who are we......

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Urology Theatre

As I have said before we have to know a little about a wide range of specialities.  Today I went to Urology theatre for a insertion of a stent into the left ureter of a 35 year old male. i thought this was quite young but the young and quite frankly gorgeous young (female) registrar said this was quite common. (btw, we all have a slight girl crush on this individual, I mean she is stunning, clever and slim! it would be rude not to!) 

in Urology there is no room for squeamishness about the nethers. Its all out on show with many tubes and fluids being inserted where no tubes should ever be inserted!! Its enough to make your eyes water but they do an amazing job. Im not in this theatre very often but the skill with which they twist and turn up the internal waterworks with the teeny tiny cameras and lasers is amazing.

with this patient We deliver one small unexpected kidney stone and insert the stent which will run from the kidney to the bladder and help to keep the ureter open and functioning. simple but so effective.

Whilst in theatre we are all wearing lead coats. This is slightly tricky for me having recently been diagnosed with 2 prolapsed discs in the lumbar spine and  I am not having a good day. The pain is sharp today and no matter what I do I cannot ease it. I feel myself start to sweat...I ease my weight from one foot to the other trying to concentrate. Still they carry on, I can now feel it trickling down my back... ‘Please please finish soon’ I pray hard....

“we are finished with X-ray”....  music to my ears..I take my leads of and realise I am covered in sweat patches, with my scrubs sticking to my back..I get sympathetic looks. from the women and dismissed by the men .I just imagine what they are all thinking...”Poor old thing, shes having menopausal flushes’....i keep my back to the wall and sidle out of theatre...

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ED this week...

The Emergency Department is stressful for everyone. Staff and patients alike. There is no way round that. We are also currently down to one room in the Xray department due to equipment being replaced so all the work goes through one very old and tired room 24/7. This room also needs replacing and if breaks before the new room is finished we are right in the steamy shit because my friends pretty much EVERYTHING that walks through the door in ED gets Xrayed. The Drs have very little time and inclination to assess patients properly so instead of Xray wrist we get Xray whole arm. Frustrating as hell when I can see the patient is moving the elbow and shoulder normally! I can refuse if the patient denies pain but its a risk with so much litigation going on. We are not clinicians anymore we are arse coverers!!

Patients that get brought to me can range from a 2 month old with bad chest to a 102 year old with a bad chest! all come with their issues and difficulties. Some elderly can be bright as a button or some can be literally hanging onto life by their fingernails. I had one batty old patient threaten to hit me with her string of beads if i touched her! Ive had prisoners swearing and cursing, men with objects lodged up their arses, you name it and I've seen it or heard it!. Sometimes it takes brutal determination to get through the day.....its no wonder we all drink!

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I saw this in the GP surgery today. Nice to know radiation is being acknowledged as a risk factor in developing nasties....finally!! 🙏

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This is a lead coat. It stops X-rays. This is what we wear whilst we are in theatre using the C-arm or any type of X-Ray when we are required to be in the room.

Xrays are dangerous. It’s radiation and the cumulative effect can cause cancer. Dont have more than you need. Always question if you are not sure.

My favourite question is ‘why’!

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This piece of equipment is called a C-Arm. the patient is placed in the middle of it on the operating table and we move it around the patient. We use it in theatre for trauma, orthopaedics, Urology, bowel ops, Cardiac procedures, Endoscopy and any other procedure that needs to see inside the body during the operation so its minimally invasive and the surgeon can keep the incision as small as possible.. We have to be able to know something about everything in theatre!!

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Couldn't have said it better myself

https://www.gazettelive.co.uk/news/teesside-news/powerful-message-shared-ae-nurse-15951087?utm_source=facebook.com&utm_medium=social&utm_campaign=sharebar

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We all look the same underneath...JUST SAYING.

(photo taken from Reddit)

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Trauma Theatre..

Theatre today. Very long case for a young lady under 30 who broke her proximal humerus tripping over the wire to her hairdryer. The Xray looked like an elderly lady fracture by the way the bone had crumpled. I’d seen 2 in ED the weekend before that looked very similar only the ladies in question had been in their 70s. This Patient had got 4 children and her youngest was 4 weeks old. i asked the surgeon “do you think she might be osteoporotic? i wouldn't say that was a normal fracture for a woman of her age?’ he rolled his eyes....and shrugged...”pppffffssssst i don't know!’ Fixing him with a steely glare behind my mask I turned and walked away to get my equipment,  muttering rude stuff under my breath.

Later that day when I booked the procedure onto our computer system I saw that a DEXA scan had been requested for her ...( a scan to check for osteoporosis) . 

 Sometimes....Just sometimes its worth speaking up as it may just make a difference.

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Late shift in ED

ED or ‘Emergency Department’. The clue is in the title. Don't rock up to ED with an injury that is 4 weeks old or a cough that is viral or a chest infection you left because you couldn't be arsed to get a GP appointment. More importantly don't moan about the fact you have got to wait four hours to be treated. The reason the wait is 4 hours is because of inconsiderate idiots like you!! 

Most of the time I like working in ED. it can be interesting and fulfilling but highly frustrating. The junior doctors have their first rotation and some would say baptism of fire in ED. They are fresh out of med school and wet behind the ears. They request hundreds of unnecessary X-rays in massive arse covering exercises mainly because they don't have a clue what is going on with their patients. Nurses on the other hand are old Pros..They’ve been around the block... They know what's what and how to treat it!!

Patient A comes round with request, from junior Dr for abdominal Xray. Pain in Abdo and difficulty weight bearing... We X-ray the abdo. Patient has been in department for 2 hours at this point.... 2 hours later she is back outside my room for pelvis and hip Xray, ‘Pain in hip, patient can't weight bear’  I speak to the patient who is now in a state. She is Tired hungry and thirsty, been scanned and prodded for suspected hernia, which was negative and now they have decided its her hip that is the culprit which is why she is back. She tells me that she has been told to go home after the hip X-ray and a letter will be sent out to her.

1.she has been in department for more than 4 hours=breach =fine to hospital

2.she leaves with her original issue unresolved

3.she has had unnecessary radiation because she wasn't assessed properly in the first place!  

......SIGH...............

Patient B is sent round by nurse with Xray request, also for Abdo Xray. ‘?? foreign body in abdominal cavity’ harassed Nurse in charge comes to explain..”Sorry guys, He appears to have shoved a deodorant bottle up his arse as an experiment whilst his wife was in hospital having her hip done and got it stuck! he's been trying to dislodge it with vast amounts of laxatives but its still there and now he's shitting round it. I wouldn't mind but he's making up some story about accidentally falling on it whilst stepping out of the shower....ffs, Do i look like I was born yesterday?”

Yes we have seen it all before, stick what you like up your arse but be honest with yourself and us and be prepared to go to theatre to have it removed. When the bowel goes into hard spasm, you are f@@ked.....quite LITERALLY!! 

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Tools of the trade!

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Inpatients...

Yesterday in the busy day of the X-ray Ninja was spent dealing with the sick and elderly that are the residents of the hospital. We get them in various states of undress, cleanliness and mental health. One Elderly lady who was wheeled in for an abdomen X-ray had no idea who she was or what day of the week it was. After her picture I asked her if She wanted to sit back up in her bed. She grabbed my hand, fixed me with a steely glare and said ”i have no idea what perfume i am wearing!’ ..God love her!

Theatre in the afternoon for an ankle fracture. Plated on one side and screwed on the other. The lady in question was of ample padding and due to her osteoporosis, her bones were like putty making it difficult for the screws to gain traction in the bone.  Why am I telling you this? Ladies it’s VERY important to keep optimum bone health and keep trim, especially after the menopause.

Stay Active

keep weight bearing and prevent sitting for long periods

Resistance exercises with weights twice a week if possible

Eat a healthy balanced diet with plenty of calcium and Vitamin D.

Get some sunlight. this is important for your vitamin D

Drink sensibly and don't smoke (or cut down)

Prevention in this case is always cheaper (for the NHS) and less painful (for you) than cure!

https://www.nhs.uk/live-well/healthy-body/menopause-and-your-bone-health/

https://theros.org.uk/

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Outpatients...

Today....Outpatients! we run an open service from 8am to 5pm for walk in GP patients and Clinic patients. This means you can get seen for your Xray the same day as the Drs appointment but obviously there is going to be a wait. Unless you get to us at Dawns Crack or you are very lucky and nobody else in the vicinity needs an Xray YOU WILL HAVE TO WAIT!! We tell patients when they arrive there is a wait but still they moan and moan.....and moan! All vey big and brave in the waiting room full of people but not so much in the X-ray room when faced with a wild eyed, frazzled radiographer who has previously been wrestling with a fractious 2 year and heard it a million times. 

I wheel a particularly deaf elderly man into the room who can't understand why I don't need his trousers off.....”NO SIR, YOUR TROUSERS ARE FINE, KEEP THEM ON. IM ONLY LOOKING AT YOUR CHEST!!”

 he doesn't hear me but the rest of the department does! Cue massive pisstake from colleagues for the rest of the day......

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Who are we......

Radiographers, that's who. We are the beating heart of the NHS, the life force that flows through all wards, ED, Theatres, Outpatients and Inpatients. We work with and are expected to know about Trauma, Urology, General Medicine, Dental, Chest Clinics, Cardiology, Paediatrics, Geriatrics, MSK and many more...I doubt there is any other profession that has such a broad range as we do.

Unless you are a radiographer you wouldn't understand or appreciate just how much we do behind the scenes and how much we contribute to the diagnosis and care of a high percentage of patients that pass through any hospital, NHS or private.

Our tools of the trade are worth millions of pounds, we take internal ‘photographs’ that can save your life yet we are often overlooked, underfunded and ALWAYS forgotten in many situations. Doctors and nurses are portrayed as the key workers in many TV dramas and in Greys Anatomy the Drs all do their own scans which in real life would NEVER happen...makes me laugh and cross all at the same time. The X-rays that are shown are so bad and sometimes shown upside down!

We are a bunch of highly skilled, technical minded geeks. Mostly women because lets face it, women are the clever, stronger sex. The male members of our department have to have strong constitutions as we talk about anything and everything relating to women’s issues. We have dark humour and strong stomachs..some days are good and other days are frustrating and hard as hell. 

I decided to write this because I want to shed some light on what we do. I have read the book by Adam Kay and it inspired me...Drs are amazing at their jobs but they couldn't do it without us. in this world of ever increasing legal action and litigation, X-rays are used more and more for arse covering purposes and many are completely unnecessary! i want to entertain (but also educate)  because honestly some days are very funny. Patients are funny and my co workers are hilarious. Never EVER take on an NHS worker in a drinking competition....YOU WILL LOSE!! We work hard and play hard....as you will see.........