Nursing; a few more questions about the profession.

DoGoodThenGo · Aug 9, 2009

Hi again. This is my third post here. I'm not a nurse, but I'm considering the profession. :) I just had a few more questions. Thanks SOOO much for everyone's time and patience with me.
1. Do you have to be really good at math to be a nurse? I can do algebra and trig fine, in that I understand formulas, but I often make stupid miscalculations in either addition or multiplication, or something along those lines. This makes me worry that I may make an error in medication dosing, which can be fatal!

Medical Dosage Caculations in the nursing profession requires mainly math up to 8th or 9th grade level. Trig is not required; fractions, decimals, precentages, additon, subtraction and algebra and so forth are. Algebra in particular as one will need to know and understand order of operations, how to set up and solve word problems and how to factor an answer back into a problem to see if it is correct. You will also have to learn basic metric conversions and some odd units of measurements such as drams.

When I took MDC back in the 1980's it was a half semester course with mandatory passing required. If one failed that was it and you were out of the program. Well one could withdrawn up to a certian point and try again, but since you could not take Med/SurgII until you completed MDC, that would complicate matters. We were also not permitted to use caculators and had to use the formulas as given by our instructors. In other words even if you knew a better way to solve a problem, it was not allowed regardless should the answer prove correct.

As for making an error, fatal or otherwise, yes it is something to worry about which is why most if not all nursing programs set very high standards for passing Med Dose Calc class. It is also why many hosptials and other clinical settings will test new hires on their math. Again such exams normally require a very high score to pass, usually 95% to 100%. Depending upon the medication and route of administration, a decimal point out of place one way or the other can seriously harm if not kill a patient.

2. Should I worry about back injuries in this field? In another thread, people suggested that I look into becoming a CNA to see how nurses really go about their daily lives. I've heard that CNAs do back breaking work, though. Is this the case, or is this thought unfounded? This worry could be caused because my mother is an occupational therapist, and she hurt her back lifting a patient.

Short answer is "yes" patient care is back breaking work for anyone regardless. Americans have grown more obese over the years and many hospitals either do not have equipment for shifting patients, or do not have enough of it to go around. Even without the gradual weight increase, shifting any sort of weight often places stress on the bady. Nursing programs do teach "nursing body mechanics", but even then. Being as all this may, there are other employment choices for nurses away from the bedside which means less if no physical labour.

3. Are you happy being a nurse? If you could, would you go back and choose another career? What things cause you the most distress/irritation/stress? I'm gathering that it's having too high of a workload, workplaces favoring policies over patients, being short staffed (which I would assume leads to overloaded workloads), and cattiness and or negativity from other nurses. Am I correct? Or, does it depend on the individual?

4. Some of the people here talk about how nurses have a huge workload, and often end up doing more than their share. This worries me because I'm naturally a perfectionist and I naturally pick up the slack. I don't know if I would be able to handle having too many duties, in too short of a time frame, to do all of them thoroughly. This is one of my biggest worries. :confused:

Part of nursing has been for quite sometime been "multi-tasking", and using critical thinking to prioritize what is required of one during one's shift. As an RN you are not only doing patient care, but act as a liason between a multitude of other services and persons and your patients. Everyone and thing from doctors, family members, Medicaid, social services, insurance companies and so forth. You do what you have to do and do it to the best you can, that is all anyone can ask. Well they may and often do ask for more, but that is another matter.

It is not often wise to try and become "super-nurse" for various reasons. Part of being an effective and safe nurse is realising when you require assistance and asking for it.

Whew. I think that covers everything that I was wondering about! If any of you feel like answering, I'd be very grateful! Thanks so much! :)

talaxandra · Aug 9, 2009

1. Nurses use basic maths all the time; the frequency of using more complex calculations depends on were they work, from many times a day in ICU to virtually never in aged care. A healthy concern about the risks of miscalculating a drug or drip rate is good.

Keep in mind that nobody will be depending on you to do this for real as a student, that you will be tested and coached as a student and grad, that you should have another nurse perform the calculation separately to see if your answers agree, and to always check backward as well as forward. A really basic example of the latter:

A litre of saline is prescribed to infuse over 8 hours. To work out the hourly rate you divide 1000 by 8 to get 125ml/hr. To recheck, multiply 125 by 8. Obviously back checking a complex calc is more involve, but getting in the habit of both using mental arithmetic and back checking will help you work faster with fewer errors.

2. Adequate equipment and no lift policies are mandatory here - I have worked in acute care with stroke patients for >15 years with fewer than half a dozen significant manual handling-related injuries ward-wide in that time.

Take responsibility for and care of the only back you will ever have from day one: never take short cuts, never transfer a patient you know nothing about, never lift/manually handle alone, report any injury as soon as it happens regardless of how trivial it is, and mentally practice assisting a falling patient o the floor rather than trying to catch them. Use the equipment you have, including gravity (eg tilt the bed head down when moving a patient up the bed) and never rush - a patient may be in discomfort for 5 more minutes while you get help or equipment but if you do your back your will last far longer and the patient will have forgotten all about you.

I have had several back injuries, including a month of leave/light duties in my first year out (following a now illegal top and tail lift). After the last one, around 12 years ago, I started doing a regular stretch class, having remedial massage, and getting help with manual handling. Fortunately my back is now fine but I maintain those preventative measures.

3. Applying to be a nurse was the best decision I have ever made. It certainly is not for everyone but it has been fantastic for me. Through nursing I have made lifelong friends, earned great income, had amazing experiences, and been able to meaningfully contribute to the lives of patients, families and colleagues. I still learn new things several times a week and am comfortably challenged.

The culture on my ward is embracing and inclusive,which is a big part of why I have stayed so long. I became a union rep when I registered and have been part of the worlds first campaign to get and maintain legally mandated nurse/patient ratios, among others. Though acuity is increasing here, as everywhere, we have the staff numbers and skill mix to manage.

4. Until you are in charge of a shift or team, the only patients you are responsible for are your own. Nobody is indispensible, ad nursing is a 24 hour job - to ensure you can provide the best possible care you need to leave work at the end of the shift and relax.

While I think it is great that you are considering these aspects already, you are getting way ahead of yourself!

Heogog53 · Aug 9, 2009

I'm going to refer you to a website called WING USA which is all about all health care personnel who are injured on the job.

I was injured almost three years ago and wasn't given enough or proper treatment by my workman's comp doctor. I am now looking at starting my third medical leave in an attempt to fully rehab my back. Earlier in my working life, I was both a body builder and a power lifter to give myself the strength I needed to stay strong and to preserve my back.

There is currently a bill in the House of Representatives which is called something like the Nurses Protection and Zero Lift reform act....anyway- WING has the details and please contact your representative to get it co-sponsored. It's a way to mandate that EVERY health care facility use equipment to move patients, not health care staffs backs, shoulders, knees and the like.

Why did I become a nurse? Because I wanted to be able to get a job anywhere, anytime, even if it wasn't the job of my dreams. That answer ****** off my entire freshman class and instructors in 1979, but it was the truth. I'm a deeply committed nurse; my patients are treated as if they were my family members.

Nursing is a tough job. It calls on you to be able to multitask, to teach, to treat, to know when not to back down from someone(doctor, supervisor, etc) to advocate for your patient, to keep up your education, as new technology, drugs, treatments come out every year, and to keep your humanity in the rush that is the work day.

Every unit has staffing issues, overtime, call, or whatever. I have been an OR nurse for years, and before that a CCU nurse, so I have never been a floor nurse. Floor nurses have my utmost respect, taking care of a huge number of patients over the course of a shift. In the OR, we do it one patient at a time, with a team of us. In a small hospital that may just be the surgeon, scrub, circulator and anesthesia provider. In a teaching institution it could be three times that number. The RN circulator multitasks, manages the personnel in the OR, coordinates with the front desk to get the next patient ready, calls to make sure that the next case cart is ready and sent up, callls recovery or ICU and gives report, takes care of the charting, orders labs, blood and the like, and has the familiarity with whatever the docs might want NOW......but as I said- it's only one patient at a time. Floor nurses do that very same thing for a bunch more people a shift. My hats off to them!

Would I do it again? Hard to say. I was a graduate student in Anthropology before I went to RN school. If I'd stayed at that particular grad school for another semester, I might be either teaching forensic anthropology or doing it now. That is a regret I'll live with. Would I have considered med school? Maybe. If I had my druthers right now, I'd have an MSN and teach nursing as either a hospital nurse educator or in a nursing school. So, I'm ambivilant. I might have gone to CRNA school back when you could get a certificate in it, but I had a very nonsupportive spouse. Yet another wrong fork in the road.

Is it worth it? That depends on how much blood guts gore and patient families you can stand. Every job has political issues, staff disagreements, icky bosses, rotten hours, mandatory OT, people in your face somehow, and policiies that don't always make sense. However, in 9 out of the last 10 years, nurses have been ranked as number one in polls as most trustworthy and honorable.

You make enough money to support yourself and your family. If single, you can put money away towards your retirement ASAP in large chunks, and if you have a family, well, not so much, but you should make a decent salary anyway.

There are 2.4 million nurses in the US today. There are only around 800,000 doctors. So who do you think really takes care of the patients, day in, day out? We do. We do an important job, and some of us do it with light and grace, grit and determination that their patients will get the best care that their nurses can offer.

It's a tough, demanding, sometimes dirty job, but there are magic moments that make it worthwhile. And this is from a nurse who wanted to be able to just get a job......