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.

A smear saved my life. You sound entitled and ungrateful. Obesity is not healthy either.

There are ‘cons’ to cervical screening (beyond a little mild discomfort)?

Is it not simply, have screening and potentially detect abnormal cells and thereby get treatment quickly and improve outcomes

Versus

Don’t have screening leaving zero chance of early detection if there is a problem, thereby leading to much worse outcomes?

Nobody likes a smear test. Everyone benefits from a smear test.

I'm interested in what you were expecting in the pros and cons of having a smear? I can't think of any medical reason you wouldn't have it done. I had cin-3 a few years back, was up to date with my smear. I don't know why anyone would opt out

Her manner sounds rather brusque, but she was doing her job and as you are overweight, discussing the dangers are part of her job - she was probably as uncomfortable as you were with the conversation which may be why she was so abrupt.

You are very lucky to have a smear test in the middle of a worldwide pandemic, free on the NHS. No, I definitely wouldn't complain if I were you.

I think you misunderstood about the speculum and it's size (speculums do look menacing!) but they are all the same size - and if you were tense then yes, it would have hurt.

It sounds like you had a horrible experience OP. Please try and ignore these ridiculous replies telling you to suck it up and be grateful.

Unless you are 5 feet tall then i'm sure you are not "morbidly obese" as PP have tried to insinuate.

It is very well known that GPs try to push women into having smears and it sounds like this happened to you.

I wouldn't hesitate to complain.

I can totally empathise with the discomfort you felt, OP.

I put on quite a bit of weight for me - similar size to yourself - during my horrendous menopause and absolutely hated being reminded of it. (Was discovered a few years later I had developed an under active thyroid and, as this is now treated, I have subsequently lost the weight and back to a 10/12.)

However, I too was guilty of missing many smear tests due to embarrassment and now realise what an idiot I was. Cervical cancer is a horrendous disease and can spread to all your other abdominal organs if not spotted early enough. (I follow the cancer support thread on Mumsnet and some very young women have died horrendously over recent years because the disease wasn't spotted in time.😢)

I agree the nurse could have used a better bedside manner but I bet she's good at taking smear tests and treats it as a straight forward procedure. I had all my smear tests when called over the last 20 years of entitlement and if I was your age I would be scurrying to the GPs once called to get it over and done with as it is so, so vital.

Be kind to yourself! You aren't massively overweight and, as with cancer, you are lucky that you are aware of it early enough to correct it within a few weeks - should you choose to do so - before it gets out of control.

It would be great if posters could focus on the actual OP, rather than turn this into a platform for sounding off about how us little women should be on our knees weeping with gratitude for smears.

Many women choose not to have them. For reasons personal to them. You get yours if you are happy to do so, and leave other women to make their own decisions.

Jade Goody was diagnosed aged 26 and died aged 27.

It’s uncomfortable. But had she had hers detected earlier, her kids wouldn’t have grown up without a mum.

I hate having them done. But having been a similar age to her at the time, it’s something I’ve continued doing.

You're getting a bit of a hard time!

To me, it sounds like you were already in a bad place as far as having the test was concerned, and like the nurse was very straightforward and brusque in a way that, while not unprofessional, wasn't going to put you at your ease.

I didn't have my first smear test until after my daughter was born... when I was 31... I found the whole idea of it incredibly nerve-wracking and just avoided it until she was born, when I decided to woman up because I wanted to set a good example to her and because I want to be around for her for as long as possible. So I think you're doing really well to get there by 26!

On the bright side, you've had it now. I'm sorry it was an unpleasant first experience for you but please don't let it put you off. Now that I've done it I won't think twice about next time!

"Make an informed choice"
"Pros and cons" of cervical screening ??!!
This is all a bit OTT and over dramatic.
And despite what you say, I think you are sensitive about your weight.
PPs have already said it all really, I think you should drop it and be a bit more responsible towards your health.

They really concentrate on your weight when prescribing the pill, something to do with it not being safe over a certain BMI I think. I wish someone had explained that when I was in my 20s. I was a size 12, only a touch overweight but the smallest I have ever been and they constantly nagged me. They gave me a flipping complex about it! If I had known it was just to do with the pill guidelines then I wouldn't have minded so much!

I think you misunderstood about the speculum and it's size (speculums do look menacing!) but they are all the same size - and if you were tense then yes, it would have hurt

Maybe you should check before you post? Speculums are absolutely not all the same size. Total rubbish.

I'm so sorry and appalled at the way you were treated. I have been taking smears for many years. Forget the insensitive comments of others. Just because the nurse had years of experience, it doesn't make her a good nurse! She had responsibility to put you at your ease, listen to your concerns, explain the procedure and be kind. I know practice nurses only have 5 minute appts but you could have had one for the chat and another for the smear. You are not wasting an appt someone else could use. Our vaginas are all shapes and sizes, I often used a longer one if the patient was tall. A wider one for multiple childbearing history. I never used the term 'large' and trained my doctors to do the same. Regular smears are vital as early cell changes can either be kept under regular observation or treated, so preventing cervical cancer. Be kind to yourself. x

It doesn’t sound like she had a very good bedside manner and a little kindness goes a long way when you’re feeling anxious. The comment about the speculum was unnecessary, a different choice of words could have put your mind at ease. Instead she chose to belittle you whilst you lay in a vulnerable state.

I can see why your upset.

An informed decision about having a procedure which takes 20 and can save your life? You’ve mentioned it a few times. I don’t really know what more information you need tbh.

With regards to how the nurse lectured you - obviously your feelings are subjective and without anyone being there with you, then nobody can comment on how she spoke and how she was being with you.

I’m afraid I don’t know the answer about the speculum.

You have to do whatever works for you in terms of complaints.

20 seconds *

YANBU, the experience could have been nicer by the sound of it and the nurse could’ve been more sensitive considering it was your first smear.
No HCP should have a “poor bedside manner”, and it’s irrelevant that “the nurse has been doing these on a daily basis for 30 odd years" (which is such a dismissive thing for the PM to say) when her patient felt upset enough to then want to discuss it/make a complaint. Seriously, having a good bedside manner is part of their job and it’s one of the NHS Core Values (scroll down the page), which include:

Compassion
We respond with humanity and kindness to each person’s pain, distress, anxiety or need. We search for the things we can do, however small, to give comfort and relieve suffering. We find time for those we serve and work alongside. We do not wait to be asked, because we care.

Nomorepies

Do you think women who have had a baby are walking around with a gaping vagina ready for an extra big speculum to be inserted?!

I use mine for storage now. It's a good sleeve for an insulated cup.

A smear saved my life. You sound entitled and ungrateful. Obesity is not healthy either

Have you thought about getting this ^^ printed on a t-shirt? That way, you could go about your business whilst simultaneously spreading your wisdom and judgement?

I think the practice could do with a reminder about what constitutes legally valid consent to medical treatment.

I think it's worse to try a smaller speculum, not be able to access the cervix ( Os) have to withdraw it and explain you need a larger one and have to repeat the procedure all over again.
The procedure should have been explained and reasurranc given that the nurse would be v gentle but that it is critical to sample the right area otherwise insufficient cells would be collected, and the procedure would have to be repeated after the lab has failed to be able to report a normal result, much worse.
That said, generally a standard sized speculum is perfectly adequate for most people unless v v overweight or with collapse of the vaginal walls.
If you are on the pill, the nurse does need to weigh you and advise if your weight is putting you at extra risk generally and with combined pill medication (small but significant) risk of embolism, along with smoking and family history.
But I get that your experience felt a bit perfunctory. Better though, that you were in and out, swiftly, procedure done efficiently and well. You can put it to bed as soon as you've had your results, for another 3 years.
These things are not designed to be enjoyable, they have to be tolerated, hopefully not painful and swift.

No one likes having their smear test.
It's awful.

I recently had mine (I'm 49) and it took 5 goes and three different positions to get it done

It was deeply unpleasant but better than the alternative

You just need to get over yourself on this one I'm afraid.

meh its just a smear test and it took a few seconds and could save your life!

@Ktmc94 I’m sorry you had such a bad experience OP. I think having a lovely nurse certainly helps in these situations so you feel comfortable to voice your concerns.

I’m a size 8-10 and both times I’ve been for my smear, the nurse has had to use the large speculum so I don’t think the size of the speculum is a reflection on your weight at all.

Smear tests are incredibly important and I do think that if you are offered a smear test you should try and attend. But I do appreciate everyone has their different reasons for not going to their cervical screening appointments.