Don't forget AWHONN, a very good resource that outlines standards of care for ALL obstetric nurses nationwide.
they are the standards to which we are all held. I would try looking there.
Where I work, we nurses DO place cytotec, after a reassuring strip/NST is obtained. We place 25mcg, in the fornix of the os. The mom is then asked to lay on her side, being monitored, for 2 hours after the cytotec is placed. Vital signs are taking on mom q 15 min x4 after insertion. If no problems, after 2 hours, they can get up and walk, move about at will.
3 hours later, if uterine contractions are mild and not more frequent than 6 an hour, we place another 25 mcg in similar manner, monitoring the same way. We may use up to 3 doses (75mcg) to ripen the cervix.
Typically cytotec is VERY unpredictable. I have found it either works too well or not enough. I do keep Terbutaline (Brethine) in my pocket in case it's needed for hyperstimulation (which sometimes DOES happen with cytotec or other cervical ripening agents).
If hyperstimulation occurs, we are instructed to give Terb, 0.25 mg, SQ and continue monitoring. If non reassuring FHT's occur, (repeated late decelerations), additionally, we give O2 by mask, lay mom on left side, and start an IV, give a fluid bolus, as per intrauterine resus. procedures. And yes, this does happen from time to time, so a nurse administering cytotec better be on his or her TOES!
Just an aside, I would prefer we administer the drug PO versus vaginally. The efficacy is the same in my experience, it either works or not. Obviously, PO is more comfortable for mom, and does not make it necessary for her to lay on her side, nearly flat. And if you have not done it, you don't know how HARD it is to put that TINY pill in the cervical fornix! WHAT A PAIN!!!! We used it PO where I used to work. And the result was identical; it either worked or not. Getting our docs on board to give PO is not easy, however. They think it's more effective vaginally. I need to find some studies on this.
Anyhow, I digressed. Typically, we do cytotec ripening on night shift, and pitocin, if needed, is started the next morning.
Lots of discussion regarding cytotec policies, hazards and benefits, is found here:
Do a search and you will find a LOT about this drug and what nurses nationwide have to say about it.
Good luck. I know I did not help too much, but hopefully, gave you some direction.