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Sonographer experiences of working during the pandemic

20 August, 2020

Author: Ultrasound Advisory Group members Ellen Dyer, Rosie Hospital Cambridge and Karen Hammett, Royal Free London

At the beginning of January 2020 no one could of have foreseen that we were about to be involved in a global pandemic. As obstetric sonographers, our sights were clearly focused on Saving Babies Lives version 2 compliance. Little did we know that life was about to change dramatically for us all. 

At the end of March 2020, the prime minister announced a national lockdown and identified pregnant women in the vulnerable group, advising them to shield to protect themselves from contracting Covid-19. Research has since suggested that pregnant women are no more likely to contract or experience complications from coronavirus than their non-pregnant peers.   

Understandably, in March pregnant women were very anxious about the whole situation. This was reflected in a sudden increase in non-attendance for routine first and second trimester ultrasound appointments. 

We know that becoming a parent is a life changing event, and pregnancy is a time when women are vulnerable to depression and anxiety. Coupled with Covid-19 concerns, sudden changes to their antenatal care with fewer face-to-face appointments and restricted hospital visiting preventing partners from attending antenatal scans, it provided a perfect storm to jeopardise the mental health of pregnant women. 

The distress these changes caused to women was reflected in the need for the Society and College of Radiographers (SCoR) to publish the Obstetric ultrasound examinations during the Covid-19 pandemic joint statement to provide more consistency across hospitals. The statement supported a move to allow women to record a short cine loop of their baby at the end of some scans. 

For many women, the midwife booking and 16 week antenatal appointments were delayed (in the early days of the pandemic), or changed to telephone/virtual consultations. This meant that the dating or anomaly scan became the first time some women had seen a healthcare professional face-to-face during their pregnancy and the pandemic. 

Sonographers know that they have a duty of care to look beyond the scan and make sure that each contact counts; but we were not prepared for the emotional support many women were about to need. 

During the pandemic obstetric sonographers have reported higher than usual patient reassurance requirements, increased disclosure of domestic abuse during scans because women were attending alone, higher rates of anxiety requiring referral to mental health teams, and distressing situations when sonographers had to deliver unexpected news to unaccompanied women.

Other areas of imaging have been under intense pressure dealing with acutely unwell Covid-19 patients, but some sonographers feel that the indirect effects of the pandemic on them have largely gone un-noticed. A shortage of supply of personal protective equipment (PPE) has been widely reported in the media at some hospitals. In the early days of the pandemic, before the publication of recommendations by ISUOG, sonographers were also confused over the PPE they required for scanning.

The emotional pressure on sonographers is not unique but is often a daily work-life demand. However, the unexpected consequences of the pandemic, described above, has added to the emotional pressure sonographers are under.  

Since 23 March, obstetric sonographers were working to keep services running when most other non-obstetric routine services were postponed for many months. They were scanning in PPE during some exceptional warm weather in April and May. Like the rest of the population they had their own anxieties about Covid-19 and the impact on them and their families.

Whilst many obstetric ultrasound teams coped by enhancing team working, (eg actively supporting one another and having gaps between successive patients), going forward do we need to think about providing better training and tailored emotional education to help sonographers to deal with these unseen pressures?

For instance, should sonographers be taught formal counselling skills as part of their post graduate training? Is there an argument that all healthcare professionals be taught techniques to protect their own wellbeing and mental health?

The ultrasound advisory group would be very much like to hear from any members about their experience of scanning and keeping the service running during the pandemic

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