Hardicre, NK, Arezina, J, McGuinness, A et al. (1 more author) (2021) Managing the unmanageable: A qualitative study exploring sonographer experiences of and training in unexpected and difficult news delivery. Radiography, 27 (2). pp. 369-376. ISSN 1078-8174
Abstract
Introduction
Ultrasound is used to diagnose pregnancy complications such as miscarriage and fetal health conditions. Within the UK, findings identified during ultrasound examination are delivered by sonographers as standard. However, little is known about the experiences of sonographers when delivering unexpected news (DUN), the impact this has on them, or their preferences for training on news delivery.
Methods
Qualitative interviews were completed with fourteen sonographers and were analysed using an inductive thematic approach. Key themes were identified.
Results
Participants said that obstetric ultrasound often involves ‘managing’ the patient encounter, including: navigating (unrealistic) patient expectations; handling their own responses to unexpected findings; and managing interaction by moderating emotional expression and communication practices to deliver patient-centred and empathic care. Persistent uncertainty of outcomes, prognosis and patient reactions, alongside high workloads, and frequent siloed working, makes DUN challenging for sonographers. DUN was experienced as emotionally burdensome, and sonographers employed personal coping strategies to reduce stress/burnout. However, the greatest mitigation for stress/burnout was support from peers, though accessing this was challenging. Peers were also described as key sources of learning, especially through observation.
Conclusion
Challenges associated with DUN are an enduring experience for sonographers. Facilitating regular ongoing support and training would enable sonographers to cope with negative aspect of the role, including the emotional burden of DUN.
Implications for practice
Long patient lists are prioritised to deal with high demand for services. However, sonographer wellbeing needs to be a key priority to avoid stress and burnout. This means facilitating protected time to access support from colleagues, multidisciplinary working where possible, and regular access to training to support DUN. Training focusing on communication practices, alongside dealing with emotional burdens of the role would be beneficial.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 The College of Radiographers. Published by Elsevier Ltd. All rights reserved. This is an author produced version of an article published in Radiography. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Ultrasound; Communication; News delivery; Breaking bad news |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Specialist Science Education Dept (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Psychology (Leeds) |
Funding Information: | Funder Grant number College of Radiographers CORIPS Award 129 Jane Ar |
Depositing User: | Symplectic Publications |
Date Deposited: | 28 Oct 2020 12:51 |
Last Modified: | 24 Feb 2025 12:00 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.radi.2020.09.015 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:167188 |