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.

The weight issue was brought up because it increases your risk of problems with the pill. If your BMI goes over a certain point it will be contraindicated.

I think if you undress etc then you’re consenting to the procedure. It’s done now. Hopefully that’s it for a few years.

@MrsWindass may I respectfully point out that the op did not get a free smear test. She got a smear test with a side of attitude that alongside all other NHS care is free at the point of delivery but is otherwise paid for by the people for the people. Not sure who took the Service out of NHS but it's been gone for a rather long time.

@MustardMitt the appointment was for her contraception check, that's what she booked for initially.

I went for my mammogram last week, as I’m in my 60’s it’s the third time I’ve been.
For the previous two the staff were very gentle and reassuring and explaining things step by step making sure I was comfortable with what was happening.
For this one she basically grabbed my boobs and slapped them on the machine like a piece of sausage meat, no chit chat at all.
I think everyone is so overwrought with Covid that they are trying to get you in and out as soon as possible.
Try not to think about it. It’s done now and fingers crossed all ok.

In fairness it's also the first time on Mumsnet I've seen 2 separate posters saying that cancer screening is ineffective

I'm not sure if you're referring to my post, but I'll defend it anyway. A smear is important and if it detects early mutated cells and possibly saves a life then that's amazing, and certainly worth it in my mind. However, everyone here is having a go at the op about being informed about smear tests, and that is part of being informed. It doesn't detect every type of cervical cancers, and having a clear one doesn't mean that you won't develop cancer inbetween.

As for bringing Jade Goody into it, unfortunately you're just proving that point. She had a few cancer scares and smear tests from what I understand, unfortunately it didn't save her. Doesn't mean other women shouldn't have one if they are able to, but if we are talking about informed decisions it doesn't always mean you get an answer that fits your narrative.

I would never say 'don't bother getting a smear', but I certainly am not going to be unsympathetic to a woman who is either worried about having one or feels she's had a bad experience. As I said, women have to put up with a lot of shit when it comes to female healthcare, we shouldn't accept it as ok or turn on each other when we say 'I dont feel comfortable with this medical procedure'.

I am glad you went for it. My first ever one wasn't great. It hurt and the nurse didn't have a great bedside manner. I was 25.

I then put off going back for many many years.

I finally did in February last year aged 41 and the nurse was lovely. It didn't hurt at all and she made me feel at ease.

Please don't let one experience put you off - the treatment for cervical cancer is a lot worse than going for regular smear tests.

[quote RosesAndHellebores]@MrsWindass may I respectfully point out that the op did not get a free smear test. She got a smear test with a side of attitude that alongside all other NHS care is free at the point of delivery but is otherwise paid for by the people for the people. Not sure who took the Service out of NHS but it's been gone for a rather long time.[/quote]
You missed my point. I lived most of my life in a private medical situation and I am grateful for every "free" test I get courtesy of the taxpayers .

Jade Goody was only 27 when she died of cervical cancer. 26 is old enough to have one.

They are horrible but so worth it.

And it's extraordinary that the heavy handed attitude is supposedly due to covid. I wonder what caused it pre 2020 because it certainly wasn't covid then. Let me see. Ah yes, rudeness.

@Elouera

Sounds like the nurse was pressed for time- having the do the script, BP, height/weight etc, plus fit in the smear! I too am suprised they were doing them, because many others have missed out.

I used to do smears myself, and would always discuss the procedure, especially if it was someones 1st time. I also used to ensure the women knew what it being done for. It is true, that if people are carrying more weight, the vaginal walls collapse and compress down when doing a smear, making it almost impossible to see anything. I personally have a retroverted uterus, and know to ask for a long speculum. The long ones are often also ' large'. I've never had children and but not offended that I need that size. I'd prefer a quick procedure where the cervix can be seen straight away, rather than faffing about, taking it out for a larger/longer one etc and repositioning multiple times! A small size is absolutely useless for anyone other than a very young teen/child, and certainly wouldnt have allowed her to see the cervix!

Its hard to comment, because we dont have the nurses point of view. At least you had it done, and hopefully your results are clear.

I had a painful experience with the standard speculum and the nurse told me to ask for the smallest one for future smears. The gynaecologist used one to extract a biopsy from the lining of my uterus pre pregnancy and every smear test post pregnancy.

@Mackerelpizza

Telling someone who has been assaulted by a HCP that she should be grateful and that it's her fault the HCP did this to her is abhorrent and repulsive.

That's a ridiculous allegation to make. She hasn't been assaulted.

You should not be using such terms to describe what happened here, you're doing a huge disservice to women who actually have been assaulted, by anyone.

YANBU

This was your first time for a daunting procedure. Instead of berating you about your weight, she should have used the time to explain the procedure and set your mind at ease.

I once had a colposcopy done very roughly by a not very nice man - I ended up in tears about it to my GP, she was wonderful and changed my ongoing colposcopy appointments to be with a woman that she knew was good and gentle. She was so understanding.

It's such a shame you had a bad first experience, please don't let this put you off going for smear tests in future, not all nurses are that mean. As everyone else has said, it's important to get checked out regularly, so please please go back when you're next due a test.

I see nothing wrong with writing a complaint letter or email so that the nurse can be reminded that she needs to be gentle and considerate with her patients.

@BrumBoo as far as I'm aware from what I've read about Jade - she was called back for a 4th time to have more cells removed.

But she never went as she was scared to go again. And thought what's the point of removing them if they keep growing back.

A decision which sadly unfortunately may have cost her her life.

You know that you can refuse treatment, right? I didnt know until I was into my 30s and had ds.

Ways to say no:
I'll get back to you on that.
What are my options.
Before we start I have some questions.
I do not consent.
Im not happy with that.
You can also just walk out.

@SkiingIsHeaven

Jade Goody was only 27 when she died of cervical cancer. 26 is old enough to have one.

They are horrible but so worth it.

But Jade Goody had smear tests. They didn't save her.

YANBU. Im really sorry for your experience OP, it's exactly these types of experiences that put women off going for these absolutely critical tests. None of this was your fault and I'm not suprised you feel as you do.

But, please don't let this put you off. I've friends in their 20s who have had abnormal smear tests and going for the test may have saved their lives. Make a note of the nurse who performed the test (ask the receptionist if needed) and ask for a different practitioner next time. When you go in explain you're nervous, felt traumatised by a previous experience and ask for the smallest speculum. Take some headphones and listen to music on your phone if it relaxes you. Do whatever it takes for you to be as comfortable as possible but please don't put this test off.

[quote Chesneyhawkes1]@BrumBoo as far as I'm aware from what I've read about Jade - she was called back for a 4th time to have more cells removed.

But she never went as she was scared to go again. And thought what's the point of removing them if they keep growing back.

A decision which sadly unfortunately may have cost her her life. [/quote]
We'll never know. I think the culture of blaming women for being scared of what some call a 'nothing procedure' is very offputting in itself. Some women have personal reasons as to why a smear is just not worth the pain, stress or mental strain and hearing how they're feckless and its their own fault if they get cancer/die is less than helpful.

Wow. .Some of the replies on here! OP.you are being given a hard time, and I don't really understand why. having a smear is an intimate experience. ..I don't know anyone who likes it. .it should always be done with care.,and this was lacking: I don't blame you for feeling the way you do. I hope this does not put you off having one in the future.

YANBU I was ambushed last time I went for my pill check because I was overdue. The nurse told me she should could do it there and then and was really quite pushy about it, I was so taken a back. I eventually lied and told her I was on my period just to get out of it. I think we all know smears are important but I don’t understand why surgeries are so aggressive about them? I actually puts me off going to see my GP.

As for why someone doesn’t want one, well there are all manor of reasons for that. It’s no one else’s business though.

Some people on here have absolutely no bloody idea about how traumatic some people find smears.
I find them excruciating. I am prescribed Valium for them beforehand but still, they are excruciating.
I have had a vaginal birth no pain relief and that was a breeze. Would rather do that again than have a smear tbh.
Nothing physically wrong - been examined.
The first 2 smears I had, they couldn’t continue because they were worried I was going to pass out. My muscles clamp down no matter what I do.
I’ve managed a few successful ones but then spend the 3 years on and off inbetween worrying.
I’m now a year overdue. Plucking up the courage to get another one. Panic attacks even thinking about it.
So please, just because it’s merely ‘unplesent’ for you, it’s not like that for everyone

I cannot believe the harsh reactions here. The most sensitive and balanced one is from someone who does this herself. First, I accept that the HP may have been overworked. However, in such a sensitive area (literally) it’s a pity she didn’t notice OPs concerns, as it could have been a red flag for sexual abuse or assault.
On the weight issue I am VERY against the fat acceptance lobby, but any HP in this position should know that the correct message delivered poorly and quickly as a box ticking exercise is not just wasted time it is probably also counterproductive.

PS Factually incorrect: ‘A small size is absolutely useless for anyone other than a very young teen/child, and certainly wouldnt have allowed her to see the cervix!‘ Even after having 2 children I found the test very painful and put off appts. A kind family planning clinic doctor suggested trying the smallest one which improved things immeasurably.

Sorry you felt not in control xxxx

Whilst most believe its a necessary procedure - It does not excuse the lack of bedside manner or consideration of your anxiety / decision to proceed or not, even in the current climate.

Again with the weight lectures - the way they are approached makes the difference whether or not advice is taken.

These kind of experiences stop people going at all.

There's about a centimetre in speculum "widths", so it certainly wasn't your weight that made her choose the speculum but much more likely your height. If you are overweight, you are at risk from the effects of the pill. Sounds like she did her job and well, tbf.

@Ktmc94 YANBU to be a bit pissed off and feel irked. You are entitled to feel this way. And I think you're being given a hard time on here.

However, I think it's a good idea to have a smear test. They save 10s of 1000s of lives a year, and are quite painless. Sometimes a bit uncomfortable, but not painful, usually.

And the nurse did sound a bit brusque! I have encountered a few brusque and abrupt nurses, but most of them are lovely. Even the abrupt ones are still good. They are just a bit 'no-nonsense!' And you ended up feeling a bit 'small.'

Don't take it to heart, and please don't dwell on it, and I can't see any point in reporting her, because you will be told she did nothing wrong. They won't care that you were embarrassed and felt awkward, and will say (like some posters on here,) that you should be grateful for the FREE healthcare! And I agree it's a bit out of order to be bullied into a cervical smear when you are just going there regarding your contraceptive pill!

Have to say though, I've never heard of a larger speculum being used coz someone is 'fat!' That's a new one on me.

It's horrible when you feel like you have been railroaded into something you didn't want to do, or weren't sure about... But don't let it get to you. I have had similar things happen in the past, and although they often mean well, it has pissed me off.

Several times before, I have been hounded into a medicine review by a pharmacy. 'Just 2 minutes it will take' they claim. ALWAYS takes 20 minutes minimum, and they ask so many questions. I see the doctor regularly, and don't need a bastard medicine review at the pharmacy. Moreover, I know they get paid for every one they do. So they are only doing it for the money, and not because they care about you and what meds you're taking! (In my opinion!)

And they are meant to give out advice on weight, but I have no idea why the nurse lectured you at your smear test. And when your weight is mentioned, it can sting a bit sometimes.

I have found they can come across as inconsistent too sometimes. For example, several years ago, one nurse told me I needed to lose weight, (at least a stone and a half,) and a nurse several weeks later, told me I was fine, and 'didn't need to worry.' I was about 2 stone over my 'ideal' weight at the time... So that made me a bit

All the best. Hope you are OK