WEEK 8 - Mobiles, IR and deer

Week 8 

Week 8 started with mobiles. We started the morning with a round at the intensive care unit. It is something i haven't gotten to do before so I didn't know what to expect. At first it was bit overwhelming - machines beeping, multiple tubes and leads and lots of different machines. Some of the machines would go wild and patient's blood pressure rocket when we lifted them to more up right position. I was allowed to move the portable machine and place the detector behind patient's back. On the second day I was allowed to move the tube and drive the portable xray machine. Rest of the days I spent doing general xrays. 

St. Stephen's Green was starting to get its' green

In IR my role was to just be an observer and I was able to see a TACE-procedure (Trans Arterial Chemo Embolisation of the liver). I also saw some PICC-lines and PortaCath-catheters being placed. IR differs a lot from my experience in Finland. There are a lot more nurses and other staff present and the room got crowded at times. I am used to just one doctor and two radiographers and not being able to do anything was frustrating. I found myself being more interested in what the doctors and nurses are doing. I was able to recognise some familiar wires like Terumo and Emerald which made me feel more at ease.

On Thursday there was a spot open in ultrasound so me and another student got to see new proceedures. We were allowed to practise scanning on each other which was very interesting. I would like to study ultrasound in Finland but sadly the time for it has not yet come. 

During the week I met some locals at bar. We discussed the looming housing crisis and the irish ghost estates. I learned that the Irish are very proud of their heritage. I also talked to a nurse from Northern Ireland who taught me about the CORU rights. He would like to go work in Ireland which would be easier with the UK license but he would much prefer to have an Irish license and be under CORU. Irish CORU would make the process to Australia harder though. 

Legendary Phoenix park deer

Week 7 - Ultrasound and theatre

Week 7

A little treat from coworkers

Ultrasound was the first modality with significant differences. In Ireland sonographers are a lot more present, doing ultrasound scans (normal and transvaginal) independently while reporting about their findings in a descriptive way. In Finland there are only a couple dozen sonographers and only a small percentage of them work just in ultrasound. In Finland sonographers are only allowed to perform simple, pre-dictated scnas like the abdomen or achilles heel. In Ireland it feels like sonographers allows natural, rewarding career progression to radiographers. 

My role in ultrasound has been preparing the room (including sterile table and sample jars if necessary), undressing the patient and selecting the right patient on the ultrasound machine. Sometimes the roles of radiographers and doctora are very clear - a doctor may not know how to select a patient while a radiographer doesn't know how to freeze the image. Overall doctors are not too fond of sonographers in Finland and sonographers feel like a threat to them. I know Ireland has fought for sonographers' rights and there will soon be a clinical study which involves radiographers diagnosing instead of just giving a descriptive report. I hope Finland can follow Ireland's example and improve the field of sonography and bring MSc level radiography education to school again. 

On Thursday I got a chance to visit the theatre. I saw one ankle surgery. I was surprised to see the radiographer move the C-arm. In Finland there are no nurses and radiographers are in charge of the sterile table and equipment. In Ireland radiographers are in charge of the C-arm movement.

Context of the modern Irish Radiographer

The differences between radiography in Ireland and Finland surprised me. Ultrasound and the role of sonographers was very fascinating. Ireland is way ahead when it comes to sonographers and the examinations they are allowed to perform. I learned about a study that was taking place at SVUH that compared sonographers with different work experiences to radiologists and their reporting. The aim of the study is to allowed radiographers to diagnose and do full reporting instead of just a descriptive report. In Finland doctors aren’t too fond of the idea of sonographers and we still have a long way to go.

Fun fact, in Ireland radiography is a bachelor of science while in Finland it is bachelor in health sciences.

Some coworkers recommended I visit the Dublin Zoo and I was not disappointed. 

Week 6 - Mammos, PET and Galway

 Week 6 

Spotted some sheep

Week 6 was the second week of my clinical placement at SVUH and this week I got to see both mammography and pet-scans. During my mammography placement I got to see mammography screenings, breast ultrasound and biopsy and one clip marking. I was also grateful for the chance to visit the doctor's office and hear about the diagnosing and   I also learned about triple assessment where patients get an ultrasound, regular mammography and see a doctor during one day. Overall the projections are criteria are the same, with post-graduate training before you are allowed to work without supervision. 

 PET-scans were more different. All injcetions were given manually by using a movable tray with a lead chamber with the syring inside. It was my first time seeing a PET-injection administed by hand, since i am used to a machine called posijet where you can set the desired amount of radiation.

At SVUH they keep the scan room quite cold. This was explained by the detector needing to be kept cold but in the scan images you could see the brown fat areas activate, and overall image quality was slightly poorer than what i am used to. I have been taught to always keep patients really warm, offering multiple blankets if needed. In the hospital i had my placement at in Finland also had a bed for all patients but   understand the restrictions caused by the small working space. At SVUH patients had comfortable chairs to rest in.

Cliffs oh Moher

On Friday I visited the museum of Irish Literature (MOLI) located near Saint Stephen's green. I had a lovely time learning about James Joyce who has a library named after him at UCD and other literature aspects of Ireland. My next goal is to read Dubliners after I have completed most of school assignments. During the weekend we took a trip to Galway. We explored the cliffs of Moher and the city itself.

Week 5 - SVUH

Week 5

Like a real radiographer

Week five marked the beginning of my five week clinical placement in Ireland. I was placed in Saint Vincent's University hospital (SVUH). I was supposed to start with two other students from my university in Finland but they were sadly sick so I ventured off alone. Soon enough I met familiar Irish students who helped me get started.

Thanks to the new bank holiday, my week only lasted three days with Fridays off for Erasmus students. I started my placement on CT. If everything goes according to plan the following five weeks I'll explore almost all the modalities SVUH has to offer, CT, PET, nuclear med, mammography, generals, ultrasound, IR and theatre. Shorter times allow me to explore a wider variety of modalities but leaves me into a more observer role. I have had a placement in all modalities so I don't mind too much.

All the essentials

There are a lot of small differences. Small differences that have snowballed into large differences I am still getting used to. In Finland the hospital offers work clothing for everyone including students while in SVUH we brought our own uniforms. I also got my first ever swipe card for hospital access (I am used to keys and wasn't prepared to get my photo taken!). The hospital is quite different from what I'm used to and reminds me more of an airport - university hybrid. 

I noticed that nurses are a lot more involved in the scanning process than in Finland. Back in Finland radiographers administer all necessary medications and contrast medium (p.o and i.v) meanwhile here we might stop the scanning process to wait for a doctor to administer a diuretic. There are a lot of people in the CT-room too, up to 17 at once while I'm used to two radiographers per machine in Finland. It also gets quite busy at times, especially when there is a patient from the emergency room!

Oral contrast is also very popular here. In Finland I have never given oral contrast to a patient but at SVUH most CT patients receive it. I was allowed to give patients directions and administer the oral contrast medium independently which was nice practise. In Finland we prefer plain water around 10 minutes before the scan. I should probably research the topic more.

This placements puts me into a weird spot - in Finland I am able to position the patients, start cannulas and do the scans on my own.  I know I am not entitled to do those things and overall I don't know what is expected of me as a student.

Week 4 - Projects and research

Week 4

James Joyce library became my second home

This week was all about group presentations and getting mentally prepared for clinical placement. I spent a lot more time on campus working on different group projects with the other Erasmus students. People were starting to show first signs of homesickness so we focused on finishing the task instead of striving for perfection.

 

Howth

We finished the week with visiting Howth with the other Finnish students. Ireland's beauty cannot be beaten even at this time of the year. 

Research In Radiography

Lately I have been thinking about research in Radiography. I am writing my thesis about Radiographers career paths in Finland and the small amount of people interested in research and the current lack of research in radiography. Every student must write a thesis during their studies which can be discouraging for future studies.  Around 10 years ago you were able to study radiography in an university and focus on researching and writing articles. After radiography moved to an university of applied sciences the possibility to study a doctorate in radiography disappeared. Now it is only possible to study general sciences.

One of the many topics

I was surprised to find out the post graduate study possibilities there are in Ireland. UCD offers many interesting choices, especially master’s degree in clinical medical imaging which includes a thesis. I find that Ireland’s model of seven courses or thesis gives a chance for the more research-oriented people to experience what it is like to make science. The lecture we had about radiography research was also very interesting and has made me consider further studies abroad.