Vag exams

bagladyrn, RN · Jul 31, 2003

If all you are feeling is "mush", you're not reaching far enough. Also, kind of angle your fingers toward the back more as the cervix is most likely posterior early in labor. Do you have some one precepting you on this? If not, ask one of the more experienced staff to let you check behind her when she finds someone with an easy cervix to feel. I've found that women who are multips are easier to approach about this when asking their permission for teaching purposes.

SmilingBluEyes · Jul 31, 2003

go in, reaching toward the small of the woman's back..... by that I mean, when you go in, move your examining hand ina curving motion, toward the small of the back----the cervix can be VERY posterior and this is the best way to find it....also.....

have her head as low (trendelenburg's position) or put a bedpan under her buttocks before examining her. This will make your reach easier, believe me. gently have your nonexamining hand on her fundus, don't exert real pressure, just gently pushing down the fundus to further bring the baby (and presenting part) toward your exam hand. Keep on going up and back til you feel it----trust me you will.

With practice, you will get this SOON. I remember asking my preceptor, "what am I supposed to feel here" And she said:

"A HOLE!!!"

I felt so stupid, but when my fingers litererally fell into the cervical os, it WAS an "OH WOW" moment for me. Give it time, you will be a pro in quick order with enough practice!

MidniteLaborRN · Jul 31, 2003

Thank you very much for taking the time to share your wisdom and expertise with me--I appreciate it--as will the residents and patients that I work with . Please... gimme more.

SmilingBluEyes · Jul 31, 2003

ask.

i am an open book.

puggy · Jul 31, 2003

Many years ago a physcian sat with me at night in labor hall until I could learn the ins and outs. He kept telling me to either feel for a hole that my fingers would slip into, or a stretch rubberband that I could run my fingers around. Hurray! One night my index finger slipped into a hole. Congratulating me he said he wanted to check to see if the baby was vertex, he did a quick vag exam, and busted out laughing. The cervix was 5cm, the baby's rectum was 1cm!!!! Hang in there, you'll get it.

webbiedebbie · Jul 31, 2003

When I was new, I did the vag exam and felt something curl around my fingers!!!!!Freaked me out at first! The baby's hand was down (was a breech). I will never forget that!:chuckle

SmilingBluEyes · Jul 31, 2003

yea you never forget the first time a finger is either sucked or slips into a rectum.

it happens to us all eventually.

RMH · Aug 7, 2003

Practice, practice, practice. And practise consecative exams, to feel changes. Patients with epidurals are the best...I've given people examples of what different cervixes feel like. ie. a role of tape is 2-3 cms, thick. A small rubber band is 5-6, 80%, soft. Ask someone for help like that. Remember everyones exams are a little different, hence the reason for consecative exams to tell progression. Good luck

renerian, BSN, RN · Aug 7, 2003

Puggy I am laughing very hard!!!!!!! You made my day!

renerian

judy ann · Aug 11, 2003

Lordy, I guess I really am old. When I started in this business, we checked cervical dilation via rectal examination, feeling the cervix through the rectal lady partsl wall. Talk about a challenge!!!

SmilingBluEyes · Aug 11, 2003

talk about HORRIBLE for the moms. I can't imagine that.