First pap

  What new skill or information have you learned over the last weeks?           

It was much less intimidating than I thought it was going to be on that side of the speculum, but I tend to make things harder than they really are and well, this was one of them.  So, I have received my fair share of Pap smears and it is so surprising how little I actually pay attention to the words that have been used. I guess it is such an odd procedure and one that so many people block out so they don’t hang on every word? 

First of all, I like to say I won’t proceed until the woman feels in control, and if at any time she does not feel in control, respected, comfortable to let the provider know either verbally or dropping the sheet which is across her lap.  It is important that she not push the speculum or hand away, so she doesn’t hurt herself, but it is important she feels safe and trusts you will do what you need to do in regards to her well-being, mind and body.  On the whole, I need to work on the technique of getting faster and figuring out how to open it without fumbling, otherwise, it was much easier than I thought.  Really, there was not much to it. It was easy to see the walls of the vagina, but the cervix was hiding.  I didn’t have to redo the speculum insertion, but just aim downwards and to the right to find the opening. It looked just like it is supposed to J The brush did its job and I got that taken care of in no time.  I did get lube all over my gloves, so I may need to figure out how not to do that.  I ended up regloving before the bimanual exam, which was annoying.  In hindsight I could have just not gloved my hand that was palpating the abdomen.  Actually, I was thinking that it could have been easier for me to feel the ovaries if I didn’t have that hand gloved as I think it took away some of the sensation. 

Needlesstosay, I didn’t feel ovaries, I felt the cervix and moved it around.  No pain was felt and we were good to go. She was not pregnant, so I did not need to feel the uterus.  It was nice to have this internal exam practice so that I could see how to position my body. I was too far away from her and the exam table was too high.  Next time, I would need it to be lower and I would need to be by her side so I could get more vertical and in a better place to determine what was what. All in all—what a great experience! YAY!