Posted on April 25th, 2017 by

Oh, the adventures of becoming a sonographer!

2D facial profile, sonographer, ultrasound technologist

Isn’t this facial profile precious? But it’s not just any profile; it’s a technically perfect 2D ultrasound example of a simply beautiful fetal profile. It’s what we strive to obtain on every baby we scan and reminds me of how I fell in love with the technology…with my own first baby:) I was well into my college career at the time, but nothing else had quite piqued my interest like my first exposure to ultrasound. Boy, I had no idea what challenges lay ahead!

Becoming a sonographer, aka ultrasound technologist, was one of THE biggest challenges of my entire life. The training was challenging, but finding myself in a new field and technology where I was painfully ignorant and unsure? Healthcare is not a place for the timid.

A Sonographer’s Start – Whoa! (What a Challenge)

If I was going to work with physicians, I better learn what I was doing fast or go home. It took a while for the puzzle pieces to fit…a good 6 months to 1 year. Thereafter, little light bulbs of realization would flicker every time I put two and two together. It was a marriage of all things unfamiliar. I was learning to read patient charts, learning about labs and correlative examinations, interaction with the physicians and with my patients. All of these things were a recipe for growing my new career as well as learning the technology. In the beginning, it was more about “How do I not screw up?” rather than “Wow, that was a great case!”

I promise you, it’s not for the squeamish. If another person’s urine, vomit, or blood bothers you, Ultrasound may not be for you. I cannot emphasize that enough! It was a hard year, and I felt like I was walking a tightrope for the vast majority of it. Brutal.

A Sonographer’s Fear

All new sonographers will miss pathology. It’s a fact of the modality. Initially, you are too concerned with getting all the right images. You’re too inexperienced to notice minor pathology. This is why it is so imperative that a newly-trained sonographer has direct supervision from someone very experienced. With lots of experience comes confidence. After a while, a newbie will start to get a feel for his/her scanning ability and stop second-guessing herself. Was I not seeing an organ because it can’t be seen or because I just couldn’t find it? It’s an awful feeling. However, it is one that can be overcome with time and, again, experience.

The more normal examinations a technologist performs, the sooner she will know when a case is not normal. Ten to fifteen scans per day over the course of a year equals a good bit of experience. After the first few months of constant supervision (if you don’t have it, ask for it!), you will start to become a little more comfortable with the examinations. You’ll then only need a supervisor’s help when confronted with abnormal cases. You may not be able to pinpoint a diagnosis, but you know it’s not what you normally see. This is very important in your early career. Eventually, you will be able to put together differentials to possibly explain what you are imaging. It’s a good feeling when you get to this point!

A Sonographer’s Advice

It was a slow learning process, at least for me, anyway. Over the years, it became easier to work with the docs. More importantly, I learned how to better communicate with my patients, which has been the most rewarding. It feels really good to correctly diagnose a case. But it feels even better to have a patient sincerely thank you for your help…or give you a hug in appreciation. It feels good to know I’ve made a small but, hopefully, significant difference. It’s been a good career. And for those who are going into it, hang in there because it gets better. For those who have practiced a long time and feel the flames of burnout, take a vacation! We all need to step back and take a breather once in a while.

Every case is someone’s health and life at stake, and not a week goes by still without learning something new. What a sonographer sees (or misses!) will either lead that patient to other tests or lead to a missed diagnosis. It is sometimes intimidating to think that a patient is on your table and yours alone. It’s up to you to find the problem in question.

I always say I would never want to relive those earlier years, yet they have shaped who I am. They helped me become a better sonographer. So get out there! Become a sonographer, become good it, research and read, and ask questions of co-workers and docs alike. Make a difference in someone’s life. Make a difference in your own:)

Here’s to a happy and healthy pregnancy!

wwavblogger, RDMS
wwavblogger, RDMS

Comments: 2 Comments »

Posted on September 27th, 2014 by

The title of the post says it all.  I really cannot count all the times in a week patients make this comment as I begin to scan them.  Mostly it’s the GYN patients because, as we know, most parents initially get all googly-eyed with Baby and then later I get the “Gosh, how do you know what you’re looking at?” (Entirely off the subject but it’s such a peeve of mine for someone to end a sentence with a preposition. I know, I know. I drive my kids crazy with this, too..)

I’ll usually respond with a smile and something like “We get lots of experience here!” and “After 23 years, I better know what I’m seeing!” I typically add here that ultrasound was positively the hardest thing I’ve ever learned and I have posted on the subject before. Well, in the field of medicine and healthcare, we’re always learning and that never stops. I suppose this is true in all of life, as well! If a sonographer has “stopped” learning, it’s time for a new career.

Ultrasound Physics, anatomy and physiology of the fetus and inhabited uterus, neonatal heads, pelvic organs, adult and fetal heart, peripheral and cerebrovascular systems (arms, legs, neck and brain), abdominal organs, small parts (this is technically what they’re called) like the breast and thyroid and scrotum are some examples of the systems we begin to learn. Also, how they look normally by ultrasound, how to measure them, what dimensions are normal, what images to obtain and how many to take are part of this education. Then let’s not forget pathology. The hundreds of disease processes or benign findings and conditions associated with each of these systems, how they present, how they affect the organs around them, associated examinations and patient labs are an additional challenge. Another aspect of learning this modality is how to operate the equipment properly, write reports, what to write/not write, how to present to the radiologist or physician and what to say/not say to him/her..most of us learn this the hard way! There is also newer ultrasound technology working in the field of nerves and the musculoskeletal system.

Surprised?! I thought you might be.. For example, when we are performing a fetal anatomy screen (the 18-20wk scan), we are attempting to rule out some 200 conditions and disease processes.

The hardest part was becoming confident with what I was seeing to recognize and decipher normal from abnormal. As a sonographer, the machine does NOTHING on its own. It is the most operator-dependant modality of imaging that exists.  This is why proper supervision is so important. The first six months out of school and working were horrendous, the next six were better, the following six months to a year yielded a better mental picture of my job as a whole and I was then ready to take on some challenges and ask more questions.

There are typically two schools of thought floating about the general public with regards to learning ultrasound..either that it’s super hard or very easy.  Those of us who have been doing this a while certainly can make it look the latter.  After reading this post, however, you be the judge!

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