self cervical checks

  1. hey all---am starting to get in the flow of doing my own SVE's, but I had a veteran nurse tell me this terrible story of one of our rampant doc's flying off the handle at her as he walked in as she was checking his VBAC, screaming "YOU WILL RUPTURE HER UTERUS!!!"

    Of course this was a terrible thing for the patient to hear,
    but my question is....
    ~do you do all your own checks?
    ~ do you do them at all?
    ~ was this doctor a total raving lunatic? i mean i know that answer, but it would seem like that would take one h*lluva exam to rupture a uterus, but then again I never met the patient or read her history, only was relayed the incident.

    any keypoints to help when trying to become a better SVExaminer?

    i have realized that you feel quite inept unless you know your patients uterus...first hand * hyuck hyuck*......

    sorry.....couldnt help it.
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  2. 11 Comments

  3. by   joyrochelle
    and i didnt realize it until after posting it.....I have some ridiculous images now.....:chuckle
  4. by   finallyRN
    We do our own checks on our patients. We do have one doctor who insists on telling us to do "gentle vag exams". This irritates us to no end. Like we would be so rough with our patients.
  5. by   sunnygirl272
    Originally posted by joyrochelle
    and i didnt realize it until after posting it.....I have some ridiculous images now.....:chuckle
    yeah, i must admit i clicked in just to see what this was about...lmao...
  6. by   joyrochelle
    Originally posted by finallyRN
    We do have one doctor who insists on telling us to do "gentle vag exams". This irritates us to no end. Like we would be so rough with our patients.
    precisely! .....i mean...we've all been at the end of tha hand before, for the most part.....
  7. by   OBNURSEHEATHER
    Originally posted by joyrochelle
    and i didnt realize it until after posting it.....I have some ridiculous images now.....:chuckle
    Well, I clicked on this link quite seriously because, you know, we had that patient one time....

    Heather
  8. by   SmilingBluEyes
    wow!!!! boy did i misunderstand this thread at first. glad you cleared it up. there ARE patients and s/o who do their own SVE's with incredible accuracy. i won't say more.

    all i can say is, imagine real hard being the other end of the check or having a pap smear. you know how that feels and what works for you.......so keeping that in mind, i go in slowly, gently, with hands or speculum as WARM as possible.......like I have all the time in the world---- with supreme gentleness. I have them breathe in deeply thru the nose and out the mouth, like in labor and let THEM relax their legs before I touch them at all. I keep eye contact with them and tell them each thing I am doing and how it is likely to feel. Also, I find if you move slowly, and probe gently, following the natural curve of the patient's back, they really relax and cooperate much better. good luck.
    Last edit by SmilingBluEyes on Oct 7, '02
  9. by   OBNURSEHEATHER
    Originally posted by SmilingBluEyes
    there ARE patients and s/o who do their own SVE's with incredible accuracy.
    And dangerous results.....

    "but I was in the room when my ex-wife delivered our kids, so I thought I could do it myself....."

    Heather
  10. by   SmilingBluEyes
    yep Heather.....true. it can be dangerous. i strongly discourage it whenever I am made aware of it. I think it is weird and dangerous both. I could never recommend it.
  11. by   OB/GYN NP
    My first answer is this: Not only was that Doc a raving lunatic ( to follow your description), he didn't know his anatomy well enough that I would let him operate on me!!! Unless that nurse had her fingers through the cervix and several cm's beyond, she wasn't even close to where a uterine incision would be in a VBAC. And if a uterus can tolerate several hours of contractions, it sure as H**L is not going to rupture from a vag exam. Shame on him for scaring that nurse like that, and for not knowing what can cause a true uterine rupture. There certainly are times when it is contraindicated to do a vag exam, but a VBAC isn't one of them. Geesh, that blows me away! Secondly, yes, I always do my own vag exams unless there's a contraindication to it. I have found that nurses are more objective when it comes to vag exams. We don't have any reason to say that the patient is more dilated than she really is, whereas the doc may have (wants to induce her so he doesn't have to stay up all night, checks her in the office, wants to send her over, says she's 4 when she's really 2 and long, you all see that too, I'm sure). Well, anyway, that's my two cents worth. Don't let ignorant people scare you into not using or learning a skill. Just keep practicing, and remember, as SmilingBlueEyes said, the more gentle you are, the better. Good luck!
  12. by   mark_LD_RN
    I have seen it many times, docs say pt is different than they are. got one that calls them complete at 8cm and wants them pushing, had another that always said baby was transverse and not progressing,and would need c/s.

    like blue eyes said, gentleness is the key and of course practice.
  13. by   Vsummer1
    Originally posted by joyrochelle
    and i didnt realize it until after posting it.....I have some ridiculous images now.....:chuckle
    Okay, I admit it... I was thinking what? mirrors? they have their own speculums ?!! But WHY would they do that? Thus I wandered into the thread wondering...


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