Always, always hand the speculum to a woman who has come in for her first pelvic exam, and allow her to check it out. I place her hand around the speculum and tell her that when it’s inside her vagina, I’ll open it just enough to see her cervix a few inches inside. 

I tell her that if she relaxes her muscles around it (and I open it slowly with her hand still around it), it will feel fine. But if she tenses up (and I’ll tighten her grip around the speculum), that tension could be uncomfortable.

 I promise not to open the speculum unless she is relaxed enough for the exam to be comfortable, and I keep that promise. I also hand her a cytobrush to touch and I explain, with photos or model, exactly what we test for and why. — Diana O’Neill, FNP, Long Beach, N.Y. (190-6)

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