Mathematical ability is an essential skill in nursing practice. Nurses and Nursing Associates must be able to correctly work out relevant calculations in order to be safe and effective practitioners. The main example from clinical practice would be drug calculations, but nurses also have to be competent in using other mathematical formulae, such as determining intravenous infusion rates and estimating weights of a patient or client using specific methods.

The journey of developing this competence for clinical practice often begins when nurses/Nursing Associates are in training at university. As a nurse lecturer, I have seen how this can lead to a student realising that they are struggling with this new form of maths. It is very important at this point to acknowledge the difficulty and seek advice to help develop their nursing numeracy skills. It could be that a student is not aware that they have dyscalculia. Dyscalculia can be defined as a persistent difficulty in understanding numbers which could lead to struggling with maths. Students can be assessed at university for this condition and then offered the right support. 

While some people may already be aware that they have dyscalculia, it is important that this is properly assessed and not just used as a generic label for anyone who finds nursing-based maths difficult. 

Dyscalculia may not be the only reason someone struggles with maths. Allison Smale, a numeracy tutor, maths lecturer and published author, agrees that it is probably more likely that someone is experiencing maths anxiety (feelings of panic or stress when trying to focus on mathematical calculations) and numerophobia. 

Talking with me in a Reasonable Adjustments In Nursing Education (RAINE) podcast about the topic, Allison explains that she has found that maths anxiety is prevalent in nursing staff and can be linked with past experiences. This includes negative interactions with schoolteachers or parents, or their own personal feelings towards maths. As a maths tutor, Allison looks to change a student’s personal feelings toward maths, inspiring a more positive and ‘can-do’ attitude, promoting a personal approach of individuals developing their own ways of calculating maths answers. 

In the podcast, Allison and I also acknowledge the impact of drug calculations assessment in a university setting, compared to experience by the bedside in the clinical areas. Nursing staff often find these calculations easier in the ‘real world’ rather than under exam conditions.

To help with this issue, Allison suggests things that students can try:

1. Envisioning the clinical context to reduce exam pressure.
2. Understanding your personal learning style.
3. Practise maths skills using curated content.
4. Seek assessment and institutional support. 

Drawing on her extensive experience, Allison has created a maths textbook for nurses which she believes could be useful to many of our nursing colleagues (including myself!)

The take-home message is that having dyscalculia, maths anxiety or numerophobia doesn’t mean that students, registered nurses and Nursing Associates can’t be safe practitioners. Accessing support and understanding their own way of learning can help them master this unique nursing skill.