How to perform a Papanicolaou Test ?

[natalia13]

Hello Nurses!

I have a question here:

I recently graduated as a Nurse. I just had my first interview and got the job on the spot, which is fantastic! it is a walkin clinic and a family doctor. The Doc informed me that he wants me to perform Pap tests. He is aware that i have never performed them and is going to teach me.

so my question here is How do i perform this? Is there any good websites, text that can educate me on this topic. I want to be well prepared when i have my first day of work.

Thank you for all the help

[txspadequeenRN, BSN, RN]

i dont think that is within a nurses scope of practice..but i will be interested in the responses here.

hello nurses!

i have a question here:

i recently graduated as a nurse. i just had my first interview and got the job on the spot, which is fantastic! it is a walkin clinic and a family doctor. the doc informed me that he wants me to perform pap tests. he is aware that i have never performed them and is going to teach me.

so my question here is how do i perform this? is there any good websites, text that can educate me on this topic. i want to be well prepared when i have my first day of work.

thank you for all the help

[OttawaRPN]

What province are you from??

[natalia13]

Ontario.

I am reading up on CNO

[evolvingrn, BSN, RN]

Never had a nurse do that....

[OCNRN63, RN]

Hello Nurses!

I have a question here:

I recently graduated as a Nurse. I just had my first interview and got the job on the spot, which is fantastic! it is a walkin clinic and a family doctor. The Doc informed me that he wants me to perform Pap tests. He is aware that i have never performed them and is going to teach me.

so my question here is How do i perform this? Is there any good websites, text that can educate me on this topic. I want to be well prepared when i have my first day of work.

Thank you for all the help

I don't think you can just learn this over the web. Personally, I would be horrified as a patient if I found out the person performing my pap had been so minimally trained. Women's lives depend on this test being done accurately. How much "training" is he going to give you before he cuts you loose and expects you to do this on your own? What about the pelvic exam? Who's going to do that part?

Maybe it's just me, but it sounds like a shaky idea.

[tyvin, BSN, RN]

In the United States a nurse cannot unless they are a family prac. Canada's scope of practice for RN's appears to be unlike that of American nurses IMO from what I've read so far on this forum. Just saying that in countries with socialized medicine the nurses are expected to handle more procedures traditionally done by the doc. I think it has something to do the economics of socialized medicine.

I wouldn't dare perform that procedure on a women without being thoroughly trained by a professional who has training in doing so and then what about the pelvic exam.

[OttawaRPN]

From the CNO:

Q. I'm an RN in a women's clinic. Lately, we've had an increase in the number of clients we see. Because of this, the physician who runs the clinic wants to teach me how to perform a pap smear. Does the college recommend specific preparation through an educational institution, or is the physician's training enough?

A. As the regulatory body for the nursing profession, the College does not recommend the types of educational preparation nurses need to perform specific procedures. As self-regulated professionals, nurses demonstrate continuing competence by assuming responsibility for their own professional development. (See the Professional Standards, Revised 2002 practice document.) A nurse may learn a procedure such as a Pap smear through an educational institution, or accept training from a health care professional who is authorized by legislation to perform controlled acts, such as a physician. As well, employers can set requirements for the type of education, courses or certificates they expect nurses to have to provide safe, effective and ethical care. Nurses determine whether the education they received has provided the knowledge, skill and judgment they need to perform a procedure competently. Regardless of the form of education or training they choose, nurses must meet College practice standards and are accountable to the College when in the learner role. Nurses are also accountable

for their decision to perform any procedure. For example, there is more to performing a Pap smear than the technical aspect of obtaining a specimen. Nurses must use their professional judgment to determine their competence for the procedure. An appropriate order (direct order or directive) must be in place, if it is required, and must have the ability to manage possible outcomes. For more information, see the Supporting Learners and Decisions About Procedures and Authority, Revised 2006 practice documents.

[AKAnurse4]

Wow Canada is really different...interesting....

[natalia13]

From the CNO:

Q. I'm an RN in a women's clinic. Lately, we've had an increase in the number of clients we see. Because of this, the physician who runs the clinic wants to teach me how to perform a pap smear. Does the college recommend specific preparation through an educational institution, or is the physician's training enough?

A. As the regulatory body for the nursing profession, the College does not recommend the types of educational preparation nurses need to perform specific procedures. As self-regulated professionals, nurses demonstrate continuing competence by assuming responsibility for their own professional development. (See the Professional Standards, Revised 2002 practice document.) A nurse may learn a procedure such as a Pap smear through an educational institution, or accept training from a health care professional who is authorized by legislation to perform controlled acts, such as a physician. As well, employers can set requirements for the type of education, courses or certificates they expect nurses to have to provide safe, effective and ethical care. Nurses determine whether the education they received has provided the knowledge, skill and judgment they need to perform a procedure competently. Regardless of the form of education or training they choose, nurses must meet College practice standards and are accountable to the College when in the learner role. Nurses are also accountable

for their decision to perform any procedure. For example, there is more to performing a Pap smear than the technical aspect of obtaining a specimen. Nurses must use their professional judgment to determine their competence for the procedure. An appropriate order (direct order or directive) must be in place, if it is required, and must have the ability to manage possible outcomes. For more information, see the Supporting Learners and Decisions About Procedures and Authority, Revised 2006 practice documents.

Thank you very much for this post. will continue further reading into the Professional Standards

[BluegrassRN]

It's not rocket science to perform a pap test; it's actually very easy. The doc I used to work for told me that there was a movement of women in the 60s and 70s who performed their own paps. They'd have "pap parties" rather than go to condescending, rude, and rough physicians who would make them feel violated and charge them too much. If untrained, non-medical people can do it, you certainly can.

Have you seen the books "Where Women have no doctor" and "Where there is no midwife"? These book, written by the Hesperian Foundation, teach the basics of health care for those who are going to work and live in places where there is little or no medical assistance available. I have the "Where Women Have No Doctor" guide; it provides instructions for lay persons to perform pelvic exams and paps. I'm sure you could lay your hands on this book, if you want.

What I would be more concerned about it the bimanual exam. I'd want quite a bit of training on that; and I'm assuming if you're doing paps, you'll be to the bimanual, too. Palpating the ovaries and uterus to ensure they are not enlarged or abnormal in any manner...that takes quite a bit of practice.

Edited to add: I was wrong, the pap info isn't in the "Where Women Have No Doctor" book. It must be in the midwifery book. Here is their book page; maybe your public library owns it, or you can find a used copy on ebay or amazon. It's been a while since I've looked in the midwifery book, but I'm almost sure it contains detailed instructions.

Hesperian Foundation

[K+MgSO4, BSN]

Can you get some training with a womens' health nurse at a womens hospital?

My pap was done by a womens' health nurse.