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!

[NurseBlueEyesRN]

We don't AROM patients, but we routinely place FSE on ruptured pt's, and place IUPC's (although I wish physician's HAD to do this...HATE putting these in!!!).

[jenrninmi, MSN, 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.

When I did my Intermediate Fetal Monitoring Class, we had to place the FSE's and IUPC's to pass, but we still do not do them at my hospital. Strange, I know.

[dwetherelt]

I managed a unit several years ago; when the BON said it did fall within the scope of RNs to perform amniotomy we initiated an education program and then let the RNs perform the amniotomy (we also inserted IUPCs and applied FSE's). BUT, I told the staff there would be no excuse accepted if there was ever a cord prolapse when they did the amniotomy.

Long story short, staff sometimes refused to do the AROM, insisting the docs do it the presenting part wasn't well applied or was too high and in the ten years I was there we had 2 cord prolapses with AROM. . . BOTH when an MD did the AROM.

Other posters are correct, you need to know what your BON allows, then ensure you have adequate training for safe performance.

[mom2michael, MSN, RN, NP]

Haven't done the research yet but I do believe it's outside my scope to do an AROM in the state where I work. We do routinely do the FSE after you are comfortable with vag exams and have been checked off by at least 3 doctors and 3 RN's who are also competent in FSE placement. We do not do IUPC insertion and I don't believe that is a SBON issue, I think that is our facility policy because I know several of the nurses have indeed in the past inserted IUPCs.

Our docs are great about doing it all themselves though especially if you don't feel comfortable or you aren't sure if the patient has a contraindication for something.