Employment Survey Results

Back in October of 2012, I posted a survey about the employment situation across the country and asked six questions relating to the job market aimed at new graduates from radiography school.  With any survey, the more responses received, the more accurate the results.  I received 30 responses to my questions, and here they are:

The results were anonymized, but it seems there are a range of responses across the board.  I know the job market is not as good as when I graduated from x-ray school in 2000, but if these responses are representative of the national average, I have seen worse. 

In my book, Becoming a Radiologic Technologist, I explained the criteria that a radiography program must have 75% of its graduates employed (in any tech job) within 6 months of graduation.  I would be interested in speaking to any of my readers who represent JRCERT to learn more about the re-accreditation process and statistics about radiography program probation due to low employment statistics. 

Until then, it seems that the market is competitive.  Like any field, that's not to say every graduate is guaranteed a job right out of school, or even a full-time day job.  There are positions available, but keep an open mind to the possibility that you may need to relocate, accept undesirable shifts, or have some delays in finding an ideal position.  I wouldn't discourage anyone from seeking an education in radiography, but you need to love what you're doing and be prepared for competition.

CR Quality Control #1 – Screen Cleaning

One of the most important, yet sometimes underperformed activities we can do to keep our image quality high is routine cleaning of image plate phosphor screens.  Each CR system manufacturer will recommend a schedule for routine cleaning of IP’s, but I tend to think that a monthly schedule serves my department well.  This may vary depending on your department’s patient volume and usage. 

How to clean: Remove image plate from cassette holder.  Inspect in good lighting to identify any potential dust, scratches, or flaking off of the phosphor layer (see images below) that may produce artifacts.  Always replace the IP if needed – discuss the need for replacement with a radiologist and/or your department manager if you are uncertain whether or not the plate has enough damage.

Take a non-abrasive cloth or gauze and dampen it with screen cleaner (see manufacturer’s guidelines for type of recommended cleaner).  Wipe in small circular motions until the entire screen has been properly wiped down and inspect for dust.  Make sure that you use something that does not leave a lint residue.  Do not place cleaner directly on image plate. 

Let each screen dry, being careful not to rest the phosphor side of the screen down.  Most cleaners are alcohol-based and should dry rather quickly. Make sure each plate is completely dry before re-inserting into the cassette.

Each IP at my facility (we are using FUJI CR) has a barcode that can be catalogued and records can be kept logging which plates were cleaned, when they were cleaned, and by whom.  It should also be noted when any damage to an image plate is identified, as well as if a plate gets replaced.  I chose a rather worn cassette for the following image because you should also visually inspect the cassette.  Some times the hinges that hold the image plate inside the cassette become loose leaving the plate to fall to the floor and become scratched.  It’s much cheaper to replace hinges on a cassette than to replace the phosphor screen.

Any radiologist will tell you if artifacts are seen on your images, but monthly cleaning of the image plates should keep them to a minimum.  This is one of the easier activities any rad tech or student can perform that can be extremely valuable to image quality in your department.  Normal wear and tear will occur as the image plates are processed, but keeping a log over time should help you predict how often you will need to replace screens and how your department should budget for them.

Other posts in this series:

CR Quality Control #1 - Screen Cleaning
CR Quality Control #2 - Creating a Baseline Phantom Image
CR Quality Control #3 - Exposure Indicator Calibration
CR Quality Control #4 - Contrast Evaluation 
CR Quality Control #5 - Sharpness
CR Quality Control #6 - Shading Correction
CR Quality Control #7 - Laser Jitter
CR Quality Control #8 - Image Artifacts and Noise
CR Quality Control #9 - Exposure Linearity
CR Quality Control #10 - Residual Image Testing

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.