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Posts Tagged ‘Drug calculations’

Euphoric

I am on a high because I passed the drugs calculations. I have been so worried about this and had managed to convince myself that I was going to muck it up so now I’m really relieved that I beat my demon. I was just speaking to son and told him the good news, he rather poured cold water over my joy by putting it into perspective, ” well really Mum I would hope that you would be 100% correct when calculating drug dosage”. I know, I know, he is absolutely right.

They decided to spring another surprise on us, a practical and theoretical test on newborn resuscitation. We usually just have an update once a year, now though many of our mandatory days also incorporate ‘tests’ to prove that learning has taken place, apparently it’s a CNST requirement. Every time we have an update something has changed slightly, today’s new facet was placing a premature baby into a plastic bag as it enters the world. These are not specialist plastic bags, oh no, any old bag as long as it is suitable for use in a microwave, not that we have the intention of putting babies into microwaves, it’s just the bag has to be heat-proof. I am pleased to relate that I also made the grade on resus skills, good job really as I’m a community midwife attending homebirths.

Long day, but ultimately reassuring and productive. The relative isolation is one of the downsides of working constantly in the community, it’s easy to get into a rut so these mandatory days are good as they pull you up, make you re-assess and update your practice and provide an opportunity to interact with your hospital based colleagues.

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My brain hurts

Tuesday is the day I might stop being a midwife. I haven’t won the lottery, a national newspaper hasn’t offered me a post as a journalist, no, nothing so positive is going to happen on T-Day, what will possibly (probably) happen is that I will fail my drugs calculation test.

I have been desperately practising my calculations courtesy of this Lanarkshire NHS web-site, I have an 80% success rate, unfortunately our pass rate is 100%, whoops. It’s the 80kg men requiring mcgms that I can’t get my head around, I seem to underdose them, it’s the mg/kg/hr that gets me every time, too many variables.

I know we have to be 100% correct with drug calculations. I am also aware when I am unsure and, we always have to check IV, IM and controlled drugs with a colleague. I know, I’m just trying to defend my shortcomings and excuse my inability to make sense of number sequences but, give me a prescription chart and the medication with it’s advice sheet and I can work out what the patient requires. There is obviously some vital component missing in my brain which should facilitate successful ‘mock’ calculations.

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Brain frying

Is it only me or has everyone’s dashboard undergone a radical modification? I thought I was lost there for a minute.

Drug calculations, it’s not true, we don’t get the push if we fail, first time, just if we fail twice. That’s a relief! It’s all a question of remembering formulae apparently, what you want, what you’ve got times the volume, drip rates, number of drops to a ml and nano’s, I have never experienced nanos before. Then there is converting decimals to fractions to percentages, holy moly, me a dyspraxic and all (thank you cartside). Here’s a sample ” Adrenaline 1:10,000 is available on the resuscitaire. A baby needing resuscitating weighs approximately 3kg.The doctor has asked you to draw up 10mcgms/kg for him to administer. What volume of the drug would you prepare?” Answers below please.

Tomorrow Amy, Jamie and Louis are being baptised, I’m really not too sure how Amy will respond to having cold water poured over her head. As her favourite expletive is “For goodness sake”, said whilst standing with her hands on her hips, it could be quite comical. I am in the middle of decorating the cake at the moment, when finished I shall take a photo so then everyone can have a chuckle, I’m just taking a break as I am not a domestic goddess and I’m struggling not to lose my temper. Hubby is keeping out of my way, he still has vivid memories of an episode involving a fairy castle cake. I had spent hours making this cake, compete with turrets, and was not happy with my efforts. Poor man made the mistake of coming in from work and reassuring me by saying ‘ It’s not that bad’. I flipped. The cake was balanced on a kitchen stool, I raised a leg, caught the base of the cake board and my glorious creation flew upwards and then landed with a splat on the floor. I rushed past his gob-smacked figure, grabbing my car keys on the way, leapt into my little mini and drove off into the rush hour traffic. When I returned an hour later he had stuck it all back together, securing the turrets with cocktail sticks, I laughed…….until I cried. There will be no repeats of that behaviour, I don’t have a mini anymore!

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Adding up

This afternoon I have a study session, drug calculations. Lucky old me. It’s quite scary really as I have been told, chinese whispers, that if we fail it is instant dismissal and since I’m certain that I have a type of dyslexia involving numbers then I’m not too sure of my success. Before anyone starts getting worried about my safety in calculating dosages and rates etc., as I’m so ill at ease with my arithmetic abilities I have my own system which involves triple paper calculations, then I use a calculator, then I check with a colleague and then I’m happy. I’m not sure if the examiner will be too impressed with the numerous bits of paper required to reach an answer. My problem is not that the numbers are unclear or transposed it’s just that when I look at them they are just numbers so each one has to be considered individually. Perhaps it’s the same for most people, I just expect it to be like reading where a sentence is there and instantly understood.

It’s my birthday today all I asked for was balloons and flowers, and I got them both!

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