The importance of restorative practices: tempering emotional labour for sonographers

Published: 31 October 2019 Health & safety

All people need self-care; that is an important statement during Medical Ultrasound Awareness Month.

It is significant that to champion self-care we also need to raise awareness of emotional labour.

For example, part of the role of a sonographer involves bearing witness to the suffering of others. Bush describes the position of healthcare staff in the following quote: "The helpers and healers of society, including healthcare professionals, are at the frontline of humanity; they see behind the mask of polite society.’1

It has been reported that healthcare staff regularly bear witness to suffering when patients share experiences and narratives of illness2. The pain and trauma of patients who attend an ultrasound examination and receive upsetting news or diagnosis, can affect the health of sonography professionals over time. This, in turn, also impacts on the sonographer’s own significant others; friends, family, and colleagues.

Multiple studies demonstrate that careers in healthcare, including the role of sonographer, can lead to tiredness, apathy and burnout. There is also growing awareness of the link between adverse safety events and errors in practice to the physical, emotional and professional distress of staff3. Currently, there is work on-going to improve cultures for patient safety with recognition that healthcare staff who have been involved in a patient safety incidents need support

SCoR are able to provide support through local and regional trade union and industrial relations representative and officers.

In addition to increasing awareness of the support that we need to offer to staff, it’s also significant that there is a link between staff experience and patient satisfaction. The patient experience library provides a timely article which reminds us that ‘care for staff equals care for patients’.

Hochschild, an American sociologist, provided seminal theory about emotional labour. She used the term to describe the regulation of emotions in the workplace, to remain within the social norms of a culture4,5. Recognition of the emotional labour that is performed during the every day roles of being a sonographer allows us to recognise and appreciate the tricky and unpredictable art of the profession.

By speaking about the emotional elements of the job, it makes a space for us to question how to support each other, including patients, in practice. It also highlights that the job of a sonographer can be stressful.

The SoR provide a range of guidance documents and advice about mental health and wellbeing that acknowledge the effects of stress on the individual6,7,8. It is important to note that although it may be an individual staff member who feels the effects of the job personally, there is a collective responsibility to restore that person’s wellbeing, not least including having supportive colleagues, managers and employing organisations.

Factors to provide support include ensuring that there is time available in the working day for debriefing, having regular clinical supervision sessions and, where appropriate, referral or self-referral to counselling services for staff. More widely there is acknowledgment that healthcare workers need better support. There are websites that offer advice for mental health wellbeing such as the Mental Health Foundation and MIND.

Tea & Empathy is an initiative run voluntarily by a group of medics and nurses. They try to provide support for NHS staff 24 hours per day, 7 days a week through a national, informal, peer-to-peer network. Contact the group via Facebook or Twitter.

Methods of self-care can be a means of restorative practice for sonographers to temper the effects of emotional labour. Bush makes a distinction between macro and micro self-care, which sonographers can undertake personally1.

Macro self-care includes taking regular holidays or breaks from work, enjoying hobbies, social activities with friends, taking regular exercise, eating healthily and getting plenty of sleep.

She defines micro self-care to be striving to achieve a sense of calm, rejuvenation, awareness and balance. Knowing when to pause for a few seconds, to breathe, and to remember during the roller coaster emotions of your day that you and your health are also important for the care of your patients.

Ethically, we have a duty of care to not just our patients, but also our colleagues and a responsibility to look after ourselves. That is the essence of restorative practice for sonographers.



  1. Bush, A., Simple self-care for therapists: Restorative practices to weave through your workday. 2015, New York: W.W.Norton & Company.
  2. Prince-Paul, M. and C. Kelley, Mindful Communication: Being Present. Seminars in Oncology Nursing, 2017. 33(5): p. 475-482.
  3. Wijma, M.I., A.R. Mohamed, and M. Hafizzurachman, Second victim support program and patient safety culture: A quasi experimental study in Bali International Medical Centre (BIMC) Hospital. Bali Medical Journal, 2018. 7(1): p. 220-226.
  4. Hochschild, A., Emotion work, feeling rules, and social structure. The American Journal of Sociology 1979. 85(3): p. 551-575.
  5. Hochshild, A.R., The Managed Heart: Commercialization of Human Feeling. Twentieth Anniversary Edition ed. 1983, London: University of California Press Ltd.
  6. The Society of Radiographers. Work-related stress guidance for health and safety representatives. 2007; Available from:
  7. The Society of Radiographers. Stress in the workplace: guidance and advice for the radiography workforce. 2013; Available from:
  8. The Society of Radiographers. Mental Health. 2019; Available from: