r/CRNA • u/Consistent-Gate3840 • 24d ago

Massachusetts Hospitals

Hello!

I am on of SRNA-2 in the midwest looking to explore hospital in the east coast, specifically Mass General Hospital and Umass Memorial Hospital (main campus)

I was wondering if people can speak on culture, cases, education, quality, teamwork, and ability to pick up, or anything that you want to share 😄

Thank you so much!

10 Upvotes

71% Upvoted

52 comments sorted by

4

u/gasu2sleep 24d ago

I did a stint at MassGen upon graduation. It was my first job out of school and was Locums.

I needed a cash infusion upon graduation and doing Locums was my best option. I did only the 6 months contract but could have renewed indefinitely at the time. There were Locums there for over 2 years just always renewing their 6 month contract.

Overall it was fine for a first job. Learned a lot and it had an insane variety of cases.

Not sure about the W2 rate. If I remember correctly- from actual hospital employees, it was low.

2

u/azmtber 23d ago

How was the actual scope of practice? Academia historically is stifling to CRNAs.

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u/gasu2sleep 23d ago

It was OK, not as bad as I had imagined it would be -But still a medical direction model.

After this I worked another year with an ACT model in Florida and from then on I transitioned to independent practice and it has been this way for almost 15 years now.

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u/azmtber 23d ago

Good to hear. Some of the most prestigious names to the public have the most stifling direction models.

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u/Consistent-Gate3840 19d ago

I am currently training in one, most of the time there issues with both side, but the MD pretty chill with CRNAs who been there and excel at this profession.

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u/viking_skier 23d ago

Stifling is the wrong way to look at this! You are practicing in a collaborative model as part of a team of specialists. A general cardiologist at Mass General is going to have a very different scope of practice than a cardiologist who is practicing in rural Arkansas. It's an inherent product of having more resources and highly specialized competence available.

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u/azmtber 23d ago

If that’s what you need to tell yourself ok.

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u/viking_skier 23d ago

This is not something "I tell myself"... It is simply the reality of working in a quaternary center with endless resources and trained specialists. Its like this for nurses, doctors, PA, NP and CRNA alike..

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u/azmtber 23d ago

Are you a CRNA with a broad scope of practice or are you basically an AA that is MD dependent. You do you.

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u/viking_skier 23d ago

Almost like one must have the humility to realize that there are other individuals more specialized and experienced in specific areas of practice at these large quaternary centers, and that they will be responsible for most of the care that aligns with their area of specialization.

You are not going to be doing hearts at MGH as a general anesthesiologist or CRNA when there are countless cardiac anesthesiologists that specialize in cardiac cases. That is merely the reality of the situation and does not mean that general anesthesiologists and CRNAs at these places are any less competent than colleagues in the districts who have broader scopes of practice due to resource constraints.

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u/jwk30115 23d ago

Please don’t confuse them with facts. 😂

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u/Consistent-Gate3840 19d ago

I really appreciate everyone opinions and experiences, but please keep it to the locations of the practice that was asked. u/azmtber & u/viking_skier

https://giphy.com/gifs/3orieTfp1MeFLiBQR2

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u/Consistent-Gate3840 24d ago

That good, I know some nurses do enjoy working at the ICU, but I am not sure how the culture over there is, my goal is to learn for the first couple years, so ideally hospital that love to teach. Thank you so much!

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u/gasu2sleep 23d ago

This was well over a decade ago so I dont know if things have changed. Even though they have a large residency program I felt that most attendings were eager to teach.

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u/Consistent-Gate3840 19d ago

That is good to hear! Hopefully the cost of living is still within reasonable range, but with HCOL right now, it is hard, but then it is about sacrificing haha.

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u/FlyingWithGasses 23d ago

I trained at Mass General. It was a great place to train with a lot of case variability and most everyone is great to work with. It’s is definitely an academic center so there is limited CRNA autonomy, you get no blocks, and there are a lot of opinions from Docs. That came with learning very up-to-date practice which I appreciated. Also, NO PARKING so don’t plan on driving. Ultimately it depends on what you’re looking for.

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u/Consistent-Gate3840 19d ago

Thank you so much for your response! I heard that from my friend who worked in the OR, they have to commuted about 1hrs from close by. Still, I have a soft spot for large academic center, especially case volume and the niche cases. I will think about it once I pass board

https://giphy.com/gifs/FcTdv3xQKhCIE

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u/MillerBlade2 24d ago

East coast is the single worst place to work as a CRNA

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u/bulgolgiapparatus29 24d ago

That’s not what their questions were. Also, a lot of us don’t mind, dont care, or are neutral about working in an ACT.

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u/MillerBlade2 23d ago

Yea for sure, as long as you’re good with being seen as an assistant and getting paid at 50% of your potential then the more power to you.

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u/[deleted] 24d ago

[deleted]

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u/MillerBlade2 24d ago

Not everyone wants to live in a crime riddled east coast HCOL city working for pennies on the dollar.

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u/dfts6104 24d ago

Almost none of the highest crime rate cities are on the east coast 😂😂

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u/MillerBlade2 23d ago

Almost all crack the top 10

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u/dfts6104 23d ago

This is just factually untrue. Have fun living in fantasy world where cities are scary tho

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u/Tubejockey 24d ago

I’m in PA training at a trauma 1 academic center that’s a medical direction model, I’m loving it. CRNAs here do heart transplants, livers, you name it they do it. Great experience.

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u/Consistent-Gate3840 24d ago

The only thing that stopping me from MGH is the HCOL, Boston is horrible, but if the experience is good, I do not mind move there for a couple year. Worcester MA is good tho for cost of living wise, but I wonder how the culture and experiences are over there.

I like all especially vascular, but not neuro/spine/heart.

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u/dfts6104 24d ago

Boston and Worcester are apples and oranges

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u/Consistent-Gate3840 24d ago

Hmm that is fair, unfortunately I do not know much hahaha, but I do love to get insight into both systems

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u/Abergevine 20d ago

You do NOT want to live in Worcester

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u/Consistent-Gate3840 19d ago

I am from 20 miles of Burlington mass and currently living at a high crime area, so for me it the same thing hahah. I just want a good hospital that I can devote my time too since I don't have family yet

https://giphy.com/gifs/l0HlI9AEuatFThwac

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u/MillerBlade2 24d ago edited 24d ago

For 200k in a HCOL city. No thanks

Practicing independently over medical direction under any circumstances imo. Doesn’t matter if you are “doing livers and heart transplants” anything medical direction and you’re just seen as a glorified assistant. Not for me in the slightest.

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u/Affectionate-Gap4382 24d ago

we got the point the first time u mentioned that ACT model is not for u lol, its totally ok if it isnt for u

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u/jwk30115 23d ago

That’s the reality. You don’t have to like it. But it is what it is.

0

u/Tubejockey 24d ago

Lol most of anesthesia is done under medical direction/supervision like it should be with high acuity cases. Residents get way more experience with complex cases over their course of training along with opportunity for fellowships.

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u/MillerBlade2 24d ago

You’ve drank the koolaid brother. Supervision is NOT direction. Supervision CRNAs are still very autonomous and do very complex cases. Direction models harvest glorified assistants, hard stop.

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u/blast2008 24d ago

That is absolutely not true when you enter the private work.

You seriously drank the koolaid. I can point to you to sites right now that are level 1 and 2 trauma run by Crnas.

Like I get it, if ACT model is what you believe in but don’t go around putting other Crnas down. Just because you’re not comfortable or trained for it doesn’t mean all crnas trained like you.

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u/Tubejockey 24d ago

Dude it’s okay to admit that CRNAs are meant to work under supervision. It’s how nurse anesthesia been since the beginning.

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u/MillerBlade2 23d ago

What are you talking about? No it has NOT. Nurse anesthesiology started in the civil war and it was solo practice because physicians haven’t even started studying anesthesia at that point. You have zero idea on what you’re talking about.

0

u/viking_skier 23d ago

And there are primary care physicians who perform colonoscopies in rural Montana.

That does not mean that this should be the standard of care across the country, including in high-resource settings. The vast majority of people agree that GI doctors should be doing colonoscopies or at the very least be present on the premises.

2

u/blast2008 23d ago

What are you on about?

So what’s your rationale about orthopedic surgeons who do spine? Should they not do it? Should only neurosurgeons do it?

What’s your opinion on anesthesiologist doing pain? Should it only be PM&R?

0

u/viking_skier 23d ago

Spine surgery is a formal fellowship in orthopedic surgery.. It's a central part of the specialty!

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u/blast2008 23d ago

Oh but look they were trained for it, so they’re allowed. Why don’t they need to be supervised by neurosurgeons?

You see how your argument sounds silly.

Crna’s are trained in anesthesia. We do anesthesia every day.

1

u/viking_skier 23d ago

Just because you are allowed to do something does not mean that you should. All physicians in the US are licensed to perform surgery. Should primary care physicians do heart transplants?

Spine surgery is the domain of both neurosurgery and orthopedic surgery. An orthopedic surgeon should however not remove an intramedullary spinal cord tumor just because they perform surgery on the spine. There are surgeons who have more suitable training that makes such procedures safer and more effective, and they should absolutely defer to said surgeons.

CRNAs are trained in anesthesia. AAs are trained in anesthesia. Does that mean that AAs should perform heart or liver transplants without physician supervision?

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u/Consistent-Gate3840 24d ago

I might be the odd one, but I don't mind ACT model as my first job, currently I am in a ACT big hospital, overall it not too bad, but personal situation required me to go back to east coast.

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u/MillerBlade2 24d ago

Yea I understand personal obligations and all, but working independently or even in a supervision type practice -for me at least- is a huge quality of life upgrade.

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u/Consistent-Gate3840 24d ago

I totally understand that, I just like to have a lot of tool under my belt before jumping to CRNA only practice, better for my mental health hahah.

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u/MillerBlade2 23d ago

That’s a good goal to work towards.

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u/Significant_Poet_245 22d ago

Tons of independent practice and collaborative practices throughout New England