Pelvic Exam Question

[santhony44, MSN, RN, NP]

I'm an experienced FNP, have done many pelvic exams, rarely have to repeat a pap for a bad specimen. I do an average of 1-2 a day.

I also try to give as gentle a pelvic exam as possible.

However, on occasion, not often, I have a problem. I can get the cervix into the ends of the speculum, but then when I'm done, I can't get the speculum to "let go" of the cervix, no matter what I do.

I get frustrated and of course it's uncomfortable if not outright painful for the patient.

I hate this- I wouldn't want that to happen to me as a patient- but I can't figure out what I'm doing wrong!! Help!

I use the disposable plastic speculum with the light in the handle, if that makes any difference. I usually use a medium but will use a small or a large if necessary. It probably happens with all sizes.

[gauge14iv, MSN, APRN, NP]

I have had this problem once or twice - particularly on exams that take a little longer and things sort of "settle into" the speculum.

Use an OB swab to push the cervix gently out of the speculum during removal. I find that this works very well and the patient is often not even aware of it.