I knew going into a family practice that I would be the one doing the pap smears. In my job interview that was actually mentioned. That is one reason why I did several clinicals in an OB/GYN office. There was still a learning curve though. One tip.. don't use too much lubricant. I was trying to make the process as comfortable as possible but had to redo a few due to contamination from it. Second tip.. Use a large enough speculum. The vaginal walls will fall too far into your line of sight if you use one too small. While this is a process that most women will tell you is NOT their favorite thing to do, a nurse practitioner can make the visit much more pleasant.
I introduce myself and ask all of the usual questions about dryness, vaginal discharge, menopausal symptoms, etc. BEFORE the patient gets undressed. I tell them that I know that this is not their favorite thing to do, but that I will try and make it as easy as possible. I leave them to get undressed and let my office nurse know that I'm ready to do the deed.
At this point, I walk into the room and say " I know that you were hoping that I forgot about you!" in a joking manner to break the tension and start the small talk while I'm actually doing the exam part. I ask if they have been told that their cervix is tipped or turned to one side or the other before I go digging around. All the while, I'm talking to myself while I'm looking at the insides and asking if the patient is doing okay and whether I'm hurting her in some way.
The trick is in the small talk. It helps relieve the tension to distract the patient.
I can usually find some way to make them laugh.
I was actually told today by a patient "while I hate having to do this every year, you just made it fun because you have personality!"
How cool is that?