When I learned to hand quilt 40 years ago I also had the tesion to tight. Now it is much looser and I usually can do 6 stitches to an inch.
I use liquid bandaid or my "Aunt Betsy" tool and depending on what I'm using that saves my finger under the quilt from being pricked. I use a thimble witha deep top so my needle does slip and my thumb can control lay on the thimble and control the needle...
I only do hand quilting but am now contemplating FMQ since I bough my Janome MC 6500...