This was my first week back to University and we went straight out onto clinical placement in the Western General. I had been here on a few occasions so I was familiar with the surroundings and I already knew some of the staff so I was quite excited about being there.

I was working in the main department and I was glad to be back, however I was nervous about going straight back to producing images. Part of me felt worried that it had been so long since I had any practical experience that I may have forgotten everything I had learnt, despite the fact that I had spent time going over books to refresh my memory before I started back. However I do recognise that this was no substitute for hands on experience. The fundamental principles are the same, but there are lots of other factors that are not described in books that only become apparent by doing the job.

My first day went great although, by the end of it, I was exhausted. Being my first day back I was double checking everything and then checking again before I proceeded. While working it was quietly comforting to realise that the knowledge I had gained throughout the previous year’s course was still with me and I was still able to enjoy the job.

Tuesday however wasn’t a good day. The day was going great until late afternoon when I made a very careless mistake. The request was for a chest and femur examination. I was happy performing the examination despite being told that the male patient could possibly be difficult. I proceeded to bring the gentleman into the examination room and after gaining his trust he was happy to co-operate with the procedure. I produced a lovely image of his chest and helped him onto the bed for the femur examination. I had another look at the request form to see which femur was to be examined, put a left marker on the cassette, and discussed with the radiographer that I would proceed to obtain an image from the hip down and then another view from the knee up. The image I produced was extremely clear but I mistakenly x-rayed the right hip. There was no excuse for this mistake and I felt extremely bad for the rest of the day. I obviously went on to obtain a left femur radiograph, but couldn’t shake the guilt of being so stupid.

Under departmental protocol and IRMER regulation 6.8.2 and 6.8.3, patients who undergo a procedure that was not intended, as a result of mistaken identification or other procedural failure, and consequently have been exposed to an ionising radiation dose, should be considered as having received an unintended dose of radiation. My mistake is classed as a radiation incident, and due to this my supervisor then had to report the incident by filling out the appropriate documentation detailing what had happened. Attached to this piece of writing is a copy of the IRMER regulation.

That same afternoon I had another incident that arose from carelessness. I had been working in the same room all day producing good images of chests without any problems. Later that afternoon a projection I performed of a chest had the apices cut off the top. After examining the machine to check my positioning it quickly became apparent how the mistake had arisen. At the Western they perform the chest examinations in the bucky and the person using the room before me had pushed the button on the side of the bucky, moving the positioning of the cassette by accident. This meant that when I had placed the cassette in the bucky, it had not automatically moved up to the correct position for a chest examination.

My mistake was to not check the position of the cassette and become too inattentive. I repeated the examination successfully but the incident taught me a valuable lesson that I was getting in to a bad habit automatically expecting the cassette to be in the correct position. I now make a point to check the position of the cassette every time. The staff were very supportive in the face of my mistakes, reassuring me that they have all made mistakes of their own and reassuring me that I am a good student who produces good work.

I spent that night feeling remorseful about my mistakes and mentally going through the circumstances that led up to the mistake in order to ensure that I didn’t repeat them. The next day I didn’t really want to go back, I really found these mistakes hard to come to terms with, as they were both down to lapses in concentration and therefore preventable.

The rest of the week went well and without incident, it was a hard week, but it is nice to be back.

This entry was posted on Wednesday, September 23rd, 2009 at 5:10 pm and is filed under Reflectives. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.