The 21st century sonographer: Role ambiguity in communicating an adverse outcome in obstetric ultrasound

Abstract

Introduction: Ultrasound plays an integral role in pregnancy management in Australia. The role of a sonographer as the frontline practitioner is to scan the patient and identify any possible abnormalities, including foetal demise. This study sought the views, experiences and practices of Australian sonographers in communicating an adverse outcome to pregnant patients in different departmental settings in public and private sector practice. Method: Ten individual semi-structured interviews were conducted with 9 sonographers from metropolitan Sydney and 1 rural based sonographer. Results: The key themes emerging from the interview data were of ambiguity and inconsistency both in understanding the sonographer role and with practice protocols around communication when delivering “bad news” to pregnant patients. Most of the participants had not received any formal training in communication techniques. Conclusion: The sonographers wanted more autonomy, but with support and an agreed and consistent approach from their radiologists or sonologists. Practice sites that achieved the best results were those that had the greatest direct collaboration between the sonographer and the sonologist, which was demonstrated in the obstetrician-sonologist-run practices. Policy reform, improved clarity and standardised protocols are needed to improve practice guidelines for sonographers in communicating adverse outcomes to an expectant mother.

Keywords

• sonographer
• communication
• role
• obstetrics
• bad news