SelectRN

I'm with you LBK82. I bought a Pocket Dilation Guide and found that it helps me alot. I use it all the time and even in front of patients. They love to see where they are in their progress. The thing that I found nice about it is that you can put your fingers through it so you can get a feel of what the cervix feels like on the outer edge of your fingers not like the charts or putting your fingers up against paper. There's even an effacement guide on the back.

Think about putting a Pocket Dilation Guide in your pocket too. It's a great reference when learning cervical exams.

I can't believe after reading your post that anyone can treat another nurse like this. Like one of the posts mentioned, do they not realize that you are going to be part of their team and need to help rather than hinder you? Sounds to me like you have second stage down. You had a gut feeling someone needed to be called when you heard the grunting, you were just waiting for some direction since you weren't the primary nurse. I'm sorry to hear this has been your experience, but one good thing is going to come from this. You will more than likely be a very good preceptor in the future. You will probably be very understanding to new nurses trying to learn because of what you have had to endure.

I heard about an interesting study in Europe that studied patients allowed to labor down with epidurals vs pushing. They reported that patients allowed to push got to the same result within 15 minutes of laboring down, so why not let them labor down. For me, many times directed pushing just makes people hold their breath to the count of ten and not necessarily push effectively. I prefer to let the patient dictate their pushing, but as other people have said before, you have to individualize to each patient.

It's been several years for me, but if I remember right, they will give you a bibliography of books to study from and areas of study to go over. The one single thing that I remember that helped relieve my anxiety was to get a copy of their sample test and go over it. They have that available also. It's pricey, but several of us at work were taking it around the same time and went in together on the test then passed it around, if that is possible for you. Good luck.

Yep, I went ahead and spent money on a Pocket Dilation Guide, and I love it! Quite a few nurses where I work have them, (the perinatal educators give them out to new nurses) and we all like them. Even after many years in OB I use mine regularly. I know checking dilation is not an exact science(maybe I'm a little more anal than most), but I like having a guide to pull out of my pocket and reassure myself with or hand over to the medical students or new residents. The patients like seeing their progress too. I learned with the plastic charts and that was great to have, but I hated not being able to find one all of the time. Next time someone challenges your exam you can just pull it out of your pocket and hand it over. Sounds like you're doing great to me!