Hospital based NP--useless with image interpretation.

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Hi, I'm a stranger in a strange land. That is, I am a hospital based NP (work on a surgical team) with an educational background in primary care. So, I received virtually NO training in reading films/scans. I thought I could pick up this skill along the way (like, in a limited fashion--so I could pick up on obvious things). I mean, I have no problem calling a radiologist to get a wet read, but it gets a little old when I just need to verify line placement or something. I am a little frustrated that my very expensive graduate school didn't really cover this topic since having basic radiology skills seems pretty necessary--and I imagine I will feel this way in a primary care setting as well (though maybe not on a daily basis). I get very annoyed with myself when I need to be able to make a treatment decision somewhat quickly, and I sit there and stare at the picture and cross my fingers that the report will be up soon.

Anyway, I'm pretty hard on myself about this, but I haven't come up with a solution yet. I have a pretty decent rads text book (which is a little much to learn with on my own), and I've tried some online "basic cxr skills" websites, but I really would like some formal training. Does anyone have a similar experience? Any recommendations of the best way to boost my skills? Or--obtain these skills since I don't really have them to boost?

I feel pretty vulnerable in this regard. While it's not REQUIRED that I do this for my job, I think people pretty much assume I have this skill, and I feel pretty awkward when someone asks me what a film shows and I have to say "dunno. let me call the radiologist."

Bah. I feel like a dork. :icon_roll

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Specializes in ICU.

So placement of what?? Lines or hardware? I work inICU, doctors are willing to teach us to read for lines. If it is lines, I start where it enters the body then trace the opaque line if it has one to the end. ETT same. Should Set just above the carina.Hardware, I have no idea. Another thing, why not walk over to the Radiologist instead of calling and have him/ her to show u how they read the interpretation. just be honest and tell them U didn't get a lot in school. Most are willing to work with u, in the long run it will help the both of u.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

You need practice. Do you have access to your hospital's ePACS? Bring up your patient's films and grab a nice senior resident and admit you need a lot of work in deciphering what to look for in the film. Do this consistently each time even if it's not your job. As you start seeing more films, you'll get an a-ha moment and the rest will be a breeze. I went to an ACNP program and though we had a class on Radiology films, I learned more during Radiology rounds as an ICU NP. I guess that's the advantage I have since we are forced to look at films during daily rounds.

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Thanks. Very good advice from both of you. I definitely need to be proactive about this. I think I hesitate because I feel like I should already know, but that's silly. I work in a teaching hospital, so I should be taking advantage of it, not hiding. The other day I was helping another surgical team take down a wound vac and their intern asked if the slough on the wound borders was purulence. Sure my first response (which I didn't say) was "wow, you haven't seen many wounds have you". But you know what? She hadn't. Now she's seen a great one and I was able to teach a little bit.

So there you go. Thanks again for your advice. I'm gonna run with it.

Cheers,

Kan

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Specializes in Emergency,.

I am a new graduate NP, about to start an Emergency Fellowship, one thing i did in school was audit a PA radiology course (thankfully as my NP program canceled the ONE DAY radiology review). the book we used was one of the better text books i have used.

i would recommend Learning Radiology - Recognizing the Basics, by William Herring. ISBN 9780323043175

goodLUCK!

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I am a new graduate NP, about to start an Emergency Fellowship, one thing i did in school was audit a PA radiology course (thankfully as my NP program canceled the ONE DAY radiology review). the book we used was one of the better text books i have used.

i would recommend Learning Radiology - Recognizing the Basics, by William Herring. ISBN 9780323043175

goodLUCK!

Thank you very much! Good luck with your fellowship!

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We had a 4 hour class in this each week. You can look at some of the state and national conferences. I don't know about NP conferences but most of the PA conferences have a CXR boot camp class. Also if you work in an academic center see if you can come in for a 1/2 day with one of the radiologists looking at chest xrays. My problems with CXR usually are around the lousy quality and/or lousy monitors. Learning how to use the contrast brightness controls on your PACs will help you with line and tube placement.

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Did you check google and youtube? There's usually a lot of stuff online for medical students.

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Specializes in Emergency, MCCU, Surgical/ENT, Hep Trans.

You are not alone. The newer software packages help, contrast as noted above.

I've seen fellows punt to radiologists, don't feel too bad. When I have a few moments, I practice looking and comparing what I think, reviewing the official reads. Often times, before I discharge, little caveat, "I'm not a radiologist." Usually have to call 1% back.

Ditto on learning radiology.

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Specializes in L&D, Mother-Baby, Special Care Nursery.
I am a new graduate NP, about to start an Emergency Fellowship, one thing i did in school was audit a PA radiology course (thankfully as my NP program canceled the ONE DAY radiology review). the book we used was one of the better text books i have used.

i would recommend Learning Radiology - Recognizing the Basics, by William Herring. ISBN 9780323043175

goodLUCK!

wow, so proactive! I love it!

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