Checking dilation help...

cardiacRN2006, ADN, RN · Aug 25, 2008

I'm not an L&D nurse, and this may sound strange, but have you ever found your own? It will give you a great idea of where it's really at.

As for the dilation-I've never done it (mine's closed, closed, closed). But in NS they told us that if you open your fingers on your other hand to the same size as the one in the cervix then it's easier to measure....

Again, not at all an L&D nurse here! Just a thought...

nursejohio, ASN, RN · Aug 25, 2008

i know there have been multiple threads on the issue. try doing a search for them, there's really great advice in some of the posts

L&Doldtimer · Aug 27, 2008

Practice, practice, practice! And then you'll find a doctor's 4 is your 2!

Acts238RN · Aug 28, 2008

L&Doldtimer, you said a mouthful!!! :yeah:

L&Doldtimer · Aug 29, 2008

Thanks...once had a doc tell me he almost always told his pts. they were farther along than they were the previous visit! Then they get to the hospital and we have to explain how one "goes backwards" in dilatation!!

Calzonan RN · Aug 30, 2008

One thing I've found helpful is I've taken the little tape measure we use to measure the baby's length and taped it at an angle from one corner of the back of my badge to the other (angled corner to corner my badge is 10 cm). This way if I have any questions I just check my patient, get an idea where my fingers are, wash my hands and then check against my badge. A lot of times you can just look at your badge and tell, yep, that's 5cm etc.

HTH

Barkow · Sep 1, 2008

Something that's really important when checking dilation is not rushing. I used to want to get in and out as quickly as possible, but the anatomy up there can be tricky on some women and by taking the time to think if you're actually feeling the cervix you'll get a more accurate measurement. The cervix is always up there, somewhere, and by taking your time you're less likely to make a mistake. Having your patient put her hands under her hips will also help make it easier to reach a high cervix.

As for measuring, I still honestly use one of those stupid plastic dilation diagram boards and look at it while I check. Sometimes I feel like a dork, but I always get the exact measurement because it's really hard for my brain to process the spatial distance otherwise. A more discrete trick is to know the speed of your EFM paper. If it goes at 3cm/min, then you know that there are 3cm between the darker minute lines. After checking the pt, pretend to look at something on the monitor strip, and quickly compare your finger measurement to the minute lines. If the width of your fingers goes over 2 minutes, the pt is 6cm.

Hope this helps!

mom2michael, MSN, RN, NP · Sep 1, 2008

I use the board to check - and I bring it with me. While I'm checking the patient, I take my other hand and measure with it on the board. My patients know I'm learning (I'm very upfront with them about being in orientation) and they actually like having a visual reference as to their own progression.

It's really cool to have a mom get excited when she realizes she was a 2 or 3 when she came in and now she's an 8. They love it. It gives them hope and it makes sure I'm doing it right and finding the right thing to be checked.

When I'm done - I wipe it all down with some Germicide wipes and it's all good.

Baby1nurse · Sep 1, 2008

Hi
I am a new L & D nurse. I have about 2 weeks left of orientation and then I am on my own! I still am having trouble with checking my patients cervix. Its hard for me to find the cervix and when I do half the time I am a few centimeters off. Any advice or tips? I know I just have to keep trying but I hate that I struggle at this.

Doing vag. exams for a first time L&D nurse is probably one of the most difficult thing to learn. My advise to new nurses is to first insert your fingers into the lady parts at the right angle. Most "newbies" insert their fingers on an upward angle and then say that they cannot feel the cervix when really they are nowhere near it. The first thing you should do is to ask the patient to put her fists under her hips. This lifts the pelvis making it easier to find those posterior cervices. Then insert your fingers as though you were inserting a tampon - down towards the coccyx. As for dilation, a really easy way to check yourself is to take a piece of monitor paper. One minute equals 3cm. Grab a piece of monitor paper and stick your fingers onto it - voila! you have a guide for dilation. Try those easy tips and your exams should be a snap!

cradlecrewer · Dec 18, 2008

Something that's really important when checking dilation is not rushing. I used to want to get in and out as quickly as possible, but the anatomy up there can be tricky on some women and by taking the time to think if you're actually feeling the cervix you'll get a more accurate measurement. The cervix is always up there, somewhere, and by taking your time you're less likely to make a mistake. Having your patient put her hands under her hips will also help make it easier to reach a high cervix.
As for measuring, I still honestly use one of those stupid plastic dilation diagram boards and look at it while I check. Sometimes I feel like a dork, but I always get the exact measurement because it's really hard for my brain to process the spatial distance otherwise. A more discrete trick is to know the speed of your EFM paper. If it goes at 3cm/min, then you know that there are 3cm between the darker minute lines. After checking the pt, pretend to look at something on the monitor strip, and quickly compare your finger measurement to the minute lines. If the width of your fingers goes over 2 minutes, the pt is 6cm.
Hope this helps!

BAHAHAHAH.....this is SUCH A COOL IDEA!...sneaky too..I love it