I am on my second month of L&D orientation and I feel so lost. I try to do SVE's and all I feel is warm squishy mush. Most of the nurses on my unit tell me it takes at least a year to feel comfortable and are very helpful, but I can't help but feel as if I'm behind the curve. Does anyone have any words of wisdom for me?
Nov 27, '13
It does take a year to feel confident in L&D nursing. I am just a year out into it as a new grad nurse. I feel comfortable with most things. For the most part with VE I can only distinguish closed to 3 cm and 8 to complete. It does take practice and even to this day I am still learning. Don't give up. Within a year you will not feel lost trust me.
Nov 27, '13
You haven't had your lightbulb moment yet. I remember when I had my lightbulb moment. My preceptor (with the patient's permission - she was heavily epiduralized) told me to just take my time and really feel around in there. Once I had that lightbulb moment, most of the time it no longer felt like warm squishy mush - I was able to find the cervix more often than not (and then within a year, I was always able to find the cervix). Be patient and keep trying - it will come.
Nov 28, '13
Hang in there. It'll come to you. Sometimes, it helps to take your time in there. If it's really high, have them make two fists and have them place their fists under their sacrum. Don't be afraid to have someone double check. In real practice (in general) , you only really have to know what 1) closed, 2) 4-5cm, 3) 8-9cm, and 4) compete feels like. Practice, practice, practice. Then you'll be inserting FSEs like a champ!
Nov 28, '13
Have your preceptor check first and then talk you thru the exam: "it's really posterior, you have to feel way back there." It's really thin and hard to feel" or whatever the situation is. This is easiest in the patient with an epidural who still has intact membranes
Look at anatomical drawings in books or on line. Sometimes when I look at a picture I can get a better idea of what I'm trying to feel and where it's likely to be located. Some places have models to practice with, ask if your facility has any, they may be with the supplies for childbirth classes.
Try to find your own cervix. It's awkward, but it can be done. It will be posterior, thick, and firm once you find it. Sometimes the double feedback (what your fingers feel and what you feel inside your own vagina) helps you put it all together.
Ask other nurses with patients with epidurals if you can check their patients, especially if it's something unusual, or if they're easy to feel e.g. A swollen anterior lip. You just have to do it over and over to train your fingers. Be patient wit yourself. Most people think they should be doing much better much sooner. You'll get it
Dec 18, '13
The day I found the cervix, I never had a hard time finding it again. At first I felt warm squishy mush too. But when my preceptor was checking the cervix, I noticed the mom was about to jump out of bed. But when I checked her, she comfortably laid there. I realized I was not reaching for enough. It true that the cervix can move forward as the baby descends...but for the most part, don't feel bad or uncomfortable to reach a little further. And it's definitely easier to check on patiens with an epidural. Then you won't feel so bad taking a little longer and not causing so much discomfort.
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