Conflicting Dosage Calculation Information

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zynnnie

21 Posts

UPDATE: I saw the dean today and he was defensive. He considered throwing out the questions but he said he will not give point for that which will still make me get below 90%. But the deal is, a two days ago, in our first attempt , they threw out the same kind of unit question because it came out with decimal which made two of my classmate to pass, but now he is saying even if he throws out the question, he will not give point. What can I do from here? Write the overall Dean of nursing or just sit out for six months?

dudette10, MSN, RN

3,530 Posts

Specializes in Med/Surg, Academics.
UPDATE: I saw the dean today and he was defensive. He considered throwing out the questions but he said he will not give point for that which will still make me get below 90%. But the deal is, a two days ago, in our first attempt , they threw out the same kind of unit question because it came out with decimal which made two of my classmate to pass, but now he is saying even if he throws out the question, he will not give point. What can I do from here? Write the overall Dean of nursing or just sit out for six months?

Ok, I'm not following. Please explain this more clearly.

Mavrick asked a question earlier about whether this is the ONLY question you got wrong or was it one of other questions you got wrong, causing you to fail. You answered it was the ONLY question.

Now, you seem to be saying differently. If it was one of many questions you got wrong, causing you to fail, you are a point-chaser. I hate that.

zynnnie

21 Posts

I failed two questions and I don't think is wrong for me to chase whatever point i think I derserve. Sitting out for six months is not a better alternative for me.

I understand this. My question to you is this, at what point in their education do you believe the students should be introduced to new rules?

Not necessarily. If this instructor, in another test in this particular course had accepted either a rounded or un-rounded answer, then yes. However, even if this instructor had previously accepted the response rounded or un-rounded, the instructions for this exam [/] were crystal clear, regardless ofnwhat the dosage calculation workbook stated. From the OP.

I agree that inconsistency between instructors can be problematic. However, to say that the OP answered the question correctly, even thou he or she failed to follow the test instructions is not the answer. Rather, the faculty should develop practical rounding rules, based on actual practice, and implement them from day one. Neither answer in the OP would work in actual practice, unless administered on a syringe pump. Otherwise, the medication volume drawn up is only going to be as accurate as the syringe being used.

The answer was correct but not recorded in the prescribed format. And again, the rounding instructions were nor inconsistent. If there was any confusion at all on the OP's understanding of the instructions, he or she should have clarified the instructors expectations.

Again, no, the OP did not pass. While some might see this nitpicking be the instructor, I see this as attention to detail. As I work in PICU, inattention to detail with drug calculations can be catastrophic.

Thanks Chare, I completely agree! You stated what I was thinking in response better than I probably would have!

No, you don't seem to understand my point. New rules for the SAME SITUATION re: instructions that are inconsistent. Your question has no context, so it's impossible to answer.

See, you do not understand my point about rule-driven and the difficulty of adaptation in the face of inconsistent instructions. The book for dosage calculations said one thing; the instructor said something different. That's inconsistency!

The school I went to our book stated rules for rounding that differed from what instructors wanted. We were lucky that from day one when we learned dosage calculations, they gave us a sheet of "Rounding Rules" and stated what to do in different instances. We needed to learn them and follow those rules. There were times, however, that certain instructors would state certain instructions on our exams, and I would read and then follow those instructions. It seems funny to be a nurse and to not be able to adapt to situations. IMO if your book states something, but your instructor states something else, it shouldn't be hard to figure out which one to follow - the instructor who is going to be grading the assignment.

The calculation is correct. Do you disagree with that? Yes, the faculty should implement the rounding rules from day one--and they did through the dosage calculation book, and now the instructor says something different from those initial rules. On this point, you are making my point for me....

So, you do admit the answer was correct. Again, is the point dosage calculation or following inconsistent instructions?

Yes. The calculation was correct. That is not in disagreement. As Chare stated, however, the calculation was not written out in the prescribed format, and as such, the answer was marked incorrect. Just because you do the calculations correct doesn't mean you get the right answer. There were times I made the stupid mistake of not rounding my answer when I first started doing dosage calculation problems on exams, and every time, the answer was marked incorrect. I didn't get partial credit because my calculations were correct. I didn't write it out the appropriate way - it was wrong.

And, I would argue that the student paid close attention to detail by giving the number after the decimal. Most drug errors are not errors of 0.3 for rounding; they are usually by orders of 10.

You get calculation of 333.3, as Chare said, the volume drawn up is only going to be as accurate as the syringe being used. But we need to remember, this is not "real life" this is a nursing exam. In my experience, most of the problems for dosage calculation problems in nursing school were not based on "real world" (e.g., the dosages ordered are no where near what would be used in the "real world").

The point here is that the instructor of the class the OP was in listed instructions on the exam. The OP was responsible for reading those instructions and following them. Whether or not the OP remembered that another instructor had said something different or even that the book said something different should not be important. The instructor in the class the OP was currently taking the exam in stated the instructions clearly for the OP to read and even go back and read if there was a question about it. IF the OP was confused after reading the instructions because the OP recalled that another instructor said one thing and the book said something, the OP should have raised his/her hand and spoke to the instructor about it right then. NOT went by different than what was clearly stated in the instructions on the exam because they were told something different or read something different in the past.

Ok, let's put this in perspective. The OP of the current thread failed and will have to sit out a semester for a CORRECT calculation.

And the OP of this linked thread will also fail and have to sit out a semester.

https://allnurses.com/nursing-student-assistance/unfair-fundamentals-clinical-1156823.html

It could be argued that BOTH students are a potential danger to patients due to lack of attention to detail, but that would be patently ridiculous.

And, yes, I'm rethinking my statement in the first line of my response to the linked thread. Let's just say, it depends on how petty your instructor is.

The OP in this thread failed not for a correct calculation - that is not in debate here. The OP did the calculation correctly. What the OP did not do was follow the instructions for rounding. Now, as you said the inconsistencies in instruction - specifically among faculty members - is a BIG problem. Unfortunately, people have to deal with it. What do you do in the times when you get inconsistencies in instruction? Do you just go with whichever one you want - the instructions you were first given, instructions you read, instructions of the person currently giving them? Personally, if it was me, I would CLARIFY with the person currently giving the instructions. I would have raised my hand or went up to the instructor (depending on what the instructor prefers during a test), and said a previous instructor said to do this, the book says to do this, your instructions say to do this - so should I follow the instructions you wrote on the exam? But even saying that question sounds ridiculous. Of course the instructor wants you to follow the instructions that he/she took the time to purposely put on the exam for the students to read and follow.

Again, not having a set policy for rounding is an issue. The school should have laid out rules for rounding to be followed in all dosage calculation problems (as I stated in my other post that my school had done). But, unfortunately, the OPs school did not do that. So, the OP needs to just follow the instructions currently being given.

As you said in response to my other post, my analogy to policies and procedures in hospitals has one thing in common with the OP's scenario - changes from one environment to another - and that was the only commonality I was pointing out.

Your comparison to the OP in this thread and the OP in the linked thread are totally different! The OP in this thread wouldn't be putting patient's in danger by not rounding the 0.3. Like you said in your other post. If this were in a hospital and the OP got 333.3, it would depend on the syringe being used what volume would be drawn up, unless a syringe pump was being used. The OP in the linked thread on the other hand seemed to have absolutely no idea what he/she was doing and didn't even seem to take the time to practice, prepare, study, etc. It wasn't about not following instructions (though, the OP of that thread tried to make it as that, it wasn't. It was that the OP did not prepare properly and had no idea what he/she was doing). This OP knew what he/she was doing, the OP did the correct calculation, just didn't follow the instructions written on the exam for rounding and even the OP read the instructions on the exam for himself/herself and knew he/she was told something different by another instructor at some point and read different in the book, but didn't take the time to at least clarify with the current instructor which instruction he/she should follow (which again, sounds so ridiculous to say, since it was written on the exam so it seems that it would be obvious what the instructor wanted the students to do).

Ok, I'm not following. Please explain this more clearly.

Mavrick asked a question earlier about whether this is the ONLY question you got wrong or was it one of other questions you got wrong, causing you to fail. You answered it was the ONLY question.

Now, you seem to be saying differently. If it was one of many questions you got wrong, causing you to fail, you are a point-chaser. I hate that.

Agreed. OP was specifically asked whether it was this 1 question or other questions including this question, and responds saying it was ONLY this question, but now the update implies that it was not just this 1 question.

I failed two questions and I don't think is wrong for me to chase whatever point i think I derserve. Sitting out for six months is not a better alternative for me.

You failed 2 questions, so you failed the exam. It seems like you are trying to grasp at something to find a reason to get 1 of those points back to be able to pass. But you didn't follow the instructions - it was stated right on the exam you were taking to round, but you didn't do it. Whether or not you were told in a different class by a different instructor to do one thing or the book said to do one thing isn't important. It was written on your exam what this instructor wanted you to do, so you should have done it. Or, if you were unclear on what to do you should have asked your instructor. You didn't follow the instructions the instructor had clearly put on your exam (which you could have gone back and read at any point during the exam if you needed clarification), and if you needed clarification beyond what the instructions on the exam said you could have asked your instructor - but you didn't. Now that you have failed, you are trying to get a point in order to pass. It sucks to have to sit out for 6 months. But, you didn't follow the instructions. It also sucks that your school didn't have a set policy for rounding rules for students to follow so situations like this never come up. Since they don't, it's your responsibility to read instructions and follow instructions, and ask for clarification when needed. You didn't do that. So, you do not deserve the point.

Also - in your update (not sure if anyone else noticed this because it took me re-reading it to catch it) but, you state "in your first attempt" they threw out questions - so you took the test once and failed, and were taking it again and missed 2 questions?

bgxyrnf, MSN, RN

1,208 Posts

Specializes in Med-Tele; ED; ICU.

The only justification that I think you could legitimately make is whether there are four significant figures in the the problem statement. If so, you could argue that 333.3 is a reasonable answer. If there are not, you are objectively wrong in your answer.

I missed a question on a dosage calculation test for a similar reason (though I did like 1.7 instead of 1.67). I didn't fight it, because it was my mistake.

I wonder, if you had missed this question, but weren't at risk of sitting a semester out if you'd fight it.

Also, regarding different expectations from different instructors, it happens in my program. Different lab values for different classes is an example. You just have to stay on your toes and know your stuff.

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