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Yes, I am aware of that and other tales

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  • Yes, I am aware of that and other tales

    Got a little bit of everything, so rather than start multiple little threads, I made one big thread. Just a reminder that I am a Nuclear Medicine Technologist.

    I'm a Big Kid Now
    One of our cardiac patients the other day was either really freaked out by having to have a stress test, or has some serious dependancy issues. Now, I understand that possibly having something wrong with your heart is a scary thing. But your husband/boyfriend/boytoy/whatever really does not need to hold your hand the entire 3-4 hours the test takes. Seriously, lady, you're a grown adult. Put on your big girl britches and deal. I'm really starting to loathe when patients bring someone else with them because the second (third, fourth....) person tends to take over. I'm talking to the patient, not you. Speaking of which....

    Moral Support
    Lady comes in for a bone scan. She has her daughter with her. Daughter does all the talking, including demanding to know--rather rudely I might add--what possible diagnoses a bone scan is used for. Me being eager to educate mention that since our scan relies on the bones' metabolism, sometimes we can pick up fractures or other injuries that x-rays might not be able to see. We can also use a bone scan for staging certain types of cancer and infection. However, the scan is extremely sensitive and not very specific; meaning we might see a hot spot, but we don't know if that hot spot is an old injury without having an accurate patient history. Kindof an aside, I talked to a tech once who did a bone scan on a jockey. He lit up like a Christmas tree, but the tech knew he didn't have some sort of disease process because she knew the guy was a jockey.

    Lady comes back in a couple hours for the actual scan and I notice her feet look hot, so I ask her if she's ever broken/hurt them that she can remember. She says they hurt all the time. Me being the good tech that I am get an extra picture of just her feet. Then she asks me if she has cancer. BWUH?!

    No, lady. Unless your doctor has already told you that you have it, we're not doing a bone scan for it. Besides, I'm not qualified to make that diagnosis. See, if you'd just come by yourself, your daughter wouldn't asked the question and you wouldn't be freaked out right now. Sorry I scared you.

    I don't know. You'll have to wait and talk to your doctor.
    I've never had so many people ask me the results of their tests. As a tech, I can't say. Sure, I know most of the time if a test is normal or not, but I didn't sell my soul to medical school so I can't make that call. Stop asking me. All I'll tell you is it looks like <insert relevant body part here>.

    I already knew that, thanks.
    Yesterday, M and I were discussing one of the proceedures on the schedule and which of us was going to inject and which was going to hit the start button on the scanner. It was decided that I was going to inject and M was going to hit the button. I hoped aloud that the patient was bringing good veins for me to stick. The charge tech turns around and says "You're going to have to get over that. When you're here by yourself, you have to stick everybody."

    Yeah. I knew that. Doesn't mean I WANT a hard stick.

    Oh, this is going to go over well...
    Yesterday a drug rep came in and did a presentation for a new stress drug. When patients can't walk on a treadmill to stress their hearts, we can do it chemically using a drug called Adenosine. Adenosine is a vasodialator which means it triggers a reaction that opens up all the blood vessels in the body that have certain receptors. Side effects suck (nausea, headache, flushing, chest pain, shortness of breath....) but go away as soon as we turn off the pump.

    The new drug is a more targeted version. It only targets A2A receptors, which are located in the coronary arteries, lungs, and some in the GI tract. We've been hearing about some nasty side effects from this new drug including sudden and massive bowel issues ("Code Browns") and at least one full code. After some investigating, the makers of NewDrug have found that the bowel issues were caused by patients eating fatty meals too close to the time they got the drug. Easy enough to fix. And that full code wasn't really a code, just a 7 second pause that was easily reversed with another medication. Still scary, but not as scary. That kind of thing has been known to happen on occasion with Adenosine as well and usually to patients who really shouldn't be having a stress test to begin with. Side effects with NewDrug are similar to Adenosine, but less intense. They also might last longer, but can be easily reversed. Personally, I feel better about maybe using NewDrug since it is a unit does and not weight based like Adenosine. It's also much quicker.

    The discussion with the drug rep brought up an interesting point. According to policy and proceedure for Hospital, nurses are supposed to be giving any drugs. Some of the networked facilities are exempt from this, but any facility that bears Hospital's name (like ours) has this rule. There's a problem. My workplace is basically an outpatient testing center with an ER. There are plans to turn it into a real hospital at some point, but for now we're still really small. We do not have a nurse readily available to give the drugs, so the techs have been doing it. And the management at our hospital know full well we are breaking policy. I don't doubt for a second that if something happened to a patient, we'd be taking the fall for it, not the management that forced us into this situation. Sorry, but it's not worth losing my license.

    Today my coworker, one of the echo techs, and the charge nurse were going to go to their respective bosses to get this taken care of. They're not holding out much hope that anything is going to get fixed. Giving those drugs is part of my scope as a Nuclear Tech, but if Hospital doesn't want to hire a radiology nurse to do it, I want it in writing that they want us doing it.

    The curse of chatty patients
    For some reason this week, all of our patients would not shut up. Sorry kids, you have to hold still for this test and that includes talking. Hush.



    I love my job. I really do.
    I am no longer of capable of the emotion you humans call “compassion”. Though I can feign it in exchange for an hourly wage. (Gravekeeper)

  • #2
    Quoth jedimaster91 View Post
    I don't doubt for a second that if something happened to a patient, we'd be taking the fall for it, not the management that forced us into this situation. Sorry, but it's not worth losing my license.

    Today my coworker, one of the echo techs, and the charge nurse were going to go to their respective bosses to get this taken care of. They're not holding out much hope that anything is going to get fixed. Giving those drugs is part of my scope as a Nuclear Tech, but if Hospital doesn't want to hire a radiology nurse to do it, I want it in writing that they want us doing it.
    Good call. Draft a written memo outlining the issue, cc it to EVERYONE, and insist on a written answer clarifying how you should proceed when a nurse is not available.

    Then ask a follow up question (any question, it doesn't matter) to give you an excuse to cc their written reply to EVERYONE.

    That should cover you nicely.
    The best karma is letting a jerk bash himself senseless on the wall of your polite indifference.

    The stupid is strong with this one.

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    • #3
      I know some people just get scared by hospitals; I sure was my first time! And when I'm nervous, I can't shut-up!
      "If anyone wants this old box containing the broken bits of my former faith in humanity, I'll take your best offer now. You may be able to salvage a few of em' for parts..... " - Quote by Argabarga

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