Thank You to the people that answered my post

Daytonite, BSN, RN · Aug 18, 2007

you are very welcome. many of these problems, believe it or not, come from actual situations. in practice, when you've got the actual drug sitting before you, the calculations and how you do them sometimes make more sense because you can see the number of tablets or the total volume you have to work with. i know you are trying to learn to do da, but other methods can work as well. as many years as i worked, the old dose desired divided by dose on hand times the amount that it is in formula is mostly what i used to rapidly figured out doses. the only time it gets really complicated is when you are working with the kind of drips they titrate to mcg/kg/min in the critical care areas or you have to start applying more than one conversion factor. since most ivs are placed on pumps these days, mls/hour is what you often need to figure out. even then, the pharmacy also calculates that for you if the doctor hasn't already ordered it that way. what your instructors are not likely to tell you (because they want you to learn how to do these calculations) is that the healthcare industry is really pushing to eliminate medications being ordered in one measurement while the drug is supplied in another measurement (grains vs. milligrams). it is because of errors that are made. a recent drug question about nitroglycerin was about giving 1/150th grain, but the pharmacy sent a 0.4mg tablet. in actuality, the bottles that the nitroglycerin come in have both measurements on the label, so no actual calculation would have had to be done. there are actually agencies that were given the kiss of approval by medicare to push to change these industry standards. one of them is the ismp (institute for safe medication practices). you can read about and link into some of these organization from the med savvy forum of allnurses (https://allnurses.com/forums/f279/).

i'm not giving anyone a reason to fight with their instructors against having to learn how to do these calculations, but i do think you should know that in actual practice giving medications it's not going to be a constant nightmare of having to calculate dosages. learning to do calculations is a good way to learn logical thinking. logical thinking becomes an issue when you start to learn about the nursing process and put all the information you have learned (anatomy, physiology, pathophysiology, medical disease, treatment of medical disease, nursing theory, nursing treatments) together to come up with a logical and rationally developed plan of care for a patient. they call it critical thinking. in actuality, it's more like following a set of rules to apply all the information you bring into a problem. the thing is that applying all the information is not as easy as it sounds, particularly when no one is going to tell you what all the information is. it is up to you to take the initiative to determine what it is. that is the thinking part of this profession. the more thorough you are, the better your plan of care is; the less skilled you are at doing that, well, your plans of care aren't as good.

so, hang in there and keep on working at these. you will also have to pass drug calculation tests for employers before they even let you start working on patients when you get hired on as a new grad or a new licensed nursing employee.