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I can't remember exactly how long it took to get comfortable with. The place where I first learned only did about 10 deliveries a month. Then I moved to a larger hospital, and my skills advanced quickly. Practice, practice, practice! You will always get those strange ones, but you will pick up certain tricks along the way, like having them put their fists under their hips when you do the exam.
I agree with the above statement even after 15 years I have still had a few patients I will get someone else to check after me. It is only when you think you know it all you become a danger to everyone.Originally posted by mother/babyRNThere are times when you just aren't sure and you ask someone else to check.....Still, after 15 years....
No one (doc or nurse) is ever 100% right all the time on exams. In the grand scheme of things, it doesn't really matter what the dilitation is as long as the patient is making cervical change. Things can change fast and that's the whole point! Consistancy of examiner is more important for accuracy, anyway. The fewer exams the better, too.
Having the patient put her fists under her buttocks for an exam as was mentioned really works. If you cannot fiond the cervix it might be very thin or as is usually the case, very very posterior.
If all is well and there is no cervical change after one hour, send them hoem......that's what we do.
Now adays especially when attempting to calm a patient I will tell them 1 2 or 3 cms, somewhere in the middle..8 9 10 somewhere near the end...In the middle is epidural if warranted...They concentrate on the number because labor as a function is or can be all about lack of control.....So, attempting to figure out ways in which they don't necessarily focus primarily on the numbers does help in many cases...
monie2004
38 Posts
How long did it take for u guys to really be confident in your exam estimates? I doing pretty good with mine but I have been getting 1-2 odd pts recently where I just cant feel it at all! Then I end up feeling incompetent to the pt and the MD!! Any help!?