On Sept. 7, the Brigham opened its new Medical/Surgical Intensive Care Unit (Med/Surg ICU) on Braunwald Tower 11C, becoming the hospital’s first unit to provide intensive care for both medical and surgical patients in the same setting. Also known as the Med/Surg ICU, the unit launched with six beds and will expand to a total of 10 beds early next year — an important milestone in the Brigham’s continued efforts to address ongoing capacity challenges.
While other ICUs at the Brigham are staffed by teams that include residents and fellows, these trainees do not make up the Med/Surg ICU team. Instead, physician assistants (PAs) work closely with attending physicians and nurses to care for patients in this setting. Caitlin Springer, PA-C, chief PA of the Med Surg ICU, recently spoke with Brigham Bulletin about how this new team came together.
What’s your career path been like so far?
CS: I was a physical therapist (PT) first for eight years. I went to PT school at Northeastern, and it wasn’t until I was in one of my last years of school that I learned more about what a PA was and what they could do. It was fascinating to me. Throughout my career as a PT, I never stopped dreaming of becoming a PA. It took me a while to finally make the switch, but I’m so thankful I finally decided to go for it!
I ended up going to PA school at Duke and had a great experience. After graduating two years later, I landed a job in the Emergency Department at Mass General. The environment was fast-paced with a diverse patient population. I learned a lot there by consulting with specialized experts.
Through my time at MGH, I became involved with the ultrasound division. That blossomed into teaching opportunities and training our new hires, as well as teaching at conferences across the country and now world. Teaching ultrasound brings me joy — I find it so rewarding to teach people a new skill where they can gather additional information about a patient, as well as give them tools to enhance success with a variety of procedures. I love seeing when something clicks with a new learner.
Eventually, I got a per-diem position at the Brigham with Metabolic Support Service. It really was my dream per-diem job
(and still is!). I love coming into every shift with that group. I always joked that it felt like Christmas morning on the days I was scheduled because that was how excited I was to come and work a shift with them! The team is amazing, and that experience allowed me the opportunity to expand my procedural skills and, later, per-diem opportunities in ICUs and other areas.
Can you tell us more about your latest role here?
CS: When the opportunity to help launch the new Med/Surg ICU as the chief PA presented itself, it felt like all of my worlds were coming together to create this new, PA-run unit. The goal is to accommodate both medical and surgical ICU patients to help offload the demands of our current units and meet the needs of our patient population, which are steadily increasing in both volume and acuity. We take patients from the Emergency Department, Operating Rooms, transfers from outside hospitals, as well as patients from our floors who have decompensated and require ICU-level care.
To accomplish this, we are led by our medical co-directors, Rachel Putman, MD, and Kristin Sonderman, MD, MPH, and an amazing attending group from whom we can learn directly from while caring for these patients. We’re staffed by critical care attendings from both the Medical ICU (MICU) and Surgical ICU (SICU), which include physicians trained in Pulmonary and Critical Care, Emergency Medicine, Surgery and Anesthesia. It’s so exciting to have such a diverse group of experts leading the PAs.
In preparation for opening the unit in September, our PA team rotated through several areas of the Brigham and Faulkner to ensure they received the training and support they needed to care for this patient population. I feel forever indebted to our colleagues in the many areas that accepted and trained our new PAs, specifically teams from the MICU, SICU, the Faulkner ICU team, the PACE Service, Cardiovascular Medicine, Oncology and the Bedside Procedure Service. Their willingness to help when we did not have a unit to train on was truly incredible.
In addition to everyone who helped train our PAs, the leadership of Jen Beatty, PA-C, Tony Massaro, MD, Ali Salim, MD, and Emily Hinchey, MBA, who helped assemble this whole unit, has been unparalleled.
What do you find most rewarding about being part of this team?
CS: I’m excited to learn and grow as a team that uses collaborative approaches and draws from everyone’s diverse backgrounds and experiences — from PAs who are new grads to others with experience in various specialties, including critical care at other institutions, emergency medicine, neurology, neurosurgery, metabolic support, oncology, pain medicine, thoracic surgery, vascular surgery and the Cath Lab. While we are on rounds, somebody will often be able to use their expertise from a prior role, which can ultimately help best manage a patient.
PAs are easily adaptable — we’re moldable. With this new unit, we get to learn directly from critical care attendings at an academic institution. I feel so lucky to have the opportunity to do this daily while caring for some extremely sick and complex patients. In addition, it’s great to be able to help decompress some of the other areas of the hospital and give them some breathing room and bandwidth.
We also benefit from the experience of many of our amazing nurses, whom I really enjoy working closely with and learning from. Nursing leaders — including Hasna Hakim, DNP, RN, MSN, MPH, CCRN-K, Warren Phillips, BSN, RN, and Kristen Hanlon, MSN, RN, CCRN — have done an outstanding job assembling and training our nurses. I am really excited that we get to build this unit truly as a team and put all of our heads together to constantly make things better. We get to set a whole new culture! It’s such a unique opportunity.
What do you enjoy most about being a PA?
CS: I love that you get to constantly learn from such a wide variety of experts and that you can explore a variety of specialties to gain a diverse experience. I love taking all of those experiences to best help my patients. You really can create your own journey based on your interests and opportunities that arise along the way. And I really love being part of a team. I always say it’s a good day if I learn something new, and with this amazing new team, there will never be a shortage of learning opportunities, so there are lots of good days ahead!
Special thanks to the entire MICU team; Lauren Jeffers, PA-C, and Meaghan Morris, PA-C, and the SICU team; Leanne Wines, PA-C, and Marissa Cauley, PA-C, and the PACE team; Deanna Wall, PA-C, and the Cardiology team; Eric Yenulevich, PA-C, and the oncology team; and Majid Shafiq, MD, MPH, and David Lee, MD, with the Bedside Procedure Service team. And KC Peoples and Alea Moscone for their continued contributions.
Physician Assistant Week is held annually Oct. 6–12 to honor physician assistants’ substantial role in improving health. In celebration of Brigham PAs and their involvement in nearly every facet of the care across the institution, Brigham Bulletin has highlighted one of the many exceptional physician assistants to cap off PA Week this year.