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

[pamelalayn]

Actually your wrong rape kits across the nation are performed by a R.N.

Ever here of S.A.N.E, come on guys!

[Reno1978, BSN, RN]

Actually your wrong rape kits across the nation are performed by a R.N.

Ever here of S.A.N.E, come on guys!

What exactly do rape kits have to do with screening for cervical cancer?

[natalia13]

thank you BluegrassRN

[OCNRN63, RN]

What exactly do rape kits have to do with screening for cervical cancer?

Absolutely nothing.

[nursel56]

Bluegrass - you might be talking about a book that was all the rage in the seventies Our Bodies, Ourselves by the Boston Women's Health Collective. It was sort of a cousin to another called Living On the Earth where they talked about delivering babies by yourself in the forest and things like that. Doing pap smears at home never really became a mainstream activity, though.

I agree with those who wouldn't be comfortable having someone train on the job to do a Pap test. The actual scraping of cells and making a slide is probably not difficult, but I would not want an un-medically trained person doing a bimanual exam considering when things aren't right in that area the symptoms are often subtle and assumed to be less serious than they can be.

[BluegrassRN]

No, I have had that book in the past, too.

I looked around on the Hesperian website for a while; you can download their book for free, directly from their website. So you can download the book and see if there are detailed instructions on how to do a pap and a bimanual. I still think paps are no big deal at all, but I agree that the bimanual would require quite a bit of training.

[Silverdragon102, BSN]

Moved to the Canadian forum

I know in the UK many nurses that work in GP surgeries and NP's do PAP's and they receive really good training and not just from the doctor but by appropriate qualified trainers on recognised courses. Personally I would want someone to do my PAP that has been trained properly and knows what they are doing and why the procedure is done in a certain way. The UK was also moving away from using spatulas to brush which was a lot better and results was more accurate and less people got recalled for repeat smears

[RGN1]

In the UK it's standard practice for a nurse in a clinic to carry out PAP smears. it's just further training that's all. I never had a PAP done by a Dr in the UK.

In areas where nurses have taken over jobs traditionally done by doctors in the past, research has shown that the nurses have better levels of patient comfort and higher results. The reason being that they are able to concentrate on a smaller range of skills & so perfect them.

This was seen recently in the UK when nurses started performing endoscopies at some hospitals & pts rated their comfort levels better & the detection rate for polyps was higher in the nurses scopes vs the doctors.

Having said all that the training has to be right - it shouldn't just be a look at the web & a quick lesson by the doctor. All training should be done properly & with careful teaching, maybe with the use of manikins.

[bananashan]

i may be wrong.. but i believe you posted this earlier somewhere else, and mentioned that the doctor also offered to pay you "under the table" ??? perhaps i am mixing this up with someone else, but if this is the case i feel like this is doubly a sketchy situation which you yourself do not seem overly comfortable with.

[RGN1]

If the above post is correct then don't touch it with a ten foot long greasy barge pole!

[CrunchRN, ADN, RN]

In the US Nurse Practitioners do this, but they have been properly trained.....

You must be careful of the cervix, and with the bimanual you want to be sure not to miss anythign on palpation.

Laiblity wise i would happily do this, but only if I was properly trained. See one, do one ain't going to cut it here......

[pamelalayn]

There are several posts here staing that a pelvic exam,pap smear etc. is out of our scope.This was simply an example of a R.N. doing a pelvic exam without a doctor.