Vaginal cervix checks

klone, MSN, RN · Jun 20, 2018

Just practice

labordude, BSN, RN · Jun 20, 2018

Echoing klone, practice, practice, practice! I think also understanding that interexaminer difference is a thing and it's not typically a big deal. There is really little difference between me saying 3 and you saying 4 or I think she's 60% and you think 70%. If you find yourself multiple centimeters apart from another examiner, talk it over with them and understanding where and what they felt. Here are some great tips from this midwifery website:The Elusive Cervix: Tips for Performing a lady partsl Exam – Rockford Midwifery

AlleeBooRN · Jun 20, 2018

I am ... thank u

AZBlueBell · Jun 21, 2018

Hi, I'm a new L&D nurse too and this was a struggle for me for my whole orientation! I feel like I'm finally starting to figure it out. It took two "easy" checks for me to finally figure out exactly what I'm feeling for. An easy check meaning when I went on the cervix was right there and thick enough that I couldn't miss it. I think when they are 2-3cm it is easier to feel because you just put your two fingers in and spread, no need to rotate around and try to guess bigger than your fingers can go. After I had those two checks (I had one during my 12 week orientation and one right after) I feel like I'm much better at them now. Because if I go in and just feel "mush" I know where to run my fingers so that I can try and hook it and really find/feel the cervix for dilation. I still struggle with super posterior cervixes, effacement, and station but I know I'll get better with time. And sometimes, when the pt reaches 7-8cm I have a hard time feeling it on one side or the other and then I really can't give an accurate statement of dilation. If that happens, I just get an experienced nurse to check for me. So hang in there and keep practicing! Ask other nurses on the unit if they have an "easy" check with any pt who isn't ruptured and is comfortable if maybe you can check too just to get more practice with it. Also, don't be afraid to take your time. My first few checks I was worried about searching and not finding it, but take the time you need to feel for it. Some are far back or off to one side. And the blog someone above posted is helpful too, I've read it a few times since starting (and googled for many others!). Good luck!

AlleeBooRN · Jun 21, 2018

Thank u so much

labordude, BSN, RN · Jun 21, 2018

Hi, I'm a new L&D nurse too and this was a struggle for me for my whole orientation! I feel like I'm finally starting to figure it out. It took two "easy" checks for me to finally figure out exactly what I'm feeling for. An easy check meaning when I went on the cervix was right there and thick enough that I couldn't miss it. I think when they are 2-3cm it is easier to feel because you just put your two fingers in and spread, no need to rotate around and try to guess bigger than your fingers can go. After I had those two checks (I had one during my 12 week orientation and one right after) I feel like I'm much better at them now. Because if I go in and just feel "mush" I know where to run my fingers so that I can try and hook it and really find/feel the cervix for dilation. I still struggle with super posterior cervixes, effacement, and station but I know I'll get better with time. And sometimes, when the pt reaches 7-8cm I have a hard time feeling it on one side or the other and then I really can't give an accurate statement of dilation. If that happens, I just get an experienced nurse to check for me. So hang in there and keep practicing! Ask other nurses on the unit if they have an "easy" check with any pt who isn't ruptured and is comfortable if maybe you can check too just to get more practice with it. Also, don't be afraid to take your time. My first few checks I was worried about searching and not finding it, but take the time you need to feel for it. Some are far back or off to one side. And the blog someone above posted is helpful too, I've read it a few times since starting (and googled for many others!). Good luck!

Once you get beyond 6-7, start counting down from 10, it's way easier. (If there is 1 cm of cervix on each side, that's 10-1-1 = 8cm). For super posterior, try having them put their fists under their butt or sitting on a bedpan, often you can tilt things enough to make it easier for you to catch and more comfortable for her.