Do you still have to do dosages math by hand as an RN now?

Nurses General Nursing

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So I'm in my first semester and we're about to start on meds and knowing how to calculate. It seems pretty easy, we haven't started the subject but looking at the pp slides, it seems like it.

I'm pretty good in math and love math like crazy lol. Science I'm kind of bad in it but after a while I get the hang of it.

Anywho, so I was thinking today, "well as an RN at the job, would we still have to take out a piece of paper and calculate the dose on hand, how many tablet there are, expected dose, etc?"

How do you all do it on the job? Do your hospitals system automatically does it or what? I'm not worried about it. But I'm really curious, I'm always asking why to things that may not matter to others but matter to me [emoji4]

Specializes in NICU.

You'll always have access to a calculator for the actual multiplication and division and such. You will have to know how to set up the calculation and have an idea how big or small the result should be. (do you multiply or divide?)

In school they told us we needed to know how to do the math by hand in case you're ever without a calculator. With computer terminals and smart phones everywhere I don't think will ever be true again. They also said you should always trust your math over a calculator. Um, no. I will always trust 3 digit long division done on a calculator over me doing it by hand.

Not all the time, but sometimes I do.

Can any of you tell me the main formulas for dosages?

I remember one of my professors in my pre reqs say that there are formulas, (I think 1 or 3) that you'll use in your whole nursing career. Idk.

Specializes in LDRP.

For pills and stuff it is usually easy to do in your head. Every once in awhile I titrate a drip manually (gtt factor, etc) and run it by gravity--I usually look the formula up and scribble it down on paper because I don't do it often enough for it to be second nature. I also used to do this with amnioinfusions (L&D), but I just run them by pump now. The IVPB med labels that pharmacy prints usually say something like "Run over 30 mins", and it's a 50 ml bag, so I have to do minor math in my head to know what to set the pump at, but it's pretty automatic now because I have hung so many 50 ml bags over 30 mins, my brain just knows to set it to 100. When I worked in med/surg and used to hang chemo there were some calculations that had to be double checked like BSA, but I had an app for that.

Specializes in Labor and Delivery.

I actually did today! Had 30 mg of betamethasone in 5 ml. Only needed a 12 mg dose. I never would have thought I would do a med math calculation outside of nursing school, but I did! Lol

Also .. Can you use nursing apps on the job??

What were apps you used in nursing school? I have an iPhone 6s+ .. So idk what nursing apps are available that are free or what

Specializes in Ambulatory Care-Family Medicine.

You probably won't be able to use any apps in school as they do want you to learn to do it by hand and/or with a calculator. I work family med and have to do med calculations occasionally for our pedi patients as the dosages are usually based on weight. It really is basic math so just don't over think it. Example: give 2mg/kg of med for 40lb patient. You just convert the weight to kg (1 kg=2.2 lb) then multiply by 2mg.

I use it probably about every other shift. The other day I had to sign off that the cardiac drip was correct based on their weight, so we had to run through the whole equation. The other day I was worried about a patient who was having out of the blue changes in LOC. I was brainstorming, and needed to check that a patient wasn't getting too much of a certain med... Looked up max dosage based on weight and had to run through the whole thing. I used a calculator for both but needed to know how to set them up. These type of problems come up less. I always use dimensional analysis because it makes the most sense to me.

Off the top of my head, I also use it when figuring out how much IV medications I need like morphine or solumedrol. Also when figuring out if I need to split a pill or not. These you can do in your head and come up pretty often, maybe 5 or so times per shift.

Our hospital requires you pass a basic math calculation test in order to be hired. Then, our specific unit required that you pass two other tests that were harder.

There were some very smart people in nursing school that just didn't get it...and it was because dimensional analysis just didn't make sense to them. Once they found their own way they breezed through it. There are several ways of solving every math problem so just keep at it until you find a way that works for you!!

We can use nursing apps, I have a 6+ too. I have an ECG app that I use often. An ACLS medication app that I use to refresh my memory, and an ABG app that I use to double check myself if I'm beyond tired on a night shift and my brain decides to quit working. Also, I saved a webpage of common cardiac meds that I use. (These apps were all free)

Specializes in Heme Onc.

There aren't really any "formulas". Its just algebra.

Specializes in Family Nurse Practitioner.

Heparin infusions require math. High risk med so need to check order. The pyxis does math for you if you specify how many mgs you need it will tell you how many mls to pull up. Good when pulling meds in stressful situations.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Yes, nurses still calculate dosages depending on the particulars of his/her particular environment. Maybe it's changed in hospital settings, but most of the time you will be asked to pass a medication administration test which includes calculations as a condition of employment.

I enjoyed learning it myself, because I learned the apothecary system (forgot what a drachm is, though!)as well as the metric system, both of which were unfamiliar to me at the time. Also speaking as a dinosaur, I don't think an a more efficient method being available or the ability to delegate something is cause to stop teaching/learning the basics.

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