Vaginal Exams

Specialties Ob/Gyn

Published

Hey nurses! Traveling to my first non-teaching hospital since being an L&D nurse, and the nurses are expected to perform lady partsl checks. Do any of you have resources I can use to get a jump start on it?

TIA

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

This might help you:

https://allnurses.com/ob-gyn-nursing/videos-to-assist-977721.html

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Thank you!

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Specializes in L&D, OBED, NICU, Lactation.

I bought one of these Pocketdilationguide.com and it's great. I started off with trouble getting a handle on SVEs, but the one thing that helped me was when one preceptor talked about the cervix as feeling like a small rubber band. Think about the feeling when your finger rolls a rubber band.

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Specializes in L&D.

Remember that the dark lines on the fetal monitor paper are 3cm apart.

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Specializes in OB, NBN, PP.

Hey! Congrats on your new job! Remember, this is a very SUBJECTIVE exam. Think of the cervix like a doughnut. The middle is where your fingers will be.

The amount you can fit inside the middle (1 finger, 2 fingers) is your dilatation. I'm sure your unit will have a visual guide. Use it to determine how much you spread your fingers to assess the cm. For example, if I can insert 2 fingers and spread "just a little", she's 3cm.

The "thickness" of the doughnut is comparable to effacement. A non-effaced cervix is around 4 inches long. My middle finger is around 4 inches. Just before my big knuckle, half of my finger is 2 inches (50% effaced). Just passed my fingernail is around 80%. So if the thickness of the doughnut reaches just before my big knuckle, I would call it 50%. Don't get too hung up. Some providers will disagree just because. Most facilities outside of the U.S. assess effacement as fully, partially, or non.

Fetal station is determined by the level of the fetal head in comparison to mom's ischial spines. Google this. It's easier to understand with a visual. It may take a couple SVEs to "find the spines". Keep at it. You'll do great!

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Thanks everyone!! All of this has been extremely helpful!!

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Specializes in Postpartum, Med Surg, Home Health.

Duncan RN- awesome explanation thanks!

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Specializes in L&D.

Just curious if you're on assignment yet and how it's going!

I also came from a teaching hospital and when I got a PRN job at a hospital where nurses did exams it was challenging and I never really picked it up.

I have a new job in mother/baby where I will cross-train to L&D so may have to practice again....

I want to travel someday but this is one reason why I think I may find a new speciality before then.

Do you find being trained at a teaching hospital has put you at a disadvantage for travel assignments in L&D?

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Hi adpiRN I do sometimes feel that way. However there are lots I'm grateful for in teaching hospitals. The assignment I'm on currently is a world of difference from what I'm used to. The nurse is expected to be the clerk, housekeeping, lab and everything in between. My first night on was a nightmare. I have a long way to go til the end of my assignment but I'm willing to take some good skills with me when it's over.

I find that knowing how to perform a VE is an impt skill for an L&D RN, so I'm glad to learn. But I'm not comfortable triaging patients and having to call their Drs based on my exam. i guess it gets easier with time.

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Specializes in Maternity.

I always tell my students that at the end of the day what you find on VE is between you and God.

I've had reasons for fluffing the numbers in the past but its something you can only do when you have greater experience in Obstetrics and understand the implications of people acting on the information you give them.

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