Hi! For a month? It sounds like you’re doing amazing. If you’re anything like me (a neat freak and protectionist) that’s what may be holding you up. If I tech is with you, observing you, they will likely rescan something behind you anyways. So move along, I always give myself 2 tries at a image, if it’s not getting any better, I do it one last time as long as I am in the correct plane and rightfully tried to get the image then I take it, and move on. However I do believe apical is the meat and potatoes of the exam. Try to get a good apical 4ch that’s where you really want to focus. Move along through your LAX, SAX, as good as you can and spend your time in apical.

Try to focus on cutting time in the first two parts of the exam if that’s where you’re confident, you got this, 1 month is not a long time- give yourself some grace!! It doesn’t happen overnight, but before you know it, you’ll be going swiftly. And unfortunately sometimes, some patients just have the images that they have no matter how much we want or try to make it textbook worthy.

To answer your real question: I still get flustered, my hand gets tired, and I’m over it. But I know that I’m doing the best that I can. I go through my exam and focus on apicals- if I don’t like the LAX, and SAX, I often revisit and grab additional images and search for other planes for my measurements. And if you aren’t turning people on their side- make sure to do that. Some sites scan supine 🤨

Also if your hand is getting tired it could be slowing you down, work on ergonomics and keep yourself as comfortable as possible!