What would happen if someone accepted an offer from a hospital, anesthesia groups ect

[Roland]

to PAY for their tuition in exchange for a contract to work at their organization/facility and then decided or was not able to do so (for either a good or bad reason)? Wouldn't this amount to a simple "breech of contract"? Thus, the grants would in essence become loans which had to be paid back perhaps with interest, and maybe even some damages (although that would be difficult for the plantiff to prove). Wouldn't this be a possible option for someone who couldn't afford school on Stafford loans alone, and didnt' qualify for whatever reason for the private "Bank One" type loans? Even if the loaner required the "loanee" to sign a non compete agreement in exchange for the grant, these are usually not enforceable outside of a very limited geographical area. Furthermore, as I have pointed out before private debts (including most court judgements) are USUALLY dischargeable in Chapter Seven proceedings while student loans USUALLY are not (the common exception being in the case of permanent disability, and even then the Dept. of Education must "sign off" on the discharge which is not lock).

What are the "downsides" to this analysis for someone in this position (which for the record doesn't include myself). I am not advocating this approach, but consider it to be a worthy intellectual exercise since it is a situation which has likely occured before and probably will again in various locales around this crazy world! To those who are still offended at the very concept being discussed I would quote Aristotle who said that "it is the mark of an educated mind to be able to entertain a thought without accepting it."

[Roland]

There are many good points above that argue against such a rash course of action. I will try to respond to some of them:

1. I do not believe the MARI idea to be rash. After all if it is good enough for the Real Estate/Banking industry which accounts for over ten percent of our GDP, then it might also be useful in healthcare (it does raise cetain due process problems, but those could be handled with carefully thought out procedures before placing someone on the list).

2. I have never understood the concept of expressing angst just because someone raises an issue for discussion. Bringing up abortion, flag burning, or terrorism for that matter does not mean that someone takes a particular position on the issue. Rather, it is often the case that they wish to explore a particular aspect of the issue, and must create the rhetorical parameters conducive to that occuring. Thus, if this were a Biology forum I might raise the question, "What would happen if scientists chose to set up shop on the island of Nevis, and start human embrionic stem cell cloning experiments".

3. It is true however, that I sometimes take Plato's cave allegory to it's logical conclusion (man will do what is in his best interests unless restrained by law, or other sanction). This emanates from a view that life is largely "war" a struggle for the best girl, job, food ect, that sometimes involves cooperation and sometimes conflict.

[canoehead, BSN, RN]

There are times, speaking of free speech, that people get so enthusiastic about showing off their knowledge, (without the judgement to use it properly) that they wind up showing off how dumb they are. Which is fine, they are only hurting themselves.

But sometimes people will be showing off and use a hot button topic, just to make everyone listen to them. (Like a kid who starts walking a fencepost so his mom will pay attention.) Then the potential to hurt people's feelings just ruins the conversation, and shows disrespect for everyone around them.

Luckily, most of us gave up showing off at age 5.

[smiling_ru]

Roland,

The employers can not place undo restrictions on the stipends. This is a right to work country. If you place restrictions on the stipends that result in an inability to work anywhere but the company that helped you it amounts to servitude, which is illegal, and that is the reason that it is not done.

Beyond that, this debate is about morals and ethics. What is the real point of your post? What is it that you really want to know?

I believe that it has been clearly established that for the most part healthcare workers are ethical and attempt to practice within their moral framework. It is a valued trait in anyone charged with another persons life. Would'nt you agree? So what are you really attempting to determine?

[kmchugh]

Luckily, most of us gave up showing off at age 5.

Snicker, snicker, snort, guffaw.

Some would do well to remember that this is a relatively small field. Perhaps showing some parts of your anatomy should wait at least until you have completed a BSN, and been accepted to a CRNA program.

Having the reputation of being a know it all or a showoff can only hurt you. Take that for whatever its worth.

KM

[JSB]

I may be putting too much thought into this, but I can't help but think that this type of posting started when I asked for advice on how to pay for CRNA school. I am the single mom with bad credit due to bankrupcy that Roland mentioned. I just want to clarify that I do want very much to go to CRNA school, but I did not mean to imply that I am willing to use unethical means to get to the end.

Also, someone posted that they would be uncomfortable working with someone who had abused credit cards and filed bankruptcy. Let me say that my credit issues are largely the doing of my ex-husband. This was a man who became severely abusive, and at the time I left him, he had racked up all my credit cards, drained the bank accounts, filed child neglect reports with DFCS about me, and told the police that I planned to drive my car off a bridge with my children in it.

The day I fled with my children (when he got into the shower) was a December morning (it was sleeting out). I had $9 in my pocket, and the children had no coats, shoes, or socks on. It was a life or death situation. I had a broken cheekbone and a broken rib, and bruises from head to toe. I filed a police report and pressed charges, and he was arrested and is now serving a 3 year prison sentence. I filed for divorce and bankruptcy too, started nursing school, was elected class president, and my grades were at the top of our class. I worked 2 jobs while going to school, and also took care of my children. When I left my husband, the children were very young - 4 yrs, 2 yrs, and 4 months old.

My reasons for posting all this are threefold. First, I believe that I am able to overcome huge obstacles to acheive my dreams, and my accomplishments so far support that. I believe that I will find a way to become a CRNA too - ethically. Second, I want to reinforce the importance of being nonjudgemental - a person should not be labeled as immoral or unethical because of a bankrupcy or poor credit - you don't know how they got to that point. Lastly, I want people who may be in a similar abusive relationship know that they are not alone, there is a way out, and you can be happy and successful.

Now I can get off my soapbox. I didn't realize my post was going to be this long.

[fiestynurse]

JSB - You are awesome! I am sure that you will find a way to become a CRNA without jeopardizing your integrity. Best Wishes to you.

[NCgirl]

For whatever this may be worth (and it may be nothing), I was told by a large medical facility's CRNA recruiter to think of their stipend as nothing more than a loan. She said many of their contracts/stipends do not end up being fulfilled;that they just get paid off by another facility when their contractee takes another job. (Is contractee even a word???) When I told her that I already had a stipend/contract with a hospital, she said I could still take theirs, but when I graduated and decided where I'd work, that hospital would simply pay off the other.

With that said, I don't know where I personally stand. I don't really think this is as much of an ethical issue as others do, but I do think it's bad business. And as others have said, the anesthesia community is fairly small. It's not very wise to burn bridges. And BTW, I didn't take the second stipend. I was amazed that the recruiter acted like it was no big deal, and happened frequently. Obviously some folks are financing school via multiple stipends. Interesting idea, simply not for me.

[Roland]

JSB, in the appraisal/mortgage business I encounterd MANY situations that were similiar to yours. These situations sometimes resulted in my advising a Chapter Seven BK rather than a new mortgage, which in most cases only delayed a BK in any case (and ALSO often results in the loss of the home since it is now encumbered by additional liens). They certainly sensitized me to the notion that you shouldn't judge someone until you've "walked a mile in their shoes." (extreme acts of evil excepted). Contrary, to the opinion of Kevin and others I ask questions or make posts out of genuine curiosity as to what the responses might be. Kind of like when I used to sit out on the front porch with a friend and a beer to "shoot the shXX" or casually debate various issues. The only difference is that even though those discussions would sometimes become heated, we knew we were still friends at the end of the day. I would simply encourage everyone to attack the argument (if so inclined) rather than the person making the argument. In over four hundred posts at allnurses the most invective thing that I've ever said about anyone is that they might be intellectually dishonest in their arguments. To me this board is not about "looking good". Frankly, I would post questions that I found worthy of discussion even if I believed that it would destroy any opportunity that I had to be a CRNA (of course I hope it won't come to that). So many people today spend so much time trying to "look good" that almost no one says what they really think about anything, or poses the sort of "tough" questions that are really worth asking.

[Kiwi, BSN, RN]

JSB, we are not here to judge you. "Do not judge, or you too will be judged." Matthew 7:1-2

It might be hard to believe this, but your past experiences will lend you the motivation and stellar work ethic to become a CRNA. Look at all you've achieved! It is YOU who has a good head on your shoulders, not those who judge you.

[gwenith, BSN, RN]

Roland it is one thing to set out ethical dilemmas and posit imaginary scenario's it is quite another to purport to having answers to problems that you do not have direct personal experience with, and are unaware of the full factors affecting the current situation.

Several times we have "crossed swords" because you have posited a course that not only is unworkable but shows that you truly do not understand the milieu and context of the original "problem".

I will give you a non medical analogy.

Imagine if you worked as a environmental engineer for General motors and someone came along and started a discussion on why we are not all driving solar powered cars. Now instead of listening to the engineers explanations of the socio-political milieu which, at present dictates that petrol remains as the primary fuel or waits for the explanation as to why solar power is not yet ready to fill the world need, this someone kept throwing up scenarios outlining how it could be done. No mention of who would do it or how they would miraculously overcome the present problems.

Now imagine yourself as that engineer - fighting your whole life to try to improve the environment looking for ways to achieve better fuel economies and alternate sources of energy and here is this person who is standing on the sidelines expounding their own personal theories - how would you feel?

[suzanne4, RN]

JSB,

Don't worry, you will make a great anesthetist. You have already made it this far on your own doing....................

Good luck to you..

:balloons:

[Roland]

Gwenith, if the person was taking up work time that would be one thing. However, if they were simply posting their opinions to an alternative energy board I would refute their argument point by point (and then proceed to discuss and if appropriate refute their counter arguments). If their arguments were totally inane and not even intellectually stimulating, I probably would either not read their posts or simply wouldn't respond. Under no circumstancs would I denigrate them personally, especially if they hadn't attacked others personally. This is one of the first rules that you are taught in debate or any intellectual discussion. You say that I have made proposals that are unworkable. I say, which proposals and why? Explain, why my proposals are ill-advised (if you feel so motivated) and then refute my counter points (assuming I am even able to offer them).

If the "market place of ideas" is to be truly free and open then people must feel that they can propose ideas, thoughts, and opinions without fear of personal reprimand. I thought NileProc, illustrated this concept beautifully above. He stated why the question at hand shouldn't be attempted (the CRNA community is small and even perceived eithics violations may have repercussions), but at no point did he denigrate me for asking it. In addition, I would point out that frequently breakthroughs come from people and perspectives OUTSIDE the area where the breakthrough is made. That is because like John Kennedy they look at things and ask "why not", rather than assume something to be unworkable based upon past experience.