5 tips for easing patient anxiety during a pelvic exam
Few women enjoy heading to their gynecologists for pelvic exams and pap smears. After all, as a health professional you are well aware that the procedure can sometimes be painful, uncomfortable and embarrassing, despite often taking less than two minutes. Indeed, for particularly nervous patients, that small timeframe can feel like an eternity. Furthermore, as Dr. Carol K. Bates argued, writing in an article published by the U.S. National Library of Medicine, there are typically certain groups of patients who find the exam more challenging than others – she lists women with disabilities, women experiencing menopause and patients who may not necessarily identify as women – trans men, for example, or gender non-conforming patients. Individuals who have experienced sexual abuse or other traumas are particularly likely to find the procedure distressing. Consequently, maximizing patient comfort should always be a No. 1 priority for medical professionals conducting pelvic exams and pap smears.
Whether you're a health professional new to the field, or a trusted gynecologist who has conducted many pelvic exams and pap smears, it's always a good time to brush up on tips and techniques for helping to ease patient anxiety. Review the list below for five particularly effective strategies:
1. Ask how the patient is feeling
It's crucial to begin the consultation by asking your patient how she is feeling. Ask whether she is nervous or scared, and explore the reasons as to why she may be feeling that way. Maybe it's her first ever exam or perhaps she has had particularly uncomfortable experiences in the past. If you can gauge a sense of your patient's anxiety level straight away, you'll be able to begin putting her mind at ease before the procedure begins. This is a particularly important step if the patient has a history of sexual abuse. Bates advised that you should ask patients, in this initial interview stage, whether they have experienced sexual trauma in the past. This is because, as Bates outlined, research has demonstrated that survivors of sexual abuse generally want their physicians to be aware of their situation, although many struggle to reveal the information on their own, preferring instead to be asked directly.
2. Explain the exam
Part two of the discussion prior to the exam should include an outline of what the procedure entails, the Sexual Medicine Society of North America argued. A comprehensive discussion will cover an explanation of the device being used – the vaginal speculum – why the procedure is being carried out, a step-by-step walkthrough of what will happen, and what the patient can expect in terms of pain and comfort level. After the talk, answer any questions or concerns the patient may have. By outlining everything that is about to come, the patient won't be caught off guard by anything unexpected.
"Outline everything that is about to come in the exam."
3. Let the patient see the speculum
Barbara Hughes, MS, MBA, CNM, writing for Medscape, explained that a useful strategy for calming a patient's anxiety is to allow her to see and perhaps even hold the speculum prior the examination. By seeing the instrument, Hughes argued that women typically tend to feel more relaxed about what will ensue. It's an effective strategy because it is fairly routine for women to undergo a pelvic exam without ever seeing the tool – exacerbating fear due to the unknown. Familiarization, therefore, is an effective approach toward curtailing a patient's worries.
4. Give the patient control
Hughes detailed another surefire approach for calming nerves – to allow the patient to have control. This entails explaining each step out loud as it happens and then asking questions such as "does that hurt too much?" and so on. The Sexual Medicine Society of North America even suggested allowing the patient to hold a mirror and watch the process, if she so desires. While some patients may find such an action strange and uncomfortable, for others it may provide a high degree of comfort, as they will be able to directly see exactly what is occurring in their own body.
The best way to allow the patient to take control, however, is to allow her to end the process at any point in time. So, if for example the patient becomes distressed and asks for the procedure to end immediately, you should invariably respect that wish. If a patient knows she has the ability to stop the process if she needs to, she will likely become much more relaxed.
5. Consider single-use tools
One-time use devices, such as the Single-Use Vaginal Speculum with Built-In LED Light Source from OBP Medical, can expedite the pelvic exam process, minimizing patient discomfort and anxiety as a result. The tool is efficient because it cuts out cleaning time associated with metal reusable speculums, and the alkaline battery-powered light source allows for a closer and more comprehensive view. As a bonus, the one-time use nature of the product ensures that a risk of HPV cross-contamination is eliminated – one less thing for your patient to worry about. For more information about the single-use speculum from OBP Medical and to order a free sample, click here.
Pelvic examinations are important routine healthcare procedures. As Bates explained, pap smears in particular are crucial for detecting pre-cancerous cells that could lead to cervical cancer. The smears can also detect the presence of certain sexually transmitted diseases such as chlamydia. Despite the importance of routine pelvic exams, women often feel anxious or afraid, particularly if they have experienced sexual abuse in the past. That's why implementing the techniques for anxiety reduction above is so crucial: A patient who feels less afraid and more empowered will take greater charge of her health, leading to an increased chance that dangerous conditions such as cervical cancer can be caught early.