Losing my mind -- help me find it?

I think your thoughts on trying a new specialty sound perfectly reasonable. If that is what is available and you are interested, then pursue them.

But maybe there are some other things you could do to help yourself out (-- and that might help you revitalize your professional life). Maybe you should address that "tiredness" before interviewing for a new job in a a new specialty. If you appear "old and tired and burned out," in an interview -- that is not very attractive to a hiring manager. And "faking enthusiasm and energy" is harder than most people think.

Have you been taking some time off to do things that refresh you? If not, you should give that a try. How is your personal life? Do you have stuff that you do on your days off that refresh you and help you to enjoy life. Sometimes, taking a single-day vacation to do something YOU really want to do for yourself (like once per month) can do wonders for your mood. It gives additional meaning to your work -- you are working to fund your great personal life. As they say, "You should be working to live ... not living to work."

Are there some professional opportunities that might liven up your work-life that would build on your expertise in adult med-surg? Maybe some projects to work on, committees to make quality improvements, etc. that might get you away from the bedside a little and add a little variety to your day. Such things might also make you eligible for promotion -- and would certainly make a you a more attractive job candidate for any other job (in any specialty) that you might apply for. Are you certified? If switching specialties doesn't work out -- or if you think switching to another adult med-surg type of unit (or adult ICU), it might help if you were certified. And doing the review and getting the certification might give you a boost (both mentally and as a candidate for other career possibilities.) Sometimes, simply having a new project or goal to focus on helps me stay emotionally engaged in my work. And building on the expertise you have developed over the years has its advantages to starting all over again at the bottom of another specialty.