shaky hands and suturing

[medstudent0258]

I just started my surgery rotation and somehow made it the whole year without suturing. My resident was trying to teach me but I got really nervous for some reason and my hands started shaking so badly. It was so embarassing and actually hard to suture with my hands totally not in control. Anyways, this is really annoying and I'm afraid it's going to keep happening. Does anyone have any advice?

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[Momentum70]

Practice, Practice, Practice. One of my surgery attendings told me surgeons were not born they were made. Everyone is shaky at first, and lot of it is your inexperience and your nervousness. Also dont get frustrated, go slow and try to mentally relax yourself. Take a few breaths, focus, and if you get some confidence from practice you will do well.

To practice, see if you can get someone to let you borrow some pickups and needle holders. You can ask scrub nurses for left over unused suture, they always have a lot. And get a pair of sterile gloves you can just reuse every time. That way you are practicing under similar conditions. You can sew up pigs feet, chicken skins, orange rinds(more difficult). Basically your hurt yourself by trying to avoid it all the time, you have to just get in there and do it.

Oh yeah, did i mention practice a lot

 

[TexasPhysician]

Practice, Practice, Practice. One of my surgery attendings told me surgeons were not born they were made. Everyone is shaky at first, and lot of it is your inexperience and your nervousness. Also dont get frustrated, go slow and try to mentally relax yourself. Take a few breaths, focus, and if you get some confidence from practice you will do well.

To practice, see if you can get someone to let you borrow some pickups and needle holders. You can ask scrub nurses for left over unused suture, they always have a lot. And get a pair of sterile gloves you can just reuse every time. That way you are practicing under similar conditions. You can sew up pigs feet, chicken skins, orange rinds(more difficult). Basically your hurt yourself by trying to avoid it all the time, you have to just get in there and do it.

Oh yeah, did i mention practice a lot

 

[Droopy Snoopy]

Also prop yourself on something if you can. This isn't always possible, but most times you can get a pinky down to steady those hands. At the very least you can make yourself comfortable (ask for table down, adjust the lights, etc.) and steady your upper arms against your body. Also stay hydrated and keep utd on meals; a little hypokalemia can make the best of 'em look like a Parkinsonian wreck.

The nerves will work themselves out though, and it really does take simple repetition to get down the muscle memory. One of my classmates said double-gloving helped him as an M3, don't know about that personally but IDK maybe something to try (and something else to practice anyway, since you'll occasionally need to double-glove anyway).

 

[ZagDoc]

Agreed, a lot of it gets better with practice (I found I was shaky on pretty much all procedures, not just suturing, and it much improved with practice).

Also, try to limit the coffee intake. The caffeine definitely kicks the resting tremor up a few notches.

Just remember, there's residents and surgeons out there who take beta blockers for the same reason. It's not just you.

 

[Twitch]

1) Get an ethicon board kit for free by calling them (google for the #). This will let you practice @ home the basic ties. The instructions are ok - youtube has some good videos that go in slow motion x1/4 - x1/2 - helpful for learning.

2) Learned this from plastics - buy unripe bananas and get a lac repair kit (ahem borrow if you must). Practice your basic sutures, running, mattresses, etc.

3) As mentioned above, get the extra suture material after surgery, and keep it with you. Practice your knots - square (two handed first, then one handed), surgeons, instrument, to start off with.

Agree with above - repetition / practice is key. No need to carve out dedicated time. Just have the string with you and practice while you're watching tv. No need to cut down on fun stuff - tying knots isn't rocket science just takes practice.

 

[medstudent0258]

As the original poster I just wanted to give an update for anyone who finds this thread by search because they've got a similar problem. Here's some encouraging words if this is you. It does get better on it's own and trust me I had a bad case for the first couple of times. Cutting out caffeine made a HUGE difference for me so I would try this first. All the above posts are right on, the more comfortable you get with holding the tools, ect you will stop shaking and things will go more smoothly. Good luck and thanks to those who replied!