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"Poor person centred care during colposcopy appointment"

About: Altnagelvin Area Hospital / Gynaecology

(as the patient),

I attended ward 43 for a colposcopy. I was called and met by a lovely nurse in the waiting area who confirmed my details. This nurse guided me to the clinic room.

On entering, there were 3 staff members awaiting me. The consultant, a junior doctor (I think) and a health care assistant. The nurse that led me to the room also accompanied me. Initially I felt totally overwhelmed by so many staff.

The junior doctor appeared to be leading the appointment and although they did introduce each staff member by name/role, no explanation was given as to why there were so many people in the room nor was I asked for consent. I felt totally distracted and anxious by this and I found it difficult to process any information being conveyed or asked before the procedure. Medical history questions that were asked felt rushed and more like a tickbox exercise.

I was clearly visibly nervous, which the junior doctor was able to identify and kindly addressed, however I was not nervous about the colposcopy itself (I knew what to expect from leaflet given before the appointment), I was so nervous that I would have an audience during such an intimate and personal exam.

I was directed to a small room so that I could undress from the waist down. Towels were provided however this felt so undignified as the towel barely wrapped around my waist. I feel a gown or larger towels should be provided to ensure you can walk out comfortably and get onto the examination bed in a dignified manner.

I cannot fault the examination itself. The junior doctor explained each step and kept me at ease as well as the nurse and the health care assistant. The junior doctor also explained what they could see on the monitor. Again, I felt so embarrassed that I had an audience watching the monitor during my colposcopy. I completely understand and agree staff need the opportunities to learn and observe and I would never have dreamed of not giving consent to this, but keeping in mind that at this stage of the appointment, I was still clueless and distracted as to why there were so many people around me.

Results of the exam were given whilst I was still on the examination chair and being reclined. I was then directed back to the room to get changed and to go out the other door. I did not realise that this meant the appointment was over and complete until I got changed and out the other door which led me back onto the ward. I felt confused, overwhelmed and disorientated at this stage.

I had no opportunity to ask questions after the exam which I had in mind. I could have perhaps asked some of these questions before the procedure took place but again, I was aware I had an audience and felt uncomfortable asking such personal questions. Overall, it felt impersonal, rushed and a bit like a cattle market.

I feel more attention should be given to person centred care and time for appointment itself. Introduction and explanation for the number of staff should be considered. From my appointment letter I assumed it would just be the consultant completing my exam. Perhaps this information could be made clear before the appointment as if I had known this, I would have been a lot more relaxed.

I was not anxious at all before the appointment as I had already had a smear test and knew what to expect however everything I have mentioned above completely caught me off guard and made the whole experience negative and on the drive home, left me feeling embarrassed, confused and let down.

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Response from Leanne Hughes, Lead Nurse for Gynaecology Services WHSCT, Women and Children Service Altnagelvin, Western Health & Social Care Trust 2 months ago
We have made a change
Leanne Hughes
Lead Nurse for Gynaecology Services WHSCT, Women and Children Service Altnagelvin,
Western Health & Social Care Trust

Service Manager for Gynaecology

Submitted on 19/03/2024 at 18:58
Published on Care Opinion on 20/03/2024 at 08:19

Dancebc98 thank you for taking the time to write this honest post regarding your recent experience within our department, it is with this type feedback we are driven as a service to make informed changes for the greater good of our service users.

I am sorry that you felt overwhelmed at your recent colposcopy appointment and I have listened to the areas that you feel could be improved upon. As a result of your feedback we will endeavour and continue to ensure communication to all patients is maintained as a priority, to alleviate any anxieties they may have. We would like to apologise if you felt that it was not explained clearly to you why so many staff were present for this appointment but wish to reassure you that every member of the team present had an important role during your procedure. Our learning from your experience is to communicate this more clearly to patients attending, at the beginning of their appointment, to make them feel more relaxed and less embarrassed and provide an opportunity to ask any questions. I am sorry that you felt you did not have the chance to ask any questions following your procedure as this is not the usual high standard of care that we as a team aim to achieve.

I wish to apologise that there was no patient gowns available to you on the day of your appointment and I have relayed your feedback to the ward Manager who will ensure gowns are more readily available at departmental level, to reduce the likelihood of this occurring again.

I am hopeful by communicating your feedback to the team and making these changes will improve our service and hope that any subsequent appointments will be less daunting and more positive for you.

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