A 100 % on Dosage and Calculations

Daytonite, BSN, RN · Apr 8, 2009

what's wrong with doing more critical thinking, more studying, and more reading? that's what students are supposed to be doing, isn't it? that's what i did. yes, i happen to think it is fair because i have been an rn for many years and i am now a patient. accuracy needs to be something you must strive for. and, i don't want a nurse who doesn't take being accurate as serious taking care of me. mediocrity isn't an option in healthcare where lives are at stake.

i was a supervisor and manager and a clinical staff nurse for even longer. it is a serious matter to make a medical calculation error as a practicing nurse. patients can suffer permanent injuries as a result. also, the social security administration has been tracking reported medication errors for years (lots of information that you are not aware of has to be reported to the social security administration) and medication errors account for longer hospital stays and larger hospital bills. to the social security administration (medicare) who counts every penny, that is inexcusable. so, a long time ago they tied their payments of medicare and medicaid patients, the bread and butter of almost all facilities, to medication excellence since it is taxpayer money. a nurse, pharmacist or pharmacy tech can't get a job today without demonstrating medication competence and ability. even if you went to a nursing school that was much more lenient, an employer wouldn't be. as a manager i hired new grads and rns and was not able to have them start their first day on the clinical unit until they passed the drug/medication calculation competency test our facility required of them in order for us to keep our medicare and jcaho certification. your school is only mimicking what is going on in the working world of nursing. not to do that would be doing you an injustice. for you to discover what lies ahead and not be prepared when you go looking for employment would be a failure of your school's responsibility to you (and to your future patients). and the fact is that tragedies of drug mistakes do happen. see http://www.ismp.org/newsletters/nursing/backissues.asp which is the listing for the link into monthly back issues of the ismps publication of nurse advise-err which prints incidents of medication errors. some of them have resulted in patient injury and death and are real eye openers. another site that prints the more outrageous med errors is http://www.webmm.ahrq.gov/ - morbidity and mortality rounds from the agency for healthcare research and quality (ahrq). click the "case archive" tab on the menu bar to find the medication errors. dennis quaid last year went public because he felt it was more important for the public and the nurses to be educated, learn and be taught about the serious medication error that happened to his twin babies. those little girls received 10x the dose of heparin that they should have because the nurses didn't look at the vial they were drawing the heparin from before injecting it. i heard him speak about it on tv and i was so angry. this is first semester nursing drug administration principles--check the label 3 times. i was taught 30 years ago in my first semester of nursing and did it to the last day i worked in the clinical area.

~Mi Vida Loca~RN, ASN, RN · Apr 8, 2009

Our school is the same way. Yes I think it's fair. My previous college you had to get a 98% I am not sure if they changed it or not. But my new school has the 3 strike rule as well.

I think it's fair because someones life will be in your hands and the thing with math is, once you master the technique, you should be able to solve the problem. It might take longer for a more complicated problem but the technique should be the same. I mean like addition. Once you master addition you can solve any addition problems, whether it's single digits or 40 digits, the method is still the same.

The best thing you can do is to challenge yourself often. Get some Dosage and Calculations work books and through the semesters self test yourself on them so that you remember the technique. When you go to test, take your time to make sure you are doing it properly, the biggest math errors happen from rushing through or being distracted, I would bet the med errors happen for much of the same reason.

I struggle with some math, so I got computer software program called Calculating Drug Dosages, an interactive approach to learning Nursing math, that also comes with a practice book to study over the summer and get familiar so I am not so lost when school starts in august and I plan on practicing weekly even if it is only 10 problems, throughout school so I don't forget.

MrazFan · Apr 8, 2009

No, nothing should be done to change the school policy. My school also has a mandatory 100% correct requirement to pass the med math exams (1 every semester). If you only do your med math correct 90% of the time, which would otherwise be a passing grade, then 10% of your patients are getting the wrong dose of their med. Not safe. And it is more important than a lot of other things, in my opinion, because while critical thinking and nursing theory is important, drug dosage calc is much more important. Messing up a drug dose can have very serious or even fatal consequences for a patient.

It might seem like it would be hard to pass the test with 100%, but it isn't. Practice the math on your own, ask for help if you need it. Maybe even check around for someone to tutor you if you feel it will help. If you are proactive and put forth the effort, then med math won't be so rough anymore, and you will be able to feel confident that you are equipped with the skills to be a SAFELY practicing nurse when you graduate.

Good luck!

meluhn · Apr 8, 2009

Our school is the same way. Yes I think it's fair. My previous college you had to get a 98% I am not sure if they changed it or not. But my new school has the 3 strike rule as well.
I think it's fair because someones life will be in your hands and the thing with math is, once you master the technique, you should be able to solve the problem. It might take longer for a more complicated problem but the technique should be the same. I mean like addition. Once you master addition you can solve any addition problems, whether it's single digits or 40 digits, the method is still the same.
The best thing you can do is to challenge yourself often. Get some Dosage and Calculations work books and through the semesters self test yourself on them so that you remember the technique. When you go to test, take your time to make sure you are doing it properly, the biggest math errors happen from rushing through or being distracted, I would bet the med errors happen for much of the same reason.
I struggle with some math, so I got computer software program called Calculating Drug Dosages, an interactive approach to learning Nursing math, that also comes with a practice book to study over the summer and get familiar so I am not so lost when school starts in august and I plan on practicing weekly even if it is only 10 problems, throughout school so I don't forget.

Thank you for being proactive instead of whining about how unfair and mean the policy is. :yeah:

~Mi Vida Loca~RN, ASN, RN · Apr 8, 2009

Hello, everyone. I am on my third semester this year. Our school requires us to take dosage and calculations test every end of the semester before moving on to the next semester. But the thing is, our school requires us to get a 100% in order to pass and move on to the next semester. It can be taken in 3 attempts. If you dont get a 100% on your third attempt you are out of the program and asked to remediate on a class the school deems you need to take based on your TEAS test or transcript and have to wait to reenter the program. Don't you think this is too much? Other schools I know require less than a 100% to pass. I know we STRIVE to be error free in giving out meds but in real life it doesn't turn out to be ALWAYS a 100% without error. By kicking you out of the program because of not getting a 100% on the dos-cal test doesn't mean your going to be a careless nurse, does it? It is like the dos-cal outweighs classes which requires more critical thinking, more studying, and more reading. I know schoolmates who were kicked out of the program even if they were doing good in their classes just because they didnt get a 100% on 3 attempts. I almost got kicked out if not getting a 100% on my third attempt in my second semester even if I was doing well in my classes. Do you think this is fair? It seems our nursing school department is unwavered to change this policy. Should anything be done to this school to change this policy?

I just reread your post and have a question, how did you ALMOST get kicked out??? You either get a 100% or your don't, so where is the almost coming from?? Just curious.

kcochrane · Apr 8, 2009

Our school just started with the math proficiency exams last semester. You had to pass with 100%, you had 3 attempts...BUT there was no penalty if you still didn't pass the 3rd time. This semester, there is a 2 point off your final grade penalty if you don't pass by 100% the 3rd time.

~Mi Vida Loca~RN, ASN, RN · Apr 8, 2009

Our school just started with the math proficiency exams last semester. You had to pass with 100%, you had 3 attempts...BUT there was no penalty if you still didn't pass the 3rd time. This semester, there is a 2 point off your final grade penalty if you don't pass by 100% the 3rd time.

That was weird, why would they say you had to pass 100% and had 3 tries if their was no penalty?? 2 points off your final grade?? That doesn't seem very efficient in making sure the students are getting it IMO. That first part still cracks me up though.

missjennmb · Apr 9, 2009

Our school has a math competency test they give at the end of the semester. They said that if you did not pass it you would not be able to pass meds.

guess what? they let people who failed it pass meds. In fact, one of those who failed it passed meds FIRST of anyone in clinicals. I failed a Med Surg final because I took more than half of my time to study and work on my math and got a 100% on my math test (nobody else got a 100%) and it did not count for anything.

I don't know if 100% every semester is the right way to go or not. If I was running a program, i would probably raise the bar every semester, incorporating remedial exercises as a result of whatever was done incorrectly, because people learn from their mistakes but I DEFINITELY think its important that nobody graduate from a nursing program who cannot do math with 100% accuracy.

Valerie Salva, BSN, RN · Apr 9, 2009

In my program- we only got one attempt to take dosage calculations- and we also had to get 100% to pass.

One classmate tried to commit suicide when she did not pass.

She survived, but I don't know whatever happened to her after that.

slsmithe · Apr 9, 2009

My school is the same way-- we need 100% to pass. A friend of mine almost got kicked out, but studied her but off for her last try and passed with flying colors.