Explain why you have chosen your specific area of study in advanced practice nursing over other types of advanced practice nursing.
I have six years of bedside experience as a Critical Care ICU nurse with medical/surgical ICU, cardiac ICU, and post-open-heart experience. During my nursing career, I have often felt frustrated in situations where it was clear what needed to be done but unable to do so because I lacked the authority and had to refer to someone who had it. My interest in becoming a Nurse Anesthetist was initially fired when I was doing a ‘critical care consultation’ on a new ICU patient who needed urgent surgery and would not survive without it. I discussed the case with the surgeon and continued with my duties. When the patient returned to the ICU, I was paged. I noted that a CRNA accompanied the patient. I was very impressed by his calm, professional, and confident demeanor; he made his report, addressed the drips, and did everything that was helpful for the patient’s comfort and recovery. I saw him accompany the patient safely through surgery and recovery. I realized that he possessed the oversight, authority, and autonomy that I had long desired to exercise for the benefit of my patients.
I have a long-standing interest in pain management. I aim to acquire the high-level skills, knowledge, and experience to become an expert nurse anesthetist capable of adding value to the profession through research. I see the program as providing an avenue to enable me to maximize my utility as a nurse serving at the peak of the profession. I also seek to fully realize my potential and apply my experience and training to date in a more challenging and satisfying role. I am particularly interested in assisting patients who are fearful or have difficulties understanding, because of age, low educational level, or language barriers, what the procedure proposed involves, and why it is necessary.
I am aware that not every nurse is a potential CRNA. The role calls for a very high level of technical skill, knowledge, and, perhaps more importantly, particular personal characteristics with which few are blessed. Among these, I would cite exceptional academic potential to succeed in the program and a career beyond; self-confidence; decisiveness, planning skills, the ability to work autonomously but also in close cooperation with others and to direct others where necessary; the ability to remain composed in possibly extreme situations; an ability to communicate with exceptional clarity and accuracy with colleagues, patients, and their families; the ability to be empathetic and reassuring but perhaps, most importantly, to possess a genuine love of nursing and the patients in one’s care. I would not be making this application were I not convinced that I can meet these criteria.
It might be appropriate to state that I come from a poor white background and, on top of a poor educational start, parental indifference to my ambitions, and severe financial obstacles, I also lost my husband quite young. Nevertheless, I have met my goals to date. I graduated from Vanderbilt with a 3.9 GPA and got inducted into Sigma Theta Tau (nursing honor society).
This has called for exceptional determination, single-mindedness, and hard work that I believe will enable me to excel rather than merely succeed in the program and beyond. I am fully aware that it is necessary to be highly culturally aware and sensitive in the role that I hope to fill. I have happily studied, worked, treated, and socialized with people of many cultural and social backgrounds and enjoy doing so. In this connection, I should mention my volunteer work in South America, assisting in setting up clinics in remote areas.
Describe your future as an advanced practice nurse (including the type of clinical practice).
I have long had an interest in pain and its management: I am particularly interested in those factors that affect the individual’s experience of pain, such as genetics and how bodies process chemicals and feel pain differently in both acute and chronic forms; the biochemical processes, beyond just the extent of tissue damage and how our diet, biochemical pathways, genetics, reactions to medications, etc. alter our perception of pain. I have often wondered why one person may be in agony while another person only suffers some discomfort with the same condition and why one person reacts violently to a particular medication whereas another does not. I hope, at some stage, to assist in research in these areas.
I shall seek to acquire significant experience in the role in a hospital setting to become an expert practitioner and then pursue further studies. My ultimate goal is to obtain a post-doctoral certificate in pain management. I want to develop ways of decreasing post-operative complications by identifying ways to tailor anesthesia and pain management to the individual. Patients with less post-operative pain can better participate in rehab activities, use fewer postoperative opioids, and thus recover bowel function faster and have less risk of postoperative pneumonia and ileus, resulting in shorter hospital stays. I want to find alternative therapies to opioids for acute and chronic pain management. I would also like to help make people comfortable without becoming dependent on opioids despite the risks of dependency. I would seek ways to prevent acute pain from becoming chronic pain.
I am applying specifically to the UXX program because I seek a highly challenging but supportive academic environment. I am also very impressed by the advanced simulated teaching facilities and the high proportion of successful students and their career outcomes.