FAQ
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Does this replace the original Hands-On Suturing?
Nope! In fact, at this time we are only offering this course to those who have completed the original course.
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Does "at this time" mean that will change later?
We are contemplating offering a challenge option to Hands-On Suturing I down the road. The challenge option would require demonstration of knowledge and skills taught in Hands-On Suturing I, as this course builds upon that information.
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Will this course be the same hybrid format of on-demand and live Zoom?
Hybrid, yes. But not exactly the same. This sequel includes over 10 hours of on-demand content, and a small group live Zoom session of 4 to 6 participants.
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How much CE will this course provide?
At least 13.5 hours of CE for midwives and APRNs.
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What topics will this sequel cover?
Oh so many! The Course Curriculum below shows everything covered in the on-demand portion. (Click "show details" to expand each each section!) Topics include labial tears, tricky hymen situations, complicated vaginal and perineal repairs, five (5!) different techniques to manage bleeding vessels, new knots, new fancy stitches, two options for what to do if you run out of suture mid-repair...we tried to cover everything that folks have asked about.
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How much does Suturing II cost?
We have set the initial price at $485 per person, which includes practice supplies* and a seat in the small group session. *Practice models and suture included; instruments and clamp stand not included.
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Is there a payment plan option?
We are currently offering a half-this-month, half-next-month payment plan option. The total cost when paying this way is exactly the same.
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Are there any discounts?
At the moment, there is currently a "discount for everyone," as this is the only the introductory pricing. We will likely raise the price after this spring, at which time there will be discounts as part of the new pricing. In addition to the upfront costs, the ongoing costs for materials for this course are quite high. (Both the models needed, and the suture provided - over an entire box per student!) A "fair" price, based on our labor and supply costs, and by how similar offerings are priced, is well above what we are currently charging. As always, we charge the lowest price we can that allows us to continue to do this work.
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What type of models are provided for participant practice?
Check out the video below about supplies - it explains it all!
Course curriculum
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01
How This Course Works
Show details- Included Supplies
- Required Supplies NOT Included in the Course Fee
- Flow of Course Requirements
- Content Warning, and also, Exciting Things!
- CE Hours
- Before we go on...
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02
Where Do We Even Begin?
Show details- Hello again!
- Informed Choice for Genital Repair
- Overview of Complicated Repairs
- Double Decker Branching Tear Full Walkthrough
- Quiz: Complicated Repairs
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03
Navigating Landmarks
Show details- Tour of the Vulva
- Need To Know Muscles
- Special Care for the Short Perineum
- Before and After: Second Degree Repair on a Short Perineum
- Quiz: Navigating Landmarks
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04
When the Hymen Needs Your Attention
Show details- When The Hymen Is Preventing Birth
- The Hymen in the Immediate Postpartum
- Hymens That Require Special Attention During Repair
- Quiz: When the Hymen Needs Your Attention
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05
Tearing Up: Labial, Periurethral, and Clitoral Lacerations
Show details- Labial Tears: Determining if Sutures are Indicated
- Labial Tears: Supplies and Anesthetic
- The Life Changing Magic of the Traction Suture
- How To Repair Longitudinal Labial Tears
- Subcutaneous Longitudinal Labial Repair Full Walkthrough
- How to Repair Complete Lateral Labial Tears
- Complete Lateral Labial Repair Walkthrough
- How to Repair Partial Lateral Labial Tears
- Considerations for the Labia Majora
- Periurethral and Clitoral Tears
- Seastar Lacerations
- Quiz: Labial, Periurethral, and Clitoral Lacerations
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06
Complicated Vaginal and Perineal Lacerations
Show details- Vaginal Floor Tear Behind an Intact Perineum
- Sulces and Fornix Lacerations
- Not A Third Degree, But Darned Close
- Printable PDF: Methods for Assessing Anal and Rectal Injury (OASIS)
- Printable PDF: OASIS Assessment Informed Choice Template
- What To Do With A Flap
- What To Do With A Divot
- Before and After: Asymetrical Repair
- Before and After: The Importance of Matching Tissue
- Quiz: Complicated Vaginal and Perineal Lacerations
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07
Managing Excessive Wound Bleeding
Show details- Identifying and Tying Off A Bleeding Vessel
- Basic Techniques for the Bleeder that Can't Be Tied Off
- Locked Blanket Full Walkthrough
- Advanced Techniques When The Bleeder Can't Be Tied Off
- Technique of Last Resort for Bleeding Vessels
- Printable PDF: Flow Chart for Methods of Addressing Bleeding Vessels (Laminated version available upon request!)
- Quiz: Managing Excessive Wound Bleeding
- Written Exam (Score of 80% or better required PRIOR to live Zoom session)
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08
Hematomas
Show details- What Where Why How
- Causes, Risk Factors, and Prevention Strategies
- Evaluating Hematomas and Suturing Impact
- Talkthrough of Hematoma Photos
- Addressing Hematomas
- Quiz: Hematomas
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09
Episiotomy
Show details- Midline vs Mediolateral
- Pros and Cons of Episiotomies
- How to Perform an Episiotomy
- Special Assessment and Suturing Post-Episiotomy
- Informed Consent for Episiotomy
- Article: ACOG Committee Opinion No. 664 Refusal of Medically Recommended Treatment During Pregnancy
- Quiz: Episiotomy
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10
Problem Solving Special Situations
Show details- Addressing a Trauma Response
- Managing Edema
- Options for Friable Tissue
- Retrieving a Lost Needle
- Prolapsed Cervix
- Running Out Of Suture
- Skin Bridges
- Migrating Suture
- Impaired Healing and Suture Eaters
- Resuturing
- Quiz: Problem Solving Special Situations
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11
Equipment and Supplies
Show details- When to Use a Tapercut Needle
- Retractors
- Homeopathy (or placebo?)
- Arnica
- Suture Clips
- Survey Results: Client Experiences of Suture Clips
- Alternative Wound Closures
- Derma Quik Review
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12
Knots
Show details- Hand Tie: Square Knot Hand Tie
- Instrument Ties: Surgeon's Knot vs Square Knot
- Why We Don't Teach The Mythical One-Handed Knot
- Aberdeen Knot
- Quiz: Knots
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13
Stitches
Show details- Doing The Two-Step
- Inverted Stitch
- A Circular Stitch for a Triangular Flap
- Horizontal Mattress Suture for a Flap Complete Walkthrough
- AAFP The Mattress Sutures: Vertical, Horizontal, and Corner Stitch
- Traction Suture
- Locked Blanket Short Walkthrough
- Quiz: Stitches
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14
Wrapping It Up
Show details- When Hospital Transfer Is Needed for Repair
- Answers to Various Questions and Final Thoughts
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Holly Scholles
Instructor Bio:
Terms and Conditions
Due to the hybrid format of this course, there are different terms and conditions than our purely on-demand online courses.
By enrolling in this course, you are agreeing to these Terms and Conditions, so please read them carefully:
1. Upon enrollment, you will have instant access to the on-demand portion. The on-demand portion through Managing Excessive Wound Bleeding must be completed by one half hour prior to your small group session.
2. You also must pass the written test with an 80% or greater by one half hour prior to your small group session.
3. Attendance and participation in the small group session is required. You are enrolling in the small group session for:
Tuesday, May 6th, 2025
Pacific: 9:15am to 12:30pm
If you cannot attend the small group session for any reason, including not completing 1 and 2 above, you may attend the make-up session listed below, for an additional $100. You may also choose to take this session in addition to the standard session, if you would like additional practice, and feedback from the instructor (same fee). The make-up session for this cohort is:
Tuesday, May 13th, 2025
Pacific: 9:15am to 12:30pm
(additional $100 fee applies)
4. In order to take this course, you must have already passed Hands-On Suturing I. If you enroll in this course without passing Hands-On Suturing I, you will receive a refund less processing fees charged by the credit card processors, which could be up to 6%. If you aren't sure if you passed Hands-On Suturing I, please email [email protected] prior to enrolling in this course.
5. Certain supplies are required to participate in the live portions of this course. Supplies for participants outside the United States are handled on a case-by-case basis, please email [email protected] to discuss.
We provide the following supplies, at no additional fee:
1. Ample suture for practice
2. Practice models
These supplies do NOT need returned.
You are required to have, but we do NOT include in the course supplies:
1. Instruments (a needle driver, Russian forceps/other non-dominant hand instrument, TWO sets of hemostats, and a pair of scissors)
2. A clamp stand for your phone (same or similar to that used for Hands-On Suturing I)
3. A pair of gloves (non-sterile is fine)
6. While we only require you to finish part of the on-demand content prior to the live Zoom session, you will need to complete all of the on-demand content prior to your CE Certificate generating. Whether you do this before or after the live Zoom session is up to you.
7. The CE certifications require you to complete a course evaluation. This is at the end of the on-demand portion, and will unlock after your small group live Zoom session.
8. Your CE Certificate for 13.5 hours of continuing education will be sent via email once Steps 1-7 are complete. The date on the certificate, once sent, will be the date you completed all course requirements, including the course evaluation. If you enroll using a payment plan option, your CE Certificate will not be sent until all payments are complete.
Refunds and Cohort Exchanges
A full refund is available if ALL the following conditions are met:
1. Less than 10% of the on-demand portion has been accessed.
2. It has been less than 30 days since enrollment.
3. It is more than 30 days until the live session.
If it has been more than 30 days since enrollment, and/or more than 10% of the on-demand portion has been accessed, but still more that 30 days until the small group session then you may switch to a different small group session, if available, at no additional fee.
This course was designed to meet the requirements of the hands-on Category 1 course for the NARM Midwifery Bridge Certificate, and for the new "LD&D Renewal" for Oregon LDMs.
This course is appropriate for APRNs, CNMs, RNFAs, and other nurses who perform post-childbirth perineal repairs. It is not appropriate for all nurses. Course completion does not authorize the learner to use skills outside their scope. Please refer to your state guidelines for determining scope of care.
HiveCE is an approved provider of continuing education by the California Board of Nursing, and this course meets the California Board of Nursing criteria for 13.5 hours of continuing education. Provider approved by the California Board of Registered Nursing, Provider Number 17686, for 13.5 contact hours.