Having worked in a medical center for a significant period of time, one would think that a high volume of daily accomplishments and achievements on a daily basis is the gold standard. On any given day, for example, a bustling medical center CT department could easily pump out pulmonary angiogram after pulmonary angiogram, mixing in a few vascular run-offs, sprinkled with a couple cardiac exams, a pinch of multiphase scans and a dash of brain perfusions. Wrap it up with the typical half dozen motor vehicle accidents and you have yourself a typical medical center day.

However, I'm occasionally reminded that our small department's daily grind is not the norm and that not every hospital faces these challenges and problems. With that in mind, we should be proud--yet humble--and confident in our abilities. We are fortunate to put our many skills to use exactly when the moment calls. I'm also reminded that we are to be a beacon to organizations that aren't equipped with the CT skill sets, experience, resources and knowledge base which we enjoy and occasionally take for granted.

As a CT department liaison to a few of the smaller hospitals in my area, I've noticed that in a small radiology department, the typical technologist is a "Jack of all trades, and master of none." Generally speaking, the CT tech is someone who can perform a scan one minute, take off to the OR to shoot that hip film the docs are screaming about, only to come back to fire off a couple of ankle X-rays.

The CT tech could very well be an army of one--someone whom the department fears will take time out of the office or a sick day! Imagine: he calls in sick and there are three ER patients who need an abdomen CT. Deflated comments come from behind a closed door, "Gosh, hope we can find the manual, or better yet, read his sticky notes on how to start up the darn thing". When it comes to CT scanning in these small departments, a few obstacles rear their heads, causing department managers to up their intake of Rolaids.

Equipment

Specific scanners may be purchased for a number of reasons. Once the check is written, it sits in all its glory just waiting to be taken for a spin. Problematically, there's only a small amount of time often allotted for training, often with just a few technologists who better take good notes. Often this takes place during "slow periods" for patient loads, translating to big frustrations as opportunities to scan-and effectively train--are hindered. Techs often assail the applications specialist with many questions, primarily out of a panicked state of mind.

Experience

Believe it or not, much of the training goes to technologists with the most experience in CT. In a small department, generally the most experienced technologists have been employed the longest. Not to be unfair, but this tech may also be the one who finds newer technology features difficult to grasp--perhaps intimidating--which can hinder the rest of the department's learning. Not to slight senior staff members, but departments may also find it beneficial to find the "computer geek" in their midst to fully take advantage of the technology upgrade.  

Education

Many small departments are strapped for funds and don't have the resources to pull together opportunities for technologists to gain extra training. Small departments struggle to cover sick time and vacation; allotting time for site visits or training opportunities can be a big stretch. Much of the emphasis of education is placed solely on the employee through CEU credits, lectures and reading performed on their own. But let's face it: you can't put into practice what you learn unless you see it, do it and have the opportunities to bounce ideas and information off of fellow techs with more experience. To add insult to injury, a number of larger institutions hold their CT secrets so close that you need level eight security clearance to even speak to them on the phone.

Patients deserve the best of what each technologist has to offer. In turn, the technologist deserves the best opportunity to train and gain the necessary knowledge to perfect his craft. Medical centers need to shine that beacon, while managers and technologists need to take heart in knowing that there are folks out there in the CT world willing to help. You just need to look.

Rick Stewart, RT(R)(CT), is CT supervisor at the University of Virginia Medical Center in Charlottesville.