in the beginning of our education, so we could learn manual techniques and get better with our positioning).

    I wish I did have more interaction with radiologists—I haven't had much. At my current site, the doctor requested to speak with me once about a specific image and made a suggestion (which I both agreed with and didn't quite agree with!). I appreciate all of the feedback I get, and probably the best kind is from the radiologists since they're the ones who have to work with our images ....

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  18. OK, I do agree with what you said Jeremy ... I also know that I'm being way too spoiled by the widespread use of AEC (though we were discouraged from using it in the beginning of our education, so we could learn manual techniques and get better with our positioning).

    I wish I did have more interaction with radiologists—I haven't had much. At my current site, the doctor requested to speak with me once about a specific image and made a suggestion (which I both agreed with and didn't quite agree with!). I appreciate all of the feedback I get, and probably the best kind is from the radiologists since they're the ones who have to work with our images ....

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