Thursday, December 13, 2007

Multiply Life By the Power of Two

"The protocol for a continuous heparin drip is 25,000 units per 250 mL of D5W. A loading dose of 70 units per kilogram is ordered. What you have available is 10,000 units per mL. The patient weighs 154 pounds. The patient's aPTT is 90 and protocol is to reduce the dose by 100 units per hour. What is the drip rate of the new heparin dose?"

The above problem is an example of a question on our math final - the final that we have to pass with a 70 or better or get kicked out of the program. You cannot advance to next semester regardless of the rest of your grades. Even if you have an A in fundamentals, you are out of the program.

In a way I understand - pharmacology math is a big deal. But come on! Talk about pressure.

I have spent the past month practicing drug calculations for at least an hour a day. I wanted to make sure that I pass this thing no matter what. So I haven't exactly felt like blogging. I have been entirely focused on getting the hang of this.

And good news! I did! I'm still a nursing student - for now.

A few years ago I attended a Different Community College and didn't pass the pharmacology math exam. Coincidentally I got the same score on that test that I did on this test, but because the schools have different criteria, this time I got by. But I'm not bitter. Life is like that. I've learned to adapt to whatever is required of me wherever I am. I'm over trying to argue what works someplace else.

People ask why drug calculations are so difficult. I wish I could answer that. After all, the math itself isn't difficult. We do basic math functions - add, subtract, multiply and divide. But look at the problem above and you tell me why it's so hard. The first thing that comes to my mind is that you have to know what information in the problem is essential to the calculation and what information is just there to distract you.

The second problem is knowing what numbers calculate and where. Which number goes on top of the equation? Which goes on the bottom? What gets multiplied first and with what? What gets divided from what and when?

I don't feel bad because I showed this problem to my sweetie, who has a two degrees and thinks math is fun, and she couldn't figure it out at first. I had to explain which numbers go with what and only then could she do it. My classmates and I had gone to the tutoring center at the college to get help with this, and the tutors were scratching their heads too. Finally the nursing program chose one tutor and she is now the dedicated pharmacology math tutor. They sat her down and explained pharmacology equations to her so now she can explain it to us. She, too, was clueless at first. As absurd as this situation sounds, I'm just grateful that they have made this resource available to us.

Now the semester is over. I passed fundamentals. I passed math. Now if you'll excuse me I have some important sit-on-my-butt time I need to catch up on.

Oh, in case you're wondering, the answer is 10 mL/hour. If you're dying to know how I got that answer, you'll have to wait until tomorrow when my headache is gone and I can explain the problem adequately.