Burnout, the Force Propelling Sonographers Away From Their Calling

Amidst the bustling corridors and resonant discussions of the 2024 AIUM Ultracon conference, a groundbreaking revelation emerged from the forefront of medical imaging research. Shedding light on the intricate interplay between Work-Related Musculoskeletal Disorders (WRMSDs) and the often-overlooked specter of sonographer burnout, the collaborative inquiry of my colleagues and I sought merely to confirm existing associations but ultimately challenged entrenched assumptions. What materialized from our investigation was a surprising insight: burnout, eclipsing the physical strains of the profession, emerges as the predominant force propelling sonographers away from their calling. This revelation, underscored by the poignant narratives of our colleagues, beckons us to embark on a journey that redefines our understanding of occupational health and demands a holistic approach to safeguarding the well-being of every sonographer.

Professional research informs us that WRMSDs can cause a sonographer to leave the profession and that both WRMSDs and burnout share similar root causes. The intent of our research was to forward the discussion on WRMSDs, by determining if there is an association between the two conditions; an association we did find: burnout was the reason for a sonographer to consider leaving the profession, not a WRMSD. That eye-opening finding reshaped how we viewed our research results. What if the profession, instead of focusing on education and engineering as the way to prevent WRMSDs, looked closer at the psychosocial causes of WRMSDs? 

We were happy to see so many stakeholders, such as radiologists and administrators, express concern for sonographer burnout. While it was gratifying to find so much support from our colleagues, we were saddened by the many sonographers who spoke with us about their own experiences with burnout. During Ultracon, sonographers came up to us and expressed their thoughts of leaving the patient care environment, or that burnout was the reason they had already changed jobs. They voiced concern that pizza parties were viewed as solutions when what they really need is meaningful change to the work and professional culture that prioritizes profits and throughput over people. Sonographers are suffering in silence, and simply want to know someone cares for their well-being.  

How can we move forward knowing that burnout is an issue for the profession and that it is also a factor related to the WRMSD epidemic? Larger research studies are needed on sonographer burnout for us to fully understand not only the scope of the problem but also its root causes.

We encourage other researchers to look at sonographer burnout as a single issue in addition to exploring its relationship to WRMSDs. If we hope to attract young, talented people to pursue a sonography career, we need to show that the career is worth it to them. It is up to us, sonologists, administrators, and sonographers, to work together to ensure that our profession supports the whole sonographer, mind, and body. 

Jennifer Bagley, MPH, RDMS, RVT, FAIUM, FSDMS, is a professor and sonography program director for the College of Allied Health at the University of Oklahoma Health Sciences in Oklahoma City, Oklahoma. She also currently serves on the AIUM Board of Governors.

Interested in reading more about Sonography? Check out these posts from the Scan:

Sonography and Work-Related Musculoskeletal Disorders

Eighty percent (80%) to 90% of sonographers and ultrasound providers across disciplines indicate they experience pain from musculoskeletal injuries, 1–3 which is a much larger percentage than in just about any other specialty within healthcare. Work-related musculoskeletal disorders (WRMSDs), however, frequently go unreported and can lead to a career-ending injury, so an alliance of 8 organizations* have come together to create the WRSMD Grand Challenge with the intent to stop work-related musculoskeletal disorders resulting from the performance of diagnostic medical ultrasound.

WRMSD Grand Challenge: Stop Work-Related Musculoskeletal Disorders (WRMSD) Resulting from the Performance of Diagnostic Ultrasound

As a part of this alliance, Dr Yusef Sayeed recently spoke about this topic, encouraging us to help promote our specialty, to progress, and to take care of this work-related issue at the very onset before things become pathology. Unfortunately, one of the largest problems within the sonographer community is official reporting of the issue and transparency. Sonographers most commonly don’t report their injuries because they fear it could cost them their job, or they are afraid of the stigma doing so could cause; this reasoning also applies to ultrasound providers and fellows, as well as is true within the healthcare field overall.

Of those injuries that do get reported, the Department of Bureau and Labor Statistics reported that the vast majority of the lost-work-time occurrences in 2016 resulted in major lost work time (11 or more days) with a median of 13 days of lost work time.

The risk factors for work-related musculoskeletal disorders have been identified as the following:

  • Awkward posture
  • Repetitive movements
  • Pinch grips
  • Wrist flexion and extension Placement of the monitor/screen

Musculoskeletal disorders are cumulative trauma disorders and develop gradually over time from repetitive activity (micro tears in the anatomy). To reduce these occurrences, alternate the side from which you scan; always standing on the right puts your right side at risk because of the repetitive motion. Step around rather than reaching across obese patients, because reaching results in you being most abducted, which also predisposes you to injury. And avoid holding the transducer in a pinch grip. In additiona, when your shoulder is abducted and your elbow extended, this puts a great deal of repetitive force on both the cervical spine as well as the shoulder joint.

Employers of sonographers also need to be cognizant of the risk factors they can prevent, such as performing more than 100 scans per month, getting less than 10 hours of rest between shifts, requiring 13 or more hours per day on shift, and night shifts (in general, night shift workers suffer more injuries on the job and have worse metabolic outcomes, ie, they suffer cardiac disease, have higher rates of CVA and MI, etc). Current business models tend to mean more scans and less time between them so sonographers are predisposed to higher rates of work-related injuries. Employees should also be able to report injuries without reprecussions. Another way employers should mitigate risk is by providing personal protective equipment such as cable straps, ergonomic tables, ergonomic chairs, etc.

Changes made in manufacturing would also help, such as making screens mobile and able to rotate and creating lighter-weight and wireless transducers, etc.

To make sonography a more sustainable profession, we need to ensure WRMSD education reaches not just sonographers and their employers but also regulatory agencies and the medical community as a whole. We need to:

  • Increase awareness, education, and transparency;
  • Understand risk factors;
  • Provide tools to prevent and reduce injuries, including forms of hazard control;
  • Engage in research to better understand occupational repetitive motion injuries; and
  • Advocate for our colleagues, patients, and friends.

View Dr Sayeed’s full webinar on YouTube to learn more about the injuries that can be a result of these risk factors:

Work-Related Musculoskeletal Disorders in Sonographers: A Look Back and a Path to Progress


References

  1. Wareluk P and Jakubowski W. Evaluation of musculoskeletal symptoms among physicians performing ultrasound. J Ultrason 2017; 17:154–159.
  2. Al-Rammah  TY, et al. The prevalence of work-related musculoskeletal disorders among sonographers. Work 2017; 57:211–219.
  3. Horkey J and King P. Ergonomic recommendations and their role in cardiac sonography. Work 2004; 22:207–218.
  4. AIUM Official Statement. Statement on preventing work-related musculoskeletal disorders. Available at: https://www.aium.org/officialStatements/69.
  5. Sayeed Y, Sully K, Robinson K. Work related musculoskeletal injuries in sonographers and providers: the Grand Challenge. Ultraschall in Med 2020; 41: 1–10.

* The WRMSD Grand Challenge Alliance of Organizations:

  • American Institute of Ultrasound in Medicine (AIUM)
  • American Registry for Diagnostic Medical Sonography (ARDMS) and Inteleos
  • American Society of Echocardiography (ASE)
  • Intersocietal Accreditation Commission (IAC)
  • Joint Review Committee on Education in Cardiovascular Technology (JRC-CVT)
  • Joint Review Committee on Education in Diagnostic Medical Sonography (JRC-DMS)
  • Society for Vascular Ultrasound (SVU)
  • Society of Diagnostic Medical Sonography (SDMS)

Interested in learning more about preventing musculoskeletal injuries? Check out the following posts from the Scan:

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