Photo courtesy of Daniel Dionne

When I was really young, I wanted to be a nurse. Those who know me now are probably laughing. It’s not that I’m squeamish about blood, but I absolutely cannot handle any other, um, bodily fluids. Ick. Thank goodness for people like Beth Hanes, who have made a career of caring for others who are sick or undergoing surgery.

[Editors note: Since this interview appeared a year ago, Beth has decided to freelance write full time. Now that I can identify with!]

Beth Hanes is a registered nurse in a plastic surgery center.  She takes care of patients before, during and after their surgeries.  And, of course, she uses math everyday.

What kind of math do you use in your job?

I use basic math for a lot of things, but probably the most important calculations are the ones related to medication use. Sometimes I dilute medication before giving it. For example, Promethazine needs to be diluted before it’s given in an IV. Using a 10mL syringe, I draw up 1mL of Promethazine and then add 9mL of normal saline (0.9% sodium chloride) to create a 10% Promethazine solution.

I also use basic math to determine, based on body weight, how much medication to administer. Medications are generally given on a milligram per kilogram basis. So, I convert a person’s weight in pounds to weight in kilograms (divide pounds by 2.2 to obtain kilograms), then I multiply this number of kilograms by the number of milligrams per kilogram to get the correct dosage. For example, Lidocaine might be ordered as 1mg/kg. A 220-pound patient weighs 100kg, so the correct dosage is be 100mg of Lidocaine.

How do you do your calculations?

I do use calculators because they’re typically faster, but I think it’s important to know how to do math by hand. I usually don’t have a calculator on hand in the operating room! Also, it’s critically important for me to have basic formulas memorized (such as how to convert pounds to kilograms). Without that knowledge, having a calculator or not is irrelevant.

Why is math important for your job?

Math skills help me ensure patient safety. There was a highly publicized case a few years ago in which actorDennis Quaid’s infant twins were administered a very high dose of Heparin. This error occurred for many reasons, but one key factor was doing the math involved. This is a classic case of calculating dosage based on weight, and obviously errors were made in that calculation. In nursing, if you misplace a decimal point, you can kill someone.

When it comes to math in nursing, I think the main thing is to be very careful about calculations, double-check them, and then have someone else double-check them. No matter how good you may be at math, anyone can misplace a decimal point when calculating on-the-fly. It’s much better to take the extra seconds to have someone review your calculations and keep patients safe than to have any sense of ego about your math ability and endanger a patient.

What kind of math did you take in high school?

I had a rather sketchy math education, because my parents moved around a lot, and I only made it through Algebra II. On the other hand, advanced math was not yet common at the high school level when I was that age. Calculus, for example, was a college course. I did not feel I was good at math in high school. However, this “low math esteem” led me to focus on practicing real-world math skills.

These days, I am fairly comfortable with math, in general, though I frequently have to think through conversion problems, which are common in nursing. I find I often want to divide when I should multiply, for instance, so I have to be careful about that! Once I have a formula memorized, however, I feel very comfortable substituting variables with real values and arriving at the correct answer.

If you have questions for Beth, ask them in the comments section. Read other Math at Work Monday entries in the archive.  And if you or someone you know wants to be interviewed for this regular, Monday feature, let me know.