Smear Test - should the speculum be sterile?

LondonDiva

beks wrote: »

If I send a smear sample off on a girl under 25 then it will not be processed by the lab (well having said that I once did a 23 year old and hers was done). Therefore I have to refuse anyone under 25 as they will just go through it for no reason. It is recommended that anyone who is concerned speaks to their GP and can then get referred to gynae if the GP thinks there is reason. As a nurse I can totally understand your concerns, if I was allowed, I would be doing them.

BS - if a test is carried out by a practice outside the routine guidelines such as a woman under 25, the lab will not refuse to process it.

If you are finding a lab is refusing to process a test (why when they are getting paid?) You / the PM / the principal need to contact the PCT, PBC lead or whoever holds the contract to report the potential risk and to ask for the contract to be better performance managed.

Practices are allowed to run tests /give medication etc for those outside the usual norm as long as they have a good clinical reason for the decision (e.g. a high family risk of a disease or a specific concern based on symptoms). For a service to routinely refuse to process a test without asking for a reason is unacceptable (unless it was a practice that is known for trying to 'chance' things a lot) and for the practice not to follow up if they were concerned is nearly as bad.

You need to have a practice meeting about your processes for patients you are concerned about (not the just in case which from what you are describing seems to be the case)

snapping_crocodile

They start them at 20 years old in Wales :rolleyes:

corsagirl_2

I'd put off having a smear but once you've had one its just something to accept you have every 3 years and it could save your life. Have to say the plastic one hurt more than the metal one. But I think some of it was down to the nurse. She asked me if I'd like to insert it myself as she found it intrusive. I'm like what the .....said thought might be better if she did (I already felt more embarrassed and thought I might fumble unnecessarily..and no lube involved..and it wasn't shaped like some of my ahem "toys"). Just as she is inserting asks if had shower (I'm thinking I now have a smelly foof, yes I'd had shower, had abstained for 24 hours). Then she gives me a running commentary of what she is doing as I slowly die of embarassment, before telling me I look lovely and healthy up there! I shall be getting the other nurse to do in 2 years time who just gets on and does it in half the time.

When you are laying there legs apart, you've know idea where she has got instruments from, I just heard drawers and packets opened which probably would be more reassuring than what the OP experienced.

tandraig

jeez - I should have added to post 'I have never missed a smear test, I am so grateful the probs were identified! even the nasty op experience was worthwhile as for the last ten years my life has been dramatically changed as 'no periods - no problems'
the thermal ablation was recommended as an easier op than a hysterectomy and believe me - after a couple of days i was back to normal and havent looked back.
so - I would recommend all women to have regular smears as its not just cancers which can be identified other probs can come to light too!

angelicmary85

Glamazon wrote: »

when it is being put into your foof and is being tested for something.

I'm sorry to have to say it but that's the funniest thing I've read in a long time! :rotfl::rotfl::rotfl::rotfl:

Ruby_Moon

beks wrote: »

I do agree that it is a shame that smears start at 25, even if that is what is recommended. Having read all the facts over and over, I do understand why they don't but Like shelley_crow, I think it is still scary that the very small percentage can still develop cancer under the age of 25 yet are not screened.
If I send a smear sample off on a girl under 25 then it will not be processed by the lab (well having said that I once did a 23 year old and hers was done). Therefore I have to refuse anyone under 25 as they will just go through it for no reason. It is recommended that anyone who is concerned speaks to their GP and can then get referred to gynae if the GP thinks there is reason. As a nurse I can totally understand your concerns, if I was allowed, I would be doing them.

If a lab is refusing to do the tests that you send to them, then there is a serious issue needing to be addressed regarding the communication of the lab and your office.
The lab is not there to question who or why a test is being done. They really don't care for the majority of tests how old the person is being tested. The lab also have no idea of a patients history or medical needs either.
If I were to receive tests back from a lab saying "Not done due to patient being 22" the lab would have a lot of explaining to do.

WolfSong2000

Ruby_Moon wrote: »

If a lab is refusing to do the tests that you send to them, then there is a serious issue needing to be addressed regarding the communication of the lab and your office.
The lab is not there to question who or why a test is being done. They really don't care for the majority of tests how old the person is being tested. The lab also have no idea of a patients history or medical needs either.
If I were to receive tests back from a lab saying "Not done due to patient being 22" the lab would have a lot of explaining to do.

This is interesting...slightly OT, as test in my case was not related to smear test, but lab refused to do it all the same and instead did a generic test which I'd had done a number of times before and wasn't of any use, hence my requesting alternate test and GP agreeing...first GP I saw about the results (not the original one) said the lab were well within their rights not to do it, but the original GP was as mad as I was when she found out they hadn't done the test. *sighs*.

As for smear tests, haven't had one yet (23 but not sexually active) but had to have a gynaecological examination whilst in the states this summer due to some bleeding between periods...doctor was so...odd. lol. Lovely, albeit very stereotypical american woman with a slightly high pitched voice. As I was sat there with my legs spread, bearing all, she proceeded to lecture me on the differences between plastic and metal speculums (had one of each in each hand). Then told me she absolutely loved my British accent, and while doing the test, said in a very high voice "aaawww, you're still bleeding! Bless you! Poor You!.." etc...has rather off-putting but I think she thought she sounded generally caring? Who knows. lol.

Also, while I'm thinking about, why all the euphamisms for female genitals? I'll say right now I'm very open when it comes to discussing sexual matters and genitals in general (never saw a reason to be obtuse about it), so is it normal to use other words to infer what you're talking about? I'm genuinely asking as if the matter ever comes up with friends the "proper" terms are usually used, and it's not the kind of thing that gets casually slipped into conversation. lol. Yeah, I'm weird, I know .

Lastly (I promise) I highly recommend reading Eve Ensler's book "The Vagina Monologues". It's a collection of monologues the author collected from a variety of women of all ages and backgrounds. There's a variety of stories - some funny, some sad, some upsetting, some uplifting, but it should be recommended reading, imo for all young women. Saw it performed live - and have the DVD - and it is just as good in that medium )

Janepig

WolfSong2000 wrote: »

Also, while I'm thinking about, why all the euphamisms for female genitals? I'll say right now I'm very open when it comes to discussing sexual matters and genitals in general (never saw a reason to be obtuse about it), so is it normal to use other words to infer what you're talking about? I'm genuinely asking as if the matter ever comes up with friends the "proper" terms are usually used, and it's not the kind of thing that gets casually slipped into conversation. lol. Yeah, I'm weird, I know .

You wouldn't have liked my midwife then. If I hadn't known better I'd have thought "foof" was the correct medical term because it was the only one she used!! She was as mad as a hatter though, but she was great. Unfortunately she retired while I was half way through my pregnancy with DS, but she knew more about pregnancy and birth than anyone else I'd come across in the medical profession!

Jxx

Nadeshka

I'm expecting to be invited for a smear anytime soon (just turned 20) and this thread has certainly been enlightening!
Although normally it's 25 I know my borough and another in London have the highest rate of teen pregnancies and STDs so they start at 20 - clearly it can vary between PCTs. I also managed to get the HPV vaccine despite being two years two old to get it in most places as they offer it to all under 25s here. One benefit of living in an STD hotspot!