Nursing school is an adventure, and there are so many things that you will learn along the way. You will use some of it often, and some not-so-often. Just like in high school, we learned many equations and information that we may NEVER use in the real world, yet we still had to learn it, and so the same goes for nursing school.
But even though there are a few things you may learn in nursing school that may not be used often, there are some things that I do feel are very necessary, and you’d be surprised that you do actually use it on the job. One is care plans. Yes, as a nurse, you will use care plans in many specialties, so it is a great idea to pay attention and do your dreaded care plans in nursing school.
But what about the dreaded dosage and calculations in nursing school? We recently received an excellent question about this very topic:
I have been an LPN for 3 years now, and I have yet to use any type of dosage calculation. Now that I am articulating into the RN program I have to take a dosage calculation test.
I asked the RN’s at the facility where I work do they use it and they told me no. I also have a friend who works at the hospital. She also states that in her 12 years of nursing. she has yet to calculate any dosages.
The IV pumps do it for you when you put in the information. If a nurse has to give an IV push, the pharmacy sends it up in the dose ordered. So what is the purpose of learning something that is not used. The pharmacy does the calculations.
Why Do Nursing Students Have to Learn Dosages and Calculations?
Thank you so much for the great question, and congrats on entering an RN program.
You know, it wasn’t so long ago that I was sitting in nursing school asking myself the exact same question. I can still feel the knots in my stomach as our class was told that unless we score a certain score on our dosages and calculations test, we would fail the class. Eek! I even remember that on the first test, I didn’t do quite as well as I’d hoped.
Thankfully, this fear and anxiety caused me to buckle down on my studies, and after a while, I got the hang of it and ended up doing very well in the class. And quite frankly, math has never been my strong area in school.
Nevertheless, I can totally relate with you regarding your feeling as if learning dosages and calculations being a waste of time. In truth, there are many things that we learn in school that are, for the most part, unnecessary or a complete waste of time.
But what I am about to say may just surprise you: Nurses do use dosages and calculations on the job. At least, I know I do.
Do Nurses Use Dosages and Calculations on the Job? Surprisingly, Yes!
I do use dosages and calculations often on the job, and many other nurses I work with do as well. In fact, I’ll give you 3 situations of when dosages and calculations skills are used on the job. As a brief side note, you’ll also have to churn this out on the NCLEX exam too, so you really do need to learn this stuff.
Situation 1: Double Checking Pharmacy: First, let me address the pharmacy part of your statement. It is true that the pharmacy will often arrange the dosages for you. But what is also true is that sometimes they get it wrong! This has happened to me a few times, and because I double-checked, I was able to correct a situation that could have been very bad.
As a nurse administering medication, you are ultimately responsible for what you give. That means if the pharmacy gave you the wrong dose, they may be liable, but because you actually gave it, you too could be held liable (perhaps even more than the pharmacy).
Nearly every medication I give, I am constantly calculating dosages and verifying orders to make sure it is correct. I often do this in my head, but sometimes I will actually use a sheet of paper to quickly calculate. So yes, the pharmacy will often do this for you (depending on where you work), but it is not 100% perfect, and as a nurse you should be double-checking each and every time.
Situation 2: IV Pumps: Now let’s talk a moment about IV Pumps. As a nurse, you don’t always depend on the pharmacy to do the pumps either, and you must make sure the pumps are accurate, because just like the pharmacy situation above, they are not always right.
Many times what will happen is that the pumps are pre-programmed, but you will receive a different concentration. This is a common problem right now because of the drug shortage, and medicines are being received in different concentrations than in the past. In this case, you will have to manually override the pumps.
You must know how to do it and double check. Again, this is something I’ve personally had to learn to do on the job, and it is something nurses should take seriously.
Like the pharmacy issues that can arise, sometimes mistakes and miscalculations happen, and again, as a nurse you are ultimately responsible.
Situation 3: In Emergency Situations (or Some Specialties), You Need to Know On the Spot: In emergency situations, you will often need to bypass pharmacy completely. I currently work in a stress lab, and I sometimes have to get medication without any pharmacy check. I just pull it and give it (standard procedure on my floor), and there is no time for pharmacy check off. Therefore, it is critical that I know the proper dosages to administer.
In addition, doctors will often give orders immediately (especially in frantic situations), and as a nurse looking at a vial with meds, you need to know how much of that medication to give them. Are you going to give them half of the vial? Or 3/4 of the vial? Again, this is a scenario I deal with daily and I will often get out a sheet of paper and quickly calculate, or just use my head if I am familiar with that particular dosage/medication.
The Good News About Dosages and Calculations in Nursing School
Judging by your question, I get the sense that you are probably one of many nursing students who aren’t too crazy about dosages and calculations. In fact, you may even hate it. So let me try to encourage you to embrace it, and to put a positive spin on it. Here are 3 reasons why you shouldn’t stress too much about dosages and calculations:
1. You’ll Get the Hang of It. I know it is hard to imagine right now, but looking back in a few years, you’ll probably know this like the back of your hand. While dosages and calculations is very hard to grasp at first, once you learn it, it is really easy. In reality, it is not really hard math. Most of it is addition, subtraction, multiplication, division. The hard part is knowing how to arrange it so that you can work it out. Once you get the hang of it (and trust me, you will), you will be just fine. You won’t even need to practice it once you do it long enough, and it will become completely routine—perhaps as routine as driving a car. You’ll just know how to do it.
Trust me. You’ll get it. Hang in there.
2. Some Areas of Nursing May Not Rely On It As Heavily. You mentioned that you asked some nurses and they said they never did it. Well, it may be true that some areas of nursing won’t use it as often as others. But it is indeed used by me in a stress lab quite often, and many people I work with use it often as well. And it isn’t always just “double-checking” either. Sometimes I literally have to use this to find out how much medicine to administer. I could also see it being used in such areas as the intensive care unit, or in pediatrics and other similar areas quite often as well.
And I’d go as far as to say that anytime a nurse has to administer any meds, they’d do well to double-check and know this skill, because they are ultimately responsible. We are all humans. I make mistakes, doctors make mistakes, pharmacy people make mistakes, etc. Double-checking can save lives and lawsuits.
3. Your Specialty Will Make It Easier. When you work in a certain area, you’ll quickly find that in most cases, you’ll use the same medications over and over. Because of this, you’ll learn the common dosages you’ll encounter, and also the quirks of the medications you administer. This will make everything SO MUCH easier on you as a nurse. It isn’t like you have to be an expert on every medication out there, and a math whiz. You’ll be able to “specialize” in your area, and you will do the same thing day after day. You’ll get to know the medications and dosages you work with on a daily bases VERY WELL, and it will become very simple over time.
Don’t get the idea that I’m some kind of math whiz, because I’m not. In fact, my husband manages all of the finances in our house, and he always laughs at me when I attempt to dabble in them. He won’t even let me touch them, and with good reason =).
I am far from any kind of mathematical genius. If someone like me can learn dosages and calculations, and actually do it on the job (many times in my head), then you can definitely learn it over time. It is hard at first, but you’ll get the hang of it.
What to Do If Your Struggling Learning Dosages and Calculations?
If you absolutely hate this stuff, and you find that you’re struggling, here are a few tips that helped me:
- Get a study guide with practice problems. Seriously, I always recommend study guides because I used them extensively in nursing school. I practiced HESI and NCLEX questions over and over, and got study guides for any class I found difficult. Many times you can find them for low prices on sites like Amazon too. I highly recommend you get a good study guide on the topic, and practice at least 1-2 hours each day. After a few days, you’ll be surprised that you get better and better. Also, I wrote an article a while back about dosages and calculations problems. You may want to check that out.
- Form a Study Group. Get together with a few nursing students and practice and teach each other in a study group. This is a great way to learn, because your friends may be able to give examples and illustrations that make sense to you, and help you learn it faster.
- Talk to Your Professor. If you are still struggling, you may want to schedule a time to talk it over with your professor. They may be able to point you in the right direction, offer some good resources, or show you where you keep making mistakes in your calculations.
In conclusion, I can totally sympathize with you on this subject. It is difficult for many nursing students at first, and nursing students often hate this class. However, as much as I hate to admit it, I do use this on the job. It really is pretty important that you learn it. Not only is it useful in double-checking pharmacy and IV pumps, but it is also necessary when you have to pull meds on the spot, or in emergency situations. And like I said above, you’ll need it to pass NCLEX too.
I hope this article has helped give you some direction, and I wish you the very best of luck in your nursing career!