Some crna decided that in order to convince me of the perfection of their exalted being they needed to insult me and my intelligence. Rather than have them languish in the comments sections of individual posts of mine, I decided to make a whole new post for their comments. Anybody who has had the "benefit" of a crna instead of a doctor and has been treated with arrogant indifference to their needs/wants and in violation of current "informed consent" laws needs to read this. As usual the commenter(s) can't see the narcissistic nature of their comments. It's all part of the illness. So here we go;
Comment #1 from "anonymous"
"I'm sorry you had a bad experience with Versed. I am a CRNA. If my patient tells
me they do or don't want a drug, I certainly try to accomadate, (sic) and versed
certainly goes in that category for me. I know many anesthesiologists and CRNAs,
both groups having good eggs and bad eggs. Please don't extrapolate your
negative experience with one pretentious CRNA to us all as a whole. I tend to
think (because of my bias) that CRNAs typically listen to their patients more
because of their nursing background as opposed to the physician background, but
that's my opinion. The anesthesiologist who downplayed the CRNA's involvement in
your husband's case, I take issue with him as you have described him. Oh well.
Good egg and bad eggs in each of the Anesthesiologist and CRNA camps. I try to
be the best I can at what I do, but the day I stop listening to my patients and
customizing the anesthetics to each individual is the day I should stop
administering anesthesia." This one is fairly innocuous, but he/she doesn't get it. Once you have been AMBUSHED by a crna, the fear and loathing doesn't just dissipate. She/he [seems female to me, judging by writing style] talks about good eggs and bad eggs. It is so important to have GOOD people in anesthesia. It isn't good eggs and bad eggs, like your Ford dealership employees. Anesthesia providers must be held to a higher standard. I was happy that the anesthesiologist was in charge AS THE LAW PROVIDES! In my opinion, crna's do NOT listen to their patients more than doctors. They feel that they are the final arbiters of "what's good for you." That mind set isn't listening to the patient. That being said I MIGHT entertain the idea that this person be in charge of my anesthetic. This is my absolute right! I can decline the services of a nurse any time I want. It's the LAW.
Comment #2 Is this from the same "anonymous" as above? It was commenting on the same post of mine. hmmmm
"You sound looney! How do you make your husband's surgery all about you? Poor you
can't take care of someone who has had surgery? I feel bad for your husband,
Your entire blog is absolutely ridiculous and without merit." Now this is more what I have come to expect from crna's and the like. The first comment shown above is the EXCEPTION. Since *I* don't like Versed and I saw what happens when you have sloppy anesthesia provided by an arrogant nurse, and don't want a repeat of same with my husband, I am the bad guy. So this proves that not only do crna's not care about the patient, they don't give a damn about what the caregivers go through either. Believe me, I don't want a Versed crazed man who outweighs me being turned loose into my custody. For that I'm the bad guy. Wow. Please note that the commenter goes beyond their faux outrage at my concern at being a caregiver if my husband reacted the same way *I* did and condemns the whole blog. Of course, because this cretin wishes to pump Versed into people regardless of outcome. As I've previously complained, all these crna's are interested in is their own selfish wishes for an easy time with the patients no matter the aftermath. Once the patient is out the door they could care less what the patient and their family/caregiver has to go through. The proof is in the comment.
Comment #3 from hypnus
"Dear whoever....it's obvious that you have no concept of what it takes to become
a CRNA. The training for a CRNA is NOT emptying bedpans or bathing patients. To
clarify any misconceptions you have let me detail this for you.
A doctor does
a 4 year undergrad degree, usually in a science field but this is NOT a
requirement. They then attend a 4 year medical school. The first 2 years are
didactic studies with the last 2 being clinical work that includes learning to
take history and physicals from patients, etc. Benign work and they don't make
any clinical decisions regarding patient care. Upon graduation they do a 1 year
general internship where they rotate through all hospital departments. It isn't
until their 2nd year that they begin their residency in anesthesia. At this
point they are in the same residency program as a CRNA. Upon completion of the
residency doctors are not required to prove competency through any board
certification, although many do complete the certification.
A CRNA completes
4 years of undergrad, specializing as an RN. The last 2 years are spent
specializing in nursing practice and doing actual patient care at the bedside
under supervision. A far cry from emptying bedpans, this includes insertion of
oral gastric tubes, IV's, drawing arterial blood gases, inserting foley and
rectal catheters, reading cardiac monitors, learning to regulate IV
medications...many of which are potent, and so forth. Upon graduation the RN is
required to spend a determined amount of time working as a critical care nurse
before they can even apply for a CRNA program. In the ICU the RN becomes skilled
at patient assessment, IV monitoring, use of ventilators, reading and
determining meanings of Swan-Ganz readings (inserted into the hear), titrating
potent drips, etc. As yes, the RN will empty bedpans because we are not above
taking personal care of a patient. Most CRNA programs require that a CRNA
applicant be a certified critical care RN (CCRN) before they will even entertain
interviewing them. The interview process for CRNA programs is grueling. Because
the programs expect the RN applicant to have understanding of critical care
medicine, interviews are performed in front of a panel of professors and even
anesthesiologists/CRNA's. The interview consists of questions regarding specific
medications and their pharmacokinetics, ventilator settings, Swan-Ganz
interpretations, arterial blood gas interpretations, and so forth. This usually
lasts an hour to an hour and a half. The panel the weighs in the applications
accuracy at answering questions, how well they performed under stress, their
GPA's, their work history and type of critical care experience before making the
selection. There are typically 250+ applicants each year to programs that only
welcome 50-75 students. This allows programs to select only the very best for
their programs. Upon entering the program the applicants spend 1 year minimum in
intense didactics, studying the same material as medical students. Because the
students already have bedside experience in critical care and training in
nursing, unlike medical students who have no prior experience in medicine, the
didactic portion of the program is more condensed than medical school. There is
no need to begin with basics of patient care with CRNA students. After the
didactic portion of the program is complete the residency begins. For nearly 2
years the CRNA will work in the residency program alongside physicians, learning
through experience and with supervision. Yes, there is a difference between the
CRNA resident and the medical resident. The CRNA is not paid, the medical
resident is. Anyway, the CRNA will spend between 60 to 90 hours a week training
in surgery, taking call, and being scrutinized. Upon completion of the residency
the CRNA student (RRNA) must take a board certification exam, which must be
repeated every 8 years, to provide competency. So before you speak of how CRNA's
are incompetent, educate yourself or you will continue to look foolish." So here we have a typical rant from a crna trying to prove, once again, that they are superior to everybody else including doctors. The whole comment is nothing but a self serving attempt to show all us cretins how superior they are. Amazing that they would even try this. So do these nurses start out like this with anti-social tendencies or is it something that is drummed into them in school? It's uncanny how many of them display this attitude. Surly, arrogant, disrespectful, insulting diatribes aimed at? What is this poster striving to achieve? Can anybody tell? The insults are designed to do what? Make us all love crna's? Somebody please tell these "bad eggs" that this kind of behavior is having the opposite impact on patients, if the idea is to convince us to allow a nurse to do our anesthesia. As an aside, an hour and a half interview is what university applicants are expected to do as well. If this example was supposed to show us how onerous the training is, it is a fail. GPA for crna's is what? 3.0 I've heard. If you can't get a B average in a NURSING school you are seriously not a good candidate for a crna. If you can't tell the difference between being a technician and having a true patient care objective, I can't help you. You are describing mechanic school for one aspect of the human body. Sort of like the person who can only do brakes on a car. Where is the concern for the person?
Comment #4 from "anonymous" again
The funny thing is that this poster tried to comment on "ANOTHER Amnesia drug" by stating the following
"Lady, I'm sorry to tell you this and burst your hysterical rant bubble, but
Versed isn't the only hypnotic/amnestic given during induction. Propofol also
has these properties, so does anesthesia gases. Versed has many other properties
too, such as prevention of seizures that can occur when large doses of local
anesthetic is injected intraop, decreasing brain hypoxia, decreasing the dose of
opioid needed for pain relief resulting in less postop nausea and vomiting, and
many more. POCD (postop cognitive dysfunction) is typically only seen in the
elderly, substance abusers/alcoholics. It is thought to be caused by the
inflammatory process of surgery. Read the facts." Here I am on my blog talking about other amnesia drugs, as I have over the years, and this genius takes the time to deride me for saying so by stating what I have ALREADY written about. Hint: if you are commenting on an article in which I reveal YET ANOTHER amnesia drug, does it stand to reason that I might already know this? So what's up with the snarkiness? The title of my post would give normal people the idea that I am well aware of the FACT that there are other amnesia drugs in use. I have written about many of them. Including Propofol. Ketamine, a blood pressure drug, Ambien, etc. So here we have the oh-so-very-intelligent commenter pretending that I don't know anything. Of course the usual digs about not being educated, "hysterical". "rant", "bubble", blah blah, blah. So predictable. Yet another crna blowing their own horn. Yawn. Of particular interest is how this person tries to disseminate propaganda by saying POCD is "typically" only seen in the elderly (who cares about them, right) SUBSTANCE ABUSERS AND ALCOHOLICS. So the implication to take from this is that IF you have a bad reaction to their wonder drug, it isn't the drug...YOU must be a substance abuser or alcoholic. Blame the victim once again. "Typically" is nothing but an obfuscation, an "anecdotal" based aggressive attempt to disparage anybody who has a bad experience. Careful nursey poo your compassion is showing...not.
Comment #5 again from "anonymous" short but sweet.
"Ridiculous dribble. Did you get rejected by a CRNA program? Is this why you are
so jealous and bitter?"
Is this what they teach in crna school? Attack people who have had a bad experience at the hands of a nincompoop nurse who feels they are a God. If somebody disagrees with them, they claim some ulterior motive and impugn their experience? Of special note; this commenter is commenting on a post where I actually LIKED a crna. Maybe they are jealous and bitter about some other crna getting a compliment from me? LOL
Comment #6 anonymous again, last one, tried to post to "My Hope For Versed Pushers"
"That's super nice of you wishing harm on other people." So this commenter doesn't like it that I wish Versed pushers to suffer the same way I did? Too damn bad. You have no problem causing suffering in your patients do you? You have the nerve to try to take the high moral ground while forcing your patients to suffer? Doesn't work like that. You people deliberately and maliciously use a drug which CAUSES suffering in so many people and then have the unmitigated gall to try to castigate me? You make your patients endure what amounts to torture and that's OK but if *I* opine that you should get the exact same treatment, *I* am the bad guy? Spare me.
that's the mentality of them. If theres an issue with midazolam, its the patient, not the drug.
ReplyDeleteIt is almost bizarre. If the patient has a known allergy to a medication, its switched to another one. Whereas with midazolam, they keep giving more until the patient shuts up.
Do large doses cause cardiac arrest?
Yes, large doses can cause cardiac arrest and will make you stop breathing. IT CAN KILL YOU and there are studies out there which show this. I have some on the blog. Of course it's the patients fault they are dead.
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