Conflicting Dosage Calculation Information

Nursing Students Student Assist

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Currently in school for BSN and we take dosage calculations exam before the start of every Quarter, we just finished one and 2 our of 6 passed. They failed four of us because we didn't round 333.3 units into 333 units.

Accordingly to the instruction, you round units and IV to whole number but my doseage calculation book given to us by the school said we can round or leave it as decimal.

Previous instructior said we shouldn't round while current instructor wants us to round.

Do we have a case against the school for wanting to make sure sit out for two quarters just cos if this.

This must be hard for you but as others have already said, you needed to read the instructions and follow them especially when you realized you got 333.3 and there was another option for 333. This is when you should really take an extra second and look up at the instructions AGAIN just to make sure. This isn't really who is smart here but who can follow instructions and it looks like they got 4 of you.

Specializes in Med/Surg, Academics.

*double post*

Specializes in Med/Surg, Academics.
But it does matter - even for a rule-driven student (or, one could say especially for a rule driven student). There was no inconsistency. Yes, the book said you can round or leave as decimal (so it would leave it up to the instructor to say what they wanted students to do, and this instructor said to round). A PAST instructor said not to round, but the CURRENT instructor said to round. You go with the rules of the CURRENT instructor - who stated on the exam in the instructions to round and apparently stated to the class to round. It is just like being at one hospital that has a policy to do something one way and going to another hospital that has a policy to do something a different way. You follow the rules/instructions/policies of wherever you CURRENTLY are, not those of where you were in the past. If you are rule-driven, and you are told my one instructor to round, and then take another class with a different instructor to round, you are going to follow the rules of the current instructor. Again, just like if you were at a hospital that said do something one way and went to a different hospital that said something another way, you would go with the current hospital you are employed at.

"Rule-driven," when applied to students and (sometimes) novice nurses, does not mean that whatever rule is in effect at the time is good; it means that the first rule sticks, and it's difficult to adapt to different rules for what is essentially the same situation.

Yes, there was inconsistency. How you can say there wasn't is beyond me.

I deal with inconsistencies in instruction all. the. time. It is a migraine headache of epic proportions among faculty. Your analogy to policy and procedures in hospitals has only one thing in common with the OP's scenario--changes from one environment to another. Beyond that, it is apples and oranges.

Let's make this very clear: The student's answer was CORRECT; the rounding instructions were inconsistent.

What is the point of the test--a test which apparently determines progression in the program? If it is dosage calculation proficiency, the student passed the test.

Specializes in LTC.
This must be hard for you but as others have already said, you needed to read the instructions and follow them especially when you realized you got 333.3 and there was another option for 333. This is when you should really take an extra second and look up at the instructions AGAIN just to make sure. This isn't really who is smart here but who can follow instructions and it looks like they got 4 of you.

OP, was this a multiple choice test? None of our med calc questions give choices. We just come up with an answer and follow the math rules they want us to follow, which are clearly stated at the beginning of the math section on EVERY exam. Was yours this way?

No, it wasn't multiple choice

Specializes in 15 years in ICU, 22 years in PACU.

Was this the only question you missed that caused the fail or did this ONE question cause your total score to fall below passing?

My opinion doesn't amount to a hill of beans at your school but if it was this ONE question that caused you to completely fail to progress, I call out your school as asinine and petty. "twas a high price to pay for missing ONE question. They're not teaching nursing, they're teaching test taking.

If this one question was part of a larger group and wasn't the only "wrong" answer that landed you in fail territory, then your failure was justified because if you were so close to failing that one question put you under, you need to take some time to review your ability to continue and finish nursing school.

No, this is the only question keeping me from progressing. We have to meet the dean on Monday to discuss the possibility of throwing it out but we have to show provide proof in textbooks. Being doing research all day

"Rule-driven," when applied to students and (sometimes) novice nurses, does not mean that whatever rule is in effect at the time is good; it means that the first rule sticks, and it's difficult to adapt to different rules for what is essentially the same situation.

[...]

I understand this. My question to you is this, at what point in their education do you believe the students should be introduced to new rules?

[...]

Yes, there was inconsistency. How you can say there wasn't is beyond me.

[...]

Not necessarily. If this instructor, in another test in this particular course had accepted either a rounded or un-rounded answer, then yes. However, even if this instructor had previously accepted the response rounded or un-rounded, the instructions for this exam [/] were crystal clear, regardless ofnwhat the dosage calculation workbook stated. From the OP.

[...]

Accordingly to the instruction, you round units and IV to whole number but my doseage calculation book given to us by the school said we can round or leave it as decimal.

[...]

[...]

I deal with inconsistencies in instruction all. the. time. It is a migraine headache of epic proportions among faculty. Your analogy to policy and procedures in hospitals has only one thing in common with the OP's scenario--changes from one environment to another. Beyond that, it is apples and oranges.

[...]

I agree that inconsistency between instructors can be problematic. However, to say that the OP answered the question correctly, even thou he or she failed to follow the test instructions is not the answer. Rather, the faculty should develop practical rounding rules, based on actual practice, and implement them from day one. Neither answer in the OP would work in actual practice, unless administered on a syringe pump. Otherwise, the medication volume drawn up is only going to be as accurate as the syringe being used.

[...]

Let's make this very clear: The student's answer was CORRECT; the rounding instructions were inconsistent.

[...]

The answer was correct but not recorded in the prescribed format. And again, the rounding instructions were nor inconsistent. If there was any confusion at all on the OP's understanding of the instructions, he or she should have clarified the instructors expectations.

[...]

What is the point of the test--a test which apparently determines progression in the program? If it is dosage calculation proficiency, the student passed the test.

Again, no, the OP did not pass. While some might see this nitpicking be the instructor, I see this as attention to detail. As I work in PICU, inattention to detail with drug calculations can be catastrophic.

Specializes in LTC.
No, it wasn't multiple choice

But were the rounding rules clearly stated on your exam, in print?

Specializes in Med/Surg, Academics.
I understand this. My question to you is this, at what point in their education do you believe the students should be introduced to new rules?

No, you don't seem to understand my point. New rules for the SAME SITUATION re: instructions that are inconsistent. Your question has no context, so it's impossible to answer.

Not necessarily. If this instructor, in another test in this particular course had accepted either a rounded or un-rounded answer, then yes. However, even if this instructor had previously accepted the response rounded or un-rounded, the instructions for this exam [/] were crystal clear, regardless of what the dosage calculation workbook stated. From the OP.

See, you do not understand my point about rule-driven and the difficulty of adaptation in the face of inconsistent instructions. The book for dosage calculations said one thing; the instructor said something different. That's inconsistency!

I agree that inconsistency between instructors can be problematic. However, to say that the OP answered the question correctly, even thou he or she failed to follow the test instructions is not the answer. Rather, the faculty should develop practical rounding rules, based on actual practice, and implement them from day one. Neither answer in the OP would work in actual practice, unless administered on a syringe pump. Otherwise, the medication volume drawn up is only going to be as accurate as the syringe being used.

The calculation is correct. Do you disagree with that? Yes, the faculty should implement the rounding rules from day one--and they did through the dosage calculation book, and now the instructor says something different from those initial rules. On this point, you are making my point for me....

The answer was correct but not recorded in the prescribed format. And again, the rounding instructions were nor inconsistent. If there was any confusion at all on the OP's understanding of the instructions, he or she should have clarified the instructors expectations.

So, you do admit the answer was correct. Again, is the point dosage calculation or following inconsistent instructions?

Again, no, the OP did not pass. While some might see this nitpicking be the instructor, I see this as attention to detail. As I work in PICU, inattention to detail with drug calculations can be catastrophic.

And, I would argue that the student paid close attention to detail by giving the number after the decimal. Most drug errors are not errors of 0.3 for rounding; they are usually by orders of 10.

Specializes in Med/Surg, Academics.

Ok, let's put this in perspective. The OP of the current thread failed and will have to sit out a semester for a CORRECT calculation.

And the OP of this linked thread will also fail and have to sit out a semester.

https://allnurses.com/nursing-student-assistance/unfair-fundamentals-clinical-1156823.html

It could be argued that BOTH students are a potential danger to patients due to lack of attention to detail, but that would be patently ridiculous.

And, yes, I'm rethinking my statement in the first line of my response to the linked thread. Let's just say, it depends on how petty your instructor is.

My bad OP, I was under the impression that your exam was MC. Hope the dean can help you pass the semester. Sending good vibes your way and please let us know how things work out.

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