CnukRN19

Thankfully, that is the only time I have been told that is the policy. 1:2 is our usual max ratio, either 2 cervical ripening patients, or a Mother/Baby couplet and 1 cervical ripening patient (we are LDRP)...and the other night shift charge nurses agree, never more than 1:2, even if an induction has be be postponed. It just blew me away when this charge nurse told me that was the policy....obviously, she has never had to take more than 2 cervical ripening patients, or she would know how hard, and unsafe, that is.

HOWEVER the MD has to have examined the patient within 24 hours of start of induction. So they see the MD in the office that day (Or on a sunday, the MD on call checks them) so there is an exam by the MD on record.

We do them, and we only do 1 cervidil. If that doesn't work, they try cytotec or the occasional foley balloon. Even when I traveled to places where they did serial inductions with more than one cervidil, the RN placed them all. Except maybe at teaching hospitals, where the MDs needed the practice.

Our policy for any cervical ripening is way crazy, and we all agree that if handed that assignment (has never happened, but the policy says it could) we will refuse, for the safety of the patients. Apparently the policy says 1 RN:4 cervical ripening patients. Ridiculous, when all it takes is one decelling baby to destroy that, and our patients are now all continuous monitoring for the most part. I didn't know this was the policy until one busy night when the day shift charge nurse said the gal that was getting the 2 4pm cervidils could take the midnight cytotec. I told her that was bull, and that I would take the midnight before I gave it to a nurse that already had 2 cervidils, and I did. She just sputtered "but it's policy!" which I said "It's a STUPID policy then!" Talk about NOT SAFE!!!!!