self cervical checks

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Specializes in Adult internal med, OB/GYN, REI..

hey all---am starting to get in the flow of doing my own SVE's, but I had a veteran nurse tell me this terrible story of one of our rampant doc's flying off the handle at her as he walked in as she was checking his VBAC, screaming "YOU WILL RUPTURE HER UTERUS!!!"

Of course this was a terrible thing for the patient to hear,

but my question is....

~do you do all your own checks?

~ do you do them at all?

~ was this doctor a total raving lunatic? i mean i know that answer, but it would seem like that would take one h*lluva exam to rupture a uterus, but then again I never met the patient or read her history, only was relayed the incident.

any keypoints to help when trying to become a better SVExaminer?

i have realized that you feel quite inept unless you know your patients uterus...first hand * hyuck hyuck*......

sorry.....couldnt help it.:D

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Specializes in Adult internal med, OB/GYN, REI..

and i didnt realize it until after posting it.....I have some ridiculous images now.....:chuckle

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We do our own checks on our patients. We do have one doctor who insists on telling us to do "gentle vag exams". This irritates us to no end. Like we would be so rough with our patients.

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Originally posted by joyrochelle

and i didnt realize it until after posting it.....I have some ridiculous images now.....:chuckle

yeah, i must admit i clicked in just to see what this was about...lmao...

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Specializes in Adult internal med, OB/GYN, REI..
Originally posted by finallyRN

We do have one doctor who insists on telling us to do "gentle vag exams". This irritates us to no end. Like we would be so rough with our patients.

precisely! .....i mean...we've all been at the end of tha hand before, for the most part.....

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Originally posted by joyrochelle

and i didnt realize it until after posting it.....I have some ridiculous images now.....:chuckle

Well, I clicked on this link quite seriously because, you know, we had that patient one time.... :eek:

Heather

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

wow!!!! boy did i misunderstand this thread at first. glad you cleared it up. there ARE patients and s/o who do their own SVE's with incredible accuracy. i won't say more.

all i can say is, imagine real hard being the other end of the check or having a pap smear. you know how that feels and what works for you.......so keeping that in mind, i go in slowly, gently, with hands or speculum as WARM as possible.......like I have all the time in the world---- with supreme gentleness. I have them breathe in deeply thru the nose and out the mouth, like in labor and let THEM relax their legs before I touch them at all. I keep eye contact with them and tell them each thing I am doing and how it is likely to feel. Also, I find if you move slowly, and probe gently, following the natural curve of the patient's back, they really relax and cooperate much better. good luck.;)

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Originally posted by SmilingBluEyes

there ARE patients and s/o who do their own SVE's with incredible accuracy.

And dangerous results.....

"but I was in the room when my ex-wife delivered our kids, so I thought I could do it myself....."

Heather

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

yep Heather.....true. it can be dangerous. i strongly discourage it whenever I am made aware of it. I think it is weird and dangerous both. I could never recommend it.

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My first answer is this: Not only was that Doc a raving lunatic ( to follow your description), he didn't know his anatomy well enough that I would let him operate on me!!! Unless that nurse had her fingers through the cervix and several cm's beyond, she wasn't even close to where a uterine incision would be in a VBAC. And if a uterus can tolerate several hours of contractions, it sure as H**L is not going to rupture from a vag exam. Shame on him for scaring that nurse like that, and for not knowing what can cause a true uterine rupture. There certainly are times when it is contraindicated to do a vag exam, but a VBAC isn't one of them. Geesh, that blows me away! Secondly, yes, I always do my own vag exams unless there's a contraindication to it. I have found that nurses are more objective when it comes to vag exams. We don't have any reason to say that the patient is more dilated than she really is, whereas the doc may have (wants to induce her so he doesn't have to stay up all night, checks her in the office, wants to send her over, says she's 4 when she's really 2 and long, you all see that too, I'm sure). Well, anyway, that's my two cents worth. Don't let ignorant people scare you into not using or learning a skill. Just keep practicing, and remember, as SmilingBlueEyes said, the more gentle you are, the better.;) Good luck!

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I have seen it many times, docs say pt is different than they are. got one that calls them complete at 8cm and wants them pushing, had another that always said baby was transverse and not progressing,and would need c/s.

like blue eyes said, gentleness is the key and of course practice.

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Originally posted by joyrochelle

and i didnt realize it until after posting it.....I have some ridiculous images now.....:chuckle

Okay, I admit it... I was thinking what? mirrors? they have their own speculums ?!! But WHY would they do that? Thus I wandered into the thread wondering...

;)

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