Patient Interaction/ Bedside Manner

You are probably thinking

“Patient interaction…be nice to the patient, I get it. Gimme the probe and let me scan!”

I completely understand but there is much more to being a Sonographer than just scanning. When patients enter our exam room we are not only an Ultrasonographer, we transform into a confidant, comforter, friend, mentor, and adviser all at once. It is important that we understand how patients view us and the power we have to make their experience as pleasant and comfortable as possible.

It’s so important to ensure the comfort of the patient because not only will it make the exam a more pleasurable experience, it will also lower the stress levels of the patient which will result in an exam with more accurate results.

So let’s go through the basic steps that I follow for every exam.

Before every exam it is important to remember to be pleasant and kind. We have no idea what the patient is going through. It is possible that the patient could be scared and freaking out because their doctor sent them to have this exam done. Help them as best you can to be calm and have an enjoyable experience while they are with you.

Introduction

• First and foremost, introduce yourself. Let the patient know where you are from (the ultrasound department) and what exam you will be performing. I’m sure you wouldn’t want to follow a stranger into a dark quiet room whether you are in a hospital or not.

• Check the identifying markers!!! Usually the patient name, birthday, and accession number. Be certain that you have the correct patient. There is NOTHING worse than performing the right exam on the wrong patient.

The identifying markers vary from facility to facility. Your department will inform you of the markers they want you to check.

• Explain the exam to the patient as well as what you are going to need them to do for the exam. Depending on the exam you are performing, you may need the patient to remove their pants, unbutton and lower their pants, raise their shirt to expose their tummy, etc. Ask if the patient is comfortable and understands what you are going to be doing and if they have had an ultrasound exam before. Explain that you will be placing gel (hopefully warm) on the location to be examined and gliding your probe along that area to view the necessary anatomy.

During The Exam

• Notify the patient as to what you will be doing in regard to towel placement (you can’t just go around touching people all “willy-nilly” lol).

• Make sure that the patient is comfortable and feels as though they are a part of the exam process. After all, it is their body and they are the ones who are in control. I also try to reassure the patient, as best as I can, throughout the exam to keep them in a calm and content mind frame. The last thing a patient needs is ambiguous uncertainty at the conclusion of an exam which will result in them freaking-out when they leave.

• During the exam the patient may become inquisitive and start asking questions. Try to answer the questions to the best of your ability without revealing any pathology or causing confusion for the patient.

Personally when patients begin to question me about their exam and possible pathology I try to distract them with education about the physics of the ultrasound machine.

For example:

Possible Vascular exam questions:

Q: What is all that red and blue stuff? A: That is the direction of blood flow. Red represents blood flowing toward the probe and blue shows the blood going away from the probe. Q: Is that normal? A: For this exam it is routine for me to observe your blood flow and its direction.

Possible retroperitoneal or bladder exam questions:

Q: What is all that black stuff? A: That is your bladder. Then I proceed to explain why fluid appears black while organs and other tissues do not.

• If the questions become too involved (Q: Is something wrong, what do you see?) kindly inform the patient that the radiologists are the ones who read and interpret these images and if I were to do the job of the radiologist that would be me practicing medicine without a license and that I could possibly go to jail, and none of us want that.

Conclusion

• At the end of the exam assist the patient with cleaning up and providing more towels if necessary. Provide a helping hand to assist the patient while sitting up.

Give the patient a moment while they sit up straight on the bed, some patients may become dizzy when re-positioned from lying flat (supine) to an upright position.

Allow the patient to gather their belongings and let them know when they should be receiving the results from their exam (the length of time varies depending on your facility).

• Walk the patient to the exit! Personally, this is the most important part of the conclusion to the patient experience. Due to all the thoughts and concerns that are on the patients mind, sometimes they don’t listen. Instead of telling the patient “make a left here, spin around, and at the far corner 2 rights there then you will see the exit” take the time to actually walk them to the exit (I promise you they will appreciate it). Then to top it all off, bid them a good day.

Adjust these tips as necessary for in-patients, out-patients, and ER patients.

This is what I do and what I discovered works for me. I hope you find this helpful!

Thanks for reading all the way until the end!

See you in the next blog!!

Stephanie

Side note: One of the amazing talents that Sonographers possess is the ability to compartmentalize. We, as Sonographers, must understand that every patient, and the circumstances thereof, are unique and vary from patient to patient. With that being said, we should not transfer the troubles and struggles from one exam to the next. Every patient should be a blank slate.