How to Do Sterile Vaginal Exams

[jennymaths]

I'm a new grad and got hired into L&D recently. Nursing school did not present much of an opportunity with vag exams. Needless to say I feel pretty clueless about doing them. I know they're checking for dilatation, effacement, station and presentation. But I don't know HOW they do it. Sure, they stick their fingers into the lady parts. But then what? What are the landmarks they are talking about? How do I know where the cervix is at? I don't even know what it feels like. I've been down there a couple times with my preceptor, but I don't know if I'm feeling the right thing. Yes, I feel pretty helpless. I've heard my preceptor talk about the cervix being posterior. What does that mean, and how does it impact doing a vag exam? If somebody could please, please, please help me out with all these questions, I would be so grateful. It would make me feel so much better if I was able to check my patients myself rather than wait for an experienced nurse to untie herself from her own mess. I feel guilty stealing others' time. So please do help me.... thank you....

[NurseInTexas12]

Don't be discouraged! Learning to check cervixes is unique to L&D, so everybody understands that you'll need lots of help learning to do SVEs at first.

Helpful hints...

-A patient who has internal monitors can be your best friend. You know that the IUPC and FSE had to go through the cervix to be placed, so if you just follow them up with your fingers, you can't miss the cervix.

-Ask any nurse who is going to check her patient if you can go with her. Don't limit your cervix checks to your own patients with your preceptor. The more cervixes you check, the more confident and accurate you'll get. Most nurses will be happy to help you!

It takes time to learn, and it can even be tricky for those of us who have experience sometimes. Your "ah ha!" moment will come, so just keep on practicing. :)