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.

I and I can’t help but think the OP is unduly miffed that the nurse discussed her weight. It’s her job to keep people healthy and if OP is heavier than what’s considered healthy then it’s the nurses job to explain the pitfalls

OP, only read half of the first page and I hope others have said the same as me already: the comments shaming you for considering your options are disgusting. There is plenty of evidence to suggest smear tests are not in the least bit reliable and the very high incidence of false positives result in some very serious unnecessary medical treatments. You are not wrong wanting to inform yourself.

Cervical cancer is very very uncommon.

I’ve never had a smear test. I will not be having a smear test. I am happy with my choice based on the evidence I have researched. And I could not give less of a damn how other people feel about that. We are not walking pre-cancerous reproductive systems, for god sake. You’re allowed to make your own choices.

[quote djddjj]@TableFlowerss healthcare workers should be continuing to provide care to an acceptable standard. This is the standard I hold myself to, and this is the standard I hold others to. There are unavoidable things occurring due to the pandemic; lack of ITU beds, delayed outpatient appointments and so on (there is an exhaustive list of course). But this pandemic is not a reason to drop basics such as, you know, talking to a women before doing her first cervical cytology. I'm not sure how the state of ITU affects whether OP could have had a decent cervical cytology appointment, unlike the one she has had which will probably make her less likely to go back in future.
[/quote]
I know who I’d rather have treating me, @djddjj... keep up the good work.

@Autumnterm

😂

In the current circumstances, I think you’d be grateful for anything and anyone!

SidekickSally

Pills are not only prescribed for contraception. It can be for those of us who have pcos and barely have periods so helping with it. I had it when I was younger despite I didn’t have a bf

You’re absolutely right, my bad.
Screening still starts at 25 regardless of sexual activity.

Writersblock2 - surely the incidence of cervical cancer nowadays is because of effective screening, not despite it?

Wow this thread is awful.

I can't believe the pile on that's happening. The OP is entitled to her feelings.

I personally find smears to be horrific due to my history. An uncaring nurse wouldn't help that.

Your experience isn't universal and lecturing people isn't helpful.

@SidekickSally Nope. The trajectory was already on the exact same downward slope prior to screening. That’s not changed at all. It’s already been stated by the medical board that if the screening didn’t already exist and they tried to introduce it now, it wouldn’t pass.

And the reason why GPs bring it up at every available opportunity is because they get monetary bonuses if a certain percentage of women st their practice agrees to be tested.

Funny that.

For the record, I don’t have an issue with a. Woman choosing to screen for herself. I have a big problem with women policing other women’s choice of autonomy, and I have a big problem with the NHS not providing accurate information to allow for informed consent. As others have mentioned in this thread, start reading Margaret McCarthy and go from there. Make decisions for yourself about your own medical care based on facts (and your own risks). Don’t rely on scaremongering tactics of other women and badly misplaced advertising campaigns.

In the current circumstances, I think you’d be grateful for anything and anyone!

It takes no extra time to smile and no extra time to be polite.

No patient should ever be coerced or bullied into a procedure and it is not acceptable for HCPs to be brusque with patients. OP was absolutely correct to report so that the nurse in question can adjust her behaviour.

Sub-standard care should always be reported so that we as HCPs can assess and improve, a pandemic is no excuse for being rude to patients, let alone not obtaining their consent to a procedure.

There are some disgusting and very misguided comments being made on here. OP I'm sorry some people are being so shitty. YANBU at all imho.

I had a similar experience with my first smear, and a few subsequent ones. I've never had children and have always been small/tight down there for some reason. Additionally, like a pp, I have vaginismus. Smears are only bearable for me if they're performed gently and with an understanding attitude. Brusque nurses haven't helped on some occasions, barking out 'I'm not going to be able to do anything if you don't relax!' - very effective, not.

What she said about needing a bigger speculum is bollocks and just highlights her own prejudices imho. I always ask for a smaller speculum to be used. On one occasion, a doctor was actually able to perform a smear using a really small brush-type thing. (I mention this in case it's of any help to you OP or to anyone else with these issues, although I'm not sure whether it has to be a doctor when it's done that way.)

Comments like 'grow up' and 'get a grip' are vile and unhelpful. I'm pleased for those who find smears OK to get through, but there are any number of reasons why someone may struggle and it's naive and judgemental to write off someone else's experience as 'mild discomfort'. I do wonder whether the nurse, and/or some people on this thread, are exercising a bit of prejudice along the lines of 'if you've not had children you don't know what pain is.' There's simply no call for people to be as horrible as some have been.

Also, yes the NHS is busy, but patients should still be able to expect the practitioner to do what they can in the time available to put them at ease and to be generally reassuring/encouraging prior to such an intimate procedure being performed. I hate the thought of anyone being put off having a smear because of a practitioner's attitude - everyone needs to have this test done at regular intervals, it's so, so important.

Totally agree with everything FestiveFruitloop posted. I know it's AIBU, but some of the responses have been disgusting.

A smear is not a nice procedure. I can’t imagine many women would say, I love it, but equally for our own sake, it’s something we really should do.

It’s great being softly softly but the nurse hasn’t got time to reassure every patient for a prolonged period. What do they have, 10 mins each appointment?

Do you feel the same about other necessary medical procedures that people feel nervous about? Taking blood, administering a vaccine, having a prostrate exam, conducting a breast examination. No time for any reassurance or tact, no ‘softly softly’, just get stuck in because the patient should be grateful for what they’re getting?

I can see how these attitudes can filter down and lead to terrible quality healthcare and nursing. When are nurses not ever rushed for time, in any setting, at any point in the past decade?

We’ve probably all experienced the difference between excellent and compassionate care, and care at a very mediocre and dismissive level. I wish people would stop trying to act like that difference is irrelevant or doesn’t exist.

Agree with @FestiveFruitloop too, some of the comments on here are terrible. My first smear was a dreadful experience, it hurt and the female gp was very nasty about it, considering I was still a virgin and very young she should have been more sympathetic. I wish now I had made a complaint but I was young and niaive. They are much better now as I realised you can choose a size of speculum that suits you rather than the standard size ones.

I can see this from both sides. Sometimes when people have been doing their job for a long time they do develop a dismissive bedside manner because they've "seen it all before". I experienced this both times when in hospital giving birth.

On the other hand, there is plenty of information online that you can view to reassure yourself over the procedure, what's normal/not etc and prepare yourself for going.

OP this is one of those things that none of us particularly like or feel comfortable with but it is so necessary.

A close family friend got cervical cancer after she ignored the calls for a test and didn't attend due to embarrassment etc. Granted this was back in the days before the internet and having all that information to hand so she completely scared herself out of going. Thankfully she survived but has had to use surrogacy to have children and she is now shielding due to COVID-19.

Long story short, please don't let this put you off going in future.

P.S. I need a large speculum as I have a deep pelvis! Nothing to do with the size of your vag, certainly not the outer parts anyway.

I keep hearing about the way obese or overweight people are treated by some doctors and nurses. This is very unprofessional. It may put some people off of going to avoid unnecessary rudeness. There are ways to educate and make a point without this.Also, there is nothing more uncomfortable for me than a smear test. I sympathise with your experience Op.

Pros and cons about screening? Pros - it would save your life by catching abnormal cells. Cons - none

Pros - it would save your life by catching abnormal cells. Cons - none

None for you, @londongirl12. Doesn't mean there's none for anyone else. And it *could save your life, it's not a miracle cancer cure.

It sounds like she had a slightly insensitive manner about her. But GPs get QOF points for cv screening. Yes they get more money for meeting their targets basically. She had probably been told to increase uptake and get more done.

OP you are projecting a look of things here. She didn't say you had a "fat vag" and no, obviously that isn't the only way to take it. They also use a larger speculum on women who are sexually active, does that mean they are basically calling them sluts? Of course not.

I don't think you would have been as angry about the smear if it didn't come after being warned about your weight.

For next time, it isn't really appropriate to go to the appointment and only then discuss whether you want the procedure done or not. As far as the nurse is concerned you are booked in for a smear, she doesn't know you are considering not actually doing it. You are your own advocate.

@Writersblock2

And the reason why GPs bring it up at every available opportunity is because they get monetary bonuses if a certain percentage of women st their practice agrees to be tested.

Funny that.

The exact same for the flu jab, doesn't mean it isn't a necessary and beneficial procedure.

@BrumBoo

Pros - it would save your life by catching abnormal cells. Cons - none

None for you, *@londongirl12. Doesn't mean there's none for anyone else. And it could save your life, it's not a miracle cancer cure.

What are the cons of it then please? I understand totally it will be very hard for someone who has maybe had a assault/ rape experience, but what are the cons for the general public?

@londongirl12

There is research (some have mentioned it in PP's) that argues that many abnormal cells change and 'heal' over quite a short time frame. Say you had a smear and it came back abnormal, 12 weeks later you could have another and it would come back normal. Generally you would receive (quite invasive, potentially damaging) treatment after an abnormal smear but the majority of these cases would have heard by themselves.

Statistically, the cases of cervical cancer are quite small and there isn't really a correlation to the amount of tests being performed.

On a humanistic level, obviously past trauma assault/abuse/medical PTSD all contribute and the "just get on with it, it's fine" narrative is extremely damaging.