Shaky Hands

This is NOT medical advice. Instead I will tell you what has worked for me.

I've had shaky hands for as long as I can remember. Even when I'm at complete solitude they are somewhat shaky. They only shake when I have to do something with my hands, not when they're just "resting". When I got into nursing school it become increasingly difficult to do skills while I was being watched because my hands literally felt weak and they would shake. I went to my doctor and he gave me the beta blocker Propranolol. THIS HAS BEEN A LIFE SAVER. In short, it blocks the receptors in your hands and it stops the shaking with no side effects. You still feel nervous, but without the shakey hands. I take it 1 hour to 2 hours before work and my hands don't shake anymore. Also fun to note, propranolol is widely used by entertainers and musicians. As you can imagine it's a little nerve wracking having to perform in front of people, so they take the propranolol to keep their hands from shaking. The only contraindication to propranolol is basically if you have severe hypotension or COPD. I'm taking the 20mg tablet PRN. It lasts for about 15 hours.

Oh, I was diagnosed with Essential Tremor. It's no biggie. No matter how much you try to "calm yourself down" before something, if you have Essential Tremor, your hands are going to shake no matter what.

I think I will go to my doctor. My one concern is I am a runner with a resting heart rate of about 45. I wonder how low my heart rate would go with a beta blocker? I would like to remain conscious.

When I am starting an IV on a child my hands still shake. Hold the needle with your first few fingers and thumb as you usually would, but rest your hand on the limb of your patient to steady it. You'll have your pinkie touching the paitent and the rest of your fingers able to move freely enough to complete the task. This is especially helpful when the patient pulls away when you stick- your hand (and the needle) will move with them and you will avoid going right through the vein.

One of the best phelbotomists I knew had Parkinson's, and shook like a leaf, but she could get blood from the tiniest babes. Your tremor won't stop you, just practice a little before you get to the bedside.

I shake also, sometimes pts. notice and ask if I am ok/nervous/etc. I believe in my instance it is a side effect of one of the meds I am on. It doesn't get in the way of my skills. I am a pretty good IV stick. Sometimes are worse than others, but it is almost always present.

Do as the others have said and just keep on doing wwhat you're doing.

Check with your doctor about medication.

Good luck!

Pat

Soooo embarrassing. After my hand tremors caused me to contaminate a sterile field while assisting a physician with bedside I and D, I couldn't take it anymore. I now take propanolol er 60mg with pretty good results (most of the time). As for venipuncture, before I stick I warn the patient usually with a joke. "I'm gonna warn you now that my hands shake like I'm on crack. I realize that a nurse with shaky hands coming at you with a garden hose sized needle can be a little disconcerting, but they steady up when it's true business time." Most of the patients are pretty understanding--thank goodness.

I had that problem for a short period of time as a medication side effect and had to change medications because it got so bad I could not even get close to starting an IV. It was an intention tremor. It went away within a week of stopping the medication. Propanolol sounds like a good option if you can tolerate it with your hear rate being what it is. Otherwise, you might see a neurologist and see if he/she has an idea on what you can try.

I have a really shaky hands too. Very shaky. My patients asks me, how come you are shaky. I always dont know what to tell them. When I was a nursing student, I bent a needle ones while trying to get medication from a vial because my hands were so shaky. I have learnt how to steady my hands as described above. I started on citalopram 20 and since then the shakiness has reduced drastically. My BP is on the low side (usually around 105/58) so, I cant take propanolol.

I'm glad to know I'm not alone, I've got shaky hands too, I'm just a nervous person that drinks a lot of caffeine, bad combo, haha. Somehow I manage to stabilize right before I stick for blood/IVs. Just gotta figure out what works for you. Medications isn't always the answer. Though for me it prob wouldn't hurt :)