Any help w/ station?

Acts238RN · Sep 2, 2008

The only time I use spines are with really obese pt's where soft tissue make it difficult. I think this is something that comes with experience.

Maybe ask your co-workers if you can do SVE's for them so that you will get more experience. That's what I did some 20 years ago:wink2:.

Good luck.

janis9799 · Sep 2, 2008

Plus four...on the floor. :chuckle

CMCRN · Sep 6, 2008

+5 in the Nursery

SmilingBluEyes · Sep 7, 2008

I agree that experience is the best teacher. Just imagine the ischial spines. That is zero. Finger breadth above, minus 1, fingerbreadth below, plus 1. With experience, this becomes really easy. Be patient with yourself.

NurseNora, BSN, RN · Sep 7, 2008

I'm sure your unit has a pelvis model somewhere. Look at it and feel the spines. They aren't really at 3 and 9 as you might imagine, but more like 4 and 8. On most women, the spines aren't prominent and are difficult to feel, and somewhat painful too. You can feel through the posterior lady partsl wall the ischiococcygeus muscle that runs from the ischial spines to the coccyx and lower sacrum. Feel it at the sacrum and follow it up to the spine. In some women that's easier to feel than the spines themselves.

But the only way you'll be good at station is by time and lots of practice. As another poster suggested, offer to do exams on other nurse's patients, especailly those with epidurals so you can take your time and use a little more pressure than you might when the poor women is feeling what you're doing.

A lot of nurses just estimate station by how far their fingers have to go to reach the presenting part. This works well most of the time unless your patient is exceptionally small or very obese. Since you won't be applying forceps or vacuum, the actual number isn't as important as where the baby is in relation to where it was at your last exam.

You'll get it, don't worry.

SmilingBluEyes · Sep 8, 2008

Practicing on women with epidurals is best, if possible, especially if they are not ruptured, for infection control purposes.

OzMW · Sep 8, 2008

I'm sure your unit has a pelvis model somewhere. Look at it and feel the spines. They aren't really at 3 and 9 as you might imagine, but more like 4 and 8. On most women, the spines aren't prominent and are difficult to feel, and somewhat painful too. You can feel through the posterior lady partsl wall the ischiococcygeus muscle that runs from the ischial spines to the coccyx and lower sacrum. Feel it at the sacrum and follow it up to the spine. In some women that's easier to feel than the spines themselves.
But the only way you'll be good at station is by time and lots of practice. As another poster suggested, offer to do exams on other nurse's patients, especailly those with epidurals so you can take your time and use a little more pressure than you might when the poor women is feeling what you're doing.
A lot of nurses just estimate station by how far their fingers have to go to reach the presenting part. This works well most of the time unless your patient is exceptionally small or very obese. Since you won't be applying forceps or vacuum, the actual number isn't as important as where the baby is in relation to where it was at your last exam.
You'll get it, don't worry.

Noice explanation Nora! feeling for the spines is part of pelvic assessment and shouldn't really be guesstimated - turning your fingers around so they point down helps to get the angle. As Nora said when you get to them its painful to the woman. If she jumps you've hit right the spot!

We were also taught to do an abdo palp prior to a ve and feel for the amount of head above the pelvic brim; which is really more indicative of how things are travelling, especially when there is alot of moulding and caput.