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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

AIBU to complain about smear test experience?

462 replies

Ktmc94 · 14/01/2021 13:54

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.

OP posts:
PanamaPattie · 15/01/2021 22:01

I believe that as part of a policy to increase screening, nurses and some GPs will take the opportunity to trap you into a smear test at an appointment if there is time and they think they can talk you into it. There were times when I went to the surgery they asked at every visit “when was your last smear test”. This is designed to catch you unawares and will put some women in a position where it is difficult to say no.

PanamaPattie · 15/01/2021 22:04

Just a question - if smears tests literally save lives - why are the NHS phasing them out and replacing them with HPV testing instead?

daisyjgrey · 15/01/2021 22:05

@BananaHammock23

YABU OP. It sounds like nurse did her job more thoroughly than most, and like PP said you're lucky to get a smear test during this time. Perhaps she wasn't the most polite, but it sounds like everything she said was correct, just not very comforting.

Would love to hear your reasoning behind not getting screened? Smear tests literally save lives. It's totally bizarre that you wouldn't want one.

Multiple people, including myself have explained reasons behind not partaking. Read the thread.
CausingChaos2 · 15/01/2021 22:07

@BananaHammock23

YABU OP. It sounds like nurse did her job more thoroughly than most, and like PP said you're lucky to get a smear test during this time. Perhaps she wasn't the most polite, but it sounds like everything she said was correct, just not very comforting.

Would love to hear your reasoning behind not getting screened? Smear tests literally save lives. It's totally bizarre that you wouldn't want one.

OP doesn’t owe you or anyone else an explanation into why she had her doubts/ concerns. And the only bizarre thing is that you can’t imagine why some women wouldn’t want one. Hmm

Really?

daisyjgrey · 15/01/2021 22:09

amp.theguardian.com/society/2003/may/22/genderissues.publichealth

Although it is a newspaper article it provides links to BMJ papers and summarises the research quite well.

Informed consent for the win.

Sidge · 16/01/2021 10:19

@PanamaPattie smears are currently known as primary HPV screening - the cellular content is only assessed if high risk HPV is present in the sample taken.

We know that 99.7% of cervical cancers are caused by high risk HPV (HR-HPV).

If HR-HPV is present the outcome for the woman depends on whether the cervical cells have changed in any way or not. It’s a much more refined way of managing cytological changes and reduces unnecessary interventions.

The move is towards urine HR-HPV testing. A woman will provide a urine sample for testing, and only require a smear if she has HR-HPV to allow examination of the cervical cells where needed.

So smears will not be stopped completely, there are still cases where a smear is needed. However with the introduction of the HPV vaccine in 2008 we are already seeing a reduction in HR-HPV in young woman and so we should see far fewer cases of cervical cancer.

Women who are outside screening age, or had a negative HPV result that have abnormal symptoms such as bleeding between periods, bleeding after sex, post menopausal bleeding, unusual discharge, pain or swelling should always be investigated and possibly referred to gynae where indicated. That doesn’t mean they need a smear though - a smear is a screening tool and not an investigative or diagnostic one (certainly not in isolation).

SidekickSally · 16/01/2021 10:22

Interesting article daisy grey. The bit that stood out for me is
"It can be uncomfortable; some women find it humiliating and it is true the majority will not benefit," she admits, but, she says, the 42 per cent fall in the mortality rate from cervical cancer since the 1980s shows that for those who do develop cancer, the benefits are very real.

I guess it’s all about your own personal risk/benefit calculation. I personally go through with smears as uncomfortable as they are because my fear of the risk of cervical cancer is more than my fear of getting a false positive and needing unnecessary treatment. Others clearly feel different.

Worldbarbie · 16/01/2021 10:29

@PanamaPattie

Just a question - if smears tests literally save lives - why are the NHS phasing them out and replacing them with HPV testing instead?
What is a HPV test exactly?

When I had my smear they are checking for HPV.Where as they haven’t always.

PinkiOcelot · 16/01/2021 10:34

You made the decision (informed or otherwise) when you turned up for your appointment.

RosesAndHellebores · 16/01/2021 10:39

If the person taking the smear is expert, kind and gentle it should be neither humiliating nor uncomfortable. The real issue is in the clinical quality, supervision and training of practice nurses. I have found the difference between GPs and gynaecologists when compared to the levels of empathy and skill offered by nurses to be extraordinary with the drs providing far far better standards.

The real issue lies with the competence and emotional intelligence of those who undertake to provide the smear.

Worldbarbie · 16/01/2021 12:23

@RosesAndHellebores I don’t mean to be crude but if you insert something inside you and you aren’t lubricated that is the reason a smear is uncomfortable.

You can’t assume the nurse is incompetent.

Toomanyparsnips · 16/01/2021 12:30

It sounds like the nurse was rude and unpleasant about issues which she should have known might be sensitive and upsetting for you. Yes obviously she does this a million times a day etc, but she's a professional - that's no excuse for not being sensitive to each patient's needs. She's meant to be a professional. I don't think you'd be unreasonable to makes complaint about her conduct, but I wouldn't expect to get anywhere as a lot of people seem to think women should be treated with contempt by medical professionals (especially when having something put up their vagina).

RosesAndHellebores · 16/01/2021 12:36

What are you referring to @worldbarbie? Could you unpack that post a bit. I haven't ever inserted the speculum myself and none of my comments have referred to a lubricant. They have referred to the skill of taking the smear - ie collecting the cells from the cervix rather than inserting the speculum.

HidingUnderARock · 16/01/2021 13:37

I am confused as to why they are even called smears. I have bled for 2-6 days after each of mine, and only the post-partum one can be attributed to the size of the speculum.

They have all hurt too both during and after. The nurse overseeing my last one explained that it was more of a scrape than a smear, and pain and bleeding were normal.

She also had to take over from the trainee who had 3 painful and apparenty unsuccessful attempts. Before someone mentions it, yes I was asked and agreed to the trainee, and was quiet and compliant throughout.

RunningFromInsanity · 16/01/2021 13:50

@HidingUnderARock

I am confused as to why they are even called smears. I have bled for 2-6 days after each of mine, and only the post-partum one can be attributed to the size of the speculum.

They have all hurt too both during and after. The nurse overseeing my last one explained that it was more of a scrape than a smear, and pain and bleeding were normal.

She also had to take over from the trainee who had 3 painful and apparenty unsuccessful attempts. Before someone mentions it, yes I was asked and agreed to the trainee, and was quiet and compliant throughout.

I think the official term is ‘cervical screening’

And for a different point of view, I have never bled and it’s never been painful for me.

Sidge · 16/01/2021 16:07

@HidingUnderARock many years ago we took the sample with a wooden spatula (ouch) and smeared the sample onto a glass slide, which was then fixed with a liquid fixative for a cytologist to review under a microscope. Hence calling them smears.

Nowadays we use a soft brush to gather the cells, which is preserved in a liquid solution pot. Technically there is no smearing involved! It’s officially called liquid cytology screening but smear is a bit more familiar.

Bouledeneige · 16/01/2021 19:06

Yes she was a bit brusque and insensitive. She probably has quite a lot on her plate right now working in frontline NHS.

But I think you're being a big precious. Ambushes and humiliations. A smear is really not that bad - how the heck would anyone ever have a baby if a smear was such an ordeal? And the pros and cons - cancerous cells get detected - or you could die from cervical cancer. It's quite straightforward and for most people it's a no brainer. Would you have to make a song and dance about having a breast scan?

I had pre-cancerous cells found in my mid 20s, biopsy and a procedure followed - it could have been a whole lot worse if not detected. I'm just bloody grateful we live in a country where it's available free and as of right.

daisyjgrey · 16/01/2021 19:11

@Bouledeneige

Yes she was a bit brusque and insensitive. She probably has quite a lot on her plate right now working in frontline NHS.

But I think you're being a big precious. Ambushes and humiliations. A smear is really not that bad - how the heck would anyone ever have a baby if a smear was such an ordeal? And the pros and cons - cancerous cells get detected - or you could die from cervical cancer. It's quite straightforward and for most people it's a no brainer. Would you have to make a song and dance about having a breast scan?

I had pre-cancerous cells found in my mid 20s, biopsy and a procedure followed - it could have been a whole lot worse if not detected. I'm just bloody grateful we live in a country where it's available free and as of right.

Have you actually read any of the responses? Hmm
littlepattilou · 16/01/2021 20:19

@Bouledeneige

Yes she was a bit brusque and insensitive. She probably has quite a lot on her plate right now working in frontline NHS.

But I think you're being a big precious. Ambushes and humiliations. A smear is really not that bad - how the heck would anyone ever have a baby if a smear was such an ordeal? And the pros and cons - cancerous cells get detected - or you could die from cervical cancer. It's quite straightforward and for most people it's a no brainer. Would you have to make a song and dance about having a breast scan?

I had pre-cancerous cells found in my mid 20s, biopsy and a procedure followed - it could have been a whole lot worse if not detected. I'm just bloody grateful we live in a country where it's available free and as of right.

Hmm

I literally give up.

LilMidge01 · 16/01/2021 20:49

I'm sorry I don't mean to be insensitive but as you as you said she 'ambushed' you into a smear test you kind of lose credibility on your version of the events as you seem to be majorly projecting and expecting the nurse to be able to read your mind. If you didn't tell her you were uncomfortable/ anxious and asked her to describe the procedure in further depth, then I'm not sure what the nurse did wrong. She did her job. It's perfectly reasonable to ask a woman renewing her pill prescription about smear tests.
And I'm not sure how purposely giving you a larger than normal speculum achieves anything for her....?
Maybe she was a bit brusque...but I imagine she is super busy and stressed at the moment too. This is a routine thing for her. and maybe she didn't pick up on your nerves if you didn't voice them.

I don't think a complaint would achieve much.

I hope you feel better soon and get clear results from your smear.

LilMidge01 · 16/01/2021 20:54

@PanamaPattie

I believe that as part of a policy to increase screening, nurses and some GPs will take the opportunity to trap you into a smear test at an appointment if there is time and they think they can talk you into it. There were times when I went to the surgery they asked at every visit “when was your last smear test”. This is designed to catch you unawares and will put some women in a position where it is difficult to say no.
oh for goodness sake! There's no ambush or 'talking you into it'. You're an adult. If you don't want one, say no. It's their job to ask as it is their job to check your health and smears are an important facet of that. If they try and tell you how important they are, its because they are trying to give you knowledge and information. Not force you to do something.

And of course, like I said...you can refuse if you want

Bouledeneige · 16/01/2021 23:23

pattilou don't let me stop you.

Bouledeneige · 16/01/2021 23:24

Literally

Bouledeneige · 16/01/2021 23:25

daisyjgrey yes have you? We doing rhetoricals?

lozster · 17/01/2021 01:20

Linking to this discussion where a consultant gynaecologist comments on the protocol.
www.mumsnet.com/Talk/am_i_being_unreasonable/3795677-Test-at-home-cervical-cancer-kits?pg=4