David Hao, MD, anesthesia resident, shares why he chose the Anesthesia Residency Program at Mass General, his experience in the program so far and advice for those with similar professional goals.
Bhavika Shah felt from a young age that she was meant to dedicate her life to caring for people’s health. And so pursuing a career as a certified registered nurse anesthetist (CRNA) was rooted in a desire to be of service to humanity, while also allowing her to apply critical thought to treating and managing diseases—career goals that perfectly fit the CRNA profession.
“In high school, my math teacher and I were discussing my love of anatomy and physiology, and my desire to care for people. She suggested the CRNA profession,” she said. “It had all of the attributes I desired in a career, so I thought it was too good to be true. However, I worked with my guidance counselor to outline the path to achieve it. I haven’t regretted any experience in my journey to becoming a CRNA.”
Today, Bhavika is one of three associate chief CRNAs in the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital. In her role, she focuses specifically on optimizing the professional development of CRNAs at Mass General.
Bhavika shares more about the decision to build her career at Mass General, the challenges and rewards that she values in her work and her vision for the future of the CRNA profession.
Q. Why did you choose Mass General?
I knew I wanted to develop my career at an institution where I could build a solid clinical foundation. I joined Mass General for its position on the forefront of innovation and evidence-based medicine. With its patient population, I was confident that I would establish a strong base and find versatility in my clinical practice. I always imagined that I would move back to where I grew up in the South, but I have stayed for the extremely collegial and respectful working atmosphere that I found at Mass General.
It’s such an honor to be a clinician where the first successful public demonstration of ether for surgical anesthesia was performed. At times, it is surreal to know that I practice anesthesia where it all began.
Q. What has been most memorable about your experience, thus far?
The focus on collaborative practice and the growth of the CRNA team has been particularly memorable. When I began my career here in 2008, I was one of 12 CRNAs. Over the last 14 years, the growth has been exponential. Today, we have almost 100 CRNAs between the Boston, Danvers and North Shore campuses! As we have grown in numbers, our anesthesia care team collaboration has only strengthened.
Q. How has your transition been to associate chief CRNA?
It’s been a smooth transition because of the immense support and welcome the two other associate chiefs and I have received as we navigate this change in the CRNA leadership structure. The department’s leadership team—Anne Que, chief CRNA, Danielle Le Hals, executive director of the department, Seun Akeju-Johnson, MD, anesthetist-in-chief, and Paul Alfille, MD, executive vice chairman of clinical affairs—and our colleagues have been so supportive. The leadership style that has been crafted is very collaborative and promotes a team-based approach which allows us to consider and implement different perspectives into our patient care.
Q. What is the most rewarding part of your work?
It’s helping a patient feel at ease when undergoing a procedure. Undergoing a medical procedure can be a very vulnerable time for patients. The time I have with a patient during the pre-operative evaluation is very critical to establish rapport and understand the other co-morbidities that will help formulate their tailored anesthesia plan. Anesthetists can ease patients’ anxiety and provide the assurance that we will see them through their procedure, beat by beat.
Q. What is the most challenging aspect of your job?
As clinicians, it is in our nature to want to help and cure, and seeing patients suffer through a disease process that can’t be cured is very difficult. Also, as an associate chief CRNA, being in three places at once and balancing my home life along with my administrative and clinical responsibilities can be challenging. I’m fortunate to be married to a wonderful husband and have two amazing boys. Becoming a CRNA and a well-rounded clinician have always been at the forefront of my professional goals, and I’m also very dedicated to and passionate about serving my community in my work. The last six months of transitioning into the role of associate chief have been a crash course in time management, so I’m learning quickly.
Q. What is one thing you want people to know about being a CRNA?
One thing? There is so much to say about this profession! CRNAs are compassionate, well-rounded, and versatile clinicians with an extensive background in critical care medicine. CRNAs receive a master’s or doctorate degree upon graduation from an accredited graduate school that offers a program specializing in nurse anesthesia. CRNAs must be board-certified and can practice in any clinical setting.
CRNAs can work independently in anesthesia practices or in anesthesia care team models, as we do at Mass General. Unique to this type of specialization, an applicant must demonstrate at least a year or more of prior ICU clinical nursing experience to be considered for admission into a graduate anesthesia program for CRNAs.
Every day in this profession is different with new patients and new opportunities to collaborate with a variety of health care teams. The ever-changing environment keeps the days interesting and requires a great deal of adaptability and flexibility.
Q. What is one piece of advice you would give a young person with similar career ambitions?
Stick with it! Education is a lifelong pursuit and doesn’t end with a degree. Setting new goals after achieving the initial ones gives you the motivation and accountability to stay focused and follow through with your plans. It is a challenging road ahead. It will take time and even little failures to achieve these goals, but the journey is rewarding.
When I think of my journey, I reflect on the words of Winston Churchill: “Success is not final, failure is not fatal: it is the courage to continue that counts.”
Q. Is there an area of the CRNA field that you're curious about today?
Pharmacological innovation focusing on the reversal of anesthesia is a fascinating area of the field that sparks my curiosity. Currently, we do not administer any medication to “reverse” the anesthetic state. As we emerge patients from anesthesia, timing is everything. It involves turning off the anesthetic agents, estimating the time it will take for those agents to metabolize and the time for patients to open their eyes when you call their name. It is interesting to follow the evolution of this area of anesthesia in research.
Q. What does the future for CRNAs look like?
With dynamic and rapidly evolving medical treatments and the impact of the COVID-19 pandemic, we are destined to see a continued increase in the population who will require health care at a rising cost. CRNAs are an integral part of the future of anesthesia care and continue to be pivotal and necessary in optimizing outcomes, providing high quality cost-effective care and improving access to care amidst an era of growing provider shortages. The scope of practice of anesthesia has expanded dramatically into interdisciplinary specialties that are frequently found outside of the operating room. These areas present a continued and critical need for the expertise and clinical care that CRNAs provide in the medical community.
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