I want to highlight an episode of our podcast, Critical Care Scenarios, today. But, it’s an episode I had nothing to do with. My co-host, Brandon Oto, has started an occasional series called TIRBO (The Intermittent Rantings of Brandon Oto) where he just talks for a few minutes about a particular topic. In this episode, he discusses doing certain procedures with your non-dominant hand. I wanted to share this in case readers aren’t regular listeners to the podcast (why aren’t you??). Also, I thought I’d take a minute to add in some of my thoughts.
I teach a lot of procedures. I teach our APP Fellows. I teach procedures to our students at Georgetown University. I do central line workshops for all the new APPs/CRNAs in the Department of Anesthesiology at UK. And one thing I’m constantly harping on is positioning. Positioning the patient and positioning yourself. This is the number 1 cause of procedural troubles (I don’t have RCT data to back that up, but I stand by it).
Twisting and contorting yourself not only is a good way to hurt yourself, either acutely or over the long term, but it’s a great way to make a simple procedure really difficult. If you’re uncomfortable, you’ll subconsciously rush and take short cuts. Your body wants to make the discomfort stop and the best way to do that is to stop doing what’s causing the discomfort (i.e. the poor position). But, most critical care providers are stubborn and so we won’t quit until we get it. So, we rush. Which in the long run actually prolongs things.
So, how does all this related to using your non-dominant hand? Sometimes the best position you can get into is going to be a compromise. I’m right handed, so I prefer to put femoral lines in standing on the patient’s right. But, that’s not always an option. Or if it is, the right femoral might not be good. So, I can reach over the patient to get to the left femoral, but that’s sometimes too much of a stretch (pun intended) and hurts my back). So, I can stand on the other side and twist myself to use my right hand, but that’s usually hard on my aging spine as well. So, I’ve developed the ability to go left-handed.
Similarly, I always teach to set your supplies on a table to your right (if you’re right handed) to do IJ line from the head of the bed. But, frequently in my place, that’s where the vent is and I might not be able to get a table there. So, I set my supplies up on the left. I can then twist and contort myself (a no-no), or I can use my left hand.
So, when you’re learning, learn with your dominant hand. But as you grow in your skills, branch out and learn to do some stuff with your non-dominant hand. It really comes in handy at times.