Are grains still used as units in medication?

  1. Just wondering here how many of you nurses see grains as units still in medication in the states? I am currently in chemistry and the professor is focusing quite a bit on this conversion, and a paramedic in our class constantly is telling us this is unneeded as he nor any of the nurses in the ERs that he talks to have ever seen grains used. Just curious on this.
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  2. 12 Comments

  3. by   elkpark
    As far as I know, ALL healthcare settings have eliminated the use of the apothecary system of measurements in order to avoid errors and misunderstandings (quite a while ago, in fact).
  4. by   Marie_LPN, RN
    Well, supposedly our facility did away with the apothecary system, but there's a few physicians that have yet to be alerted (or listen) that this is in effect.
  5. by   Betty_SPN_KS
    We have an older nurse (in her 70s) who still charts "Tylenol gr X" instead of "Tylenol 325 mg ii". But I haven't seen a doc order in grains.
  6. by   suzanne4
    Thyroid tablets still come in 0.5 grain or 1 grain. (not synthroid, but the old fashion one)

    Too many med errors can be made, especially in pediatric units. One case always comes to mind, a physician wrote for grains and the nurse read it as grams, even had the order checked with another nurse, and they gave grams of tylenol to a 2 year old. Next thing, the child was being treated for a tylenol overdose.

    It still can show up on a calculations exam, but in everyday practice will you see it? Chances are quite slim, unless possibly with tylenol in some of the older docs.
  7. by   smk1
    Quote from suzanne4
    Thyroid tablets still come in 0.5 grain or 1 grain. (not synthroid, but the old fashion one)

    Too many med errors can be made, especially in pediatric units. One case always comes to mind, a physician wrote for grains and the nurse read it as grams, even had the order checked with another nurse, and they gave grams of tylenol to a 2 year old. Next thing, the child was being treated for a tylenol overdose.

    It still can show up on a calculations exam, but in everyday practice will you see it? Chances are quite slim, unless possibly with tylenol in some of the older docs.

    thanks for all the replys! now that i am finally taking some of the required sciences for nursing i find my interest in all the minor details heating up again. (last 2 semesters were algebra, speech classes, english, psych classes etc..) I think I was in science withdrawl! :chuckle
  8. by   pickledpepperRN
    I cannot tell which one but a registry medication test was so old it had questions about how to give U-80 insulin in a U-40 syringe!
    At least they didn't test on how to sterilze glass syringes and resharpening needles!

    LOTS of grain to gram questions. The only cardiac meds were NTG, Isordil, and Inderal.
  9. by   chris_at_lucas_RN
    For sure there is one place that grains are still being used, and that is on the medication math quizzes you will be taking in nursing school. Become familiar with the conversion factors so you don't have to relearn them and/or retake the quizzes.

    Noting this from suzanne's post (I think it was suzanne....)

    they gave grams of tylenol to a 2 year old. Next thing, the child was being treated for a tylenol overdose
    This is terrible and could have been avoided if either of the nurses had been familiar with the dosing guidelines of the drug, which they should have been, or looked it up, since they didn't know proper dosing for the drug. They, as nurses, were responsible for what they gave, legally. They "did harm" in a manner consistent with malpractice, by a direct act, which would be assault and battery.

    You won't have that problem because you are going to learn lots of good stuff about commonly prescribed medications, and before you give a patient anything at all, you are going to rehearse mentally whether the drug is safe to give, and mostly because you will call the pharmacist if you have a med question, and hold the dose until you verify with the physician that he meant grams instead of grains.....

    I know this because you are already thinking about practicing nursing and you aren't in nursing school yet. Good for you!
  10. by   oramar
    It took a long time to get some of the older doctors to stop writting grains but I personally have not seen it in at least 5 years. Now if only we could get them to put the date and time on all their orders. Last inspection that is what my hospital got sighted for, very few doctors were putting date and time on orders.
  11. by   DCCCRN2Bn05
    We questioned that on our last math test, of why we had to learn it when no one uses it. We were told there are a few older docs that still order it in grains. And even a few meds that can only be ordered in grains. (though I don't know what they are) Needless to say we had all forgoten how much was in a grain and missed that question miserably, but now we'll never forget :imbar
  12. by   tweety21
    Interesting question. In British Columbia (Canada) I have not seen it used in any of the acute care areas I have worked. However, we do still teach it in our nursing programs as it is in all the pharmacology textbooks I have ever seen/used.
  13. by   teeituptom
    Quote from spacenurse
    I cannot tell which one but a registry medication test was so old it had questions about how to give U-80 insulin in a U-40 syringe!
    At least they didn't test on how to sterilze glass syringes and resharpening needles!

    LOTS of grain to gram questions. The only cardiac meds were NTG, Isordil, and Inderal.

    I remember sterilizing syringes and sharpening needles when I was still a corpsman
  14. by   sweetielin
    at my hospital, one doctor occasionally orders meds in grains. then we have to convert it to mg.

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