Amniotomy

[Nino]

We have recently been instructed by a physician to do amniotomy. They have assured us that in the written policy that we are covered by I feel unsure of this. It takes experience in knowing the landmarks and the parameters to figue position alone. The physician that taught us is the only one that wants us to ROM. Has anyone else been confranted with this and how did you handle it?

[spike]

We have a policy at our hospital regarding amniotomy. We only can do it if there are indications such as questionable fhr tracing or difficulty maintaining a tracing. This can only be done if they are a 0station and at least 36 weeks. We have some docs that are more insistant about having it done than others and will even ask for another nurse to do it. It has helped since we developed this policy because it used to be that there were no guidelines at all to tell the doc's that we were not comfortable with the procedure. I can honestly say I don't even remember the last time i did an arom, so I don't feel to uncomfortable about it now. I will only do it if I need to get a scalp on to see what is going on. If it is a poor quality tracing I will sit and hold the darn thing on before I arom. michele

[MercyAngels]

Where I work it is strictly against policy for a nurse to perform an amniotomy; I was surprised to hear that you could!! Another example of learning something new every day!

[LDRPRN]

Before you do AROM please be sure that your hospital does indeed have a written policy to cover nurses doing the procedure. Also you need to know if your state allows the procedure as a deligated function. Our hospital does not allow the nurses to perform the procedure even though the state would.

[Caseyrnbsn]

Please check your Nurses state practice act. There are very few states that allow RN 's to perform amniotomy due to the risk of eveyones expertise level being different and the risk of a prolapsed cord.. Protect yourself because know one else will if a bad outcome happens.

[PC]

Make sure you go through a local certification process ( and do x amount under direct supervision of the physicians) and have written strict guidelines. This will help keep you out of court when you have a prolapse ( if you notice, I said WHEN - not IF).

[Fay]

The doctor is not responsible for your actions, you are. He will be the first to bail in a deposition and dump on you. Also, make sue you are "acting within the scope of employment." Cover your (well, you know)