BMUS News - Summer 2020

View from my Bike

Cycling to and from work during Covid has taken on a new significance: essential travel, key worker, daily exercise, fresh air and stress buster all come together in one eerie package.  Now more than ever I realise I am so lucky, living where I do.  Isolation in west Wales is not difficult, it has many advantages.  As I drop down the hill alongside the Cleddau river, cycling along deserted lanes and cycle paths through green fields on a beautiful sunny morning, it’s hard to comprehend what’s happened to our lives, our working practice and society at large.

Withybush Hospital is about as far west you get from London (10 miles further west than Truro).  As the pandemic hit London initially, we watched as the numbers crept up daily along the M4 corridor, towards Wales.  Looking back, it’s easy to forget the high anxiety levels that we all experienced.  A week into lockdown, I increased my own stress level sites a tad, by managing to make my journey into work more eventful.  My bike hit a slick of mud/slime, which had been there since the floods (remember those - it seems another lifetime away).  Suddenly I’m somersaulting with bike above me, landing on the concrete with a smash to my left posterior chest.  After five minutes of lying on my back in the mud (West Wales is sparsely populated, a downside of the ease of self-isolation is there is no one around to help pick you up when you crash!) I managed to clamber upright and gently tried some deep inspirations.  Having convinced myself of no signs of pneumothorax I gingerly cycled the rest of the way into work.  Not great timing with Covid on the way, but after a week of walking to and from work and taking the bus, I was back on the bike.  A colleague took great delight in showing me a newspaper headline “why cycling to work may not be good for your health”- seems the accident rate and its associated morbidity can overshadow health benefits at times?!

Increasing pleuritic, intercostal and shoulder girdle pain prompted an MRI to exclude vertical body crush fracture.  One of the perks of the job - they found me a slot very quickly.  I have managed to keep up my record of whenever I have been scanned there are positive findings - appropriate use of imaging continues. You know there’s something up when the table propels you back into the scanner with the radiographer’s words, “just need to do one more sequence”.  Fortunately, no vertebral crush fracture, just a small haemothorax and several fractured ribs as the diagnosis.  Not great timing with Covid on the way but hey ho.  One interesting patient experience is that I now know how long a brachial plexus neuropraxia takes to recover – about 5 months, and scanning is good rehab.

The timing of Catherine Kirkpatrick’s e-document on scanning the lung (which came out at the beginning of the pandemic), with its links to YouTube video clips etc, teaching scanning techniques of the lung, was timely in many ways.  An easily readable and concise document, and one which I put to practice quickly.  It was extremely reassuring to watch your own pleura gliding smoothly on respiration, with resolution of the haemothorax.  Thanks Catherine.

The pandemic, and its associated hysteria, has seen the best and the worst of our society, and the same applies to Medicine and Radiology – it’s simply the facets and range of human nature.  I am sure that I am not alone in being impressed at how colleagues put their shoulder to the wheel and rolled their sleeves up, working new rotas, covering extra shifts, stepping in when needed etc., etc.  Admittedly some Radiology colleagues were seen to put a new emphasis on remote working and headed for the hills, which was sad.

The agility that was shown by the NHS in the early stages was impressive, but battle fatigue is now a recognized reaction. The expectation that we (as in Radiologists, Sonographers, radiographers etc.,) can simply flick a switch and clear the resulting backlog is at best naïve. I suspect I am not alone in finding that the dreaded “WFH” misnomer for hiding behind a laptop and forgetting the principles of clinical medical practice has added a new unfortunate stress to my working practice.

A batch of inappropriate referrals was handed over to me recently, for vetting.  Rather than write yet more letters to referrers asking for appropriate clinical information - I rang the relevant GP practice to speak to the physiotherapist who had generated the referrals.  The reply from the receptionist “oh she doesn’t work here; she is working from home” was honest and candid! It’s prompted an immediate review of physiotherapy triage for musculoskeletal conditions in our health board - not good for some but hopefully better for patients. It’s embarrassing to have to ask colleagues have they examined the patient, but ask we must at times in these “new ways” of working. Our minister, Mr Hancock hasn’t helped, he seems to be unaware of the fact that a WhatsApp consultation can’t replace clinical examination for a suspected lump.  It’s sad when you see colleagues unable to conceptualise the context of risk but anxiety is not confined to patients alone.  Let’s hope there is a return to sanity soon.

One of the many interesting features of the current situation is seeing us oldies getting to grips with social media - Zoom, Skype etc. New skill sets are being learnt as regards behaviour whilst on Webcam, trying to remember to mute the microphone when not speaking, avoidance of slurping mugs of tea or chomping through lunch (not a good look).  A WhatsApp group between my Radiology colleagues undoubtedly enhanced the way that we worked as a group.  An innovation which facilitated several positive changes in our working practice and one which we look back on and say, why didn’t we do this earlier?

The discovery of the meme by us oldies is intriguing, I never realised there is a world of humour out there about Radiology, and in particular Radiologists.  Some of it is very funny and as always with good humour - close to the truth.  Worth digging out the World War II German generals’ spoof with Hitler as the clinical director - very funny but keep the sound volume down!  The radiology registrars will have the links - if you haven’t already tapped into this vein of social media?

For me my journey is done this morning, so time to lock the bike up and head in to the department and see what awaits.  I am undoubtedly lucky in being able to work and commute in the way I do (well, ok -barring the odd crash!).  I do not have the hassles of tube/traffic jams/parking/city life etc., that many have to put up with.

So to my colleagues and fellow BMUS members who have worked, and hopefully come through these difficult times, and in particular to those who are managing to juggle home and family commitments with work - thank you!  I hope you stay safe and can find time to recuperate and recover.  Not always easy!

Never was there a more appropriate time to say “Iechyd Dda” to you all, “Good health”!

Prof Rhodri Evans
BMUS President

Vacancies on BMUS Council

At the end of 2020 there will be 3 vacancies on BMUS Council however, in order to maintain the constitution, the election this year will not be a free one as at least one of the vacancies must be filled by a medical practitioner.  The election to fill these vacancies will be announced shortly on the website and by member e-mail.

However if you are interested in applying this year, the Council Member job description can be found here.

You may feel that you would like to be involved in the work of the Society however, are concerned that you may not have sufficient experience at present to be a Council Member.  One of the ways to gain experience of the workings of the Society is to join one of the Special Interest or Clinical Interest Groups or the Sounding Board, most of these Groups either meet physically or virtually or a combination of both.  The groups work on various aspects of our education programme, professional development or safety guidelines or statements. Our Clinical Interest Groups are sub specialties of our Education Special Interest Group, which in turn is one of the elements of our Science and Education Committee.

Information on all the BMUS activities can be found here https://www.bmus.org/information-about-bmus/committees/ .  If you would like any further information on how you can join in the activities of the Society please do not hesitate to contact joy@bmus.org .

Prof Adrian Lim
Honorary Secretary

Update on the Health Education England /BMUS preceptorship

and capability framework for sonographers

Members may be aware that BMUS was commissioned by Health Education England (HEE) last year to develop a preceptorship framework for newly qualified sonographers, and provide some guidance on capability development for more experienced sonographers. This work builds on the existing work around education and career framework for sonographers including the development of undergraduate educational programmes in ultrasound.

The first arm of this work is nearing completion. It offers a framework on how newly qualified sonographers (both from undergraduate and postgraduate programmes) should be introduced into the workplace as newly qualified sonographers/preceptees.

What has been most striking from the literature review aspect of this work is the patchy and varied nature of preceptorship programs for newly qualified sonographers.  While many other health care professions have detailed guidance on preceptorship, this has not really been translated into a formal structured period for sonographers.

The reasons for this are varied.  Sonography has been an evolving profession for many years.  This evolutionary development makes ultrasound an exciting and varied place in which to work, but changes have frequently grown organically rather than by design.  It seems that ultrasound practitioners (whatever their background profession) have largely fallen between the gap of fulfilling regulatory and capability requirements of their background profession, are being expected to integrate rapidly into ultrasound departments on qualification for service delivery reasons.

The unintended consequence is that newly qualified sonographers may find themselves feeling unsupported through their early months of autonomous practice.  Experienced sonographers do want to support their newly qualified colleagues but frequently have neither the tools nor the time to provide the level of support required. Middle management is frequently unaware that there is an issue.

HEE have recognised that preceptorship for newly qualified sonographers and a framework for capability development for existing sonographers is a vital step in further developing sonography as a profession in its own right and takes this issue very seriously.

The preceptorship aspect of this framework is nearing completion.  It had been intended to hold a preceptorship study day in the autumn of this year, so that consultation on this document could begin. Unfortunately, the COVID-19 outbreak has derailed this plan.

BMUS is now looking at providing this consultation electronically and will be publishing initial proposals shortly.  I would urge all members to read the proposals carefully once published and provide constructive feedback when the consultation goes live.

Dr Peter Cantin
BMUS Honorary Treasurer

2020 Annual General Meeting

The Annual General Meeting (AGM) is normally held during the Annual Scientific Meeting in December each year.  Unfortunately, the cancellation of this year’s event due to the COVID-19 pandemic has created a difficulty on how BMUS can successfully hold its AGM, given the continued issues around social distancing.

The Society is currently planning to hold a face to face Science & Education Committee & Groups meeting in November, and it is hoped that the AGM can be held in conjunction with these meetings during the lunchbreak.  It is our aim to also live stream the AGM in order to allow as many members as possible to attend.

We will be writing to each member with further details on how you can register to attend closer to the time.

Prof Adrian Lim
Honorary Secretary

‘An investment in knowledge pays the best interest’

It’s been a long year so far and is only August! However, the power of resourcefulness brings opportunities.

The ethos of BMUS has always been to bring high quality ultrasound education to its members and wider community. We have not let a virus and social distancing stop us! We have taken BMUS ultrasound education to the world of the webinar - I can’t deny that it wasn’t strange sitting in my dining room talking to myself for an hour about the anatomy of head and neck scanning, but on-line education allows flexibility and versatility. Sitting down to one hour of CPD is perfectly manageable in our busy ‘new normal’ lives, allowing education to fit around our schedules and be integral within it. It doesn’t replace a day out together with the ultrasound community, meeting like-minded people, the interactive nature of a study day, quizzing the speakers and making new connections. But it does offer new advantages such as a chance for in-depth presentations to be offered by experts - a chance for leaders in their fields to give more detail than would be possible on any study day – how often have you wanted to hear so much more from the minds of the brilliant speakers on a study day! Well now you can. Then there’s convenience, no long days travelling here! And not to mention the variety on offer, many Sonographers work amongst many different disciplines and often have to pick one study day which may be only be themed gynaecology, general medical or obstetrics etc., but with webinars we can have our cake and eat it! Tune into anything that takes your fancy.

So, keep a look out for #BMUSWebinarWednesdays (follow us on Twitter and Facebook) but don’t worry Ultrapost will also land in your inbox and let you know what’s coming up, so keep your eyes peeled and register your interest.

After all that education on #BMUSWebinarWednesdays, it’s what we do with it that counts.  Extending our knowledge leads to renewed enthusiasm when we return to our clinic lists and patients.  It’s great to see how two Sonographers, Ruth Reeve and Stephen Moore, have come up with a venture to encourage Sonographers to publish work. Within a very short space of time I was completely bowled over by how the SWaP (Sonographers Writing and Publishing) initiative took flight (read more here). This wonderful endeavour is another example of how technology brings our closely knit ultrasound community together with distance being no barrier - Ruth and Stephen’s careers see them work at completely the opposite ends of the UK, with interest and participation in the group from different continents/ time zones including Australia and Africa! BMUS has offered its complete support to the SWaP project and many experts within the BMUS family from all specialities will be supporting wherever they can in order to encourage work a flurry of high-quality published ultrasound works - including case reports, essays, original research or posters etc. Whatever it may be we also – secretly -  hope many pieces of work make it into the BMUS journal, Ultrasound and/or are presented at the ASM in Cardiff 2021!

All that talk of CPD and Education enough to be going on with? No? Of course, it’s not!

There’s definitely more, August see the launch of the inaugural BMUS Journal Club. Contain your excitement – I know I can’t take much more either! You cannot miss this though. It’s a Twitter based journal club (that’s where it’s at these days, if you’re not there, where have you been? Get your twitter handle and join the Twittersphere, even convinced out President Elect, Pamela to sign up!). The forum will run on an evening for 1 hour in line with the release of the BMUS journal, Ultrasound. The Editor’s Choice article will be the topic of discussion which is freely available for all to read for a period of two weeks. We hope for interesting debates and discussion – and a little fun of course. Join us using the twitter handle @BMUS_JC.

So, change is brought upon us at BMUS as it is for all. Challenges? Of course. But there are opportunities to do things differently and achieve so much. BMUS will continue to provide every opportunity possible for all its members to continue to develop, to adapt and overcome. We at BMUS hope to always achieve our fundamental ethos of providing education for our members and will nurture new ventures to blossom to attain it. Join us on the journey!

Mrs Catherine Kirkpatrick
BMUS Development Officer

Membership Fees 2021

I am pleased to inform all members that the current rates of membership will be held at the 2020 rates commencing January 2021.

*Preceptorship rate applicable to BMUS undergraduate student members completing their course and moving into clinical practice.

** At the end of Year 1 the rate will increase to Preceptorship Year 2 rate.  At the end of Year 2 the rate will rise to the full rate for a Sonographer.

Prof Adrian Lim
Honorary Secretary

BMUS Annual Members’ Survey

It is very important to BMUS that we understand and respond to our members’ needs and offer benefits that are of value, to do this we need to survey our members annually to gain these insights.

Therefore, during January this year, BMUS circulated its first annual digital survey to the membership.   The survey was open for 4 weeks, with a reminder sent after a fortnight. Disappointingly, approximately only 18% of the membership responded, however the information gained from those who did reply was very useful.

The aim of this year’s survey was to get to know our members’ needs better, to use the information to help shape the work of BMUS and inform the society’s strategic plans.  The survey questions were a mix of multiple choice and free text. There were 16 questions in total which took, on average, just over 5 minutes to complete.

From the responses we were able to identify

• The top three reasons people are members of BMUS, are for the Ultrasound journal, Professional Guidelines and reduced rates on events.
• The responses also indicated that the majority of members use BMUS Professional Guidelines and Statements in their day to day practice.
• That members generally visit the website on a monthly basis to check on policies and guidelines, and to book events/courses either our own or our partners’ events. Most members visiting the website do find it easy to navigate.

Some of the questions asked

• What features would you like to see the BMUS Website provide?
• How do you think BMUS can improve the benefits it offers to its members? (Include improvements to current benefits or new benefits we could offer.)
• Is there anything else BMUS could be doing to support our members?

The answers we received from these were varied, inspiring and very useful. We are already using this information to launch and provide further benefits to our members.

Some of the results of the survey can be found here, however should you wish to read the full report this can be found on the BMUS website under the tab ‘Information about BMUS’.

We will be undertaking the next Annual Member Survey in January 2021 and again it will only take a few minutes to complete. Please look out for the emails - obviously we would welcome a greater number of responses and further engagement with our members.

Prof Adrian Lim
BMUS Honorary Secretary

BMUS News Survey

BMUS News is our quarterly printed newsletter. You can see past copies here. Our Winter 2020/21 was the last edition we did as a hard copy. 

In May in the midst of the pandemic and lockdown we produced our spring edition as an electronic version rather than a printed copy. This was so our contributors could write articles closer to the publication date. In the ever-changing world of Covid-19 we wanted to ensure our newsletter gave you information as up to date as possible. This summer edition is also electronic for this reason.

Do you like the electronic version? Or would you prefer it to return to a printed copy? Please could you give us your views here. It should take no longer than 2 minutes. https://www.surveymonkey.co.uk/r/QVRP85R

The BMUS Team