Saturday, July 7, 2012

Midazolam: Debate or Dialogue?

Recently I had occasion to admire a crna over at nurse-anesthesia.  GASP!  I know, it doesn't fit with my visceral hatred of most of them.  However I am a very discerning person and I recognise that people can change.  Some people can learn from their experiences and maybe even learn from the experiences of others.  How we verbalize these learning experiences makes all the difference. 

The person I admire from nurse-anesthesia is the SAME person who originally wrote the nasty thread on that site here;  This is unreal. You have to see it.  Amazing huh?  This is from 2007.

Here's what he thinks now on a recent thread; 
"Midazolam is a short-acting benzodiazepine in adults with an elimination half-life of one to four hours. Keep in mind that elimination half life is time it takes for a substance to the lose half of its pharmacologic, physiologic, or radiologic activity. So if you are doing a case for between 4-6 hours you really dont need more than 2 mg of versed."
Isn't that refreshing?  Of course even 2 mg of Versed is far too much for me and everybody else who has had a severe reaction to Versed...  ZERO mg is sufficient for me.  But this comment is in rebuttal to a crna who has used TWENTY SIX MG of Versed in a single procedure.  My mind would be completely gone after this.  I can't even IMAGINE how bad that would be for us.  Obviously this man has had a learning curve since he first wrote about how bad people were.  (He agrees that those of us who don't want to be poisoned with Versed have the RIGHT to refuse it.)

Anyway, I went to this person's blog pages and found this;  Logical fallacies - Blogs - WWW.NURSE-ANESTHESIA.ORG  I wish everybody had to take debate.  As an aside, my daughter is in debate and I am now a debate judge so I know about this subject...  I just wrote YESTERDAY about personal attacks from crna's!  The red herring (see rules of debate) of this statement "you must suffer from fibromyalgia" interjected into a debate on the misery that Versed has cause for so many of us is breaking one of the rules of debate.  It also completely stops any 'dialogue' between health care providers and patients doesn't it?  Why would they do this?  (rhetorical question)

I tend to combine dialogue with debate.  I already know that I'm right about Versed.  I can debate that all day long, but it doesn't really help me to be right, especially about Versed.  What I need is to hone my dialogue skills, such that I can convince these others that I'm right.  Kinda hard when the opposing team resorts to personal attacks, ridicule, and general snarkiness.  You know what that means to me?  All those personal insults?  It means that they have no answer to my argument and so must stoop to this kind of behavior.  Which is counterproductive.  It breeds zero respect for them or their profession.  (crna)  Apparently I can't convince them of this either!  Lol!  (It also means that *I* win the debate)  Does it alarm anybody else that we can't have a decent dialogue with anesthesia providers?  We can't debate an issue without it degenerating into a patient bashing exercise?  And we trust them with our lives?

Anyway, this PARTICULAR crna, even though he holds Versed and (ugh) Ketamine dear, has my respect.  I think it might be because he took that "debate" a few years ago.  Maybe all crna's should have debate as a requirement, and PASS the class with a good grade.  They need to read the attributes of "dialogue" as well.  The perfect place to start is on this crna's blog where there are 2 very excellent posts on both debate and dialogue.  (link is above)

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