Surely doctors who do this should have short fingernails?

[bgudd]

I had my Mirena coil replaced this week. It's the third replacement and I don't remember any pain at all from previous times - just a bit of discomfort. But this time it was intensely, sharply painful, and made me scream out. I'm wondering it was because the doctor had long fingernails. They weren't talons, but they were long enough to stick out, and therefore stick in. (I noticed them because they were painted black and quite chipped). Aibu?

I used to work in an area that involved lots of contact with different medical specialisms (forensic, GUM, musculoskeletal, etc) and the GUM doctors were very much ‘street’ in the way they presented themselves. I suppose they have to really, to be more approachable to the clientele they will have who (for lifestyle and other reasons) may be wary of authority and suits.

But I don’t think you’re being unreasonable- long nails don’t sound appropriate at all for a healthcare setting.

No way should her nails have been long and painted in that role.
It's possible to dress fashionably (or 'street', or 'alternative', or goth-y) and keep your nails clean and trimmed.

Why do her tattoos matter op?

Huh??

Put a complaint in. Nails should be short and free of varnish its basic infection control.

They don't. I mentioned them for context. The nails were part of an overall look which seemed unprofessional to me personally, but I have only complained about the nails.

She did also have very long hair, which wasn't tied back (unless she tied it back at the last minute before the procedure and untied it before I recovered). Would that be an infection risk too?

Whilst I absolutely agree about the nails I think you’re coming across as a total snob sneering at the ladies outfit and overall style choices.

You're being overly sensitive and/or judgemental. I haven't sneered at all. I was a little intimidated by it if anything. But I got over that, and have only complained about the nails.

I fully understand why someone in that setting might want to dress a bit "street".

lol I don’t think I’m the one being judgemental here.

You have been lucky previous times for no pain. It is painful every time I've had it changed

dressing for the role?
what on earth do you think sexual health means?

They sometimes need to use a tenaculum to grasp the cervix to move it into position. They're basically sharp metal pincers, and they can pierce. I imagine this is what you felt.

dressing for role? What on earth does this mean?

sexual health clinics are a vital preventative medicine part of the NHS - they have nothing to do with anything apart from ensuring that there is a clinic for people to access help and support. You seem to be implying that they are only for some kind of deviant part of the population.

I would much rather attend a clinic where they are super trained in putting coils in - rather than somewhere where it is an extra (but long dirty nails should be fed back).

Again “in that setting” - bloody hell - I think you need to check your hidden/internal bias

I’m on my third Mirena. I have never seen an insertion video before and even had a trainee on one occasion do the removal / insertion. This video terrified me! I’m still 3 years away from needing it replacing, but I think I’ll have nightmares about this video!

It wouldn’t be the fingernails making it painful as fingers are only at the start then everything else doesn’t involve them - speculum, tenaculum, coil
i had one fitted that was very painful and a couple that were fine
depends where you are in your cycle, how you feel that day, what pain relief you’ve taken etc etc
the last one barely hurt and then I had a vasovagal reaction and ended up being tilted on the bed as my BP dropped

It’s not bias. As I said in a pp, I used to work with different medical specialities and the GUM doctors as a group had a much edgier style than any of the others. Hardly any wore suits, there was a lot of coloured hair (pink at the time), punky cuts, piercings and tattoos. Undoubtedly an element of the casual look is not putting up barriers to any service users, some of whom may feel excluded by or antagonistic towards suits and overtly conservative fashion.

By contrast our medical jurisprudence cohort tended towards the very formal in their clothing and the very gallows humour in their conversation!

No - that’s still a hidden bias in your reaction. Edgy? Generally people wear scrubs these days - makes it easier with all the secretions and body fluids. But “dressing for the role” is really a poor view of the whole situation

the nails being dirty and long is not good, but - they are not the source of the pain - that’s not how the procedure works

I don't think fingernails could have caused that much pain. More likely it was the tenaculum jaws (look up a picture, quite horrifying). Was local anaesthetic spray or gel used? It's becoming commonplace now but wasn't, so if she was trained a very long time ago she may still use none.
However, long polished nails are definitely an infection risk. When I was a medical student at a handwashing teaching session, we all had to cover our hands in a liquid which glowed under a UV light. The idea was to see what bits you hadn't actually washed from doing a basic rinse job, and then to be taught how to do it properly. The girl in my group with nail polish on, her nails glowed so intensely it was shocking. Something to do with the textured finish IIRC, meaning the liquid and thus organisms were much harder to wash away.

The Mirena is enclosed in a device with a long handle which is held by the medical practitioner outside the body, it has a release mechanism that is activated when the coil is in the correct position.

doctors are not allowed long nails or nail polish. Are you sure she was a doctor? Sounds inappropriate and gross.

Health care staff aren’t allowed long nails or nail polish! Infection control would have a field day with this!
ETA
Long hair should be tied back too!

I have no hidden bias - I've been completely open about the fact that I found the doctor a bit intimidating because of the way she was dressed and her tattoos. I didn't particularly like the way she kept calling me "darling" either, or some of the questions she was obliged to ask me because it was a Sexual Health Centre rather than a GP service. But all that is by the by - I'm a pragmatist and got on with it. I only posted here because of the sharp pain, and my concern that it might have been due to the nails. Several people have kindly explained that the nails probably weren't the cause of the pain, which I'm pleased to hear.

What do you mean, before you recovered? Was this not just a standard, in the room coil removal? If so, I don’t see how or why you wouldn’t have been able to see everything that was happening the whole way through. Also, with any manual examination with the fingers, it should have been explained but also obvious and you’d see and feel them doing this. Then you’d see and feel the speculum being inserted before removal, which isn’t done with their fingers but with the tool that’s been mentioned previously.

It’s not really adding up unless there’s something we’re missing?