[monie2004]

How long did it take for u guys to really be confident in your exam estimates? I doing pretty good with mine but I have been getting 1-2 odd pts recently where I just cant feel it at all! Then I end up feeling incompetent to the pt and the MD!! Any help!?

[kcrnsue]

I can't remember exactly how long it took to get comfortable with. The place where I first learned only did about 10 deliveries a month. Then I moved to a larger hospital, and my skills advanced quickly. Practice, practice, practice! You will always get those strange ones, but you will pick up certain tricks along the way, like having them put their fists under their hips when you do the exam.

[SmilingBluEyes]

It takes LOTS of practice to become proficient and even now, after nearly 7 years checking countless cervices, the doctors and i occasionally disagree. that's ok. its a bit subjective anyhow. just relax and keep trying. don't give up. you will get it.

[tamrnmomof4]

Here is my little tip..I have short fingers (a liability for a L&D Nurse), but if they are in early labor, and the cervix is post, then have them put their fists under their buttucks, it almost always works and I can find the cervix....I hope it helps

[mother/babyRN]

There are times when you just aren't sure and you ask someone else to check.....Still, after 15 years....

[ImaStork]

Originally posted by mother/babyRN
There are times when you just aren't sure and you ask someone else to check.....Still, after 15 years....

I agree with the above statement even after 15 years I have still had a few patients I will get someone else to check after me. It is only when you think you know it all you become a danger to everyone.

[BETSRN]

No one (doc or nurse) is ever 100% right all the time on exams. In the grand scheme of things, it doesn't really matter what the dilitation is as long as the patient is making cervical change. Things can change fast and that's the whole point! Consistancy of examiner is more important for accuracy, anyway. The fewer exams the better, too.

Having the patient put her fists under her buttocks for an exam as was mentioned really works. If you cannot fiond the cervix it might be very thin or as is usually the case, very very posterior.
If all is well and there is no cervical change after one hour, send them hoem......that's what we do.

[at your cervix]

Don't worry about it if you don't agree with others exams. I work with one doctor that always checks 1-2 cm more than anyone else so when I call her, I just say "she is my 4 so she's probably your 6." That way, we're both right!

[mother/babyRN]

Now adays especially when attempting to calm a patient I will tell them 1 2 or 3 cms, somewhere in the middle..8 9 10 somewhere near the end...In the middle is epidural if warranted...They concentrate on the number because labor as a function is or can be all about lack of control.....So, attempting to figure out ways in which they don't necessarily focus primarily on the numbers does help in many cases...