Failed drug calculations quiz, need some encouragement...

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Specializes in Developmental and Peds with disabilities.

:crying2: :nuke: :sniff: :banghead: :bluecry1:

Hello all. I am 23 year old student and mother of a toddler. I have been in school for two and a half years and have finally reached my second clinical semester...well, was in it anyway. I failed the drug calculations quiz for the third time and was told I would recieve an F for the course. It literally broke my heart. I am a good student, have never failed ANYTHING before, even before the nursing program. In introduction to pharmacology where we learned to do drug calculations, I never made anything less than a 96, even on the final. I had to make 90 or above to pass the quiz, and on each try I missed one too many (20 question test, missed 3 each time). It's not like I went in there blind, I studied really hard and refreshed myself. One day I studied calculations for 4 hours straight with no breaks. I had my first ever panic attack only moments before turning in the third test. I am so mad at myself, the question involved grains and the instructions said to round off to the nearest 100th. I got 1.802, answered it 1.8, and was told I was supposed to round up to 2. The answer form was tablets, and while I know it's not really possible to give 8/10s of a tablet, I was afraid it was a trick question, like maybe if I put 2 tablets it would have been wrong because that would exceed the safe dosage or something. The worse part about it is that I may have to wait a whole year before I can retake the class. This means I will have no classes to take, which means my grants will stop and I will have to begin paying back my student loans if I am not enrolled at least part time.

Lately I have been really stressed. My husband and I are having problems and are going through an on and off trial separation. I feel overburdened between bad financial struggles, lack of time to study without interruption from my three year old, an inability to keep the house from looking like anything less than a disaster (it's either clean or study) and a kind of quarter life crisis. I'm a 23 year old mother in college with no time to myself to be a young adult. I'm terrified I'm wasting the only chance I will ever have to enjoy my youth and have had a hard time coping with all the stress.

I'm really hoping for some words of encouragement, maybe some stories from people who may have failed a class before and everything turned out for the best. I can't stop crying and any advice on how to deal with my stress in a healthy way would be very much appreciated. Thanks in advance and send a prayer out for me please

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Specializes in Pediatrics, ER.

Katie, I'm so sorry you're going through this. You have a whole lot crammed onto one tiny little plate, and this may sound cliche but maybe this is a blessing in disguise. You're under a serious amount of stress right now, and those stressors have to be affecting your thoughts and actions. Maybe you need to take a litte time, re-evaluate. Having a panic attack is a sure sign something isn't working. While you wait for the course to reopen, use this time to clear the air...prioritize...what's most important to you? What do you need to change to make your dreams work? Have you tried talking to the instructor about your rationales, about what you didn't understand on the exam? If it's a total loss, maybe there's a program out there that's a better match for you. If you can, try to withdraw from the course. Some schools will tell you it's as bad as failing, others weigh it much less than they would an F. Financial aid can be a hassle, but there's always a way to finagle just enough money. I worked full time 40-60 hours/week during nursing school, used credit cards to cover what student loans and scholarships didnt, and took every exam on no more than 3 hours of sleep. But I did it, and now it's two years behind me and I'm almost out of debt. You too will find a way. Everyone has their own personal struggles that better them in the end. No matter what, take a step back and a deep breath, and do some reflecting. If this is what you truly want you will find a way to make it happen. You just might take the scenic route to get there, and there's nothing wrong with that. Good luck to you.

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Specializes in Developmental and Peds with disabilities.

thank you, rn4weeones. Let me also add that I do not take my mistake lightly, I am well aware that a miscalculation in medical dosaging can be dangerous and even deadly, but I am also very upset by the fact that it was because I didn't round up to a whole number (something that with certain drugs could also be dangerous) that ultimately hurt me.

I begged them to let me withdraw instead of failing, but was told that it was not an option. I even took my case to the head of the department, but she was adament that I recieve the failing grade. it hurt even more when she said that I was incompetant to do clinicals. I dont think she meant it in a degrading way, but boy did it hurt. no one likes to be called incompetant, especially when they tried so hard to succeed and failed anyway...

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Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

Katie803

So so sorry to hear this. It IS heartbreaking, but if it's any comfort, here in Australia we have to get 100% on ALL drug calculations, and to show our working out as well. I failed my first lot, so I drove home to my temp accommodation, studied for about 5 hours STRAIGHT and passed the next day. We only get so many tries.

I got so stressed during my 2nd-3rd year, I had to take a break from study. I worked, tried to relax (did yoga, pilates, caught up more with friends etc) and then went back to study next semester. You may have to admit defeat for now, and take a break. You cannot do it all I'm afraid. I used to think I could but it isn't possible. You have to look after yourself and your little baby. And you may need time out from your hubby if he is stressing you out and you can't get back together for now.

Studying, working, being a Mum, and the stress with your husband is all VERY HARD. Give yourself a break. You are NOT a failure, or anything close to it. You are a struggling, very young, single Mum doing your best to get through this crazy thing we call life. YOU ARE NOT PERFECT, though TV programs and ads would have us think different of people in your situation (notice how in ads the houses always look perfect?!)

Give yourself some time to look at life in a different way and do something else. Can you go work somewhere else for a while, or can you afford to stay at home with your baby? Can your hubby do more baby sitting, or a family member help out while you go get some career and marriage counselling?

As to the calcuations, the first step is to go back to basic maths. Yes I know it is a drag. One good book I bought (which I don't know if you can get in the US) is 'Nursing Calculations' (7th ed) by J D Gatford & N Phillips. It looks like you can get it through Elsevier. It is a very easy book to understand and goes through all the calculation steps, and is slim enough to take with you on clinicals. It has all the practice questions and the answers in the back.

But this won't help you unless you UNDERSTAND the maths, or understand where you went wrong. Can you remember the questions you got wrong, or ask your university for practice tests similar to the one you did. Where did you go wrong? Do you understand about dosages for tablets, IVs, IM injections? Can you remember your formulas and why those formulas are used?

You may really need to take time out to sort out the maths question, and just practice as much as you can. When you look at a question, ask yourself WHAT are they asking me to do exactly? What dosages have I got to work with? What answer would make sense, for example, give 40mg of Frusemide and you only have 20mg tablets in stock. Well you know that the answer wouldn't be say 4 tablets because simple maths means 40 x 4 = 160mg and you know that isn't right, and that most Frusemide dosages are broken up during a 24 hour period (think of the Dr's order too - does the answer make sense with the order?) That is a simple calcuation but it illustrates the point.

But please go back to the basic maths (the book above has basic maths in it), and start from scratch. Sometimes I used to do STUPID mistakes like I always seem to calculate 2 into 6 goes 2, but then I look at my maths and the answer, and know something has gone wrong. Also another thing that really helped me was doing the calcs a little slowe, in big writing with a working out column on the right hand side of my page. Even doing one calculation per page helps, cos it stand out more where you went wrong. After you have the answer, do a REVERSE calculation to see if you come out with the same equation, then you know you can't be wrong.

There are all different ways to do calcuations, you have to find what works for you. But for me (who failed maths all through school - I was a dunce) KEEP IT SIMPLE! Don't make it harder than it has to be. If you're slower at maths, so what, better to get it right than rushing and failing.

I failed a unit not long ago for post graduate studies, and I was so depressed I was going to drop out, but I changed my studies and tried different tactics for study, ie: having proper breaks, going out walking, eating better, sending emails to friends for support, doing a bit of yoga/stretches to get me off the couch so I don't get sore and stiff.

Girlfriend, we are on different sides of the ocean but you sound like you need seious support from friends and family. Get out there and tell anyone and everyone who listens YOU NEED HELP. Otherwise I am worried you will fall into a depression. Try to get some counselling even through your university. Adn you ARE very young, which worries me.

If you need someone to talk to, email me privately whenever you want, and I can help you with maths if you want.

Take care do some seious thinking and make the right decision for you, not everyone else, or to live up to unrealistic ideals.

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katie803--

Do you remember what the original question asked? The one that you were talking about with the grains?

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I hate the way some medical math tests require you to round. We use Procalc which has some odd rounding conventions and conversions. My background is in research where you use exact conversions, so rounding a number like 940 to 1000 seems crazy to me (yes Procalc does this).

I know when we took the exam, if we were off because of rounding and showed that we did the calculation correctly, it was counted as a correct answer. It seems ridiculous to fail you over something like that.

I am a working mother of two and full time nursing student in my first semester, so I understand the stress you under. My marriage is certainly in a rough place as well and I have less than stellar support at home which makes things more difficult. My only saving grace is that my husband is going to college for the first time and is starting to learn how much work classes really are.

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Specializes in Med/Surg, DSU, Ortho, Onc, Psych.
I hate the way some medical math tests require you to round. We use Procalc which has some odd rounding conventions and conversions. My background is in research where you use exact conversions, so rounding a number like 940 to 1000 seems crazy to me (yes Procalc does this).

I know when we took the exam, if we were off because of rounding and showed that we did the calculation correctly, it was counted as a correct answer. It seems ridiculous to fail you over something like that.

I am a working mother of two and full time nursing student in my first semester, so I understand the stress you under. My marriage is certainly in a rough place as well and I have less than stellar support at home which makes things more difficult. My only saving grace is that my husband is going to college for the first time and is starting to learn how much work classes really are.

Why on earth would you round 940 to 1000? You always round to the nearest whole number. What calculation requires you to do this. For example, if your answer for an IV calc says 106.6 mls/hr, you would set the pump at 107 mls/hr. I don't really understand why you would have to do this. Have you got an example?

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Specializes in Flu clinics, Med/Surg, Acute Care.

I'm sorry to hear about that. :crying2: Can you take non nursing classes to help with your g.p.a and grants? At my nursing school when someone failed they also had to wait a whole year to retake the class, however they had to START ALL OVER from the beginning of the nursing program and ask permission to do so(if there was space). So a lot of people had to take non nursing classes to help with their status at the university until it came around again. I hope you have that option. Don't beat yourself up! It happens to the best of us. Look at what you kept missing on the pharm tests and learn from those mistakes. Remember there are NO TRICK QUESTIONS on nursing exams, even pharm ones. The nursing schools are not out to trick you just out to make sure you are safe. They want to make sure you wouldn't be trying to give an 0.8 of a tablet. :p So keep your head up! It sounds like you are going through a lot of stress at home, which led to careless mistakes. Don't let this discourage you from being a nurse, or make you think that you don't have what it takes, or are not smart enough. Just look at it as a learning experience. Use this time to get the things at home in order, so you will be better prepared when the opportunity comes around again. I wish you the best!:nurse:

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Specializes in Flu clinics, Med/Surg, Acute Care.
thank you, rn4weeones. Let me also add that I do not take my mistake lightly, I am well aware that a miscalculation in medical dosaging can be dangerous and even deadly, but I am also very upset by the fact that it was because I didn't round up to a whole number (something that with certain drugs could also be dangerous) that ultimately hurt me.

I begged them to let me withdraw instead of failing, but was told that it was not an option. I even took my case to the head of the department, but she was adament that I recieve the failing grade. it hurt even more when she said that I was incompetant to do clinicals. I dont think she meant it in a degrading way, but boy did it hurt. no one likes to be called incompetant, especially when they tried so hard to succeed and failed anyway...

At my nursing school we were incompetent for clinical or not allowed to do them if not passing the parm cal test at the beginning of each clinical rotation. This is for safety reasons. They also wonder why you would be failing so many times after already passing pharm class. The school only cares about safety and cutting down on meds errors. Rounding rules are important in school because it is important at work too. If a patient is to receive even 0.6 of something we still round up if its in tablet form. If its an injectable or something then of course we wouldn't. The school wants to make sure you are paying attention to all aspects of the orders, routes and forms available of the drug. While its sad that you failed the course, if you are not allowed to go to clinical how can you proceed. As the other person said just look at it as a learning experience. I don't doubt your ability to give good pt care I just think you had a lot going on. Its better to learn in school how to manage stress, and being safe in practice. Then to try to do it on the job.

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Katie803--

I went back and looked at your original post this am. That question was driving me nuts last night! Because from the information that you gave in terms of them wanting you to round to the nearest 100th didn't make sense to me. So with a refreshing night's sleep(ahhhh.......)and fresh eyes I looked at it again.

Now if they wanted you to round it to the nearest 100th, then technically the correct answer would be 1.80. But I think they meant to say round to the nearest whole number.

Okay, why am I saying this? Let's break this down here: First of all the question is asking about tablets. Your never going to give 1.8 tablets. Think about it--have you ever taken or given your kids 1.8 tablets? I don't mean this in a derogatory way or to make you feel stupid--So please don't take it that way--I just mean it in taking a moment to think about it--for example,"Have I ever took that or given my kids that?" or "Do I know of anyone that has done that?" That's what I mean about it. So I apologize if it comes off that way. Sometimes it's hard for me to put into words what I want to say!

Now, getting back to the math question: So if your talking about tablets--and after your calculations you end up with an answer such as 1.8--you would round up your answer to 2. Hence, you would give 2 tablets.

Now, I'll explain why you'll do that: looking at the answer of 1.8--Look at the eight (this number is in the "tens" column). Since the 8 is more than 5 you would round up--the number you would round up would be the 1. So if we round up the 1 to 2 (remember because of the 8), you would then end up giving 2 tablets. I hope this makes sense.

I struggled with the nursing math also--so I totally understand where you are coming from and your not alone!! Some of those stupid tablet questions threw me off too!! I had a wonderful tutor who broke things down for me (I mean were talking the basic level!!), in addition to giving me tips and suggestions on how to do the math. Her helping me and her encouragement really made the difference!!

Just as she helped me and passed along her knowledge, I would love to do the same for you. Because once you master the nursing calculations (and YOU WILL), you too will be able to help someone struggling with this and pass along your knowledge and things that you have learned. That's the beauty of it!! Nursing school is all about working as a team and helping each other along the journey to becoming an RN.

If you have additional questions about what I've talked about here, or if you have any more math questions, you can PM me. I'll give you some ideas, tips, and suggestions on doing the nursing calculations.

I want you to know that YOU CAN AND WILL CONQUER this nursing math!!!

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Specializes in Oncology&Homecare.

:redpinkheKatie, to paraphrase Winston Churchill, don't ever give up! It looks so bleak right now and I know that you are depressed but " where there is a will there is a way". Take a deep breath and take a break. You have a lot going on. I couldn't even get in to a nursing program until I was 33 years old because my ACT scores weren't high enough. I also hadn't taken High School chemistry. In time I found the program that was right for me. It can be done. Sometimes we just have to wait. Please know that you have alot of support. I'm sure all of us can relate to all or some of your story. You have my best wishes and prayers.

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Specializes in Developmental and Peds with disabilities.

Gosh you guys, thanks so much for all the support! I got teary eyed reading all of the posts, and to anyone reading this post now, the more encouragement and stories you share, the more you can help not only me but others who can relate to my situation. I think you are all right, I've been in college with no breaks (no summers off or anything) for nearly three years and maybe I am a little burnt out. It's time to take a breath and a step back. My best friend and I have decided to save a little money each week and go on a nice vacation towards the beginning of next year, and hopefully afterwards I can come back refreshed, prepared, and ready to start anew. As for my issue with math, I have always been mathematically challenged, but this dimensional analysis they teach us now actually clicks with me. The only problem I have is grains. for example, one of the questions I missed was: you have on hand gr 1/150 per 2 mls. The order calls for gr 1/100. How many milliliters will you administer? That one threw me off, if anyone can set it up to show me how to do it that would be great. The question that broke me was: The order calls for .0006 grams. You have on hand gr 1/200 tablets. How many tablets will you administer? (I think that was it, I might be wrong, but that's what I remember). Any other problem I can do no sweat. Looking back on the second problem, I realize my mistake. I tried to convert grains to grams when I should have done miligrams to grams and then milligrams to grains. See? Now that I'm calm I can do it! I'm still disappointed, but as a spiritual person I have to have faith in the fact that God has a plan for me and whether or not I like it this set-back is part of his grand scheme. Maybe there would have been some terrible accident on my way to school one day where I would have died and this is His way of making sure that doesn't happen. Who knows? Keep the stories and encouragement coming please, it really helps me when I get depressed. Thanks so much!!:)

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