The New Math

Whether I like it or not math is an integral part of nursing. I have a love/hate relationship with math - I hate it and love the fact that I've survived math classes in spite of myself. It was bad enough in High School, when my Algebra teacher only passed me after I promised I'd never take another math class in my life. Then in college (the first time around) I had the brilliant idea to take Logic as my math requirement instead of the dreaded Algebra. I spent the entire semester learning that, if your facts are lined up properly, I could be proven to be a male Australian goat herder with a speech impediment. It had almost as much relevance to my life as Algebra, but was twice as infuriating.


Then, a few short years back, came Nursing School. In our Orientation meeting one of the first things we were warned about was the Math Tests. There would be one in the first year and one in the second. Passing grade was 95%. Anything less was a fail. We would have three attempts to pass each test and if we didn't we were out of the program. Not the class - the program. They were nursing math questions, like this:


You have an order to give 5 mcg per kg of a med to a pt who weighs 184 lbs. Your med is one gram that is to be reconstituted with 10 mls of sterile saline. How many mls of the med would you give?


Do you have any idea how many hours of sleep I lost over these tests? And somehow (this is another post for another time) I passed them. I passed the first one on the first try and the second one on the second try. Good thing there wasn't a third or I'd have stroked out on the spot.


But like Algebra, this type of math is self-limiting. To start with most meds are pretty straight forward. So is the whole kg/lb conversion. Most of the meds we use in codes have very clear cut dosages that don't change. And as the final safety net all of us have someone else recheck anything that makes us nervous. So even though I dreaded the math it hasn't been all that bad. It just hasn't been that relevant.


There's a new Nursing Math that is a lot more applicable these days. It worries me, because if I were ever tested on this I'm not sure how I'd do. Here's an example:


1. You are assisting a primary nurse with charcoal administration down an orogastric tube. You are wearing a brand new pair of scrubs in a really cool color. The room measures ten feet by twelve feet. The patient starts to gag before the tube is pulled. Knowing that charcoal can spew out of a tube in a six foot radius (even with a thumb over the opening) and the stretcher is two feet wide, how many feet per second do you have to back up to get less charcoal on you than the primary nurse?



2. You are the primary nurse taking care of a very shy female teenager in the gynecology room. Her private physician arrives to see her, but you can see that he is in a really crappy mood. After much coaxing, the patient finally agrees to a pelvic exam. How many people will open the door during the exam?


3. One of your patients is an elderly, confused male with an enlarged prostate. He has a catheter and will be admitted to the floor as soon as his labs come back. Somehow he manages to get off the stretcher. The drainage bag is firmly hooked to the side rail. Knowing that the catheter is 12 inches long and the drainage tubing is three feet long, will he be able to reach the door before pulling out the catheter?


Now that's the kind of math I could use.