[miragal]

Hi everyone!
I am a new nurse just recently graduated from nursing school and am about to start my real job next week. I previously worked as a student nurse in the ER- I was offered to stay but prefered to to start off in a Med department because i thought it was a good idea to start off there in the begining of my nursing career. I interned as a student in this department and it was very difficult for me- but I very much want to face this challenge and succeed there. I want to become a capable knowlegable nurse.
I have one main problem that I am very nervous about. The big problem is that I am awful at medication calculations(mathimatical) and am so nervous that I am continuously going to make mistakes, during my intership I made so many mistakes -my counsler was shocked that I did not know what I was doing but was very nice about it and helped me out - he did me a favor and didn't fail me for all the mistakes I made.
The problem now is that I am responsible for my own actions- I used to try to go over calculations at home but the minute I was faced with the calculation in the madical department I would freeze up and not even know where to begin to solve the problem. I am very worried about it/ My counsler told me that I put it in my head that I am bad at Math and have convinced myself of it and so therfore even before i try to solve the calculation I am convinced that it is too complicated for me. I have always been bad at Math and despised it. I was wondering if anyone has the same problem or can can give me some advice on how to solve this before I start my new job. I don't want the staff to think I am stupid or put my patients in danger.
Thanks,
Gali

[MeghanRN]

We all have to start somewhere with med calcs, and I know I started off being so nervous and not understanding med calcs at all!!

Heres what I recommend- Springhouse makes a book Called Dosage Calculations Made Incredibly Easy.
This book starts off with the complete basics, then works you up with calcs. It works out the problem right in front of you and shows you how to correctly do it.

This book really helped me- it retails for abot 36$ but it was well worth it to me.
It also has practice tests at the end of each section so that you can make sure you are understanding the calc. correctly.

I wish you good luck!! Med calcs seem hard at first, but once you get used to them, they arent bad!

Always remember to have someone either help you with a med calc, or double check yours until you feel more confident in doing them. Although, its always good to have someone else check your math all the time, just in case.

[NorthernRose]

Doing any type of math was what kept me out of becoming a nurse for so many years. I was totally terrified of any math past the basics I needed to have to balance my checkbook!! Our instructor was the best in teaching us how to calculate meds...to the point I actuallylooked forward to doing them!!
For IV's the basic is...divide divide multiply. Divide the amount needed by the number of hours to infuse, divide that by 60 (for minutes in an hour) and multiply that by your drip factor. ex. 1000cc in 8 hours 1000 divided by 8=125 (this would be your ml's per hour) divided by 60 (minutes in an hour)=2.083 times drip factor of 10 =20 drips per minute. Piece of cake!! If you already have your ml's per hour just divide by 60 and multiply by your drip factor. She had a certain way to do med calculations too...I'll have to refresh my memory on them and get back to you : ) Good luck!! 99% of the horror of doing calculations is fear. Just believe in yourself and you can do them!!

[FutureNurse35]

You have to believe in yourself. If you passed the Nclex exam, you can calculate math. The nursing math is really not that hard if you have the confidence. If you believe you are going to make mistakes, you will because you have already tell yourself that. You have to break out of the fear.
Meditate on this scripture: Roman 8:15For you did not receive a spirit that makes you a slave again to fear, but you received the Spirit of sonship.[a] And by him we cry, "Abba,
Fear stifles our capacity to think clearly and rationally, thus affecting our behavior.
Fear leads to indecision. We are afraid to make decisions for ourselves or others. Such indecision creates constant anxiety.
Fear diminishes our capacity to achieve. We cease trying to accomplish certain goals due to our fears. We become increasingly unproductive as our fears increase.
Fear can cause panic. We suffer from anxiety attacks and other debilitating emotional upsets. We live in inner turmoil.
Fear fosters torment. Emotional storms brew within. Peace and joy are seldom experienced.
Fear damages our relationships with others. We are afraid to be around other people. Perhaps you have been divorced and do not want to be hurt again.
Fear damages our relationship with God. We feel uncomfortable in God's presence, perhaps sensing that He is displeased with us for yielding so consistently to our fears. We do not enter His presence with thanksgiving and praise. Worship is rarely practiced.
I think you are an intelligent person. You just have to deal with fear of medication calculation. Just pray every morning before you go to work to ask God to guide you through each day. You can do it!

[miragal]

thankyou all for encouraging me! I know that i have to get past this fear. I really appreciate your responses- I know that practice makes perfect- I'll work on my calculations

[Daytonite]

Actually, most hospitals are on unit dose and the pharmacy sends up the patients oral doses pre-packaged with tablets already broken in half in need be. Also, a lot of times, I found the pharmacy also put the amount of liquid to be drawn up from a vial for an IV piggyback on the label. That aside, the one and only formula I've ever used that works every time is:

dose desired divided by dose on hand multiplied by the amount the dose on hand comes in (tablet or cc's)

It's gotten me through PO and IV meds, and titrating medicated IV drips.

[grinnurse]

Miragal-

I can so relate to this fear b/c I was the same way in school and my instructor in clinical told me the same thing about how I was thinking.

Now, 7 months into the "real" world of nursing, I still have another nurse verify the dosage with me even though they have all been right, I would die if I screwed up on something as important as that!! Don't be afraid to let your preceptor know that dosage calcs are one of your weakness so she can show you how to apply it to the meds.

I also keep a "cheat sheet" on my clip board that shows me how to do the formulas and that has eased my anxiety level 100%!!

Good luck and you will get it down!!

[Cardigan2]

Hi NorthernRose...thanks for the tip...that's awesome! Do you remember the med calcs?
Cardigan2

Originally Posted by NorthernRose

Doing any type of math was what kept me out of becoming a nurse for so many years. I was totally terrified of any math past the basics I needed to have to balance my checkbook!! Our instructor was the best in teaching us how to calculate meds...to the point I actuallylooked forward to doing them!!
For IV's the basic is...divide divide multiply. Divide the amount needed by the number of hours to infuse, divide that by 60 (for minutes in an hour) and multiply that by your drip factor. ex. 1000cc in 8 hours 1000 divided by 8=125 (this would be your ml's per hour) divided by 60 (minutes in an hour)=2.083 times drip factor of 10 =20 drips per minute. Piece of cake!! If you already have your ml's per hour just divide by 60 and multiply by your drip factor. She had a certain way to do med calculations too...I'll have to refresh my memory on them and get back to you : ) Good luck!! 99% of the horror of doing calculations is fear. Just believe in yourself and you can do them!!