Checking your patient's dilation.

Specialties Ob/Gyn

Published

Specializes in Nurse tech in CCU.

Okay, so I know that the human body is so different from a mannequin. Today was my first time checking dilation on my patient. Even though my instructor tried to help me, I still didn't quite know what I was feeling. It was weird and I couldn't feel the cervix or where it even was. I felt lost in the lady parts. However, the second time I checked, I felt the head. Although that's a good thing, I would still like to know some tips as to how I can check dilation without feeling lost for the next time.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

OB is way out of my league...... moved this for better response.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Practice practice practice. That's the only advice I can give. Also, find a compliant, epiduralized patient, and really spend some time feeling around in there in order to familiarize yourself with landmarks.

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It took me at least a year to be comfortable with basic labour exams (4-10 cm). It took me another two years to start to feel confident with dilation under 4 cm, effacement, and consistency. I still have trouble finding spines and determining fetal position! It takes so much time--you'll always be learning!

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Like my preceptor tells me---go in straight first as far as you can until you feel resistance. Check if that's the cervix, if not, move your fingers up, and feel there, then left, right and bottom. Feel for a little ridge (if she's dilated a few cm) and then slide your fingers into the ridge. If her cervix is posterior, when you feel it, move it so it's anterior (or infront of the lady partsl opening) and check that way. It is hard. Some women's cervix hides and if the woman is overweight, it's really hard. My preceptor had a GREAT idea (she really is a SMART woman!) go around the hospital floor and find things that are circles. Close your eyes, and stick your fingers in them and see if you can figure out the cm, get the finger spacing, and match it up to the chart. I've been on the floor two weeks, and so far I would say I'm about 80% on target. Sometimes I'm way off though!

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Specializes in Nurse tech in CCU.

ahah. I can only imagine what the people who watch the cameras will think of me if they see me doing that!

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LMAO! I'm sure they know what you are doing! I do it at home too! LOL! I have a 9 year old daughter who is very into medicine, and she wanted to know what I do, so I explained and now she's even checking dilation of round objects here at home! LOL!

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Specializes in L & D and Mother-Baby.

If you can find the head (or presenting part) slide your fingers around until you find a circular ridge. If you can't get your finger inside at all, she is closed. If you can't find it, slide it behind the baby's head where you will find a posterior cervix. Some preceptors teach you to use the monitor paper as a guide. I believe that once section is 3 cm. 2 sections is 6 cm. and 3 sections is 9 cm. Practice makes perfect! You'll get it! TAKE YOUR TIME!!!

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Specializes in L & D and Mother-Baby.

If you can find the head (or presenting part) slide your fingers around until you find a circular ridge. If you can't get your finger inside at all, she is closed. If you can't find it, slide it behind the baby's head where you will find a posterior cervix. Some preceptors teach you to use the monitor paper as a guide. I believe that once section is 3 cm. 2 sections is 6 cm. and 3 sections is 9 cm. Practice makes perfect! You'll get it! TAKE YOUR TIME!!!

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