[raininghere]

I am exploring graduate career options, and I wanted to get your opinion. I currently work as a ICU nurse (med/surg), and I'm not happy there at all. The things we're doing to the patients should be illegal; yesterday I put an 88-year-old patient with end-stage Alzheimers on CVVH. 90% of what we're (the healthcare providers) doing is expensive, painful, and is likely to result in no improvement in either the patient's condition or quality of life. I'm good at my job, I love the intellectual challenge that ICU provides, but I don't like coming to work wondering what ethical codes I'm violating that day. Did any of you feel this way? And what direction did you pursue after wards? Thanks so much!

[pilateschick7]

Intense distaste for aspects of your job is very natural. I have several friends currently in CRNA programs in my area of the country. My friends who are "happiest" are attending private Christian programs. They really keep ethics in the forefront of all aspects of the program. IMHO I think your choice of practice setting would really affect your happiness with this Anesthesia. Vanderbilt has a great program for Palliative Care that can really allow you to be a patient advocate, my favorite professor in nursing school just finished her Phd. Hope this helps.

[one_crna]

Originally Posted by raininghere

I am exploring graduate career options, and I wanted to get your opinion. I currently work as a ICU nurse (med/surg), and I'm not happy there at all. The things we're doing to the patients should be illegal; yesterday I put an 88-year-old patient with end-stage Alzheimers on CVVH. 90% of what we're (the healthcare providers) doing is expensive, painful, and is likely to result in no improvement in either the patient's condition or quality of life. I'm good at my job, I love the intellectual challenge that ICU provides, but I don't like coming to work wondering what ethical codes I'm violating that day. Did any of you feel this way? And what direction did you pursue after wards? Thanks so much!

You should definitely check out the CRNA route. Find someone to go and shadow. I felt the exact same way when I was an ICU nurse. I feel much better about what I do on a daily basis for my patients.

[FLTraumaRN]

I think we all find aspects of our job that we dont' like or don't agree with. I think the same could be said for CRNA's. You need to find something that you like more than you dislike. CRNA may be the route for you. I would suggest that you shadow a CRNA for 2 reasons.
1) It will let you see what they do and you can decide if the huge committment of school is worth it for you.
2) If you decide you like it, it will look good on applications and interviews. Almost every school out there that I know asks about wether you have shadowed. I know my school did in the interview.

[neurogeek]

Sounds like you are going through what most of us have at one time or another....it's only natural to find yourself questioning the morality of a situation like this. However, keep in mind that becoming a CRNA will not stop you from being involved in these same situations. What happens when you have to deliver the anesthesia on that 88 y/o end-stage alzheimers patient? You won't get to select your patients in the OR either. Sounds like you are very much a patient advocate & that is a great bonus. You will probably make a great CRNA, but no it won't alleviate the moral & ethical issues at all.

[stanman1968]

I am sorry to say that you will run across these situations wherever you go. Our ability to delay death has far outstripped our wisdom in applying it. The corollary is how do you KNOW, I mean with 100% no doubt absolute godlike certainty that the patient you are caring for will not recover and lead at least a few more quality of life years?
answer we do not so we must do the best we can to save who we can and make the best judgments at all times.

[raininghere]

Thanks for all of your advice. I thankfully had a great group of patients this week (and reasonable family members!), so I'm going to stick in out in the ICU. I'm definately planning on shadowing a CRNA this summer and a few other professionals before making any further decisions on school. Thanks so much!!!

[pilateschick7]

What about trying a different ICU specialty. The newness could help with burnout and would look good on an application to school. Does your ICU have open visitation?