Several types of nurses perform ultrasounds, depending on the clinical setting and purpose. The nurse you’re most likely to encounter using ultrasound is a sonographer (a dedicated ultrasound technician), but registered nurses, nurse practitioners, and certified nurse-midwives all use ultrasound in specific ways as part of their practice. The key distinction is between nurses who use ultrasound as a tool during patient care and those who perform full diagnostic exams.
Sonographers vs. Nurses Who Use Ultrasound
A diagnostic medical sonographer is the specialist most people picture when they think of ultrasounds. Sonographers complete dedicated training programs (typically two to four years) focused entirely on producing and interpreting ultrasound images. Many hold credentials from the American Registry for Diagnostic Medical Sonography (ARDMS). While sonographers aren’t nurses, they work alongside nurses and physicians in hospitals, clinics, and imaging centers.
Nurses who use ultrasound, by contrast, typically perform focused, limited scans rather than comprehensive diagnostic exams. They use ultrasound as one tool among many, whether that’s guiding a needle into a vein, checking on a baby’s position, or assessing a patient’s heart in an emergency. The scope of what a nurse can do with ultrasound depends on their level of training, their credentials, and where they practice.
Certified Nurse-Midwives
Certified nurse-midwives (CNMs) are the nursing professionals most closely associated with performing ultrasounds as a core part of their role. They use obstetric ultrasound throughout pregnancy to estimate gestational age, confirm the number of babies, assess fetal position, locate the placenta, and measure amniotic fluid levels. These scans help identify high-risk conditions like a low-lying placenta or abnormal fetal presentation early enough to arrange specialized care.
The ARDMS offers a specific Midwife Sonography Certificate for CNMs and certified midwives. To qualify, a midwife needs an active certification from the American Midwifery Certification Board plus at least 12 hours of continuing education in OB/GYN ultrasound within the previous five years. The certification exam covers focused gynecologic ultrasound (14% of the test), first-trimester obstetric exams (19%), second and third-trimester obstetric exams (35%), ultrasound protocols (13%), and equipment operation (19%). This credential signals that a midwife has demonstrated competence in performing and interpreting the scans most relevant to prenatal care.
Research supports midwife-performed ultrasound as effective and safe. Studies show that primary healthcare providers, including midwives, can perform accurate third-trimester obstetric ultrasounds to identify risk factors even with relatively brief focused training. Midwife-led ultrasound programs in settings ranging from rural Uganda to Malawi have been used to date pregnancies, assess high-risk conditions at labor triage, and reduce complications during and after delivery.
Emergency and ICU Nurses
Registered nurses in emergency departments and intensive care units increasingly use a portable form of ultrasound called point-of-care ultrasound, or POCUS. These are quick, focused scans done at the bedside to answer a specific clinical question rather than provide a comprehensive diagnostic image.
The most common use by far is ultrasound-guided IV placement. When a patient has veins that are hard to find or access, using ultrasound nearly triples the chance of a successful first-attempt insertion compared to the traditional feel-and-look method (with an odds ratio of 2.95). Children benefit even more, and the technique consistently reduces the total number of needle sticks a patient endures. A meta-analysis of the evidence found that ultrasound-guided IV insertion is faster, requires fewer skin punctures, and works reliably across different clinical settings and age groups.
Beyond IV access, emergency nurses report using ultrasound for bladder volume checks (to determine if a patient needs a catheter), the FAST exam (a rapid scan of the abdomen and chest to detect internal bleeding after trauma), and basic cardiac assessments to evaluate how well the heart is pumping. In surveys of emergency department staff, registered nurses ranked IV access and bladder volume assessment as the POCUS applications they use most frequently and feel most confident performing. They were least confident with abdominal exams and nerve blocks, which tend to require more advanced interpretation skills.
Training for these skills is relatively focused. Rutgers Nursing, for example, offers a critical care ultrasound course that runs about 7.25 hours and covers basic cardiac windows, lung and pleural ultrasound, abdominal ultrasound, vascular access, and deep vein thrombosis detection. These short, intensive courses are designed to give ICU and emergency nurses enough hands-on skill to perform bedside assessments, not to replace the comprehensive training of a sonographer.
Nurse Practitioners
Nurse practitioners (NPs) occupy a unique position because they can, with proper training, both perform and interpret diagnostic ultrasound exams. The American Institute of Ultrasound in Medicine (AIUM) includes NPs alongside physician assistants and other advanced practice providers in its training guidelines for performing and interpreting diagnostic ultrasound. To meet AIUM standards, an NP must demonstrate competence in the anatomy, physiology, and pathology of the organs being examined, and must be able to analyze a full set of images to render a clinically appropriate interpretation.
During initial training, NPs must perform ultrasound exams under the supervision of a physician or another qualified provider who already meets these standards. Once credentialed, NPs in specialties like women’s health, family practice, or emergency medicine may integrate ultrasound into their patient evaluations. The specific scope varies by state licensing laws and by the NP’s practice setting. In some states and health systems, NPs independently order, perform, and interpret focused ultrasounds. In others, a collaborating physician must review the images.
What Determines Which Nurse Does Your Ultrasound
The type of nurse handling your ultrasound depends on where you are and why the scan is needed. In a prenatal clinic staffed by midwives, your CNM may perform a focused obstetric ultrasound during a routine visit. In an emergency room, the nurse starting your IV might use a handheld ultrasound probe to locate a vein. In a primary care office run by an NP, your provider might perform a bedside scan of your abdomen or thyroid as part of a physical exam.
For a comprehensive diagnostic ultrasound, the kind where detailed measurements are taken and a formal report is generated, you’ll almost always see a dedicated sonographer. The images are then interpreted by a radiologist or the ordering physician. Nurses who use ultrasound in their practice are performing focused assessments: narrower in scope, designed to answer a specific question in real time, and integrated into the care they’re already providing.
If you’re specifically looking for a career that combines nursing with ultrasound, the most direct paths are earning a CNM credential with a midwife sonography certificate, pursuing an NP specialty that incorporates POCUS, or training as a sonographer (which is a separate allied health profession, not a nursing track). Each route involves different schooling, different credentials, and a different day-to-day role at the bedside.