American Registry for Diagnostic Medical Sonography® (ARDMS®) Chair

Tricia Turner, RDMS, RVT

Work-related musculoskeletal disorders (WRMSD) lie at the root of chronic injury for diagnostic imaging professionals. Normal, everyday practice demands physicality, and this can lead to significant challenges with pain and musculoskeletal disorders. It has been reported that up to 90 percent of practitioners work in pain at some point with WRMSDs costing employers $120 billion annually.

Just one major area of stress or weakness can result in injury. Some causes may include a lack of flexibility or strength, fatigue after lengthy or intense shift scheduling, skipping ergonomic tool adjustments in daily practice, or even seemingly small habits, like routinely turning to a poorly adjusted monitor.

Shifting how we work to take care of ourselves is part of doing a good job. We must empower our community to value personal wellness, both in our individual practice and management strategies, as necessary to helping patients attain health. We must embrace self-care in the workplace.

Emphasizing Optimal Positioning for Daily Scanning

Each unique practice or area of specialty presents different opportunities for injury. However, all clinicians can apply proactive strategies to mitigate pain.

For example, practitioners who choose to scan left-handed can set up working positions that alleviate a lot of physical stress. Adjusting monitors for easier viewing and adjusting chair height or tables for a shorter reach can result in a better scan for both the patient and practitioner.

Do all you can to practice within your personal reach. By adjusting our workspaces to fit individual needs, we establish a foundation for our success.

Incorporating Regular Movement to Reduce Static Posture

Static posture is one of the worst offenders in provoking injury in diagnostic imaging. We must move.

• Stretch before you scan and throughout the day. Several short stretches have greater impact than one long stretch.

• Keep compression bands or a stress ball at your desk for quick exercise or subtle movement during lunch.

• Add a set of lunges to the end of a coffee break.

• Climb one flight of stairs instead of taking the elevator.

• Park further away from the door to give yourself a reason to walk.

At the end of the day, any 30 minutes of movement during the workday may lead to better overall health. There are many opportunities throughout the day for us to choose to move, and each choice leads us toward health and away from injury.

Where Strategic Resource Management Can Play a Role in Mitigating Injury Risk

Health care, much like any great partnership, demands teamwork at every level and every facility to secure success. Today’s diagnostic imaging professionals hope to strike a nearly impossible balance: provide quality care for as many patients as possible with limited time in our day. The hours may feel short, but the days – and shifts – can become far too long.

We all want to care for as many patients as possible, but the list can be overwhelming. It’s essential for teams to work together to balance patient demands and allow enough space for individual practitioners to find time for themselves amidst the noise.

With mindful planning, facility and team leaders can protect and preserve practitioner wellness so clinicians can function at their maximum capabilities to enhance patient care. We look to leadership to advocate for healthful and appropriate scheduling as well as strategic resource management that emphasizes practitioner wellness.

Taking Advantage of Ergonomic Solutions and Monitoring the Use of Mobile Imaging Devices

Supported by years of research, study and informed design, ergonomic and adjustable tools are more widely available to health-care practitioners than ever before. It is essential for leadership to understand the value of not simply providing these tools but managing their incorporation into the workflow as well.

For example, mobile scan equipment can significantly contribute to musculoskeletal injuries. Portable tools offer incredible flexibility for patient care but can be very difficult to manage. Accessing patient rooms is often a juggling act. When managers rotate sonographers through portable service, their bodies get a break between sprints. This seemingly small choice in resource management and scheduling can significantly reduce the risk of injury.

Holistic Wellness: Embrace Self-Care Off the Clock

In medicine, we commit to lifelong learning. Exercise is also a lifelong activity. Caring for your body cannot be compromised on or off the clock. The habit of committing to strength and movement minimizes risk and injury over time. Consider yourself an athlete. Professional athletes train with intention, care for their bodies and warm up to avoid injuries.

Remember there is no right and wrong exercise. There are only different strategies to build strength and make time for our personal health.

• Take a walk. Walk across the hospital parking lot, at your kid’s sports practices, and after dinner. These steps add up.

• Practice with Chinese medicine balls or strength putty to build hand strength for more confident, controlled scanning.

• Explore exercise that interests you. Look up walking groups, dance activities, the gym or personal trainers in your area. Some trainers will come to your home.

Above all, build exercise into your life on your terms. Find movement that gives you joy and make it a priority. We tend to compartmentalize our lives, but our experience proves cumulative. Good habits at home impact how we feel at work and vice versa. Health comes from working to strike a balance.

1. Murphey S. Work related musculoskeletal disorders in sonography. 

https://www.sdms.org/docs/default-source/Resources/work-related-musculoskeletal-disorders-in-sonography-white-paper.pdf?sfvrsn=8

1. American Registry for Diagnostic Medical Sonography (ARDMS). WRMSD grand challenge. Available at 

https://www.ardms.org/wrmsd-grand-challenge/

2. Society of Diagnostic Medical Sonography. Sonographer responsibilities. Available at: 

https://www.sdms.org/resources/careers/work-related-musculoskeletal-disorders/sonographer-responsibilities

Articles

Recognizing the significant potential for workplace injuries in the radiology field, these authors discuss the proactive benefits of optimal positioning and disruptions of static posture as well as a heightened management awareness of ergonomic solutions and potential issues in maneuvering mobile imaging units.

Combatting Workplace Musculoskeletal Injuries in the Radiology Community

The past year has definitely presented many challenges. There isn't a person that hasn't been impacted by the pandemic. But what we can do now is grow from the challenges we face and share what we've learned along the way. As our team reflected upon the changes that occurred over the past year we wanted to better understand what practices might remain in place. To that end we conducted a survey of medical professionals. While some of the effects were negative, many other changes are turning out to have been valuable learning opportunities that will positively improve healthcare for the future. Below is a sampling of what we learned.

When asked about how they worked through the pandemic, the medical professionals consistently answered that adaptability was a reoccurring response.

82% of practice operations, during the heights of COVID in 2020, were moderately or significantly impacted by the pandemic.

63% adopted new efficiencies – such as contactless check-in and check-out, online registration processes and telemedicine appointment options.

As one respondent shared: “Televisits were the biggest boon in the last year. [They] allowed our providers to maintain contact with patients who were unable to come in due to living in retirement homes or other group facilities.” Another surmised: “The precautions made patients feel safer and more willing to come in.”

COVID also presented significant challenges that tested clinician’s fortitude. In the early days of the pandemic, lack of adequate and ample PPEs, added daily workloads and staffing shortages were major stressors for clinicians.The added fear and pressure of practitioners having to keep themselves, their patients, and families safe triggered mental health and burn out issues for many in the healthcare industry.

In a separate study conducted by the AMA and Hennepin Healthcare in Minneapolis, it was reported that nearly 

 and nearly 40% identified as anxious or depressed.

“We’ve learned to expect the unexpected.” With continuous training and technology evolution, there was shared sentiment that: “Patient care is always getting better. We come to work every day prepared to put others first and to juggle any and everything that is thrown at us – mentally, physically, and emotionally.”

Approximately 83% of practices reported that new efficiencies adopted because of COVID will remain in place after the pandemic.Nearly 75% of practices are back to most if not all pre-COVID operations and patient volumes as of August 2021. “As the pandemic continues, all of our contactless practices are improving health safety for everyone,” said one respondent.”

COVID has proven to be a catalyst for change in numerous industries. Schools have embraced remote learning, companies have discovered successes of a work-from-home workforce and according to the survey, the healthcare industry may have also become safer. More than 70 percent of those surveyed believed that the standard of safety applied to each patient in the pandemic improved.

Respondents to the Inteleos survey were also prolific on how the healthcare system can better prepare for the future. Further, there was significant alignment on several of the ideas put forth. The list below captures some of those key take-aways:

Given the current Delta spread worldwide and other possible variants, keep enhanced safety guidelines in place until the pandemic is completely under control.

Keep telemedicine and other digital platforms in place.

Maintain as many contactless procedures as possible.

Support continuous practice, training, and certification in pandemic protocols to assure the highest quality healthcare.

Routinely assess, address, and support practitioners’ mental health wellbeing.

To improve communications, develop preparedness plans that are updated annually to establish well-defined standards, processes, and efficiencies.

Stock adequate amounts of resources and supplies, such as PPE and disinfectants.

Allow ample time to clean between patients.

Continued patient education, such as full-time mask wearing, hand sanitizing, social distancing, and temperature monitoring.

Evaluate what worked well and what did not and be ready to pivot should another situation like this arise.

What we know for sure is that we will continue to deepen our perspective in the months and years to come. We also know that the healthcare community – having been utterly steadfast while on the front lines – is stronger, more committed, and truly innovative when we stand together. While differences exist, the survey respondents proved once again the collective commitment to serving others and exceptional patient care remains at the crux of everything they do.

, RDMS, RVT, American Registry for Diagnostic Medical Sonography® (ARDMS®) Chair; 

MD, RPVI, RVT, Alliance for Physician Certification & Advancement™ (APCA™) Chair; and 

 – a global non-profit community of more than 158,000 medical professionals united in assuring that patients obtain the highest quality healthcare, recently took the pulse of our community as we begin to look beyond the pandemic to see what outcomes we can carry forward to better ourselves and those we care for.

There isn't a person that hasn't been impacted by the pandemic, but what we can do is grow from the challenges we face and share what we've learned along the way.

Tricia Turner, RDMS, RVT

Articles

Combatting Workplace Musculoskeletal Injuries in the Radiology Community

How COVID-19 Has Inspired Changes in Healthcare