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EP. 97 The Hidden Skill No One Teaches in CT: Clinical Thinking · Cat Scan Guru Podcast

• 0:00
  Hello and welcome back everybody.
• 0:01
  Welcome back to the Cat scan Guru podcast.
• 0:04
  I'm your host Karina Hogan. So welcome back.
• 0:07
  Hope you guys are having an amazing week.
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  I know it's getting nice and warm here in the Midwest.
• 0:13
  Finally, because you know me, I am tired of snow and I've said
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  this on probably every single podcast episode.
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  I am not a fan of snow because I come from the West Coast.
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  So if you guys are checking me out on TikTok, make sure you
• 0:24
  follow on TikTok. I am currently doing a Muscle
• 0:27
  Mommy Come Through the Journey With Me series in the next 60
• 0:31
  days so I can get summer ready. So it's an awesome series that
• 0:34
  I've created because my fitness journey is like one of the
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  things that I hold near and dear.
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  Even though I've been through a fitness journey about 100
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  different times in the last 20 years, but this time it's really
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  something that I've prioritized. Some seasons in my life have
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  really changed my perspective on it and I have just taken it just
• 0:54
  by the reins and just stuck with it, which is amazing because
• 0:58
  physically, not only do I feel better, I look better than I did
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  in my 20s and I'm in my late 40s.
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  Like I'm very close to 50. If you can imagine, if you guys
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  see me on TikTok, you probably like, you don't even look like,
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  you know, you're 48 while I am. OK, so, so make sure you guys
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  follow along with that journey, make sure you subscribe to the
• 1:18
  YouTube channel. Lots of good stuff coming to the
• 1:20
  YouTube channel. Lots of videos are going to be
• 1:22
  uploaded for as far as protocol videos.
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  So I'm going to make a playlist for that so you guys have access
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  to that. And I will start posting more on
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  Instagram. And I've kind of paused a little
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  bit. It's because it's a lot,
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  especially when I have two brands because I run two
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  different brands in my business and it is a lot to keep up with.
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  Also, you newer technologists, if you need guidance as far as
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  protocols, make sure you guys get the CT protocol reference
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  guide. It is available to you link is
• 1:52
  in the show notes and you get access to two different courses
• 1:57
  plus an audio series in my schoolroom community.
• 2:00
  So make sure you guys check all that out get your protocol guide
• 2:03
  today, get your pocketbook today.
• 2:05
  There's a mini pocketbook as well that I've created.
• 2:08
  So make sure you guys get your resources so that you can be the
• 2:11
  best technologist you can be, which I know you're going to
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  just rocket. So everything is in the show
• 2:17
  notes, so go check it out. So let's get into today's
• 2:19
  episode. Today's episode, I'm going to
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  kind of take a deep dive on the hidden skill no one teaches in
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  CT, and that skill is clinical thinking.
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  Now SCT technologists were really not set up in a way to
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  really think in a clinical aspect.
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  It's more technical and more of, OK, here's the patient, this is
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  what we need to do scan and then next patient kind of like the
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  Ford factory conveyor belt, which that is something that
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  we're not. But because of high demand, high
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  capacity in the over ordering of CTS July effect is coming guys.
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  We just experience this where we don't really think very
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  critically when it comes to, you know, thinking in a clinical
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  aspect. So what I want you guys to take
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  away is, is that CT isn't just pushing a button.
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  I know a lot of rhetoric has been going around about all
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  we're just button pushers or we just, you know, just do the exam
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  and we don't have to worry about anything else.
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  And then you wonder why radiologists calls and yells and
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  say, why didn't you tell me that there was a critical finding on
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  there so I can read this a little bit quicker.
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  So there's kind of like that dynamic there.
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  CT isn't about pushing buttons. OK?
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  We do a lot more than that. OK.
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  We do a lot of clinical things in CT.
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  It's not about pushing buttons. What really just grinds my gears
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  is when I see comments on social media where texts say, well, all
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  we do is push the button. We don't have to worry about
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  anything else. Yes, you actually do.
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  Because if something goes wrong, do you know how to go in and
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  take care of it? If a reaction happens, do you
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  know how to go in and take care of it?
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  Or are you just a button pusher? So that rhetoric needs to stop
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  because it's uncalled for and we are not button pushers.
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  OK, here's the other thing. Interpreting orders and making
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  sure that correct protocols and correct scanning techniques are
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  executed. So when we have a list of CT
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  orders, we have to look at why they're ordering it.
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  What's the reason the patient came in?
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  So that we select the correct protocol and the correct scan is
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  done on the patient. Now we know as text, a lot of
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  these orders are just wrong or they don't make sense or the
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  providers that are ordering it and the physicians that are
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  ordering it, they have no idea what to order.
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  And I always encourage them and say, you know, a simple phone
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  call saying, hey, I'm not sure what to order, but I'm looking
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  to rule out XY and Z. Now, if I'm not 100% sure, I
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  refer them to the radiologist. But nine times out of 10, we can
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  always guide them in the right direction on OK, this is what
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  the patient is here for. This is going to be the correct
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  order. This is the correct protocol.
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  This is is what we're going to scan.
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  So there is clinical thinking that we do have to do when it
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  comes to interpreting orders and making sure that the patients
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  get the right scan. Now, another point is, is there
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  are some technologists that wait for direction instead of being
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  the go getters. I witnessed this time and time
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  again throughout my career where you have either students that
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  are training in CT or you have new technologists that are
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  crossing over from X-ray and they're waiting for some type of
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  direction instead of just being the go getter.
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  You got to take the initiative, guys, OK?
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  The only way that you're going to learn and be successful and
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  make sure that you can think on your own is you got to be a go
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  getter. You can't wait for a technology
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  to say that case has been sitting there for 30 minutes,
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  are you going to do it? Rec has been sitting on the
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  printer for the last 15 minutes, are you going to scan that
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  patient? You have to get up and be the go
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  getter. There is a difference between
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  technologists who are lazy and technologists who are
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  successful. The successful ones are the go
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  getters, and I know that's going to trigger some people, but we
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  see a lot of laziness when it comes to CT and a lot of it is
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  it has to do with how the technologists are trained.
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  The newer generation, we have to show them the proper way to do
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  things. We can't just let them just wait
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  for some kind of direction. That's not how that goes.
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  OK, So we have to be more proactive in making sure that we
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  have a lot of go getter texts. Now another point that I would
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  like to make is not knowing how to correct them mistake or
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  adjust when needed. Now this goes back to my first
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  point on CT isn't just pushing buttons.
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  So if CT is pushing buttons, how do you know how to correct a
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  mistake or you need to adjust something?
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  Let's say you need to adjust a technique, or you need to adjust
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  a rotation time, or you need to adjust window levels in window
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  widths. So that's why I say CT is not
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  just pushing buttons. You have to have a lot of
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  clinical thinking to know when there is a mistake, how do you
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  prevent it and fix it right away, or if you need to adjust
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  it when you need to or if you need to repeat a scan because
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  you missed something. So a lot of clinical thinking
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  goes into this. Then there's lack of confidence.
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  I have to say a lot of newer texts that are coming in and
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  they lack confidence because CT is very complex.
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  There's a lot of moving parts. There's a lot to know and your
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  brain cannot absorb everything there is to know.
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  That's why I always recommend, please take notes, take notes,
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  write it down. I'm Gen.
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  XI got to write shit down. Okay?
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  I know like the younger properly population, you know, the
• 7:43
  younger generation, they, you know, have their iPads and
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  everything is digital. They're very visual.
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  I'm a very visual person, I will admit.
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  OK, but I still need to write things down because my brain
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  can't process everything. So however, whatever method that
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  you have to remember something, use that because that is going
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  to be that confidence boost that you need.
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  And a lot of newer technologies like confidence, because either
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  they're made to feel like they're not confident, they're
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  made to feel like they're not learning properly, or it's that
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  you should just know, no, we have to stop that shit too where
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  it's not where you show them one exam and then you expect them to
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  just execute it correctly the next go around.
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  It takes practice and repetition to become good at a skill.
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  When you're trying to be good at a skill, which CT is a learned
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  skill, you have to practice and you have to repeat those exams
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  over and over again. Then going back to my point,
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  something similar is feeling dependent and unsure or you're
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  dependent on who you're training with to just tell you exactly
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  what you need to do and then you feel unsure when you're out
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  there by yourself inning you know the patients or executing
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  what you need to do. You have to be more independent,
• 9:00
  asking questions, asking the wise, taking notes.
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  And OK, here's this. What do I do if this happens?
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  If you know contrast doesn't enhance properly, what can I do
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  differently? Well, this protocol wasn't
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  correct. How can I adjust it next time or
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  fix it? OK, you have to be independent
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  because you can't always depend on the text that are training
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  you or the text that are working with you because not all of them
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  are going to be able to save you if there's a mistake, OK, so you
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  have to learn and be independent and be sure that.
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  OK, yes, this is the correct protocol.
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  Yes, this is what I'm executing. Yes, this is how much contrast
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  I'm giving. OK, Now there's some things that
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  I want you to think about when it comes to making sure
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  clinically we're thinking appropriately when we are doing
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  the job and training. So more often than not is what
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  is it that they're looking for as far as what they're ordering.
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  So if they're ordering a CT of the head, for example, what is
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  the clinical reason and without contrast is going to be
• 10:02
  appropriate. OK, now let's say contrast bolus
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  on APE is another example, wasn't as bright or you can't
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  really highlight the pulmonaries.
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  So what adjustment can I do if needed to make sure that I get a
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  better bolus the second go around?
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  If you're allowed to scan again, there's some facilities, you
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  know, they do have you repeat it.
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  Or what can I do to adjust on the next patient to make sure
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  that I have an adequate bolus? And the last point is what
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  protocol should I use for any type of exam?
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  Let's say, say if you're looking for, you know, an SVSVC
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  thrombus, OK, what protocol am I going to use?
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  So typically those are venograms.
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  And is this the appropriate protocol?
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  And to make sure that, you know, OK, when they're looking for
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  this, this is the protocol I need.
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  Then this is the exact, you know, technical factors that are
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  set up in the protocol that are correct.
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  And this is the amount of contrast and you know, the delay
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  after I inject contrast. So those are some points to
• 11:00
  think clinically. And honestly with our CT
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  training, we have to be on point as far as how we're training the
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  new technologists that are coming in.
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  We can't feed them to the Sharks guys, because I know there's
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  some techs that do that. We have to make sure that they
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  learn the proper way. So we have to set the example so
• 11:17
  they can follow the appropriate and successful example.
• 11:21
  So that is it for today's episode.
• 11:23
  Hopefully those points hit home. So make sure you guys follow on
• 11:26
  TikTok, follow on Instagram, subscribe to the show, subscribe
• 11:30
  to the YouTube channel where I give you all the CT education
• 11:33
  and all the CT tips and all your CT resources and needs here.
• 11:37
  So thank you so much for joining me in this episode and I will
• 11:40
  chat with you guys in the next episode.