Published Dec 4, 2009
besomebody
1 Post
Okay, this is a little embarrassing, but is it possible to not be able to do an adequate cervical exam for dilation and effacement due to having too short of fingers? I can't ever feel a cervix, or reach the "end" of the lady parts, my fingers seem too short. Also, I feel like my ring finger is ramming against the poor mama's perineum because I'm trying to get more length out the two fingers that are in there. I'm new to OB, it's my 4th week, and I'm starting to get worried. I've done about 25 exams. I never thought of my fingers as being short until I got to OB. Are there any tricks for those of us that don't have long fingers??:imbar
Da_Milk_of_Amnesia, MSN
514 Posts
This is why as a Murse, lol. I would never personally do OB. I don't have any tricks try your middle finger perhaps ? Uhhh...i mean everything is gonna get stretched anyways so i supposed going elbow deep wouldnt really do much considering the patients going to shoot a baby out of there. Is it bad if I'm laughing while typing this ? lolol
rn4babies63
174 Posts
Don't feel bad! It takes alot of practice. I've done OB for 13 years now and probably have the smallest hands, shortest fingers on staff. Many times I have to get someone with longer fingers to reach a cervix. Often I can just barely reach the outer os but can't grab it to pull it forward. Of 25 exams, however, surely somone's cervix was anterior enough for you to reach it. Just keep practicing!
HM2VikingRN, RN
4,700 Posts
That is why I am a psych nurse...i have oven mitt hands....
erroridiot
266 Posts
This is entirely possible.
I purchase my gloves in the kids department and use kid size bowling balls due to short fingers, small hands.
Iggy123
26 Posts
im sorry i started laughing when I was reading this...I know its part of the OB nurse job but just the way you worded it...must be hard though when your expected to do this as part of an important nursing function at work and its hard for you and its not really your fault!
HeartsOpenWide, RN
1 Article; 2,889 Posts
a lot of women are posterior, reach farther back. And yes, I have small short fingers. I wear a five and half sterile glove.
cjsbaskets
31 Posts
Have you compared your hands to some of the other nurses on your unit? lady partsl exams are tricky to learn and if the woman doesn't have an epidural it is very uncomfortable for her to have someone "digging" around. I remember when I first started I had a hard time too and then someone told me "it's like sticking you finger in a coke bottle" and after that it became easier since I now had an image in my mind. Sometimes putting your opposite hand on the fundus and pushing down a little helps too. Ask your peers to let you exam a patient that they know is 3-4 cm. so you get the "feel" Good luck, keep trying.
Guest321574
221 Posts
You may already know this, but try having the mom make 2 fists and put underneath of her bottom. Just this slight position change can help you reach a posterior cervix...
nurse/midwifekim
14 Posts
Get someone to double scrub with you, you do an examination after them and then get them to talk you through where the cervix is, etc.
Good Luck