Complex, Challenging, Fulfilling: John’s Role as a Certified Registered Nurse Anesthetist (CRNA)
Early in his nursing career, John worked in a surgical intensive care unit, where he had one group of colleagues who always seemed particularly happy: certified registered nurse anesthetists, or CRNAs.
“I didn’t know what a CRNA was when I went to nursing school,” John said. “But they all really liked their jobs. I started asking them about what they do and there’s a lot of overlap with what ICU nurses do…it’s not a big stretch to imagine yourself in that role.”
Today, John Photos, CRNA finds himself in that same role, working as a certified registered nurse anesthetist at South Shore Hospital – and he’s just as happy as those former CRNA colleagues.
“It’s a stressful job, but it’s very fulfilling,” he said.
Getting started through clinical partnerships
John’s South Shore Health career began in 2020, when he was a nurse anesthesia student at Northeastern University.
As part of our clinical partnerships with both Northeastern and Boston College, John completed the clinical education portion of his degree as a student nurse anesthetist at South Shore Hospital.
After completing his clinical, John knew he wanted to stick around.
“I wanted to work here,” he said. “It was at the top of my short list of places to work when I got out of school because of the scope of practice that the CRNAs have due to our patient population.”
That patient population includes pediatric patients, trauma patients, maternity patients, and more – allowing John and his CRNA colleagues to use all of their expertise and training during every shift.
“If you work here, it’s because you want to work hard and because you get to see and do cases that allow you to practice to the full potential of your training and license,” he said.
The role of a CRNA at a modern hospital
While most patients are familiar with anesthesia, many aren’t familiar with the multi-faceted role of today’s CRNAs.
CRNAs are closely involved with a patient’s care from the pre-operative period through the end of surgery.
Prior to surgery, CRNAs work alongside anesthesiologists to develop anesthesia plans specific to each patient and play a crucial role as patient educators.
“I explain our anesthesia plan, answer any questions they may have, and try to get to know them a little bit,” said John. “You try to build a rapport with them to have them feel comfortable and understand what you’re going to do when you get in the operating room.”
During these interactions, John and his CRNA colleagues strive to alleviate any concerns and ensure patients are as prepared as possible for their procedure.
“They’re literally putting their life in your hands for the time that they’re under anesthesia, so I take it seriously,” he said. “I want them to get to know me and to trust me.”
During operations, CRNAs take an active, hands-on role in each procedure.
“CRNAs are putting in airways, managing the ventilators, managing the anesthesia, basically, from start to finish,” John said.
As part of a patient’s larger surgical care team, communication and collaboration are vital parts of the CRNA role.
“We’re coordinating things about the kind of anesthesia the surgeon might need for the procedure, and always being in communication with the surgeon during the surgery is a big part of our job as well,” John explained.
“The nurses help us out tremendously in filling in gaps that we might have questions about,” he continued. “They often know a lot more about the patient’s backstory, which is very helpful.”
John cited the importance of all members of a patient’s surgical care team, as everyone plays a key role.
“As CRNAs, we work with so many great caregivers and colleagues,” he said. “Pre-op and PACU nurses, anesthesia techs, nursing assistants, support staff…anesthesiologists and other CRNAs as well.”
“Everyone in the operating room works hard and has an important role to play,” said John. “We’re fortunate to have such an outstanding team across the board here at the Hospital.”
Once a procedure is complete, CRNAs bring patients to the post-anesthesia care unit (PACU), where they begin their recovery.
Complex care, close to home
Unlike many community hospitals, South Shore Hospital’s surgical platform handles very complex cases – something that appeals to John.
“We’re a trauma center, so we have to be ready for anything that comes through those doors,” he said. “We work with a lot of pediatric patients. We have a very busy OB department, and that’s all in addition to our general surgery population.”
John embraces the variety of cases and procedures, where no shift is quite the same as the one before.
“In one day, I’m doing pediatrics in the morning, but then I’ll be doing general surgery later,” he said “Then I might be in OB by the end of the day. It keeps you on your toes. You have to come in ready to work.”
Compassionate care for all – especially our youngest patients
Earlier in his nursing career, John considered working in pediatrics.
In his current role as a CRNA, he has the opportunity to care for pediatric patients, where he enjoys putting them at ease prior to a procedure.
“Surgery is stressful for everyone, but especially for kids,” he said. “It’s a lot of unknowns. My job is to make it as smooth as possible for them, to try to get to know them, and to have a little bit of fun when possible to alleviate anxiety.”
That “fun” comes in many different forms, things that CRNAs learn as tricks of the trade.
“I’ve stolen all of my material from the people who’ve come before me,” John laughed. “You tell jokes, you sing songs. If the anesthesia machine has a balloon, we can get them to blow the balloon up, or we do funny drawings.”
“Paying it forward” as an educator
Since finishing school and beginning his career as a CRNA, John has embraced the role of educator, helping orient new CRNA colleagues and working closely with student nurse anesthetists.
John sees this as his way of “paying it forward” to give students and new colleagues positive experiences, as he remembers being in their shoes.
“I had wonderful preceptors when I was a nurse in training and as a student nurse anesthetist as well,” he said. “I remember coming in and being very frightened, not knowing what I had gotten myself into. I try to give them a chance to grow, a chance to see what we’re doing, but to make sure we’re doing it safely.”
Embracing the community care model
John spent the early part of his nursing career working in academic medical centers, including in Boston, but has found his home at South Shore Health.
“I believe in this model of being able to care for the people in the community,” he said. “Everyone knows everyone else. There are times where patients come in and say ‘oh I know this person’ or they went to school with this person.”
“It’s like being part of a community or a family.”
