AIBU to complain about smear test experience?

[Ktmc94]

On Monday I contacted my GP surgery to get a new prescription for my pill. I spoke to the nurse who sorted that out but then proceeded to ambush me into a smear test appointment. I have looked into the screening for myself and was not convinced that I wanted to participate (I'm 26). I got flustered and agreed to the appointment thinking that at the very least I could have a discussion with her about it.

Then yesterday I arrived for my appointment. Blood pressure taken for pill and then I was weighed (didn't see the weight on the scale but I'm about a size 14/16). What came next was effectively a lecture about my weight which sent me reeling because I was already feeling nervous and uncomfortable about what was to come.

I was then ordered to strip behind the curtain without further ado, I tried to intimate that I was feeling apprehensive and was basically told to get on with it "it's only 20 seconds it's fine". No reassurance, no chat about the procedure or pros and cons of screening.

She then presented which, to me, looked like a rather large speculum and I voiced my concerns about it and was told that due to my weight a larger size was needed (I have never given birth). I was shell-shocked by this pronouncement and the bloody thing hurt before it was even opened but was once again told to relax and get on with it.

I left the appointment absolutely devastated at being lectured about my weight while feeling too vulnerable to assert myself. Fine, I need to do something about it but to launch immediately into a diabetes and heart disease lecture and then telling me that because I'm a bit chunky it means I must have a fat vag and offering no further explanation on the matter was just too much in my view.

I couldn't sleep last night tossing between wondering if I'm overreacting and feeling very upset about what happened. I phoned the practice manager this morning to discuss what had happened and was not encouraged. She skipped over the part about me trying to make an informed choice before deciding to screen and said "but you're 26 you should have had one by now" and "the nurse has been doing these on a daily basis for 30 odd years" and then rounded off by saying "not in any way to diminish your feelings about what happened" while having no comment on the fact that a weight lecture took up more of the appointment than some much needed reassurance about an invasive test.

I can't find anyone of any size who has been refused even a try with a smaller speculum and if I'm being honest I'm not massively fat, just pandemic misery has got me seeking dopamine in the biscuit tin but she could not have cared less about the state of my mental health. I'm still spotting and cramping which I had to find out for myself were side effects.

You were at the smear appointment to have a smear. If you had wanted a discussion then you should have made an appointment for that

So sorry you had a bad experience OP. I would definitely complain. At the very least the nurse carrying out the smear should have explained to you what it involved.
Maybe she was having a bad day, or maybe she’s in the wrong ‘caring’ profession.

@Hankunamatata consent is part of the procedure.

When you are at the appointment isn't the time to discuss pros and cons etc. Its a 10min appointment to do the procedure.
The pros are you find out if you could have cancer
The cons are it is painful/uncomfortable/embarrassing etc

At 26yo you need to learn to voice what you are thinking

@Hankunamatata

I disagree. OP was at liberty to decline the test at any time. No obligation to proceed

OP, I think the nurse sounds awful. Since you've already spoken to the PM, perhaps not much point in complaining, but when you go back for your next smear, you should let them know that you have had a bad experience before. Lots of people (me included) find smear tests distressing. Staff will likely be more compassionate if they know you're worried. Don't rely on them guessing, if you don't tell them

I'm absolutely horrified by some of these comments and can imagine a few of them have come from nurses who perhaps need to work on their own standard of conduct?

Kindness, respect and informed consent are a must for any procedure and are listed in the nmc code for nurses. Covid is no excuse for abandoning these principles of care. As part of everything I do I explain to the patient what I am doing, check they are happy to go ahead and try and alleviate any concerns they may have.

Tact, diplomacy and empathy don't come easily to everyone, no matter how many diplomas or degrees they have. The nhs has some truly amazing staff but unfortunately a fair share of bad eggs too.

Sorry you had this experience OP. I would write a letter to the practice manager explaining that you think her previous response was inadequate and outlining the failings you have experienced from this nurse. I get my smears through my local sexual health service at the hospital where I always see a doctor who is respectful and professional - you could consider this for when you're next due a smear test.

I think complain is not a helpful word to use in this situation. Giving brief feedback in writing will be more useful. You said you spoke to the PM on the phone and didn’t find their response helpful and it probably won’t be noted. Feedback could be constructive eg suggest what would have helped, such as leaving the weight advice till after the smear.

YANBU to be upset about the nurses d her lack of tact YABU to not go for a regular smear

Well done on phoning the practice manager, I'm sure it wasn't easy to have that discussion. If it was a rushed appointment it was obviously a poor time to discuss your weight. Did you make it clear to the practice manager that you were making a complaint, it sounds like she tried to brush you off without making a formal complaint and that's obviously in their best interests.
You had the most intimate procedure possible and you're entitled to more respect. Would it be possible to go to a well woman clinic or a more specialized surgery the next time.

My best friend went for her first smear at 25. She was diagnosed with cervical cancer. Not HPV actual cancer that needed surgery.

But this does sound a bad experience so I would complain yes

At least you've had it done now; hopefully you won't let this bad experience put you off smear tests altogether.

Don't be like me; I never had a successful smear until I was actually 43....

I had a such a bad & unsuccessful experience with a practice nurse trying to do my smear at 25 it basically put me off for years... and years...
Then last year I had unusual bleeding so my gp said she would do my smear.

I was really anxious and told her so she prescribed diazepam which helped me to relax & despite me being a size 14 she used the smallest speculum & I had a successful smear test.
Luckily the results of the tests were ok. But I would've felt so angry with myself if they weren't.

I think that the mistake your nurse made was giving you a weight lecture right before your smear.
It's hardly going to relax you is it?!
Also fully undressing is not necessary.
I wore a short loose dress when I had my smear & literally just took my pants off.

Ask in advance for a smaller speculum if you feel you would prefer that.

Remember you can withdraw consent to any procedure at any time - if a practitioner makes you feel uncomfortable in future then don't let them go ahead.

People are being very harsh.

Smear tests can be very traumatic for survivors of sexual abuse/ rape.

The patient should always be put at ease.

She was not unreasonable to mention weight, but OP hardly sounds obese so I doubt she’s a huge risk of health problems at 26......

The nurse still should have been sensitive/ diplomatic though and it’s horrible the way she did it. What if it was a teenage girl? That’s how some people end up with eating disorders!

Was this ‘nurse’ skinny herself, btw?

@Icanseegreenshoots

All of the nurses that work in my surgery are severely overweight, and yet it is their job to tell others to lose weight! It is just as well most of the patients are polite and are not into fat shaming in the name of medicine.

It’s laughable

[quote Summersun2020]@daisyjgrey me (sorry to be “that” person). My GP bluntly pointed out I had gained a significant amount of weight since my last appointment and I now had an overweight BMI. He wasn’t unkind, just factual. It did spur me on to shed a stone-I hadn’t realised I had an unhealthy bmi until that point (although I’m sure this isn’t the case for everyone).[/quote]

As you said though, polite and factual is one thing, berating a person who is already in a very vulnerable position is quite another.

Some people would do well on this thread to remember that, besides all else, OP has just had her first cervical cytology sent for analysis. I certainly find the time waiting for results a little anxious, and I'm sure many would agree.

In any other circumstance you would not be posting about all the abnormal results you/your friend/you neighbours aunts cousin have had. OP has HAD the screening and done and does not need scaring- what do you think that is going to achieve right now?

Let's all remind OP that a) it's good the screening as been done b) put it to the back of your mind whilst you await results c) the vast majority of results are normal.

Spotting and cramping?! No way! Wow I'm so sorry. That was a real violation. I've learnt to be more assertive after a few uncomfortable experiences and now I only have a doctor doing mine.

I'm so sorry. That's totally rubbish about a big speculum! Yes it was the right thing, to have one - yes 26 is late to start. My first one was at 16. But that's no excuse for the behaviour.

I'd probably end up changing my GP practice ...

You're not obese as a 14/16. Omg. I'm afraid some women on here are horrible about this. Telling you to lose weight was, as you rightly point out, not the focus of the visit. I'm sure you know it's better to be slim in terms of health. But the nurse was supposed to be helping you through your first smear test, ffs.

I also want to know why you wouldn’t want the screening? I mean I delayed and delayed having my first one because I was frightened but I wasn’t in anyway thinking I didn’t want to participate in the long run. It’s important to get checked out.

I think that the mistake your nurse made was giving you a weight lecture right before your smear. It's hardly going to relax you is it?!

This.

It’s clear that some posters on this thread would gleefully abolish the concept of ‘bedside manner’ if they could.

I haven't read all 12 pages of replies, but I think many of the responses seem overly harsh. While I would strongly urge you to have regular smear tests, I think the brusqueness with which the nurse treated you about the procedure was unacceptable as was the response of the practice manager.

They made no allowances for any reasons why a patient might be reluctant or anxious for an intimate examination. It would have been right to talk you through the procedure and take the time to reassure you.

The attitude you experienced is likely to put anyone off future smear tests and that's dangerous.

I really hope you don't let this determine a future refusal for smear tests, they are so important and when done sensitively they shouldn't be painful- emotionally or physically.

I suggest you take the time to put your thoughts on paper. Then draft a letter of complaint, keeping to the facts of the matter and removing the emotion (bar, 'it has caused me great distress') and that you're concerns were dismissed. State what result you'd like from the complaint and keep it clear and concise.

Don't forget PALS.

With regards to future smears, find someone who will deal with you gently and sensitively and if you're struggling to find this via the NHS I'd consider getting it done privately if this is an option for you.

When you consider how distressed many people get about the dentist, I don't think your distress can be classed as unreasonable.

I also think some of the replies you've received don't take account of how easily a patient can feel a lack of agency in medical settings, it isn't always easy to speak up and stand your ground in these situations.

Best of luck to you and please, please don't let it prevent you from future smears.

@djddjj

Well we’re in the midst of a pandemic so I for one, are grateful that nurses are putting themselves at risk to continue to do their jobs!

If it’s not that important then perhaps the nurses that do smear tests could say it’s not a priority.

It’s not a nice thing to have done, it’s crap and maybe she was a bit OTT and dismissive but it’s probably because she’s got a higher than average work load at the minute and she hasn’t got time for umming and arrring.

No one forced the OP to have it done. She should have been more assertive and said no!

The nurse got no self gratification from that I’m sure. She’ll me under pressure and hasn’t got time to go through the positives and negatives. People should know that already.

I think you're being a bit unreasonable.
I understand you were nervous but it IS an important test, and it's done now so you're good for the next 3 years!

I was very nervous about having a smear and put off my first one for years. Eventually I went to get the contraceptive injection one day - aged about 30 so 5 years overdue for a smear, and the nurse reminded me (again!) and I gave my usual "oh yes, I'll book it soon, I just keep forgetting!" with no plans to actually do so. The nurse came back with "well my next appointment is free so I can do you now if you like!" and I didn't really have any excuse so I went with it.
It was uncomfortable, yes - but I was sort of glad it was over with. And have had them when I'm due ever since! And it's almost pleasant compared to when I had the coil fitted and subsequently removed!

Too add- I’ve known a fe young friends come back with abnormalities so if that was the case for OP I’m pretty sure she wouldn’t be complaining.

@TableFlowerss

I'm an emergency department doctor, you do not need to tell me about healthcare staff putting themselves at risk.

I am quite appalled by your comment and hope you are not a healthcare professional.

Perhaps I'll try it out at work then, if that's what's classed as ok. I'll do all of my examinations, including pelvic and rectal examinations, without explaining the procedure or asking if the patient would like to ask any questions. They've come to a&e, they should expect it right? Yep, let's do away with all bedside manner and empathy. Great.