Math requirement for RNs?

[llg]

I have a question for both practicing RNs and students alike:

It's come to my attention recently that some nursing schools are on longer verifying that their students can do basic 4th grade math. By that I mean add, subtract, multiply, and divide without using a calculator. They assume that calculators will always be available and that therefore, nurses don't need to know how to do basic calculations anymore and don't have anything in their curriculum that requires students to do those things. In fact, they are aware that some of their students definitely can NOT do those basic calculations when they involve fractions and/or decimals. Also, the TEAS test now allows applicants to use calculators: so they are not testing those skills, either.

To me, that seems like a safety issue. There might come a time when a calculator is not available.

1. What do you all think?

2. Students ... are you competent adding, subtracting, multiplying, and dividing fractions and decimals?

3. Practicing nurses ... are there any times you need to use basic calculation in your work (without a calculator)? Can you give me some examples?

4. Is anybody verifying those skills in orientation anymore? (med tests without calculators, etc.)

Thanks,

llg

[Julius Seizure]

The whole point of the thread is that it is now possible to graduate from high school and graduate from college without being able to do the basic math because students are being allowed to use calculators for every homework assignment and test. The TEAS test, NCLEX, etc. all allow the use of calculators now -- and many schools allow calculators all the time, too. So a student can have a 4.0 average in college and still not know how to divide 425.5 by 18.2. Or multiply 1/3 by 1/5.

I disagree that "basic math skills" revolves around the ability to divide 425.5 by 18.2 or multiple 1/2 by 1/5 without a calculator. That is not the world that we live in today. Basic math skills means knowing how to use your calculator to do those math problems and understanding the concepts behind them. The dreaded "common core math" is about just that: understanding HOW numbers work is more important than being able to do long division by hand or knowing all your multiplication tables by rote.

[pixierose, BSN, RN]

I disagree that "basic math skills" revolves around the ability to divide 425.5 by 18.2 or multiple 1/2 by 1/5 without a calculator. That is not the world that we live in today. Basic math skills means knowing how to use your calculator to do those math problems and understanding the concepts behind them. The dreaded "common core math" is about just that: understanding HOW numbers work is more important than being able to do long division by hand or knowing all your multiplication tables by rote.

Being a former teacher, I have to agree with this. While I agree, to an extent, that nurses should have the ability to do basic math ... well, these basic math skills begin being taught around 2nd, 3rd grade. And calculators are indeed introduced in grades as early as 3rd grade. Even with our state standardized testing ... for many of the questions there is that little calculator icon on top.

These are the students entering colleges, traditional nursing schools (for the most part).

This is the reality of education today.

I think we we need to adjust our thinking: understand how those numbers work. Why does that med calc look off? Why does it look right? Yes, my school made us learn the equations. We had to show the work. But I used the calculator (several times to double check my work). If I didn't know how to develop the equation, I wouldn't have my answer.

But I think some of the worse things I have seen? Mistakes by docs, the MAR, pharmacy, with outrageous dosages. And nary a critical thought to be seen by the nurse giving the med.

[ItsThatJenGirl, CNA]

Kind'a in the middle. Many schools are letting their students use calculators 100% of the time: that's a fact. So while it might not be possible at your school, it is very possible at other schools. As long as the student can type the numbers into the calculator correctly, they don't have to know what to do with the decimals in a multiplication or division problem.

The TEAS test has recently changed their policy and now let students use calculators -- and for a least 1 school, their TEAS pass rates increased dramatically. The school's investigation into the sudden jump in TEAS schools showed that the students were now able to succeed in the math portion of the test (using calculators) where before, they had much lower scores on that section without the calculators. I talked with some students in that school and they admitted they did not know how to handle decimals with multiplying and dividing and that they never could have passed the TEAS without a calculator.

The school said it allows students to use calculators all the time so that it doesn't matter whether the students can do the calculations by hand or not.

That led me to ask here whether other schools are doing the same thing ... allowing their students to pass through their programs without ever having to show competency in basic arithmetic. Based on the responses in this thread, it looks like that is the case. Students have to know how to set up the equations, but don't have to actually multiply or divide the numbers themselves.

Also, I have been teaching hospital orientees for many years -- and I see many orientees who can't do calculations with fractions or decimals unless they have a calculator.

Yikes! It's a totally foreign idea to me. We use mental math all the time - even today in my Micro class when we were doing bacterial counts with dilution factors. No calculators allowed. I guess I'm lucky.

[SummitRN, BSN, RN]

Quick handrwitten notes to colleagues are usually done in print, not script.

My handwriting is nearly illegible even when using print. I doubt I could easily write script (despite all the recesses I missed to work on my handwriting, which did no good).

Should I be allowed to be a RN?

Or does my ability to do algebra, geometry, calculus, and physics in my head make up for that?

[DoGoodThenGo]

This lowering or removal of math standards for student nurses must be coming from private/for profit schools of nursing.

College/university nursing programs still must adhere to state mandates regarding math requirements for students seeing to be awarded an associate of bachelor degree.

Schools do test pre-nursing students and many do not allow calculators.

https://www.keene.edu/academics/programs/math/mathctr/assets/documents/the-basic-math-exam-for-nursing-sample/download/

Where calculators are allow such as the TEAS ATI (but not TEAS V), but a basic four function version only is allowed.

Use of calculators for TEAS, SAT or whatever standardized test and or in college level courses likely reflects a simple truth; for a decade or more even primary school students have been allowed to use the things.

Those of us who are "boomers" likely recall the drill; math was taught one way, and that was the way your teacher assigned. You memorized times tables/multiplication wheel, struggled through long division, fractions and decimals, the lot. For those to who maths came easily all was good. However the often "show all work and use assigned formulas only" left no small number of students failing or doing badly. They could get the right answer if left to their own devices but "Sister Benedict" wasn't having any of that.

Gradually the focus of primary, secondary and even in some cases post secondary math is not the how you get there, but that the answer is correct. If you need a calculator to do so, then so be it.

Same as with nursing math/med dose calculations. If you went to school say prior to the 1980's or 1990's (give or take) it is most likely you learned "ratio and proportion", show all work, and use only standard assigned formulas. For some students (see above comment) this wasn't a problem, but for those that didn't "get math" or just needed to do things their own way (but still get the correct answer), many instructors were having none of that either. Dimensional analysis has proved a God send for many nursing students.

Even back in the days of IVs with roller clamps Lippincott and other nursing manuals had charts one could Xerox or consult to get drip rates. Thus the concept of "cheat sheets" isn't exactly new.

However one universal truth about math remains; the more one works with numbers and understands things it is easier to comprehend the various relationships between not only numbers but what you are doing. Understanding the relationship between numbers allows a professional nurse to at once (hopefully) catch some off the wall number that pops up after she or he presses that "equal" button.

In any event, hospitals and other healthcare facilities have long ceased relying upon whatever educational credentials a new or even experienced nurse brings. Nearly everyone takes a maths exam now, and some places may or may not allow calculators for all or part of the test.

Computers/calculators are only good as the information being fed into them; if you put in garbage, that is what you'll get out.

[llg, PhD, RN]

I disagree that "basic math skills" revolves around the ability to divide 425.5 by 18.2 or multiple 1/2 by 1/5 without a calculator. That is not the world that we live in today. Basic math skills means knowing how to use your calculator to do those math problems and understanding the concepts behind them. The dreaded "common core math" is about just that: understanding HOW numbers work is more important than being able to do long division by hand or knowing all your multiplication tables by rote.

I agree that such content is essential ... but that doesn't mean that basic calculation skills (at the level traditionally taught in 3rd through 5th grade) aren't important also. More than 1 thing can be important at the same time. While calculators are available most of the time, there may be occasions (e.g. natural disaster, military, transport, etc.) when a calculator is not available.

[llg, PhD, RN]

Quick handrwitten notes to colleagues are usually done in print, not script.

The operative word there is "usually." That's not the same as "always." What happens when an important message is written in cursive?

If your handwriting is illegible, then by all means -- print. But I contend that you should still be able to read cursive that is written with reasonable legibility.

[Aheffro1]

I just finished up all prerequisite classes and applied to a community college ADN program. In order to apply I had to take pre algebra, algebra and statistics, plus take the teas (scored 93% in math section). There is no way an applicant could get in not knowing how to add/subtract and everything else.

[llg, PhD, RN]

This lowering or removal of math standards for student nurses must be coming from private/for profit schools of nursing.

Thank you for the throughtful post. I appreciate the effort that you invested in the topic.

For the record, this was not a for-profit school. It is a state run, Community College ADN program. Though, from the other responses in this thread, the practice of NEVER requiring students to do the calculations themselves is pretty common within a lot of schools.

As a hospital, we have allowed calculators on our med test "forever" for all the reasons people have stated in this thread. But based on what we are now seeing and hearing about this issue, we are now considering adding a short calculation test (without calculators) to our orientee med test. It concerns us to think that our staff couldn't do it by hand if they had to in an emergency. We also may write some of the directions in cursive to make sure everyone can read it.

We're just not sure what to do with people who fail at either skill.

[SummitRN, BSN, RN]

The operative word there is "usually." That's not the same as "always." What happens when an important message is written in cursive?

If your handwriting is illegible, then by all means -- print. But I contend that you should still be able to read cursive that is written with reasonable legibility.

You want to write in cursive?

If some millenial can't read cursive, they'll ask an old nurse.

If not everyone can read the way you write, then don't write that way! PRINT!

Or my case, TYPE and click print.

Do you think NCLEX should be in a cursive font so that old school folks can keep handwriting cursive notes?

I just saw a doc 2 finger typing into the EHR. Kids today need typing classes for the future, not cursive classes for backwards compatibility with the old school.

[Julius Seizure]

If you went to school say prior to the 1980's or 1990's (give or take) it is most likely you learned "ratio and proportion"..... For some students this wasn't a problem...., but for those that just needed to do things their own way (but still get the correct answer), many instructors were having none of that either. Dimensional analysis has proved a God send for many nursing students.

I'm a dimensional analysis girl! Makes so much more sense to my brain!

[llg, PhD, RN]

You want to write in cursive?

If some millenial can't read cursive, they'll ask an old nurse.

If not everyone can read the way you write, then don't write that way! PRINT!

Or my case, TYPE and click print.

Do you think NCLEX should be in a cursive font so that old school folks can keep handwriting cursive notes?

I just saw a doc 2 finger typing into the EHR. Kids today need typing classes for the future, not cursive classes for backwards compatibility with the old school.

It's not about me wanting to write in cursive. It's about me wanting the staff to be able to read cursive in case a patient needs them to be able to read it ... (e.g. reading medical records from past visits ... reading notes from patients who can't talk ... reading notes/letters from patients' families ... etc.)