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Awakened Anesthetist
This podcast is for Certified Anesthesiologist Assistants, AA students and anyone hoping to become one. As a CAA, I know how difficult it can be to find guidance that includes our unique point of view. I created Awakened Anesthetist to be the supportive community of CAAs I had needed on my own journey. Every month I feature CAA expanders in what I call my PROCESS interview series and I create wellness episodes that demystify practices you have previously assumed could never work for "someone like you". Through it all you will discover the power you hold as a CAA to create a life by design rather that default. I know you will find yourself here at Awakened Anesthetist Podcast.
Awakened Anesthetist
[PROCESS] Breaking Barriers in The Evergreen State ft. Sarah Brown, CAA
Discover how Washington Academy of Anesthesiologist Assistants President, Sarah Brown, paved the way for CAAs in Washington State. Hear her PROCESS from Georgia to Seattle, balancing career & family, and breaking legislative barriers in this 2024 CAA victory.
Do you want CAAs licensed in all 50 states? Then you should
1. Join the AAAA (American Academy of Anesthesiologist Assistants)
2. Donate to the AAAA Legislative Fund
3. Listen to ep. 35 [PROCESS] The Stars Align in Nevada ft. CAAs Stephanie Zunini, Jada Wabanimkee and Joey Parrish
Do you want to work in Washington state? Then you should
1. Donate to the WAAA (Washington Academy of Anesthesiologist Assistants)
2. Join the WAAA
3. Read the WA AA bill SB5184
Do you have the desire to open a new state? Then you should
Email the AAAA Legislative Committee Chair, Brie Seekford, CAA
and just for fun: Pic of WA Governor signing the CAA bill into law ft. Sarah and her 5 day old baby!
You can now text me! Questions/Suggestions
Introduction to Mindfulness for CAAs Sign up HERE
Thursday, Sept. 26th 6pm CST/ 7pm EST
Walk away knowing you can do it.
FREE 30 min class. All are welcome!
Want more? Stay in the know by subscribing to the Awakened Anesthetist Newsletter- more resources, exclusive content and ways to connect.
Let's Chat! Contact me:
awakenedanesthetist@gmail.com
IG @awakenedanesthetist
Again, I had that very similar feeling that I mentioned about having an AA school, where I felt like I should just know how to do this already.
Speaker 2:Welcome to the Awakened Anesthetist podcast, the first podcast to highlight the CAA experience. I'm your host, mary Jean, and I've been a certified anesthesiologist assistant for close to two decades. Throughout my journey and struggles, I've searched for guidance that includes my unique perspective as a CAA. At one of my lowest points, I decided to turn my passion for storytelling and my belief that the CAA profession is uniquely able to create a life by design into a podcast. If you are a practicing CAA, current AA student or someone who hopes to be one, I encourage you to stick around and experience the power of being in a community filled with voices who sound like yours, sharing experiences you never believed possible. I know you will find yourself here at the Awakened Anesthetist Podcast. Welcome in. Welcome, everyone to season four of the Awakened Anesthetist Podcast. I'm really excited to have Sarah Brown, who you may have heard of, because she just did something really big and important for certified anesthesiologist assistants and we're here today to talk about it, and I'm just really excited to bring another season of process episodes to our community to really give an example of what it means to use the CAA profession to live a life by design rather than default, and Sarah is another prime example of that. So let me go ahead and give you the timeout and the logistics behind Sarah before we jump into our episode. Sarah is a 2011 Emory grad. She, after graduation, worked full-time in Georgia, in Gainesville and then in Atlanta, and then she took a big move and moved across the country to the state of Washington where she pursued another degree and is currently working as a therapist in Washington and then worked really hard as the president of the Washington Academy of Anesthesiologists Assistance and just passed the legislation for CAAs to work in that state in 2024. So I'm excited to give you all a lot more details and to meet Sarah and hear her incredible journey. So I just wanted to welcome you, sarah, to the Awakened Anesthes podcast.
Speaker 2:Thank you, thanks, mary Jean, happy to be here. I know this is an exciting opening episode and I hope every season I open the season with another state passing and maybe so many states passing that I can't interview everyone. Yeah, so, yeah so. I love to start with a rapid fire round. It really scratches a nosy itch for me, and here I just think it's fun to hear who you are and how it relates to who I am as well, and maybe the listeners. Okay, let's do it. I don't know why this question is so interesting to me, but what time do you go to bed? What time do you get up? Oh, geez.
Speaker 2:Give details.
Speaker 1:Well, I'm a mother of two young children, so pretty much by the time they go to bed I am not too far behind them, so I would say by nine each night yeah, I'm. I'm pretty much done for the day, and then I'm waking up usually around seven um, so it's a good long stretch considering that I have, you know, two little good for you.
Speaker 2:I feel like that's an absolute feat, because you have a newborn or a few months old, correct? Yeah, she's four months old. Four months old, yes, so you're doing great Awesome.
Speaker 1:Yeah.
Speaker 2:Yeah, not too bad, huh? When you're waking up at seven, are you drinking a cup of coffee or are you a tea person?
Speaker 1:Oh, coffee for sure, yeah, yeah, I do like fresh grounds and pour over, usually Also have a Nespresso. So usually one of those two or both.
Speaker 2:And you live in Washington, so it's kind of like you can't not be into coffee. I feel like For sure yeah.
Speaker 1:Or make a run with the kids to a coffee shop. That's fun too. Yes, what's something that never gets old Surfing. Oh really, yeah, yeah, surfing is one of those things I feel like I could do forever. I never get tired of it when I'm out there Not that I get to do it a ton living like in the inland Northwest, but when I have the opportunity I could do it all day long If the sun weren't beating down on me. That's the rate limiting factor there, but otherwise never gets old, yeah.
Speaker 2:Very interesting. I have, of course, like a thousand more questions I'd love to ask you, but maybe another time. Sure, tell me about growing up and what it was like to be you, maybe the culture you grew up in or the environment and how that shaped you.
Speaker 1:Well, I grew up in Georgia, so in the South, and I grew up in a town called Gainesville, georgia, um, and I grew up in a town called Gainesville, georgia, just about an hour north of Atlanta, and, um, I grew up with two older brothers and, uh, parents still married and, um, my parents actually both grew up in Gainesville too and their parents grew up in Gainesville, so it is a very like old Southern family, southern family that's been in the same town forever. So I'm really, you know, in my family at least, the first person to leave Georgia. My family was, you know, we're like middle class and you know, I was listening to Lindsay's episode recently and how she talked about growing up with a family who was always like education driven. My family was similar, but it was really medically education driven, so that was always just what I assumed I would do.
Speaker 1:Didn't hurt that I was, you know, good at it and gifted in math and science too. So, um, yeah, I grew up, my dad was a pharmacist, my grandfather was a surgeon, my uncle's a surgeon, um, you know, lots of cousins and things like that were in the medical field as well. My brother is an AA also. So, yeah, it's just kind of um the path that I assumed I would take and didn't really know anything different. And my parents are still in Gainesville today.
Speaker 2:Wow, I'm just so interested to hear how you moved away from just all that stability and like what drove you, so I'm excited to get there. When did you first hear about the CA profession? Were you thinking you were going to go to medical school and then this fell into your lap? Or because of your brother?
Speaker 1:Yeah, I definitely just heard about it first from my brother. He was a few years ahead of me in age and school and everything. So actually it's funny me and both my older brothers all were thinking about pharmacy school while we were in college because my dad was a pharmacist. Pharmacy school is extremely competitive, mainly because there aren't very many pharmacy schools, especially in Georgia. It's a small class size, there's not a lot, so it's pretty competitive. Just it's a small class size, there's not a lot, so it's pretty competitive. I knew that you know going into it, but probably around like my sophomore year is when my brother entered AA school and so that quickly shifted for me because I learned of the program and he really talked it up and I did some shadowing of a family friend who's an anesthesiologist and was like, okay, this is probably a better fit for me.
Speaker 2:And what, at that age, made it seem like a better fit over, maybe, pharmacy school and feeling like your chances were as good. Are there more pharmacy schools than AA schools, or is it there's more AA schools than pharmacy schools?
Speaker 1:Yeah, I was thinking better fit. I just enjoyed it more. I didn't love being behind the counter. I grew up seeing my dad as a pharmacist and worked as a pharmacy tech through high school and college and I did not. I love the flexibility of like not having a traditional nine to five and kind of being able to do it part time and you know, imagining my future and thinking that would be a good fit for me, but I did not love being behind that counter all day and I wanted something a bit more dynamic. So when I started shadowing and learning about anesthesia, I was like, okay, this, your, your day is not like Groundhog Day. You're have a very different day every day of the week. So that was much more appealing to me, as well as the potential to work full-time, part-time and have the flexibility for a lifestyle that I wanted.
Speaker 2:I just think it's interesting your perspective on what it means to be a CAA, because you were growing up in the hub of CAAs. Like I think that's interesting that you're like, oh, one day I could work part time as a CAA. And for me, I, you know, I grew up in Cleveland, Ohio, which was another hub, but I just never saw anyone working part time. Like I feel like that's a newer phenomenon that you and I both have got to enjoy at different times. So, and I just think that is true, Like it is true now that you can work part-time or have a flexible shift or something, but that's evolved, you know. Yeah, absolutely, Absolutely, Very interesting. Okay, so for all of the prospective AAs who are listening, or people who are currently in AA school and are needing a little bit of they want to relate to you, I would love for you to share how AA school was for you the good, the bad, what you remember, what you blocked out.
Speaker 1:Oh, geez, yeah, Let me take myself back there. It's been about 13 years now, so well, 15 years since I started. It was a time that felt like here's what I remember. I remember starting AA school and feeling like I should already know everything there is to know about anesthesia. And I don't know if that was just my own internal expectations of myself or if that was the preceptors that I had and all of that, but probably a combination of both. But I remember feeling very overwhelmed by that and starting day one, I'm like I'm already behind and when I look back on that now I'm like that is so silly. I was literally there to learn this and so I felt pretty overwhelmed at times and having to like remind myself like I've only been doing this for a month, I've only been doing this for six months, like this is the point of anesthesia school is to learn and to not feel like I've already, I need to know it all already. So I would say that was probably the more challenging aspect of it to me, like the hours, the long hours, all of that that was okay, like I didn't necessarily mind that.
Speaker 1:That fits my you know personality pretty well.
Speaker 1:I had a lot of fun too.
Speaker 1:I, you know, was really good friends with a few of my classmates and we had long study sessions and you know, stay up late, drink a lot of coffee, like I loved traveling second year and doing the rotations, especially when I got to do it with good friends and doing the rotations, especially when I got to do it with good friends. So I have really fond memories of that part of it and seeing myself develop and flourish and kind of coming into my own. Yeah, I think that if I could give some advice to my younger self and to, potentially, to some SAAs, listening would be to go a bit easier on yourself with your expectations and remember that you're here to learn. So ask the questions, even if you feel like they're dumb questions, because this is your opportunity to do that and to learn the way that you like to practice, learn best practices and to absorb that information without having to you know posture in some way that you are not kind of in the dark and you're you know you're not a little bit confused and lost at times.
Speaker 2:So it is such a delicate balance, man. It is just it's tricky. It's a tricky way to learn learning medicine. I mean, medical students go through this, residents go through this that you are, you're in the real life, non simulation learning. It's very tricky. So that's great advice, and I hear a few people who are listening screaming, ask her when it clicked, like when did you feel like, oh, okay, now I have it. At what point in your education? As a hope Maybe?
Speaker 1:this is a hope for them listening. It definitely was not until second year. Um, I would say that first time that I could run an entire case, start to finish, without without needing to like look behind me in my preceptor to be like are you happy with what I'm doing? Am I doing the right thing? You know that feeling that we all have of like let me read your face to like see if you're, if I'm doing it right or if I'm gonna get the look of like what are you doing?
Speaker 1:you know, oh the look, yeah the look of just like, oh man, these students, you know, I think for me having that confidence of like I don't need to look behind me, I know what I'm doing is is best for this patient, it's the right thing to be doing at the right time. I know what I'm doing is best for this patient, it's the right thing to be doing at the right time, and I know that I do have eyes on this situation right now so I'm not going to get into anything dangerous or out of line. But for me that felt really empowering to be like Like okay, I don't really need the backup mentally, emotionally or whatever you know to affirm that I am doing right by my patient. So that for me was like getting a few of those under my belt. I was like, okay, I actually can do this.
Speaker 2:So definitely sometime second year, I would say halfway through somewhere around in there. Yeah, yeah, that sounds, that sounds about right. Yeah, and I just think if you're in AA school right now, you know exactly what you're talking about, so I think they'll find that helpful. Great, walk us through, maybe just immediately post-graduation, and you stayed in Georgia for a while. Maybe fast forward us through what made you leave Georgia and go to Washington.
Speaker 1:So yeah, after practicing in Georgia full-time for four or five years, I was at a point in my life where I kind of got an itch to try something different. And not that I wasn't happy with my profession as an AA, but I thought, you know, this is the opportunity, before I have too many roots, to explore different interests of mine. And so I felt for a long time actually a real interest in mental health therapy and I did a few like trainings on the side, similar to what I hear you, you know, do like little trainings here and there and gathering these skills and resources. And I did that for a while. One of the trainings that I did was in Seattle and I flew out a few times a year to an organization called the Allender Center and did some trainings with them and kind of just felt like, whoa, this is really something that I want to pursue, and so they have a master's program as well.
Speaker 1:And so I decided to put a pause on my full-time job in Georgia and kind of uproot my whole life and move to Seattle to pursue this. And, honestly, when I started I was like I'm going to give it one semester, you know like, let me just see, I had a great working environment in Georgia. I was working in Atlanta Medical Center, had a fantastic group and boss who was. I talked to him about all this. I was like I need to. I need to have a few things like safety nets lined up for me to feel like I can do this.
Speaker 2:Yeah.
Speaker 1:I said. One is that I need to know I can come back to my job if I and when I I was expecting to come back when I decide that I'm ready to come back. And he was like, yeah, just say the word, like we'll have you back. And I was like two, I need to be able to continue to work PRN, and can I do that here? And he was like great, love it, Like whenever you want to come.
Speaker 1:So it was honestly just hard to say no to at that point, because I had that safety net and I thought I felt really free to try something, knowing I could come back. And so, with his support, really I felt like let me go and try this. So I did. I moved to Seattle and those first few weeks I was like I'm not going to make it, I'm not going to do this, I'm going back. You know it felt so brilliant an identity shift. You know that occurred, but you know I stuck it out and that was almost 10 years ago, nearly 10 years ago. So I continued to work PRN at that hospital until it closed a couple years ago.
Speaker 2:So I just I love this. I just think this is exactly what gets me so excited about the CAA profession and how to use it as a tool. I want to know more about the safety piece, because that is so real and I think is one of the strongest aspects of the CAA profession that it really can give you safety, and I would love if you could be blunt about what that exactly meant in terms of finances or that job, like being able to come back to the job and who this manager was. Was this an anesthesiologist? Was this a CAA? Who was this person who was so willing to work with you?
Speaker 1:So he was an anesthesiologist and his name was Dr Harris and he was the one who I had those conversations with. He was sort of the chief of the group at the time. Yeah, we just always had a really great working relationship. I felt he really had my back multiple times, not just on this, not just on this issue, but a lot of issues. He just really went to bat for me and I imagine other AAs and CRNAs as well that were in our group.
Speaker 1:So in my opinion he was a fantastic boss to work for and, looking back clearly on my story, he's a big part of why I felt free to pursue more of who I wanted to be. So, yeah, that type of leadership is hard to come by. Even when he didn't necessarily understand or wasn't his thing that he would have chosen, he could see that that's what I needed and kind of set the stage for me to have that environment to come back to that group, to come back to for the next. You know, eight years seven or eight years that I continued to fly back and forth from Seattle to Atlanta to work the weekends.
Speaker 2:Yeah, Every weekend, or what were you trying to hit? Like a monetary goal, or were they like here are the days you could work, and so you had to make that work.
Speaker 1:It was a monetary goal, for sure. It was basically enough just to ensure that I didn't have to work in Seattle, Like a lot of my classmates, you know, in grad school, working at Starbucks and stuff like that. So I just didn't want to have to do anything like that and so I made enough money to pay my rent, have money for food and of course, I had some savings that I was using to pay for school and that I could dip into and stuff. So that was part of it. I wanted to work at least one weekend a month, which is what I did for a very long time. Sometimes two weekends a month, Christmas break, summer breaks, things like that when I wasn't in school. I would come back for longer periods and work two weeks, three weeks a month. It was a really easy ideal situation for me.
Speaker 2:Oh my goodness. I just see so many people who are CAAs right now thinking like, oh my goodness, I've never thought maybe I could sort of do it this way and then also maybe pursue this other side thing I want or this other next thing I want and for all the students listening, I do these opportunities still exist. This wasn't like a thing that happened in what? 2014? Was that? When we're kind of talking about this?
Speaker 1:Yeah, 2015 is when I moved to Seattle. So yeah, and that went on for, like I said, until Atlanta Medical closed in 2022.
Speaker 2:Yeah, I'm doing something similar to pursue new things for myself as well, working PRN and basically get to pick the days I want to work in Kansas City, the big hospital, and sort of use it as support financial support as well as stability in terms of like. Okay, if this new thing doesn't fly, I can always come back to working as a CAA, which I love too, which is a nice perk. It's not something I don't want to do, right.
Speaker 1:Right, exactly, and that's very similar to, and to answer, your question about safety and all of that. That was a big part of it for me was that the CA profession is lucrative and it's very hard work at times. But I felt, after working several years full time, full call, I felt I was really good at it. You know, I had that sense of like, I feel pretty confident about what I'm doing and always there's room to grow, always there's room to, you know, improve. But I think that was part of the safety that I knew like I'm not getting out of this too early. I'm not, like you know, going PRN or whatever too soon.
Speaker 1:I felt like coming back once a weekend or once a month or twice a month, you know, for a few shifts each time kept my skills up. It kept me, you know, engaged in the job enough and I had that strong few years of like really coming into my own and developing my skills and knowledge and confidence as a provider to step away from it and know that coming back wouldn't be too intimidating. So there was that piece of it and the financial piece of like. It's really risky, after having a very well-paying, comfortable job, to say I'm going to step away from that. Most people don't do that and I got all sorts of sideways looks from family, from friends, from colleagues about why would you do that, and it's no secret that mental health therapists make significantly less than AAs, so it was never a purely financial choice for me to do this.
Speaker 1:It was like I wanted to be really authentic to myself and I knew that I had more of my life that I wanted to develop and explore. But, like I live in reality, I needed to know that I had some a safety net of job to come back to that could pay the bills. If it came to that and which is, in part, you know we'll get into this, I'm sure, but why? I was really passionate about bringing AAs to Washington too, so that I didn't have to travel across the country anymore. You know, and they're very personal for me as well, as you know, to develop and help the profession and the patients of Washington. But truly driving it was a personal desire of like I don't want to have to sacrifice any part of myself and, you know, having two kids now it just got an Atlanta Medical Center closing, it just got more and more difficult for me to have that sense of safety and security to go back to. So I had to get creative and create it here.
Speaker 2:So, mm-hmm, and the journey began. I just, I just love that, sarah. I'm just really proud of you as a fellow CAA. I just really love the bravery that it took to do that and the authenticity following. Your authenticity is so. It just gets me all excited. So I hope people feel inspired as well when they hear that story. And yeah, let's get into the Washington legislative process, because absolutely that is something we're celebrating on this episode. I think the first question I want you to answer is just we know a little bit about your why and the passion behind it, but how did you logistically get into making a difference in the CAA legislation in Washington so when I was working one of these period shifts in Atlanta Medical Center, I was working with an old colleague of mine who I worked with in a different hospital in Georgia.
Speaker 1:He was also working PRN that day and he was Ralph DePauw and he was on the board of Quade at the time and he was like, hey, you're living in Washington, right? He's like, would you be interested in starting a state academy there? And I was like I don't really know what that means, but sure you know.
Speaker 1:How hard could it be? And he was, like you know, I later found out that the WSSA, the Washington State Society of Anesthesiologists, was hoping to introduce AA legislation and they contacted Quad A to let them know. And so Quad A said well, we're going to need, you know, some boots on the ground in Washington, as you know, an AA Like who do we have? And you know there aren't many of us out here, so I was kind of the obvious choice there, I think. Um, that's kind of how I was pursued about it, and a lot had already been going on behind the scenes as far as the WSSA and their lobbying team getting a bill going.
Speaker 2:And what year was this? What year did you start the State Component Society? 2021. 2021. Okay, so very recent, honestly. The bill passed in 2024 and you had started the State Academy for Certified Anesthesiologist Assistant in Washington in 2021.
Speaker 2:And, unbeknownst to you, just kind of piecing this together. If I'm hearing you correctly, there was a lot of movement behind the scenes that you kind of were plugged into when you said, sure, I can start the State Component Society, yeah, why not? And then you were like, oh, okay, yeah, okay. So I think it probably will be helpful for everyone who's listening.
Speaker 2:If you don't know about how a CAA bill or an AA bill is passed in a state, it can be confusing, and I only learned about this last year when I talked so in depth to Nevada, and so I do want people to walk away from this episode with like a really grounded understanding of what an AA bill passing looks like in terms of the steps, and I also want to say it's a little bit different in every state, so it's not something that is absolutely 100% applicable state to state, but give us just a basic overview, if you could, of the legislative process in the state of Washington, okay, so, every year there's a legislative session, and the session is this period of time, usually a couple of two or three months, where that is the time of year where bills are heard and voted on, so that doesn't happen year round.
Speaker 1:That happens during specific times called the session, and so a lot of work is done in between sessions to actually get the bill to the point where it's being heard in the session, and so that had already been going on behind the scenes, and so when ICANN came on, a lot of those conversations with legislators were already happening, the bill had already been drafted and they were working on what's called a sunrise review, which is not unique to Washington, but I don't know that. It happens in every state, and that is when the Department of Health studies a profession, a new profession, and or maybe they study a specific part of a profession that there's legislation about. At any rate, that Sunrise Review is very extensive and had already been going on too. So by the time I came onto the scene, the bill was being introduced in the 2021 session and the Sunrise Review had been done and was completed, and they had given their recommendation to license AAs in Washington. So may I interject?
Speaker 2:for a moment. Sure, yeah, can you just explain who was doing all that work? If it wasn't you and it wasn't the Quad A, who was that?
Speaker 1:That was mostly the lobbyist for the WSSA, the Washington State Society of Anesthesiologists, and they hire a lobbyist to help work with legislators to draft the bill, to get the Sunrise Review going, and they kind of. That's why we have lobbyists, because we're like anesthesia providers, we don't know what needs to be done. We're like anesthesia providers, we don't know what needs to be done. So they hired their own lobbyist to follow all these rules, follow all these steps and get a bill introduced. So that was already up and running by the time I came on.
Speaker 1:Then what happens during session is that your bill is first introduced either to the Senate committee or a house committee, which is, you know, you have two branches of the legislature the house, the Senate and then within those branches there's subcommittees, little committees that meet for things like finances or healthcare or infrastructure, all those types of issues.
Speaker 1:And so our bill was heard in the healthcare committee and that first year it didn't get out of committee, meaning that it wasn't voted on, it didn't pass the committee. Then it goes technically to a rules committee, so another committee after the first committee, and then it goes to the whole one side of the legislature, so either the House or the Senate, wherever the bill was introduced, and then, once, if you get to that third step, it goes back to the other side of the legislature, into a committee, into another committee and then to the whole of that group and along the way there's usually amendments happening to a bill, and every time an amendment happens it has to go times that your bill has to be voted on and that you have to stress out about it not getting passed out of this committee. So there's a lot of steps involved and then eventually, if it gets through all of that, then it's put on the governor's desk for his signature, which is the final thing that has to happen.
Speaker 2:So yeah, quite extensive process and extremely stressful times, yes, I can imagine, and so many out of your hand moments like where you're just waiting for a phone call, I imagine, or an email to say it passed, it didn't pass.
Speaker 1:And here's our next steps or an email to say it passed. It didn't pass. And here's our next steps. Yes, Well, I was not necessarily waiting on a phone call to see if it passed or not, because I was either present physically or watching on Zoom every committee and every meeting that was had. The only ones I couldn't be a part of were the rules, because those are in-house, they're closed and not open to the public. But yeah, I was always watching.
Speaker 2:I was always tuning in live, so I was not sitting around waiting on a phone call.
Speaker 1:You were there. Yes, I was there. Yeah, wow, so yeah, there's a lot happening in between each of those times too, because we get little snippets of information from our lobbyist, which is why she's there on the Olympia Capitol having conversations and we're involved in a lot of those conversations too and we get information like this legislator has an issue with this part of the bill, this legislator has an issue with this part of the bill. We have to meet with them and help, educate, help. There's some compromise that goes on. That's where the amendments come in. You know, there's just like so many fine-tuned little tweaks that happen behind the scenes to finally get the bill to where you get enough votes for it to pass, so it's extremely complicated.
Speaker 2:And this was it was attempted in 2022, in 2023, and then it passed in 2024. How many hours do you think each week you put into this for three solid years? I mean, I know you did work before that as well, but, like when it was trying to be passed, trying to be passed.
Speaker 1:It's hard to say honestly, because during the session it was pretty much around the clock. Wow, I didn't probably have to be that involved but I needed to be for my own. That's just my way of being. But I made myself more involved than I probably needed to be and I think my lobbyist at times was like let me just handle it, especially when the baby was coming. You know she's like take a break, I've got this, you know. But I'm like what's going on? I need to know everything. So during the session I was it was around the clock this year In the summer. In between, very little I mean I would do an email here or there. I would, you know, do a post or something if I needed some support in that way. Met with legislators, you know, occasionally in the downtime, but during the session things happen so quickly that if you wait 10 minutes to reply to an email it could be very different. Wow, yeah, it was very fast-paced this year in particular.
Speaker 2:In 2024, the year that it passed Wow.
Speaker 1:Something we did this year we actually did in 2023, but it was for the 24 session and it was at the request of the legislators was that we held, we participated in, what's called stakeholders meetings for the bill, and so this was an opportunity and that the legislators they don't like to see, they didn't like the contentiousness of the bill. So there were you know, there was a lot of we want this, we want this and nobody could get on the same page. And so they suggested and what often happens are stakeholders meetings, and so we participated in these meetings with the WANA, which is the Washington Association of Nurse Anesthetists, and the WSSA, and legislators and their staff were present, and so we had a series of stakeholders meetings leading up to session two to discuss the bill and to try to get on the same page about what would happen with the bill. And so I'm not sure if that happens in every state or not, but just to give a little bit more insight into this year, what it took to get the bill across the finish line was kind of coming to the table with the WANA, with the WSSA, and making sure that everyone had a voice and that these conversations were happening in real time in front of the legislators.
Speaker 1:What often happens and was frustrating in the process, is that we would meet like the WSSA and the Washington Academy would meet with legislators and we would kind of give them our pitch and then two weeks would go by and they would kind of give them our pitch and then two weeks would go by and they would hear another pitch from the WANA. And they have so many bills that they're hearing and so much going on that they can't remember what was said two weeks ago. All they can probably remember is what they're being told right now, you know, and it can get really confusing for them and a lot of information. And so we found it very helpful to have those conversations real time in front of the legislators so that they could ask questions of all groups involved, of all the stakeholders, and we could all provide our responses in real time. And so that took up a good bit of time and emotional energy and preparation as well this year.
Speaker 2:Thank you for sharing that, because oftentimes AAs come in as like information givers as opposed to like a contentious party. You know what I mean. Like, I just think our position seems to be we're not here to fight, we're just here to solve this problem. Again, I just think it's hard to have that type of attitude when the other side is possibly being contentious two weeks after the legislators talk to us.
Speaker 1:Yeah, it is hard because we don't have the upper hand right. We're not practicing in this state, we don't have a lot of constituents in this state, so we have to in some ways tread lightly because we don't have you know, there's not a robust understanding of our profession and so we have to come in with a lot of education and a lot of defending inaccurate representations of our profession. And so definitely tricky to do without coming across as contentious, which we don't want to be, but at the same time not letting a different narrative run away. Like, we definitely wanted to be in control of the narrative of AAs, because we are the experts on AAs, we are the AAs and we needed to be in control of that narrative so that we weren't chasing our tails trying to readdress misinformation but we could get the correct information out there ahead of anyone else's.
Speaker 2:So Do you think the process of re-educating is that what you felt like you were doing most of the time? Yes, Wow.
Speaker 1:That's most of the conversations.
Speaker 1:If it were only us presenting the information, of course, I think any legislator would be like oh okay, this makes a lot of sense, you know, yeah, but when you have different groups speaking to our profession about what they understand it to be or what they've heard it to be and how it impacts them, how they imagine it will impact them, there's a lot of just honestly false statements being made not speaking to anyone's intention to speak falsely or to lie, but that just ended up being what it was is that there was legislators would hear things and we would be like that's actually not true.
Speaker 1:So there was a lot of cleanup work that had to happen the first couple of years information before others had the opportunity to get out their interpretation of our profession, so that we had to kind of come behind and clean that up. That's a lot of. What we do is having the same conversation over and over and redirecting legislators back to a different conversation that we want to have, not about how this will tear apart another profession, but how it will actually be good for the patients of Washington.
Speaker 2:How did you get comfortable speaking to legislators or speaking in this stakeholder meeting? Did you practice? Did you have someone in your life ask you questions? What were you actually doing to prepare?
Speaker 1:Oh, great question. Well, by the time I was in these meetings, I had been doing this for a few years, but I do remember the first time kind of starting the academy and we were getting everything formed. And again I had that very similar feeling that I mentioned about having an AA school, where I felt like I feel like I should just know how to do this already, because everyone around me, even the AAs around me who had been involved in the legislative process that I consulted with, had a language. It was like learning a second language and they were already speaking the language and they felt very confident in what they were saying and doing. And I was like had that very familiar feeling of like I think I should already know this Apparently. You know, I should know how to do this, I should know this information. Even just someone saying, oh, the academy or the society or the session or whatever, I'm like wait, what's the session again? Oh, the society or the session or whatever. I'm like wait, what's the session again, what's the society again, what are we talking about? You know like the very simple terms. I had to ask so many questions and remember that, like I've never done this before. That's why it feels hard because it is hard.
Speaker 1:I remember meeting with Richard Evans, who was the director of government affairs at the time for Quad A, and he was like, oh, when we start meeting with legislators, you'll blah, blah, blah, blah, blah. And I won't ever forget that, because I was like, wait, we're going to be meeting with legislators. I'm going to no, no, no, no, no, no. I thought that's what you were for. I thought you were for that, not me, and so it felt extremely intimidating. At the time I came to learn that legislators actually really just want you to be a regular person and leave the technical lobbying, political conversations up to the lobbyist, which thank God we had a lobbyist, because I could just be an AA, I could just be myself, I could just tell my story and kind of ask those questions that reveal very quickly to anyone that I'm not a politician, I'm not in this world, you know, and that actually felt really relieving to me. I didn't have to be, I didn't have to be a politician, I didn't have to be a lobbyist. I could just be an AA and tell my story and ask those questions that you know everybody else is like already knows the answer to, but I don't, and that's okay.
Speaker 1:The way I prepared was just really over time. You know, the first meeting that I had with a legislator was here in Spokane, which is where I live now Spokane, washington and we met at a hotel restaurant and the WSSA lobbyists flew over from the West side of the state and met with me and this representative out here and I don't think I said very much at all. I think I was just like, ah, like I don't know what's happening. I was pretty nervous. Over the years I got much more comfortable talking and, just you know, speaking up a bit more and yeah, it took some time. I had a lot of tremendous support from the Quad A, from folks who have done this before me and coaching me, especially during testimony time in the session, about what to say, how to say it to make it concise and understandable and how to boil things down to be a bit more easily understood by politicians who have a lot on their plate and aren't medical experts usually. So there is a lot of just learning by observing and by doing it. Repetition.
Speaker 2:I'm so inspired by hearing this. It's really encouraging, as a regular CAA who I consider myself to be to hear another regular CAA say that they're just looking to hear your story, they're just looking to find the humanity within you and connect with that and be like, oh okay, I can see why she wants CAAs to work in this state, because she's commuting by flight to Atlanta and she has a family here in Washington, wants to stay there. All of that makes sense to them more so I think I get worried that like, oh, if I was ever called to do this, I'd have to use these expert terms and like wow them with my understanding of the state legislation and the laws. And that's not at all what you're saying. That does maybe happen in some ways that lobbyists are doing or other people, and maybe you grew into incorporating a little bit of that language, but at the basis it was just who are you, who is Sarah, and share that? Yes, oh, my gosh, that is so inspiring.
Speaker 1:Yeah, it was a huge relief to realize like, oh, I don't have to be a part of this political group and speak their language. It was definitely helpful for me to understand what was going on. But, yeah, my lobbyist was always like just tell your story, let me handle all of the politics of it. And that is exactly what we needed, because you have to have someone talking the politics for bills to get passed. But it does not have to be you, someone who and they want to talk to the lobbyists, they want to have those conversations with the lobbyists because they have a shared language. They would much rather have those conversations with lobbyists than with us, so it was a win-win for everybody.
Speaker 2:And just if you're listening right now and you're not sure what a lobbyist is, there is another episode that was actually the season three opener, where I interviewed several people who worked to pass the Nevada A bill and what their exact role is.
Speaker 2:So after you're done listening to this, if you wanna have a little bit more knowledge and just hear the legislative process again at the state level, I will put that link in the show notes and it would be really, really helpful to listen right after this. Okay, of the many, many, many more things, I wanna ask you one of the biggest moments, at least for us watching on the outside, because you're also running all the social media for the Washington Academy of Anesthesiology Assistance, which is how I met you and know about all of these goings on is that the bill took a turn in 2024. It looked like it was going to go to the governor's desk and be signed in and celebrate and yay. And then, about two weeks before, it all seemed to fall apart possibly, and I would love if you could share what you can about the behind the scenes of leading up to that that happening and then the bill actually being signed this year.
Speaker 1:Yeah, so when the bill passed the legislature which means that it got through all of those committees and both chambers that I mentioned, got through all of those committees and both chambers that I mentioned the final step was for it to go to the governor's desk and our lobbyist was in contact with the governor's office and they said this seems like a bill the governor would sign. We don't anticipate any issues with it. I mean, he doesn't have a really high veto record, so it just would seem really out of the ordinary for that to happen. And so we felt really confident, and I'm not sure that we ever really had a reason not to feel confident, and I'll explain that later. But we started to not feel confident a few weeks after the bill got out of the legislature. So it passed the legislature. We're thinking great, the governor is on board, shouldn't be a problem. I think there was about a month, if I'm not mistaken, about a thinking great, the governor is on board, shouldn't be a problem. I think there was about a month, if I'm not mistaken, about a month long period.
Speaker 1:The governor had to sign all of the bills, and we're talking hundreds of bills that he has to sign. So you know, a couple weeks went by and we're like lobbyists was like it's okay that the bill hasn't been signed yet. We still got time. Then, like another week went by and we're like starting to get a little bit worried. You know, like what's he thinking? Cause the, he, the the office wouldn't really give us many details on what he was thinking. Um, then we heard that it was scheduled to be signed and we were like awesome, like great. And then about an hour after it was posted to be signed cause the agenda is posted publicly to the governor's website the agenda changed and the governor's office called our lobbying team and the legislators and said that bill has been removed. And we didn't know why, if it would be added back, if he was not going to sign it. We didn't know what he was thinking.
Speaker 2:Like reconsider the whole bill after speaking to who knows who about who knows what. But something changed his mind, because he's the last step, or the governor is the last step to getting a bill passed into law at the state level.
Speaker 1:Correct, yes, okay, and he has the power to getting a bill passed into law at the state level, correct? Yes, okay, and he has the power to veto. Okay though, and so just kind of wipe out more or less wipe out everything that we just did for the last three years so yeah, um, and it's one person, it's one vote.
Speaker 1:So like versus the legislator, where's legislature where it's like, well, if this one person doesn't's one vote, so like versus the legislature, where it's like, well, if this one person doesn't want to vote for it, that's fine, we can get other votes. In this way, it's one vote at this point. So it's like if he doesn't want it, then it doesn't happen. And I don't think that that was ever actually the case for him. I don't think that he was ever like I'm reconsidering it. I just think that someone like kind of put a flag on it for him and he was like okay, well, let me. I need to look at this a bit further.
Speaker 1:Whereas before he's kind of briefed on the bills, you know he's, his staff informs, I think, a lot of like what, what happens, and it's a bit of a team effort. And I think that's why we were getting information initially that his staff was like this is something he's likely to support expanding access to health care. Of course, this is in line with his values and all of that. And then his office went essentially radio silent for the next week and we didn't hear any updates, even though we were asking updates, even though we were asking and in the meantime we were garnering a lot of trying to garner a lot of support across the country to have folks call in and email into the governor's office, which you probably remember seeing all those posts like call the governor call the governor email the governor and I think he just probably got tired of him and his office probably got tired of hearing from both sides so much.
Speaker 1:I think he just probably got tired of him in his office, probably got tired of hearing from both sides so much I think he had to go radio silent to just block it all out and say let me focus on the bill, let me focus on the facts. And then the night before he signed the bill which was his very last day signing any bill that session, oh gosh, and he's not running for reelection, so it was his very last bill signing ever the night before we got a phone call it's on the agenda for tomorrow, wow. So I hopped a plane for Seattle. I wanted to be there, me and my family, even though I had just given birth four days or five days previous.
Speaker 2:Five days before. Yeah, I was seeing this all go down on Instagram. I'm like this woman, sarah. I could not believe what you had just endured while having a baby. You didn't know if he was going to sign it or not right while you were delivering this baby. It was all just so up in the air no, yes, out right while you were like delivering this baby.
Speaker 1:It was all just up in the air. No, I, yes, I was, and I will. You know, it was so intertwined both I call them both of my babies yeah, the bill and my daughter. They were so intertwined that, like even during labor, I was like having thinking about this stupid bill. I was like this is insane. Why am I thinking about this right now? But, yeah, the bill baby was born five days later and so I got to be there for the signing.
Speaker 1:And so cool as a mom to have both of my kids there, but especially my daughter there, you know, holding her and getting to one day tell her about what, you know, a strong women can do in the world and the impact that we can have. That was like the best week of my life, so far. It was going to be a hard one to talk.
Speaker 2:Wow, amazing.
Speaker 2:I have so many more questions for you, but in the interest of time, maybe a couple more, because I do think people are going to hear your story and think, okay, well, I want my home state to open or I want to have this opportunity to move X, y, z, and I just never thought it's possible. But now I think maybe it's possible. So I think there's kind of two groups of people. The first is a CAA or an SAA who knows they want to open a new state and they have that passion and drive and maybe it's their home state. What is their first step to take?
Speaker 1:become a member of the Quad A.
Speaker 1:I am ashamed to admit, but I think it's important for people to know that after a couple years of working full time and you know, I was a Quad A member right out of school but I let my membership lapse and especially then going PRN, where I didn't have my group paying for professional memberships, I wasn't a member anymore for a long time.
Speaker 1:And it wasn't until they approached me to start the Academy that they were like, by the way, you need to be a Quad A member to do this. And I was like I was like, oh, of course, like happy to, you know. But that's even how I got re-involved with the Quad A and now I'm also the subcommittee chair on the Quad A and so I'm interested, I'm from the state, I have connections in the state, you know. Express your desire, because there may be someone from the state society in that state also contacting Quad A, saying, hey, I'm in this state and I want to do it, and we can, you know, join forces and start to create a little army of people who are motivated to get this done. So that would be the first step.
Speaker 2:Awesome, beautiful. Everyone's taking that and going now. The second group of people I would love for you to speak directly to are those maybe that I fall into, where I'm enthusiastic about the profession spreading, but I don't know that I have the passion or the desire to open up a whole new state. It's not a personal investment for me at this time in my life. How can I, or those people, make a difference?
Speaker 1:There's two big buckets of the ways that you can be involved. One is with your time, even if it's just a little bit of time, and one is with your money. So I'll start with the money piece. First. Donating to the legislative fund for Quad A or donating directly to a state academy that you feel personally interested in is profoundly important and useful the lobbyists that I mentioned. Pretty much all of our funding comes from the Quad A legislative fund to hire her. And then we have a little bit that comes in from people donating directly to the Washington Academy, but every penny that we receive goes toward the lobbyist. So, donating your money if you're like, hey, I can't even be bothered to write an email or phone call at this point, totally get it, give some money. That would be great. The second, and what I found really to be so crucial, was when you see a post or when you see an email come from Quad A about we need you to sign this form, we need you to email, we need you to call. Those take like very little time five minutes or less usually and are so helpful. So if you see those types of opportunities, even if you feel again, if you feel like I don't know what to say.
Speaker 1:In an email, you can usually ask someone or you can just I will just tell you. It's usually just about sharing your story. My name is so-and-so, this is where I live. I'm an AA. Please vote yes for this bill to expand healthcare in this state. You know that it's a really simple and easy message, and so anytime you see the opportunity to do that, I will just say personally, that type of response helped me so much when I'm all the way out here on this side of the country and I feel really disconnected at times from the larger AA community, to know that I could put a post out there or have Quade send out an email and that there would be a large response from people actually following through with.
Speaker 1:This was everything, and we needed that, because there are a thousand CRNAs in Washington state and for every CRNA in the state they have family, they have friends that they can reach out to, that are constituents calling in, and so we needed to show like we may not be in Washington state yet, but we're out here and you know we care about what's going on too, and we would love the opportunity to come and work in that state and have our tax dollars in that state and have our families in that state and plant roots there, and so that type of opportunity, when you see it come along, it's really easy to do. Super low commitment. It means the world to the people who have the boots on the ground doing the work and it goes a long way with legislators as well.
Speaker 2:So good, yes, yes, yes.
Speaker 2:That's everything I was hoping you would say, and I just want to reiterate a theme that's come up just from me talking to people who I'm like whoa, I'm talking to Sarah, who passed the CAA bill in Washington. I'm talking to the Quad A president to really see, it is by you, sarah, sitting in Washington attempting to pass this bill, that my email coming from Kansas City, missouri, hits you. You see it and you're like okay, people care. And okay, this $50 came in and I'm going to use that now to pay the lobbyists this month, which is the only way that this is going happen. Like that gets in my brain, like, oh, this is only one step away from me. This is not a hundred circles away from me where people are doing this. This is just one small step and I can really make a difference. It's inspiring as a CAA to know that one person can make such a huge difference, and it also can feel pretty daunting and I think holding both those truths is sort of you know the beauty of being a CAA right now.
Speaker 1:So it's just a CAA who is choosing to do something, or or who is choosing not to. So that's the only difference. It doesn't. There's no super heroes. There's no someone who's more qualified or less qualified. It's really just the person who decides to show up and do it.
Speaker 2:Yes, yes, yes. What is next on the horizon for you, what's next in your life? By design Sarah Well.
Speaker 1:I feel like I'm getting closer and closer to my dream of being able to do both jobs that I love here in the state. So now that the bill has been passed, we have entered the licensure portion of the process. So we're working with the medical commission right now, the Washington Academy as well as the WSSA, to finalize the license that will eventually be the license of AAs, and so that's a lengthy process as well. It's the government Nothing's like extremely fast. So we're looking at still quite a few months, up to a year out from that being done. That's my hope and my dream of what is on the horizon for me is to be able to practice in this state, to work and exciting to share that we already have groups in the state interested in hiring us and I'm in contact with those groups and working with them to make sure that they are ready to go when the licenses are ready and have their ducks in a row and ready to accept AAs into their practice Amazing.
Speaker 2:Amazing. Well, I can't wait to catch up with you in a year and you can maybe help share how, after the legislative process, comes the licensure process, and then comes the hospital accreditation process, and then comes the hiring process, which are all steps to get you where you want to go. And I would love to check back in in a year and just see where everything's at. What do I want everyone to know? I want them to know that in the show notes I'm going to put a link to donate directly to the Washington Academy of Anesthesiologists Assistance, who needs your support right now to help them push through that licensure process. Correct, that takes money. Yes, so we're going to put that in the show notes. I'm going to put a link to email Bree Siegfried, who is the current chair of the Quad A legislative committee. If you are listening and you're like I don't really care that much about Washington, sorry, sarah, we love you, but I care about something else, or you know I want to do something. You can email Bree. And then the Quad A legislative fund is an ongoing fund that is large and each year the state component societies let's get in the weeds to it slightly, because we're talking to CAAs, the state component societies of CAAs put in a request to this legislative fund to be doled out money, and that money is oftentimes used for the lobbyists and so, yeah, it all just really matters and it's all. You're just one step away from making a huge difference as a CAA. So I really encourage everyone to check out those links. I'll also put the Nevada episode in the show notes so that you guys can kind of get the ball rolling if you're sort of interested, and to hear another state say the same thing a different way in their experience. I just really appreciate everyone listening.
Speaker 2:Sarah, I appreciate you being here and giving me your time so generously, and I can't wait to check back in in a year. Sounds great, thank you. I hope you loved that episode as much as I did. Something to really help the show is to forward this episode right now to another CAA colleague or another AA student in your life and tell them why you loved the episode and why you think they would love it. That really helps take this message far and wide into our CAA community. Of course, doing all the other things like following me on Instagram at AwakendAnesthetist that's where I show a lot more behind the scenes. You can join my email newsletter. You'll find a link for that in the show notes and, of course, you can leave a rating and review for this podcast on whatever app you're listening to me right now. Thank you all so much for being here. This community means so much to me and I hope you're all out there taking small steps towards living your own life by design. Let's talk soon. Yay, okay, I'm going to press stop recording.
