Saturday, July 18, 2009


Wow. I'm half-way through my first quarter of full-time clinicals. My site instructor came and observed me scanning, and I passed my evaluation. YES! I also had my first "seminar," which is a day set aside for all the classmates to come together, share stories from our sites and present cases. I presented a pelvic case on Adenomyosis, and got 50 out of 50! Can I get another "YES!"

I have learned so much and come so far in these four weeks. So many things that I have learned in class make so much more sense to me now. My skills have have grown each day, and now I can pretty much perform a full pelvic exam, both transabdominally and transvaginally. Yes, I do that. I can also pretty much perform a full renal exam as well (we look at aorta, kidneys, bladder...). I am getting there with my full abdomen exams. I'm still slow, which is to be expected, but I am learning how to sweep through organs, and train my eye to notice the abnormal, subtle things. I can do a first trimester OB exam both transabdominally and transvaginally, evaluating mom's anatomy as well as measuring the the embryo and gestational sac. It makes my day when I see that little heart rate, and see that everything is OK. Its pretty sad when its the opposite.....

I have learned two types of ultrasound machines, and am getting more proficient in the knobology of each of those. I have learned the department's "system" of records management for each patient, as well as the computer programs they use and how to enter patient information and look up records. I also present cases to the radiologists (our site calls them on the phone). Some of the radiologists love to teach me things, and I appreciate them so much. The other sonographers are awesome at teaching me as well, and I am grateful to them as they are not obligated to take on a student, but they do and it adds extra work for them. They provide me with excellent feedback and nuggets of wisdom every day.

I know my way around the hospital for the most part, and have started to spend time in the inpatient ultrasound department. It is there that they see ER patients and perform procedures such as biopsies, thoracentesis and paracentesis (draining chest and abdomen fluid). I have seen and assisted in a couple of procedures. I have also gone on a couple of "portables" ultrasounds, where the sonographer takes the machine upstairs to ICU, etc. to perform exams. That's been very sad to see how sick some of these patients are, but also how wonderful some of these people are to meet.

That's probably the best part during the day, is meeting all of the different kinds of people. Some I remember vividly. Some are super annoying. Some are quite large. Some are quite young (always amazing when they're pregnant). Some are rude. Some are incredibly interesting. Some are very funny. Some are very dense. Some don't have much time to live. Some ask lots of questions. Some love to learn. Some hardly say a word. Some are holding back tears. Some are in pain. Some are very old. Some don't speak English. Some have interpreters. Some are beautiful scans, and you can see all of their anatomy. Others, you put the transducer down and you can't see a THING. Life is a box of chocolates - you never know what you're going to get.

Some days I feel like a complete doofus. Other days, I feel like a rock star. It is up and down like this constantly, which is difficult for me. I would like to start feeling confident, but I don't know if that is ever going to come. Some days I make dumb mistakes. Other days, I'm feeling quite smart. Some days I say stupid stuff. Other days, I sound intelligent. I really don't like all of this insecurity that I'm feeling, and I'm hoping this goes away with more experience. Its definitely keeping me humble, and that I hope I don't lose. I desperately want to be good at what I do, so its hard to have these up and down days of doing well and not doing well. It is seriously like a roller coaster. I suppose it is all progress. Typing this today, has made me realize how far I really have come. Yet, I know how far I have to go!!

Yesterday, I took Melanie practice driving. I was relating to her process of learning to drive to my learning sonography. Everything is new, and each time out for a drive, a small tidbit is learned. For each practice, the tidbits add up until finally you know how to drive. Even so, the skills are continuing to be perfected even years later. Pretty soon, the driving comes naturally and it becomes automatic. I'm thinking this is how it is with me and ultrasound.

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