They spoiled me and now I'm freaking out !

CuriousMe · May 31, 2009

I notice the guidelines you gave were all for adults. No pediatrics ... not much about how you would actually give the med ... what you would do in a real-life situation if something didn't seem right ... etc. There was a recent thread here on allnurses about a question (asked by a hospital as part of the interview process) that asked the candidate what she would do if she calculated a dose of some drug to be 40 pills. The new grad was not she answered the question correctly. It was funny to read the comments in that thread. Many of the students made it all very complicated and twisted the question into many different shapes as they struggled to answer it. The experienced nurses all thought the question was easy -- they would do their calculations over again to double-check their work because they probably had made a mistake in their original calculations!
It's beginning to seem to me that schools are failing to teach students how to actually give meds in real life -- perhaps not focusing on that enough in their clinical rotations. I know many of the students who come to my hospital don't give many meds because the instructors are spread too thin to adequately supervise them and hesitate to delegate that teaching task to the staff nurses.
Hmmmm .... interesting

We're tested on med calculations in our Lab/clinical class. We're taught about the indications, pharmacokinetics, pharmacodynamics, mechanism of action, contraindications, nursing actions, etc of all sorts of drugs in our two terms of pharmacology. We cover some pediatric info, but most of that we learn in our chronic and acute care classes during pediatric chapters.

However, someone in my program must be doing something right....because when I read your post the first thing I thought of was....I'd redo my calculations. I'd next double check the dosage in the order to the dosage in the drug book and I'd finally reconfirm the order with the Doc before giving 40 pills to anyone...no matter what their size.

Peace,

CuriousMe

llg, PhD, RN · May 31, 2009

We're tested on med calculations in our Lab/clinical class. We're taught about the indications, pharmacokinetics, pharmacodynamics, mechanism of action, contraindications, nursing actions, etc of all sorts of drugs in our two terms of pharmacology. We cover some pediatric info, but most of that we learn in our chronic and acute care classes during pediatric chapters.
However, someone in my program must be doing something right....because when I read your post the first thing I thought of was....I'd redo my calculations. I'd next double check the dosage in the order to the dosage in the drug book and I'd finally reconfirm the order with the Doc before giving 40 pills to anyone...no matter what their size.
Peace,
CuriousMe

Yes, it sounds like someone is doing something right -- or you just have a good on your shoulders. I suspect it's at least a little of both. :yeah:

It seems to me that the clinical peds instructors are not teaching much about med administration in peds patients. Maybe they are wrongly assuming it is being taught in pharmacology.

mRpeNa · May 31, 2009

so now i'm in my last nursing course and ofcourse at the beggining of each course we have a drug calc exam. So no biggie right ? You study you pass. So i studied and then i get to the exam and to my surprise it was not multiple choice like the rest of the drug calc exams. I was petrified ! Not only was there no answers starring me in the face we had to also get an 85 instead of an 80 to pass. To top everything off instead of finding out that night whether we pass or fail we won't find out until monday and we tested on thur. This was a double whammy. Well i did my best i just hope and pray i passed. I'm sorry for complaining. I just don't like to be spoiled and then brought back to reality in such a harsh way. I'm used to multiple choice, having to get an 80 or better to pass, and finding out the same night. Don't spoil us and then change the rules on us later. But thats nursing school for ya and to be honest there is no other place i'd rather be. :loveya: Wish me luck guys. I'll find out monday. It still won't keep me from checking grades q 5min though.

they did spoil you guys!

We never had multiple choice...and we have to make at least 90%...and show our work!

I know you did well!...keep us updated.

NurseLoveJoy88, ASN, RN · May 31, 2009

Update- Well grades got posted earlier then I thought.... I received a big fat 95 % I got only one wrong ! I'm so over joyed right now. I want to thank everyone for their support, and most of all ( you all know me) I gotta thank God.

Now on another note- If anyone has a drug calc exam or is struggling this is what helped me. For each problem I wrote out the following:

Order:

On hand:

Conversion ( if needed)

What I needed to find:

Using this I was able to take info from the problem and work it out. Here is an example.

The doctor has order gr 5 of penicillen. On hand is 100mg/tabs. Find # of tabs to administer.

Order: gr 5 penicillin

On hand: 100mg/tab

Conversion: 60mg = 1 gr

Find: # of tabs

5gr times 60mg divided by 100 = 3 tabs

I just made this up so I'm not sure how accurate the dosage is but this is an example of how I broke each question down. Yes it was time consuming but It obviously worked.

I guessed I mainly freaked because there was no MC and I wasn't sure about when to round and when not. I'm just glad its over and I passed. Whoo... I can sleep tonight !

~Mi Vida Loca~RN, ASN, RN · May 31, 2009

Yes, it sounds like someone is doing something right -- or you just have a good on your shoulders. I suspect it's at least a little of both.
It seems to me that the clinical peds instructors are not teaching much about med administration in peds patients. Maybe they are wrongly assuming it is being taught in pharmacology.

Honestly I think that was a matter of common sense. I am not even in nursing school yet and when I read that thread that is the first thing that popped in my head. To get that answer you probably made an error so re check. To me it seemed like common sense, if I picked up a Rx and it read to take 40 pills I would re read, if I did read it right I would call the pharmacy and double check and if he said that is what Dr ordered I wouldn't take it and instead get a second opinion before I took 40 of anything at one time.

~Mi Vida Loca~RN, ASN, RN · May 31, 2009

Congrats to the op. Our school is 100% and three tries also. They supply calc as well.

sandraellen · May 31, 2009

nursing student 19, what school are you attending?

swirlything · May 31, 2009

Well, when you're giving meds to patients, you're not going to have multiple answers to pick from when figuring out how much to administer. If you cannot figure these out without it being multiple choice, I don't want you giving meds as a nurse!

My school does the same thing. Multiple choice until the last semester, except you are expected to get 100% on all of them, right from the start.

llg, PhD, RN · May 31, 2009

Honestly I think that was a matter of common sense. I am not even in nursing school yet and when I read that thread that is the first thing that popped in my head. To get that answer you probably made an error so re check. To me it seemed like common sense, if I picked up a Rx and it read to take 40 pills I would re read, if I did read it right I would call the pharmacy and double check and if he said that is what Dr ordered I wouldn't take it and instead get a second opinion before I took 40 of anything at one time.

That's what the experienced nurses thought. But some of the students started reading way too much into the question and were saying things like "call the doctor" and "hold the med" etc. without thinking about what a real person would do in a real situation. They were trying to figure it out based on interpretations of principles they had learned in school, and in the process, they forgot their common sense.

Couture85 · May 31, 2009

At my school, you have to make 90% (you have 2 tries or your out). We don't have multiple choice questions, but we can use a simple calculator. Med. calc. is always tough for me so I have to practice a lot!

madnurse2b · May 31, 2009

This is an interesting thread for me to read as I ocassionally administer medication tests to students and new grads in my work as a staff development educator. Our standard test is a multiple choice test and the students/new grads are often thrilled at that. A big smile comes over their face when they first see it.
However, the second half of the test (also multiple choice) is not calculations. It is about the uses, side effects, etc. of some common medications and questions about how you would administer them to children of different ages. (They receive a handout and a lecture on everything on the test a few days prior to having to take the test.) When they reach those questions, you can see their moods change as they take it. When we grade the test, many get extremely high scores on the first half and then do really horribly on the last half. Several have commented that their schools don't teach that kind of stuff and they have never been tested on the meds themselves or on how to give them ... just the calculations.
So, I'm curious. How many of your schools test you on the uses, side effects, etc. and administration of the most common medication? Are your tests only calculations or are you also tested on other aspects of the medication administration?

Ours tests really heavily in Pharmacology on the most common meds in class. And every semester they take specifics - when doing med/surg electrolytes they might throw in someone with classic dig toxicity symptoms with hypokalemia. Looking at the med side effects as they relate to specific other issues you are handling in the class, that kind of thing.

I was lucky, having been in Primary Care for so long, I handled all of our patients prescriptions - I knew the major tests to check for specific drugs, major side effects, and ones that you "call the doctor" 'cause we were the office. But there were a lot of people who struggled with Pharmacology. I get a lot of "I'd just look in the book", but you don't have time to look for everything on the floor, you gotta know some of it. Of course my book is on my PDA so I do keep it handy.

With regards to drug calc tests - we have 95% every semester, no multiple choice, show all of your work. Fun for the first day of clinical!

NurseLoveJoy88, ASN, RN · Jun 1, 2009

How about fun for the first day of class. We got a packet in the mail to study with and the first day of class we had our drug calc exam. That was really fun