Clinical Communication Tips for Sonographers

Last month, we talked about internal communication methods and best practices. If you missed it, be sure to check it out here! 

This month, we’re moving on to communication within a clinical setting. Your communication skills can mean the difference between a positive patient experience and a negative one, so we’re sharing our four top tips for in-office patient communication. 

1. Make Patients Comfortable 

While you feel at ease in your familiar place of work, the patient is in a foreign environment. Try to make them as comfortable as possible so that you can conduct the exam without hindrance.  

Show them where the restroom is and offer them a chance to use it before the exam (if applicable). Let them know what level of dress is needed for the exam and how they can change privately. Then either let them know how to position themselves on the table or if you will be back in to help them get positioned for the exam. 

The next step is icebreakers. Icebreakers are easy if you need to ask about something in the patient’s chart. If their chart is clear, ask something family-related. For instance, at an OB exam, ask if this will be the first grandbaby. Questions like these serve a dual purpose. Chatting puts a patient at ease while you gain information about prior pregnancies or family history. You'd be surprised what comes up in casual conversation that people leave out of their paperwork! 

If the patient is more private or closed off, switch to a topic you could talk about all day: ultrasound. In a recent article for Cassling, former sonographer Jennifer Ott says, “I’ve found that most patients, especially first-time patients unaccustomed to an ultrasound, are fascinated to hear about how the ultrasound system works, the purpose of capturing an image from multiple angles, the reasoning behind the sequence you’ve selected and even the inner workings of the ultrasound system and transducer.” 

Showing your openness to communication can make patients more cooperative and more open to communicating in turn. As patients communicate with you, practice active listening and be attentive to feedback—especially nonverbal cues. Grimacing, flinching, fidgeting, or sudden silence when the patient was chatty are all signs of discomfort. 

2. Set Patient Expectations 

One big way to make patients comfortable is to communicate expectations early and as you go. 

Communicate expectations early by summarizing the exam you’ll be performing and answering patient questions. In her recent article in Vein Magazine, Julie Cardoso, RDCS, RVT, RPhS, says, “Patients are not always briefed and, even when they are, may not understand the healthcare lingo. Patients will often come into the imaging lab unaware of which exam is going to be performed or what it entails. Sometimes, they are under the impression that their appointment only entailed speaking with the physician. A patient who has recently received a peripheral arterial exam and is now receiving a peripheral venous ultrasound might be perplexed as to why they are ‘having this exam done all over again.’” To alleviate the confusion, she recommends taking time to explain the modality, duration, and purpose of the exam in clear, concise terms before beginning.  

It’s best practice to continue communicating throughout the exam. Give the patient a heads-up before reapplying cold gel, changing the pressure or position of the transducer, or moving them. If your level of communication needs to change, set patient expectations again by kindly asking them to hold their questions or wait for your response. Explain you’re focusing on something, and you’ll be happy to answer them in just a moment.  

Side note: OB sonographers often have to also set expectations regarding photos and video during the exam. If your clinic doesn’t allow these, we recommend setting these expectations before the exam as well. Acknowledge the policy you’re bound to keep, validate the patient’s disappointment, and make sure they know they’ll be taken care of. For example, “I know the policy is unfortunate. The doctor just doesn't want anything documented or recorded prior to them reviewing the images. I will make sure that I get you some pictures though!" 

3. Handle Exam Findings 

We know sonographers are in a tough spot when it comes to answering direct questions about exam findings. It isn’t in your job description to diagnose or reveal results, but deflecting these questions can be difficult, especially if you can plainly see the exam results.  

We recommend clarifying your role before you begin the exam with a statement like, “I’m going to take the images, but I won’t be able to tell you if things are normal or not. Your physician will review the images and communicate the results to you after the exam.” We want to stress that it is best practice to communicate this prior to the exam. Waiting to clarify this until a patient asks a question can give the impression that you’re dodging their question because you've visualized an abnormality. 

Regardless of how well you try to set expectations, though, patients will likely still ask questions about their results. We recommend being honest in your responses and adopting a neutral or positive tone. Something like, "I’ve taken a lot of images today. We’ll have to review them all carefully before your doctor can provide results,” is neutral in tone and lets the patient know what to expect next. If the patient asks a question you don’t know the answer to be honest and positive in your response. You can say something like, “I don’t know the answer, but I think your referring physician will.” Sometimes you diffuse patients who keep asking questions with a humorous comment like, “I don’t get paid enough for that” or “You're going to get me fired!” 

Another way to minimize questions is by keeping your composure throughout the entire exam. Regardless of what you see on the screen, keep up your end of the conversation and maintain a positive and helpful demeanor. If that feels dishonest to you, remember you’re keeping the patient from becoming unnecessarily anxious or worried. The physician will be able to diagnose and answer all their questions or provide treatment options. 

4. Manage Non-Positive Patient Emotions 

There may be times when you interact with patients who aren’t feeling positive about their visit or are having a bad day. The range of negative attitudes and outlooks patients can bring in with them varies greatly. Some patients may want to cooperate, but anxiety over their health or fear of healthcare facilities are impairing their communication. Other patients may exhibit irritability, impatience, and anger, making them act argumentative or frustrated. Some can become unreasonable. 

Your goal is to allow patients to express negative emotions without reacting in a way that impedes your communication and your ability to perform the exam. Maintaining your composure, allowing the patient to speak their mind, and responding with positivity are often enough to get you through an exam. Speak with confidence and provide frequent instruction. Cardoso adds, “Encountering authority gives the patient a sense that the situation is under control and can be resolved.” 

In a worst-case scenario, patients may make inappropriate remarks or actions that leave you feeling uncomfortable, distracted, degraded, or even threatened. The first step is to verbally set boundaries and ask them to remain respectful throughout the rest of the exam. If they don’t respond to your request, you can end the exam early and address the issue with your supervisor. 

Side note: As much as you can, try to identify whether cultural or language barriers are at play. A patient who seems uncooperative may need some additional accommodation and empathy. 

BONUS! Accommodate Physician Preferences 

Once the patient exam is over, your communication skills will be put to the test again when you communicate findings to the physician. Physician communication styles vary widely, so it can take some time to discern how a physician prefers to communicate. Some like sticky notes with bullet points and no pleasantries. Some like hearing “good morning” every day. Feel free to ask them about their communication style. The sooner you understand their preferences, the sooner you can help them be most efficient and effective.  

That’s it from us! Do you have any clinical communication tips to add? Drop them in the comments below.