How many L&D nurses rupture membranes or insert IUPC's?

[Salgal08]

I'm wondering if most L&D nurses rupture membranes or insert IUPC's? Does anyone know if there are AWHONN guidelines on these procedures?

Thanks!

[LDRNMOMMY, BSN, RN]

Here is AWHONN's position statement. Where I worked in NC, nurses with validated competency could place an FSE, only providers placed IUPCs. Nurses did not perform amniotomy. It was considered practicing midwifery. http://www.awhonn.org/awhonn/content.do?name=02_PracticeResources/2B3_Focus_PregLaborMgt.htm

[nurseshepherd]

None of the hospitals I've worked L&D would allow RNs to perform amniotomy although all of them would let those of us who have been 'checked off' place an FSE. One of the larger hospitals I've worked at would let RNs place IUPCs as well once you had been through an inservice and observed by a more experienced peer. The AWHONN site listed is something to get real familiar with as an OB nurse.

[ldnursedana]

We do not perform amniotomy either. We can replace an FSE if the original one comes off once we go through an inservice and we do not do IUPC. When I was doing my preceptorship at a nearby hospital though, their nurses did all of the above.

[L&DRN03]

I work in a teaching hospital and all of the above is out of the relm of our practice.

[MemphisOBRNC, BSN, RN]

We apply ISEs on ruptured patients and insert IUPCs. We can apply an ISE on an UNruptured only per AWHONN guidelines.

[Crazy_L&D]

I currently work in Wisconsin where nurses may place IUPC's after completing a competency, however I previously worked in Pennsylvania where nurses could not. In neither place could we perform AROM.

[Sandwitch883RN]

We are not allowed to AROM or place IUPC's as RN's. However we routinely did FSE's on ruptured pts and placed cervidil. I just started working in a new facility. I'm not sure of the policies yet because i'm still in orientation. I start work on the floor next week. However, from the description on the competency list we only "assist" with FSE placement. I'm sorta bummed by this because I like to be able to do as many skills as possible to be competent at them but on the flip side if we cant do them it's one less thing to be responsible or liable for.

[NurseNora, BSN, RN]

There are a few states whose Nurse Practice Act allows RNs to perform AROM. I don't remember any of them. Check your state's NPA to see if it's allowed where you live.

Become familiar with your state BON site as well as the AWHONN site. You'll be consulting them both from time to time.

[tntrn, ASN, RN]

We don't do AROM's on purpose, but honestly, I've had them rupture on exam without any attempt on my part at all. We place FSE's and IUPC's. In fact, I just did my Fetal Monitoring Class and placing both was part of the deal.

[AmyLynn219]

We are not allowed to AROM but we as nurses place FSE and IUPC's all the time. We had to feel comfortable with SVE and had to be there at least a year. I know I feel comfortable placing them.

Amy

[LizzyL&DRN]

We are allowed to AROM under certain conditions...1. We must have an order from MD. 2. Pt must be at least 4 cm dilated and at 0 station and in active labor. 3. We must have been signed off by 3 physicians that witnessed the RN perform AROM.

We also insert IUPCs and FSEs. The docs love that we can AROM their patients but they do try to take advantage. We are constantly reminding them of our policy. "no doctor I cannot break her water, she is only 2 cm and -2 station, you'll have to get out of your nice comfy bed and do it yourself.":wink2: