Advice for doing vaginal exams

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Hi! I a new grad (Graduated in June of 2008) and I have been orienting on a maternity floor since August 1st. Because we're a small hospital, I have to become familiar with nursery, labor and delivery, and post-partum care. I am really struggling with lady partsl exams. My preceptor never showed me how to even do one (which way to stick your fingers in) but I gathered that from watching. The biggest issue I have is figuring out dilation, effacement, and station. I get the idea of each of these concepts, but always seem to just get "lost" in the lady parts. Surprisingly, I have almost "guessed" the dilation correctly on people, but I still feel lost. I've noticed too when people are dilated more that I have a tendency to go in "too far" and I'm touching the baby's head versus the cervix. Any suggestions for grasping lady partsl exams? I know it "takes a long time" to understand that, I would just love some advice or guidance so I don't get discouraged.

Specializes in Cardiac, stroke, telemetry,Med-surgical.
Here's another trick I was taught early on because I had a problem with keeping my fingers at the same position once I got out of the lady parts.

Place your other hand on a solid surface (I usually use my thigh) and spread the fingers of both hands to the same width so you can see before you remove your hand.

I have heard of some places using a (sorry for the crudeness) "twat box" for practicing, but I haven't seen one.

Anyone seen or used one?

:yeah::yeah::yeah:

Yes! You are right! I tried and your small trick works: my second hand spreads the fingers the same way/same distance the first one does! I hope that it works the same way in less comfortable situation (right now, I am at home, relaxed, near my kitchen table :wink2:)

Thank you! Great tip!

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Specializes in Cardiac, stroke, telemetry,Med-surgical.

Check this website. The cost is only 8 dollars. You might find it useful.

http://pocketdilationguide.com/prod.html

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That looks like a great resource....I will go ahead and get one.

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I have heard of some places using a (sorry for the crudeness) "twat box" for practicing, but I haven't seen one.

Anyone seen or used one?

My school has one.. It's pretty cool, except it's hard as a rock and difficult to spread your fingers in!!

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Specializes in L&D telephone triage.

If you have a cervical dilation board, they are great to play with during your down time. You can just sit around and practice with it. It's a big help.

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I do not spread my fingers......I keep the index and middle fingers together and sweep. If I spread my fingers......no one would ever be more than 6 cm. You should know while you are in there what your measurement is. It does help to actually visualize the charts etc. so you know exactly what 3 or 6 cms looks like. Practice on any round object in the house while not looking and then measure it so again you know what to imagine while you are in there. We have family practice physicians who run to the dilation chart with their fingers spread and personally I think they look like fools. Harder to imagine how far you are spreading your fingers than to actually take a measurement. It comes with experience and practice.

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Specializes in L&D.
Check this website. The cost is only 8 dollars. You might find it useful.

http://pocketdilationguide.com/prod.html

I've got one of these! I keep it in my pocket! It works great!

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