Do nurses do med math

There are not a ton of medication errors. The media makes it seem that way. Ultimately, as the person administering the drug you are responsible. You do need to do med math. Maybe not the long way they have us do it, but you have to verify what you are giving is what they are receiving. That is part of the 6 rights of medication administration.

I check. Always. The pharmacist is human also. He or she can make a mistake. I don't want their mistake to kill a patient or fall on me as I am giving the med.

The nurse is the last line of defense. Physicians make mistakes too, and the pharmacy may not see it. It's up to me.

Thanks, Heather. My instructors make it seem that way too (that there are many medication errors) they said it's the number 1 cause of hospital deaths.

I think I just get frustrated and know you're right, I just have such a mental block with these dosage questions. I think I need to just do them repetitiously and it'll get easier.

Um, pharmacists can make errors, too.

Um, pharmacists can make errors, too.

This...

A pt received TEN times the dose of a medication; it was an obscure med, one that hasn't been used, but the pharmacy made the error...

I used med math everyday; I've had to double check a resident giving 1.5 times the dose-although it was verified by pharmacy, the pt would've had complications-it was a sedation medication (Versed).

If you have an eMAR & scan meds, pharmacy has done the math. But as mentioned above, they aren't perfect either; pay attention, especially when you only need half tablets...don't forget to cut them. In an emergent situation, you can't wait for pharmacy verification...do the math & give the dose.

Some depts may not fully use EMR. For instance at my facility in pre-op & PACU, we don't scan meds & orders are marked on pre-printed order sheets. Meds do not get verified by pharmacy at all with the exception of the pre-op antibiotic. Most med math is pretty simple but in some instances (like calculating a wt based peds dose), I grab another nurse to double check with me. We also rarely use pumps, so have to actually figure drip rates.

So, I guess what I'm saying is, yes, pharmacy does the math in most instances but you can't blindly follow it without thinking about it. And there will be times where you have to do the math yourself.

Even if you use eMAR and scan meds you still do med math. What about when you're administering controlled substances from the pyxis? You need to figure out how much to draw up when you need to give 1.5 mg of ativan and you have a 2 mg/mL vial.

I'm a Pediatric nurse and we live and die by being able to calculate dosages, often changing being that many are based on current wt. I've been in the Peds setting for only a year now and have seen more med errors in this setting than others.

Doctors prescribe dosages outside therapeutic ranges and pharmacists label dosages incorrectly.

You are ultimately responsible once you administer the med so know how to calculate and have a reference manual (or app) available on your shift

I have to use med math very regularly in the ED...

I did a lot of med math as a peds nurse. You are always calculating for weight in kg. As an adult nurse now, not so much but I still do it occasionally. I think it comes easier to me then some nurses who have always worked adults do to my peds experience.

Yes you must know med math. If you're having trouble with it, you'll need to sit down with a nursing calculation practice book and practice, practice, practice. You're not only going to be dealing with meds dispensed by a Pyxis or similar. If you're an RN, you have to be able to calculate IV flow rates; 250 mg of K+ infused over 30 minutes is going to have a catastrophically different outcome than infusing the same amount over 24 hours. Also as patient advocates we are the last line of defense against med errors. It's your patients' lives and your license/livelihood at stake. Don't take a nonchalant attitude towards math. I know it's tedious and boring but it's absolutely necessary. As for the instructor who told you that you don't need to know med math, they need to be reported to your department chair.