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

[AdobeRN]

Funny how we all learn so differently....in LVN school we were taught dimensional analysis, so confusing to me. During my first clinical rotation an older, experienced nurse showed me ratio-proportion and all of a sudden med calculations were so easy for me.

[SummitRN, BSN, RN]

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.)

Funny... I've never had a ventilated or nonverbal patient ever write script... only print. (And one could ask the patient to print)

Also, one need not be able to write cursive to read it, and it isn't that hard to learn... (it is much harder to learn to read doctor scribble whether script or print, and that skill is not taught in nsg school)

Bottom line:

If a millennial can't read cursive, someone can help them.

If I have a patient who writes in French, I'll have someone else translate.

You just don't have me convinced that cursive in necessary to be a RN, or an adequately educated citizen. The utility of script decreased in direct proportion with the ubiquity of the keyboard. There is only so much time in education and cursive now ranks in importance somewhere between basket weaving and the use of slide rules.

Hey we should make nsg students learn to use slide rules in case they can't find a calculator! (I have two of them... I can teach someone in exchange for basket weaving lessons)

[debirn918]

I find this discussion to be very interesting. Nurses need to know basic computation in order to provide safe care to patients. I tell my students "I don't care how you get the answer, but I want it to be the correct answer". I have asked them to show their work, not to penalize, but to see where they may have gone wrong in setting up the problem. As someone earlier said: "does it make sense"? I frequently find the errors being made when they add instead of subtract, or multiply instead of divide. If the answer tells you to give more than 3 pills, you may want to reset the problem. What can the repercussions be related to incorrect calculations? We read the stories and see results on the news. Loss of limb, cognitive ability, or even a patient's life. What about the nurse who makes the error? Loss of job, license, criminal charges and in some cases mental health or even suicide can be the result. Isn't it worth it to know how to calculate? Let's not allow common knowledge and skills be forgotten.

[nfahren05]

I can't remember any time when I had to do drug calculations without a calculator so arithmetic ability is less critical than the ability to do the dimensional analysis needed to set up the mg/kg equation to figure out the missing variable. Nowadays the pharmacy does virtually all the drug math, but every nurse should be able to set up the equations. I have only worked for one hospital, however, that actually tested new nurses during orientation.

[Gotti_girl]

you should know how to do it in your head, however, your math can be wrong so 100% calc is the best way to prevent errors!

[smartassmommy]

I agree even though I am terrible at basic math! I Googled my "problem" once to see if anybody has discovered that people have a learning disability with math, similar to dyslexia. No one has, gosh darn it!

Yet I got A's in chemistry, balanced equations like a pro! I can easily calculate doctor ordered 250 mg, it comes in 725 mg per ml, or doctor ordered 25 mcg, it comes 50 mcg per ml in a 2 ml vial.

But if you gave me a basic math test dividing and multiplying decimals and fractions......I think I'd eventually figure it out but it would be painful for me to do and I'm sure painful for you to watch.

Look up dyscalculia.

[tyvin, BSN, RN]

In my BSN program probability and statistics was required. Algebra I within 5 years was required to get into the university my nursing program was in. That really helped with the prob and stats class...crazy professor wouldn't let us use calculators...all longhand calculations. Considering some of the recent nurses I've come across; I'm not surprised.

[twinmommy+2, ADN, BSN, MSN]

Brownbook, you are so not alone in feeling that you have dyslexia in math. I have always felt this way. In a lot of ways math just doesn't make sense to me. Not in a way that impairs my nursing, but makes it difficult especially with four teenagers in my house. Give me anatomy, chemistry, pharmacology any day over math.

[AnxietyMaven, BSN, RN]

My BSN program requires a dosage calculation test at the beginning and end of every semester. You get three chances to pass with 90 or above (basically missing 2 questions). If you don't pass you can't do clinical (beginning of semester) or pass to next semester(end of semester). In the final semester if you don't pass, you won't graduate. No calculators are allowed. If you don't pass a second dosage cal you are removed from the program. I don't know if that answers the OP question or not.

[knurse10]

Shouldn't we all have basic math literacy?

I think it depends on how you define math literacy. Setting up an equation for dosage calculations correctly shows that you are math literate. The people who can't make it this far have no place in nursing, calculator or not.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

To add to the coming troubles I see ...

Some school systems are no longer teaching/requiring cursive writing (hand writing, script, etc.). Students are graduating high school without being able to write in cursive and only a minimal ability to read it. Everything in their schools are printed in block letters. I've read that history professors and other social sciences are concerned because their students can't read documents that aren't in block print -- diaries, hand-written letters, etc.

The school district that my niece and nephew attend is such a school. As teenagers, we discovered they couldn't sign their names in cursive -- only in block print. We have since insisted they learn to read and write cursive on their own so that they will have the ability as adults.

I just started my new job. I signed all of my documents and to my surprise, I was instructed to go back and PRINT my name above my signature. Mind you, these documents called for my signature. I guess computers can read signatures....and everything now has to be scanned and accepted into THE SYSTEM...aka the computer. Remember The Jetsons? It's happening...

[Kitiger, RN]

No calculator? Natural disasters come to mind.

How about a power outage in the home (private duty nursing) and your phone is dead.

Hey, I always carry a flashlight and extra batteries along with a battery operated pulse oximeter because - in some areas - power outages are not uncommon. I've walked into a home for a night shift where the only light in the house was a dim flashlight. (My own flashlight will last the night!) Of course, vent patients and others who are life-dependent on electricity would have to be moved to a power source.

Many of our clients are on the same meds for years, but sometimes the pills from the pharmacy don't match the dose required. And sometimes the pharmacy sends the wrong dose, period, but you can give the correct amount if you know how. Not infrequently, the doctor will call in a dose change, and you will have to calculate the correct milliliter amount to give.

It's fine to use a calculator, but you must also know how to do it without a calculator.