Imagine two women (roommates) who are close friends. One day, one walks in on the other one naked in the bathroom.
"Oh! I'm sorry. I really needed to pee, I didn't realize you were in here!"
"It's ok, I was getting distracted anyways...I'm not feeling great."
Roommate #1 is a nurse practitioner...."What's the matter?"
"Just feeling run down a bit and my nose is a little stuffed. And my breakfast is sitting in my stomach like a ball of lead. Ugh!"
"Well, if you want, I can have a look at you and save you a trip to the walk-in. I can even write you for antibiotics if you need them. Only if you're comfortable though, if you'd rather see your doctor that's understandable."
"Really? I'm fine with it if you are. It would save me having to call in late to work if you can do it in the next hour or so."
"Oh, it shouldn't take that long. Maybe 20 minutes at most. I'll just do the basics, you don't even need to put your clothes back on-just come into my room and sit on the bed. I'll grab the thermometer and a stethoscope. You haven't taken any medicine yet have you?"
"No, nothing yet. I have...another question though...I was wondering if you could check something else for me..."
"Ask away, the worst I can do is say no, right?"
"Um...well...could you check my breasts for lumps? I get so paranoid about that, and I don't want to have to make another doctor's appointment just for that."
"Yeah, I can have a look. Like I said, as long as you're comfortable. Just come into the room when you're ready."
Nurse roommate goes into her room, turns on a lamp and grabs her stethoscope and the thermometer. Sick roommate comes in, covering her breasts with her arms as though she's gotten a little nervous.
"Ok, just sit here on the edge of the bed. Try to relax, I won't hurt you. Let me take your temperature...just put this under your tongue. Good, perfect."
Roommate starts to relax. She drops her arms to her sides and slouches a little. Nurse looks at the thermometer when it beeps.
"Hm. You do have a little fever. Let me feel your glands. Does this hurt?" She gently feels along her roommate's jawline for swelling.
"No, that doesn't hurt. I thought I had a fever."
"Your lymph nodes feel a little puffy. You've got something kicking around in there, all right. Now, I want to check your lungs, take deep breaths through your mouth for me...in...out...again in...out...deep as you can in...and out...one more....good. You sound congested, but nothing awful yet. Can you lay down with you head on the pillow? I want to check your heartbeat next. Just lay back and try to relax."
Sick roommate coughs a little and eases herself back onto the bed. Nurse roommate puts her stethoscope back into her ears and pulls her swivel chair a little closer to the bed.
"Just breathe normally, and if you need to cough just turn your head to the side. Don't hold it in...also, I am going to have to move your breast to listen to the apex of your heart. Does that make you uncomfortable?"
"No, its fine. My regular doctor has to do that too, since I'm a C cup. Whatever you need to do is fine, I don't want you to miss anything important. God, I'm feeling lousier by the minute."
"I can see why! Ok, just let me listen to you now."
Nurse puts the bell of the stethoscope at the top of roommate's chest and listens for a few seconds...then moves it to the other side...and to the top of her breast...and to the other side.
"I have to lift your breast now..." She murmurs, as she gently lifts it out of the way.
Sick roommate turns her head and coughs again. The nurse keeps the stethoscope pressed to her ribs and concentrates.
"It's ok. I'm almost done checking your chest. Your heart rate is a little high but that is normal with a fever. You're getting goosebumps now too...you really are getting sicker!"
"I can feel it. What a drag. I can't go to work like this. You can write me a note, right?"
"Oh for sure. You don't want to pass this all around the office anyways, coughing makes you more contagious too. You said your stomach was bothering you, right? What kind of pain is it? Indigestion kind of pain? Cramping? Sharp pains?"
"Well, its crampy and acidy feeling. The cramps are almost like period cramps, and like I said, my breakfast isn't sitting well."
"That sounds awful. Let me check your belly with my stethoscope, and we can try and figure that out. Relax as much as you can, so I can hear everything."
She presses gently into her roommates' belly, checking her aorta first, then listening to her bowels. Then, she slides it a little lower, just to the top of the waistband of her roommate's panties. She makes a face when she is listening.
"Hmmm. There is definitely something going on here. I need to palpate your stomach to check further, and I should really check your femoral pulses. I think you might be having some female issues too. Can you slide your panties down? I need to examine your lower belly more closely and I think I might need to have a look at your ovaries and uterus. Only if you are comfortable with that, and I won't be able to do a speculum exam since I don't have one here."
"Well, what is going on? I saw you make a face. Of course if you think you need to do a more detailed exam I'll let you. You're probably more gentle than the lady who does my gyn exam anyways."
"For starters, your bowels sound like they might be a little backed up. I need to feel them to be sure. And you mentioned period like cramps, so it might be a good idea to check and see if your ovaries are inflamed at all, or in any pain. I know you just had your period so it's not that, right?"
"No, you're right. If my bowels are messed up what will you have to do? Not an enema, please! My mom gave me one once and I HATED it!"
"We can probably avoid that, but it depends. I'll know more in a few minutes. Just slide your panties to your ankles, and open your knees the tiniest bit so I can check your pulses. Good." She presses her fingers into the feverish girl's groin, finds the right spot, then listens with the stethoscope, repeating the action on the other side. "Those are fine. Let me check your belly now, tell me if anything hurts. I'll be gentle."
"Hmmm. Yup, your belly feels a little hard. We can avoid an enema but...mmmm...might need to do a rectal exam to get you moving. Yup...that is what you need. Does it hurt over here?" She presses gently over the girl's ovaries.
"It hurts there, but you pushing doesn't make it worse. Are you really going to put a finger...up my bum?"
"Yes, but just for a minute, and I swear you will feel so much better afterwards. Hey, I'm already going to have touched and seen every other part of you...what's one more?"
"Before I put gloves on and check your vagina, let's do the breast exam. Here, I'll put a sheet over your privates for now. Can you put your arms behind your head for me? Perfect. Let me know if there is any pain." She gently started to probe the reclining girl's right breast, as goosebumps from the fever stiffened her nipple. "Almost done. Good. This side feels fine. Now let's have a look over here...no pain, right?"
"No, not when you push, but the goosebumps make my nipples sorta sore. Ugh!"
"That's normal. Everything feels fine though, you have perfectly healthy breasts. Now, I'll be as easy on you as possible, but I absolutely need to have a look at your vagina and your rectum. This won't take long, and it could rule out some serious health problems. I'll put the sheet over your top half since I'm done examining you there and I promise to explain everything I'm going to do."
"Ok, just be gentle! I get sort of nervous when the doctor has to look down there."
"You'll be just fine, if you relax and breathe." She puts on some rubber gloves and picks up her roommate's recently discarded underwear. "Have you had any unusual discharge from your vagina dear? Anything that's not clear, or with a bad smell?"
"No, nothing like that."
"Good. I was checking the crotch of your panties for that, just to be sure. Next, I need you to put your knees in the air and spread them open for me. I'm just going to spread your labia and look first." Her roommate closes her eyes and positions herself as requested, exposing her clean, neatly trimmed vaginal area to the nurse.
"I'm going to touch you now. Just the outside. Good. Good. Relax, I'm just spreading you to look at your urethra and vaginal opening. Easy. Thaaaat's it. And a quick look with the penlight..." She aims a small light at the exposed genitals of her roommate.
"Is it ok? Please say it is!" Her roommate said nervously as she held tightly to the sheet covering her chest.
"It's fine so far. See, it's not so bad, is it? Can you spread your legs a drop more? Perfect. Your anus looks fine as well. No outer problems anyways. Let's do an internal exam now. I'm going to lubricate my finger and insert it into your vagina, while I feel your belly. It shouldn't hurt, just take deep breaths and let me check you."
"I hate this part..." She said as a well lubed index and middle finger gently slipped into her vagina.
"You're doing fine, though. Almost done...just let me feel here...and here...ovaries seem fine. Good. Squeeze my fingers...good. Your vaginal walls are nice and healthy as far as I can tell...uterus feels fine...ok. All done." She took her hand away from her roommate's slightly gaped open vagina, and gave her a second to relax.
"This might be hard for you, but I really need to do the rectal portion of the exam now. It will only take a minute, and I promise you that you will feel sooo much better in a little while if we can get your bowels to move. If you really don't want me to do it, I won't, but I think you should let me give it a try."
"We've gotten this far. And if it will help that's a plus. I have enough to deal with coughing and shivering, let alone with stomach pain."
"Here's what I'm going to do...I'm going to have you turn onto your belly, and open your legs. Then I am going to gently spread you apart, and enter your rectum with one finger. Once you relax a bit more, I am going to insert a second finger, and then I am going to move them around inside you to try to stimulate your bowels. You might feel an urge to go to the bathroom, and that's normal. Don't tense up, just relax. I'm going to be checking the inner walls of your rectum for any abnormalities as well. Any questions?"
"No...just try not to hurt me!" She turned as requested and closed her eyes.
The nurse pulled on new gloves and gently parted her patient's cheeks. She saw her tiny hole and gently put some lubricant on it, then firmly pressed against it.
"Take a deep breath and push. Here we go. Good. Yes. Just relax...see? Not so bad, right? That's one finger. Now, here comes the other one." She started to squirm a little bit at the added size but stayed still and allowed the second digit to enter. "You're not badly impacted, this should work. You feel fine. Just one more second and I'm done." After making sure her patient's anus was examined thoroughly, she slid her fingers back out.
"There, all done. That wasn't so bad, was it?"
"Surprisingly, no. What is your opinion?"
"Bed rest. For at least today. Plenty of fluids. I'll call you in to work and write you a note, if you want. And in another hour or two I want to know how your stomach feels, if its still like it was when I listened to it earlier you might need a laxative. But what you probably need the most is sleep. Throw your pajamas back on and get back to bed."
"I will. Thanks for taking such good care of me. My stomach already feels better."
So uh thats that. Hope someone enjoys it, hope its not too boring for something I threw together on a Sunday afternoon.