Explain why you have chosen your specific area of study in advanced practice nursing over other types of advanced practice nursing.
I am an experienced nurse with 6 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 being 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 was in need of urgent surgery and would clearly 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 the patient was accompanied by a CRNA. I was very impressed by his calm, professional and confident demeanor, he made his report and addressed the drips and did all that was necessary 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 and I aim to acquire the high-level skills, knowledge and experience to enable me to become an expert nurse anesthetist capable ultimately 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 as it stands at the peak of the profession. I also seek to accomplish my personal potential by applying the considerable fruits of my experience and training to date in a more challenging and satisfying role. I am particularly interested in assisting patients who are particularly fearful or have difficulties in understanding, by reason of age, low educational level or language barriers, what the procedure proposed involves and the reasons why it is necessary.
I am aware that not every nurse is a potential CRNA as the role calls for 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 in a career beyond; self-confidence; decisiveness, planning skills, the ability to work autonomously but also in close co-operation 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 of 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, in the face of a poor educational start, parental indifference to my ambitions and serious financial obstacles and then early and unexpected widowhood, I have met my goals to date. I was able to graduate from Vanderbilt with a 3.9 GPA and get inducted into Sigma Theta Tau (nursing honor society).
This has called for the kind of 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 the setting up of clinics in remote areas.
Describe your future as an advanced practice nurse (include 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, 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 it is that 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 certain 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 in order to become an expert practitioner and then to pursue further studies. My ultimate goal is to obtain a post-doctoral certificate in pain management. I would like to develop ways of decreasing post-operative complications by identifying ways to tailor anesthesia and pain management to the individual. Those patients with less post-operative pain can better participate in rehab activities, use less post-operative opioids and thus can recover bowel function faster and have less risk of post-operative pneumonia and ileus resulting in shorter hospital stays. I would like to find alternative therapies to opioids for acute and chronic pain management. I would also like to help make people comfortable without them becoming dependent on opioids in the light of the risks of dependency. I would seek ways to prevent acute pain from becoming chronic pain.
I am making the application specifically to the UXX program because I seek a highly challenging but supportive academic environment and I am assured that this will be provided by graduates of it. I am also very impressed by the advanced simulated teaching facilities and by the high proportion of successful students and their career outcomes.