hand tremor - how to control?

  1. Just wrapped up my preceptorship and am really looking forward to working as an RN. However, I'm starting to get concerned about how and if I'll get over having shaky hands while doing phlebotomy and IV's. I've got about maybe 40ish blood draws under my belt and maybe 5 IV's. I know this is still not much, but when does the hand shaking/tremor go away? I'm fine giving injections, and using a straight needle doing blood draws helps cause I can anchor my hand (too sort of keep it from shaking), but using a butterfly and IV's is aweful. I try to relax (which I feel I am, I don't feel my heartbeat or anything) and take deep breaths, but the minute I have to make fine adjustments and have a light grip on the needle device, I can't stop the tremor. I'm going to pre-op next week to get more experience with IV's but am now nervous it's going to be a stinky experience if I can't find a way to relax my hands! Any advice or tips on things to try? Would a beta-blocker be a bad idea? I'm really contemplating asking my doctor.
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    About adventuregirl, MSN, NP

    Joined: Nov '04; Posts: 35; Likes: 2


  3. by   Liddle Noodnik
    Quote from adventuregirl
    Any advice or tips on things to try? Would a beta-blocker be a bad idea? I'm really contemplating asking my doctor.
    I wish I did, I have the same problem. Beta blockers didn't help much. Some have used Neurontin with good effect too, but it didn't help me much. Anxiety of course, and thinking about it, and having someone watch what I'm doing (LOL) makes it worse.

    For IV's or phlebotomys and stuff, first, I sit next to the patient rather than bending over him/her, I rest my wrist on his/her arm/wrist, or the bed (I can't just "hang my hand in the air" because then the tremor is impossible...). Telling the patient to look out the window and take deep breaths helps THEM relax, which helps YOU remember you're doing this for the pt and not for yourself. Hey, whatever works, right?

    I have had people tell me it's not as bad as I think - others wonder if I am ok and should I have a breath of fresh air, ha ha - I also worry some will think I am coming off a bender!
  4. by   Daytonite
    Laugh if you want, but I was told by a neurologist to "just take a deep breath and let it out slowly" when I was complaining to her and showing her how my hands were shaking. I was really worried that I might have MS. (We nurses can be such hypochondriacs!) She looked at me like I was from another planet. After that, I started doing that whenever my hands would shake and the tremors stopped immediately. And, I was working as an IV therapist at the time putting little 24g needles in little babies! Still works for me. So, I don't have MS. I can't tell you why it works, but it does. It probably has something to do with anxiety of some sort.
  5. by   fey_lassRN
    No medical advice, just wanted to say that you can work with tremor. I got dx'ed with essential tremor in nursing school, and you learn to work around it.
  6. by   locolorenzo22
    I personally take a deep breath, let it out while I working with a needle, and then concentrate on everything around the needle, not just the needle itself......it helps to have a wide field..and sitting vs. standing is always a good idea!!1
  7. by   UM Review RN
    OK, this is going to sound really weird, but it works for me.

    Years ago, the fashion was to paint scads of eyeliner on our eyelids. I could never get both eyes perfect. I'd wind up looking like Cleopatra in one eye and Kiss with the other. Drove me crazy till one day I read this fashion tip:

    Open your mouth.

    Yes, open your mouth, because when you open your mouth, it somehow relaxes the eye muscles. At the same time, it steadied my hand.

    And it worked like a charm!

    So now, when I have to relax and get that IV, I open my mouth.

    Isn't that the craziest tip you ever heard? But I'm one of the best IV sticks on my unit, so don't knock it till you've tried it.
  8. by   Justine1986
    I was taught by my nursing instructor that your hands shake when your shoulders are tense. If you relax your shoulders your hands stop shaking. It has worked well for me!
  9. by   Propranolol
    i have a hand tremor too. it gets pretty noticeable when i get nervous. I talked to my doctor about it and he gave me the beta blocker inderal. works just fine. good luck.
  10. by   imnowacko
    I have terrible tremors. Dx as essential tremors I was on Inderal ER 80mg BID...didn't really help. Yes, nerves make it worse, but I too was able to start IVs and do blood draws. I worked in SDS prep, so starting IVs was a must. What I hate the most about them is that the patients thought I was nervous. Some people have fragile veins and sometimes you hit a valve which made me feel like a failure, but with my repeats, I actually had people request me, so I couldn't have been that bad. Unfortunately, the more you use the muscle group the more you'll shake, so take a deep breath find your target and more than likely you will get your target, especially if you can rest part of your hand on something.
    I read the only way to get rid of them is a wire inserted into your thalamus, but not 100% always works.
    Good-luck to us all with this "disability"