Nicole Moore, Certified Anesthesiologist Assistant and 2025 AAAA* President, shares her journey from discovering the CAA profession through a Google search to becoming a pivotal leader in CAA advocacy and education.
*American Academy of Anesthesiologist Assistants
In this LIVE Season 4 Finale recorded @ AAAA 2025 you will hear how Nicole:
- Balances full-time clinical practice with AAAA presidency through an intentionally designed schedule
- Discovered the CAA profession while questioning whether medical school aligned with her life goals
- Led successful legislative efforts in Virginia resulting in CAA licensure after 8 years of advocacy
- Emphasizes building relationships with physician anesthesiologists as key to legislative success
- Shares a powerful story about a patient who experienced cardiac arrest during a C-section
- Maintains balance through family support, planned downtime, and periodic digital disconnection
- Views leadership as something that found her rather than a deliberate career plan
If you're navigating leadership as a CAA, want to continue growing professionally, or need a reminder about why you chose this profession, this conversation will ground you in what matters most.
Support Aaliyah Walker and her advocacy for PE Awareness and Black Maternal Health—work inspired after her OB emergency and the care she received from CAA and 2025 AAAA President, Nicole Moore. HERE and on TikTok @authentically.aaliyah
You can now text me! Questions/Suggestions
Sign up to learn how you can join the first Pre-AA cohort of CAA Matters and get a rare head start in AA school. Learn More
+Check out my Pre-AA Highlight on IG
Stay Connected by subscribing to the Awakened Anesthetist Newsletter-
for more CAA specific resources, exclusive content and offers.
Watch episodes of Awakened Anesthetist Now on YouTube!
Let's Chat! awakenedanesthetist.com or on IG @awakenedanesthetist
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Welcome to the Awakened Anesthetist podcast,
the first podcast to highlightthe CAA experience.
I'm your host, mary Jean, andI've been a certified
anesthesiologist assistant forclose to two decades.
Throughout my journey andstruggles, I've searched for
guidance that includes my uniqueperspective as a CAA.
At one of my lowest points, Idecided to turn my passion for
(00:28):
storytelling and my belief thatthe CAA profession is uniquely
able to create a life by designinto a podcast.
If you are a practicing CAA,current AA student or someone
who hopes to be one, I encourageyou to stick around and
experience the power of being ina community filled with voices
(00:49):
who sound like yours, sharingexperiences you never believed
possible.
I know you will find yourselfhere at the Awakened Anesthetist
Podcast.
Welcome in, welcome AwakenedAnesthetist listeners to this
special episode replay.
This was previously recordedMarch of 2025, live at the Quad
(01:13):
A 2025 in Charlotte, northCarolina.
I'm really grateful to everyonewho was able to join us in the
room that day.
Your presence really helpedshape this conversation and if
you didn't have a chance to bethere live, I wanted to be sure
you still got the opportunity tohear from our current Quade
President, nicole Moore.
So let me introduce Nicole alittle bit and tell you some
(01:36):
more about her in this timeout.
Nicole Moore, of course, is acertified anesthesiologist
assistant.
She graduated in 2017 from CaseWestern Reserve University's
DCAA program and she currentlypractices full-time, still in
Washington DC.
Nicole has intentionallydesigned her schedule to support
(01:57):
both her clinical work and herprofessional leadership work,
which I think is really heroic.
She works 40 hours a week work,which I think is really heroic.
She works 40 hours a week,takes Wednesdays off to teach
Sim Lab at Case DC and then sheworks a 24-hour in-house shift
every other Thursday, whichfrees up every other Friday
where she can focus on heradvocacy and, of course,
(02:20):
presidential work.
In this conversation, nicoleshares how she's expanded her
professional impact throughteaching, through advocacy,
through leadership.
She really shares theprogression of her leadership
roles, which I think is superexpansive to hear how the Quad A
president started in smallerroles, and she also shares some
(02:43):
of her failures, which I'm sograteful for, because that is
the truth and the reality, butalso the part that oftentimes we
don't get to hear.
I also want to point out thatduring this episode, nicole
reflects on a really powerfulclinical moment she had from
fall of 2024.
Nicole was in a high-risk OBemergency case where she was
(03:06):
caring for a parturient whosename is Aaliyah, and Nicole has
since been given permission toshare Aaliyah's story.
Aaliyah herself is trying toeducate from her own platform
about PEs and PEs in pregnancy,and you can go to the show notes
if you want to learn more aboutthe story that Nicole shares in
(03:28):
this episode, learn more aboutthe educational efforts that
Aaliyah is making about PEawareness, and Nicole talks
about how this experience reallygrounds her back into her, why
for clinical work, and remindsher why she chose the path of
being a CAA, which helps keepher motivated and grounded when
(03:50):
she's doing all of the somewhattedious jobs of presidency and
legislative efforts, wheresometimes it can feel like you
are taking two steps forward,three steps back.
I'm so grateful I had the chanceto interview Nicole live at
this year's Quad A.
If you are listening andnavigating what it means to lead
as a CAA, to continue growing,or you're wanting a reminder as
(04:14):
to why we chose to become CAAsin the first place, why you
chose to do what you do, thenthis episode's really going to
land and impact you episode'sreally going to land and impact
(04:38):
you and I hope you enjoy hearingfrom our current Quade
president, mrs Nicole Moore.
She just got married.
Okay, we good, awesome, well,welcome everyone to Awaken
Anestis podcast.
This is the second time I'mgetting to interview the Quade
president live.
I actually interviewed threeQuade presidents you're my third
(04:59):
, but then Quade finally let medo this in person.
So I'm grateful to be here andI'm really excited to get to
know you, nicole, better.
The point of Awaken Anestispodcast overall is just for CAAs
to really become aware ofwhat's possible for each of us,
as opposed to thinking that wecan only do what we immediately
(05:20):
see around us.
And so interviewing people likeleadership and the Quad A
president is really expansive.
To know that if Nicole can doit, you know we can do it.
So I really want to learn aboutthe human behind the presidency
.
That's really what I'minterested in.
So let's dive in with the rapidfire, which is my oh so
favorite.
I don't know that anyone elseloves it as much as me, but I
(05:41):
love asking little pryingquestions.
So, nicole, are you a night owlor an early bird?
Oh gosh.
Speaker 2 (05:50):
Probably an early bird, not necessarily by choice,
but definitely have turned intothe early bird.
Speaker 1 (05:55):
Yes.
Speaker 2 (05:55):
What time do you get up?
Work days, obviously like 5,530.
And two, unfortunately, theweekends is also like.
I'm lucky if I sleep in past630 and my husband wants to kill
me all the time but yes we'velearned to work with it yes,
well, you mentioned your husband, so you're newly married, newly
wed.
Speaker 1 (06:13):
When was your wedding and where was it?
Speaker 2 (06:14):
so it was January 18th um so just a couple months
ago and we did it in Kent Islandin Maryland, so just up the up
the road from DC.
So we actually just got all ourwedding photos back, so I've
been swiping through them all.
It's been fun.
Speaker 1 (06:28):
Yes, I've seen a few on Instagram.
Thank you for sharing.
Let's pick another good one.
What's your guilty pleasure?
Tv show or series?
Speaker 2 (06:38):
Oh gosh, recently it's been a lot of Bravo.
My friend got me into the wholeVanderpump scene Okay, that I
had never, ever been at allinvolved with, and so I have
successfully binged all of theVanderpump rules and like one or
two spinoffs at this point Idon't know if I'm happy to admit
(07:00):
that to the entire people thatwill listen to this.
Speaker 1 (07:03):
We love it.
We love that you're hereAwesome, okay, last one, one
word to describe what it feelslike right now to be the Quad A
president at Quad A 2025.
Speaker 2 (07:16):
Oh gosh, I'm going to pick two, because I can't
decide between the two Excitingand a little nerve-wracking.
Yeah, that's real.
Speaker 1 (07:24):
Totally Okay.
Well, I love to jump in andhear how my process guests,
which you are, found out aboutthe CAA profession, and then
what intrigued them most aboutbeing a CAA that drew you in.
Speaker 2 (07:38):
So I actually found out about it on Google.
I was really interested inmedicine, specifically
anesthesia, when I was anundergrad and I had every
intention of going to medicalschool and residency and doing
the whole road to becoming ananesthesiologist.
And about three years into whatwas an engineering degree, I
(08:02):
panicked and was like I don'tknow that I want to do all of
medical school and residency.
Looking at timeline of life, Idon't know if I want that much
more schooling in my future.
And so I literally Googled jobsthat involve the operating room
, that don't involve medicalschool, and I got a list of a
lot of different things andanesthesiologist assistant was
(08:25):
one of them.
And so when I kind of deepdived a little bit further into
it, I found out more about itand started applying and decided
that it was a good fit.
Did you have to go back to getactually was statistics, because
(08:45):
I was already on a pre-medicaltrack, I had already met most of
the requirements or had themslated into my school schedule.
But statistics, for whateverreason, was the one that sticks
out and I mean it was fine.
I didn't love having to go takeit, but no we did it, we
(09:05):
survived.
And where did you go?
What AA school did you go to?
I went to Case Western in DCOkay, graduated in 2017.
Speaker 1 (09:12):
All right, and tell us about that application
process.
Were you thinking it was CaseDC?
Were you open to?
Speaker 2 (09:18):
other schools pretty open.
To be honest, there were backwhen I applied I think we only
had six programs or so at thetime, three of which were case
programs Cleveland, houston andDC and I was in Columbus, ohio,
for undergraduate at the timeand so I really wanted to stay
in Ohio, be close to family, andso I had applied to every AA
(09:41):
program.
To be honest, I was kind oflike I'm going to take what I
can get, because I just wantedto be in the school and do the
career and I interviewed up atCase Cleveland and got kind of
waitlisted for lack of a betterterm there, but I had ranked the
other programs saying I waswilling to go.
I actually got a call fromShane on New Year or Christmas
(10:05):
Eve.
Speaker 1 (10:06):
Who's the program director for Case DC?
Speaker 2 (10:09):
And he said I know you wanted to be in Cleveland,
but we've got a spot for you inDC, if you're willing to come
out here.
And I was like you're going togive me a spot, I'm going to
take it.
So I went to DC and that's howI ended up there and I'm still
there, amazing.
So I went to DC and that's howI ended up there, and I'm still
there.
Speaker 1 (10:26):
Amazing.
And you're working in the DCarea still, yep, so I'm still in
DC.
Speaker 2 (10:32):
I've moved to a couple different hospitals over
the years, but still in thedistrict.
Speaker 1 (10:37):
Wonderful, awesome.
So you must have liked it.
Speaker 2 (10:39):
I did Surprisingly.
I thought I was going to hateit and not enjoy a big city and
want to move back to the Midwestand go back home and I loved
the city, all there was to do.
It helped that a lot of myfriends from class, a lot of my
classmates, stayed that year inDC and so staying with the
familiarity of classmates andfriends that I had made through
(11:01):
the program kind of solidifiedstaying- I think it's
interesting to be talking tosomeone who I know has a lot on
their plate and then alsothinking, oh, this person has to
go to the OR nearly every dayas well.
Speaker 1 (11:15):
Can you tell us a little bit about your work
schedule now, because you'restill full time, correct Yep,
still practicing full time as aclinical CAA, and then you're
also volunteering every year?
I want to say volunteering asthe Quad A president.
Every role in the Quad A is avolunteer position.
And tell us how you're managingthat just time-wise.
Speaker 2 (11:36):
Yeah, so I still work a full-time job, so 40 hours a
week, 80 hours, you know, everytwo weeks technically.
So I actually switched myschedule a little bit.
My work was gracious enoughthat it was kind of a mutually
beneficial thing.
So I now work a 24-hour shiftevery other week to get a big
chunk of my time at clinicaldone, to really free up my
(11:59):
afternoons and evenings so thatI can take calls and do meetings
and all of those things.
If you ask any of my other quadA leadership, my response rate
really depends on kind of my ORday.
If it's a nice friendly OR daywhere I'm not bouncing between
you know 100 endo cases I canrespond to emails, you know, in
(12:20):
our downtime while we're waitingfor a surgeon or the room to be
ready or whatnot.
But there is a lot of that.
Every moment is usuallyaccounted for and then you have
to try to fit to what you weretalking about earlier your own
well-being into all of that is alot.
But yeah, finding the rightwork schedule and having a
supportive family, household athome to kind of let you do
(12:41):
things when you're not at workis really helpful at home, to
kind of let you do things whenyou're not at work is really
helpful.
Speaker 1 (12:50):
Yeah, and one of the other things I learned about the
Quad A presidency is that it'sa three-year commitment, and so
the first year is help me withthe language President-elect,
president-elect.
Now you're the president andthen you're the past president.
Correct, immediate past.
Immediate past president.
So when you're signing up orputting your hat in the ring to
be elected right, it's anelected position you know that
it's going to be a three-yearcommitment.
(13:11):
Correct and talk to me abouthow you knew that this was the
right time in your life, knowingthat you were still going to
work full-time and have awedding to plan and then perform
and do.
Why you picked right now.
Speaker 2 (13:23):
So it was a lot of discussion with my now husband
of you know I love beinginvolved and I've loved what
I've done with Quade and StateAcademies in the past and I knew
I wanted to do it.
And when we looked at kind ofthe timeline of what does life
look like from our family sideof things, it was we can do it
(13:45):
now and, yes, we're going toplan a wedding or we can do it
in 10 to 15 years from now,because really we want to start
to settle down, hopefully havekids, things like that.
And he is by far one of themost supportive people with the
schedule and the calls and theemails.
But he rightfully so was likewhen we have kids, I want, you
(14:10):
know, especially a baby issomething that you can't just be
a million places all at once.
So he was like we just reallyneed to think about it.
And so it was kind of like nowor revisit in 10 to 15 years.
And I was already in the swingof things doing various
legislative things, and so wesaid, all right, let's go ahead
and do it.
Do it now.
And so, lucky for me, he wasvery supportive of the idea and
(14:32):
we just kind of went for it now.
Speaker 1 (14:35):
But I think that's very real, to hear that
sometimes you have to say yeseven though you're not quite
sure exactly what it's going tohold, and that there is this,
you know, and particularly withthe presidency, there's people
on both sides of you to help.
But yeah, I just think tovolunteer to lead our community,
our profession, is such a hugeundertaking that I just, I hope
(14:59):
other people hearing how you'remanaging it allows them to think
, OK, maybe I can do that too.
You know, I don't have to haveample you know I don't feel like
I have all the time in theworld to be able to still do
this and still contribute.
Speaker 2 (15:10):
I think I think that's a really fair point.
I think it's very overwhelmingwhen you look at it from the
outside, but, even being so, wedo these three year commitments
right.
As president, elect president,immediate past president.
The two years now going on tothe second, this year looks very
different than it did last year, and it's somewhat nice because
(15:30):
, depending on you know who thattrio is that makes up those
presidents.
We very much work as a threesome.
It is really not a one personand then two kind of outsiders.
We very much all three worktogether.
Danny and Emily, who areimmediate, past and incoming
president or president-elect,are on almost every phone call.
(15:52):
It's always kind of the threeof us and so, based on whoever's
clinical schedules, it canchange right.
So staff has been great.
They work around whatever theschedule happens to be, and so
for people that I think arereluctant to get involved
because of things like that,it's nice to know that you can
make any schedule work.
(16:13):
You have to be flexible and bewilling to give up.
You know your own personal timeand some hours you might not
normally, but you can make anyschedule work with the people
you're doing it with, which isnice.
Speaker 1 (16:25):
Yeah, that's encouraging.
How different was.
I love your story of being thelegislative chair and how you
got there.
Speaker 2 (16:32):
I want you to tell that a little bit.
Speaker 1 (16:34):
Some more details.
And then also, how different isit being the legislative chair,
which I assume is one of thebiggest committee positions,
versus being the quad Apresident?
How well that prepared you tobe the president now.
Speaker 2 (16:47):
Yeah.
So, like you said earlier, butobviously I guess our podcast
listeners won't have been inyour speech necessarily.
So I actually ran for a boardseat in what would have been
like the fall of 2020 electionsto kind of go into the 2021 year
, 2020 elections to kind of gointo the 2021 year.
(17:08):
I ran for a board of directorsseat because I had been involved
in state academies with DC andjust sort of Virginia and just
had really liked it and I hadbecome friends with some of the
leadership and was like I thinkI really want to be involved and
start to learn a little bitmore.
So I ran for a board seat, kindof honestly out of nowhere.
To be completely honest, I justsaid why not?
Let me put my name in the ringand see what happens?
And I didn't get it, which isfine.
(17:31):
And Crystal Cam was actually, Ibelieve, the president or
president-elect at the time andshe reached out to me and said
you know you didn't get electedfor the board seat, but we have
a legislative committee chairopening because our chair just
resigned from the position.
Do you have any interest inthat?
You had said you know thesecommittees interested you and I
kind of hemmed and hawed and waslike I don't know, that sounds
(17:52):
like a big responsibility.
But you know, if you guys aregoing to be there to support me,
like, oh sure, I'll give it atry, not really knowing anything
about legislative things I didnot come from a legislative
background it was a whole newthing to learn.
But they helped me with it andkind of guided me through it and
I fell in love with it and so Idid that for about three years
(18:15):
for Quad A before I ran forpresident-elect.
The difference between the two,I think, is just legislative
committee chair is so much workand Brie Siekford, our current
committee chair, is doing aphenomenal job with that.
But it's in one realm and soyou kind of get to focus on just
(18:38):
that realm of things, whichmakes it, I think, a little bit
more digestible.
It's also, for the most part,timing it's busy in one section
of the year and then kind ofdies down.
You always have your grassrootsand things that you're doing to
kind of prepare for the nextlegislative session, and that's
just as important as the actualsession itself.
But it definitely becomes moreof a manageable time commitment
(19:02):
as the year kind of goes on, asopposed to the first couple
months of the year whereeveryone's in session and
hearing bills and all of this,whereas the president I think
it's just consistently busy allthroughout the year and you have
those different silos of things.
You have the meeting, you havepractice, you have legislative,
you have membership and you havekind of all of these different
(19:25):
areas in the committees that areall great at what they're doing
but ultimately come back to youand the board to ask guidance
or approval and I think I kindof underestimated how much went
to the presidents until I wasinvolved in the doing of it I
was like oh wow, yeah, we do alot yeah.
Speaker 1 (19:45):
I imagine so, because from the outside, I think the
community is probably onlyrecently starting to hear a lot
more of the legislative effortsand maybe that social media that
we're just seeing more of thework that it takes behind the
scenes.
And for you to say that youdidn't know much about the state
legislative process is so true,because the first time I
learned about it I'm like, ok,let's break it down.
(20:07):
It's like the Senate and thenthe representatives, and you
feel so inadequate that youdon't know.
But it is this whole otherworld in language it is.
Is this whole other world inlanguage it is.
And I would love to ask abouthow the legislative process in
Virginia started, because youwere the legislative chair when
it started, correct?
Speaker 2 (20:26):
I actually was still in school when it very first
started.
But, yes, I so they had effortsgoing all the way back.
The first one that comes tomind is 2017.
And I know they did some workbefore that, so I apologize to
all the Virginia folks that didthings before that.
But 2017 was one that I reallyremember because I was a second
year student at KSDC and I wasactually living in Virginia,
(20:49):
right across the river at thetime, and they had kind of
pushed for it and they did astudy that ended up not coming
out in our favor and kind ofderailed the efforts and fast
forward to, you know, covid, andnow we have all these work
shortages and they pushedlegislation again.
I believe 2022 was the year andwe actually heard from a
(21:13):
hospital system that's prettyprominent in Northern Virginia
that was like we're short peopleand we need to run our ORs, and
so they were very much kind ofthe re-ignition of these bills
to help with their staffing, andwe legislated a little bit.
It ultimately came to thedecision that they were going to
(21:34):
do a new study.
To see, you know, nowpost-COVID, a lot of things have
changed since the one that hadwere going to do a new study to
see, you know, now, post-covid,a lot of things have changed
since the one that had been donein 2017.
Speaker 1 (21:42):
Can you say more about the study, because I think
that is an interesting point inthe legislative process that I
don't know that peopleunderstand?
Oh yeah, but I've heard thatseveral times from other states.
Speaker 2 (21:51):
Yeah.
So some states every state's alittle bit different.
Some states do what's calledlike a sunrise review, where you
fill out basically what is thiscareer, how would it help the
state, why does the state needit?
And it's just kind of questionand answers.
Other states do actual likeworkforce studies from either
the Department of Health or theone in Virginia just recently
(22:11):
was the Joint Commission didtheirs, and they look at, you
know, are there shortages?
How would licensure of CAsaffect the shortage?
Would it actually help them?
The other thing they lookedinto was CRNAs and kind of how
would expanding their practicehelp or not help the workforce
shortage, residency slots?
(22:32):
So they looked at kind of allof these different options and
see which one would actually behelpful.
And so they had tabled our billto do this joint commission
study and it came out at the endof 2024, kind of fall into
winter.
They presented their findingsand they found unanimously of
(22:53):
the joint commission that theywere short-staffed and that
licensure of AAs would help withthe shortage.
And so it was a unanimousrecommendation from the Joint
Commission of Virginia that AAsbe able to have licensure, and
so that was really kind of whatpicked up the ball in 2025.
(23:14):
We got really good support fromit was actually the Virginia
Society of Anesthesiologists the.
VSA reached out to the VAAA, theAcademy of Anesthesiologist
Assistants even I still stumbleover all of our words and said
you know, we have this study nowand we have bill sponsors.
We really think it's a greattime for you guys to put forth a
(23:38):
lot of effort to this.
We think we're settingourselves up for a really good
year.
And so with that we talked toour legislative team and our
director of government affairs,with McGuire Woods, and they
kind of did their own littleresearch and ultimately the
decision came to hire our ownlobbyists on the AA side of
things.
That worked phenomenally withthe VSA lobbyists as well.
(24:01):
And so the two of them workedtogether and we went down and we
did testimonies and we wroteall of our letters that I'm sure
lots of you saw me email andpost about and just kind of
trekked our way through theHouse and the Senate and to the
governor's desk and hegraciously signed it on Monday
before we came here, which wasthe best surprise to the
governor's desk.
Speaker 1 (24:19):
And he graciously signed it on Monday before we
came here, which was the bestsurprise in the world Very
convenient, yeah.
So like pre-2017-ish to 2025 iseight years plus of
disappointments.
Honestly, it sounds you knowups and downs, but I don't know
that.
That's a super unique story.
Even I think probably somestates are fighting that same
(24:41):
battle.
How did you, since you wereinvolved in that on the
legislative side, stay motivatedthrough all those years of
trying and trying and trying?
Speaker 2 (24:51):
until you succeeded.
It's really, I think, looking atother states, honestly we in
the last couple of years havesuccessfully gotten a few states
between Utah, nevada,washington, and so seeing those
successes are reminders.
You know that it is possibleNevada had been in the works for
(25:11):
years and years and years andjust kind of waited for the
right time to finally get itpassed, and just kind of waited
for the right time to finallyget it passed, and so I think
looking at all of those is justa reminder of it takes so much
time and although it seems likewe're not maybe doing anything
or making any progress, it wasreally relying on the
relationships that I had startedto form and built, and so I
(25:34):
actually don't know that a lotof people know this.
I went to so many different VSAmeetings.
They were gracious enough toinvite us to send a
representative and talk aboutwho AAs are and educate their
residents and their membership,and it was really cultivating
those that then kept theirinterest in it and their support
.
That way when they neededsomething they knew who to come
(25:57):
to.
And so then we were involvedwhen the time came, and so it
was really leaning, I think, infostering those and then hearing
their support.
Even though we weren't makingprogress in the legislative
chambers per se, we kept gettinginvited to these things and it
was like there is support in thestate from the physicians and
from different people.
So it will come.
(26:18):
It's just when is the righttime that it will all fall into
place.
Speaker 1 (26:22):
Yes, legislation sounds a lot like finding the
right time.
Correct.
It doesn't A hundred percent,it's almost like it doesn't
matter what you're fighting for.
You just have to have the rightsynergy of parts to put in that
finally gets you the outcomeyou want.
Speaker 2 (26:36):
Yeah, exactly, it's a lot of timing.
A lot of timing Interesting.
Speaker 1 (26:40):
Well, I want to switch gears a little bit.
Oh, we are so good on time.
You told me in our discoverycall so how these process
episodes work is that I findpeople who are interesting and
are doing something different orsomething that oftentimes these
are things that I want to doLike, oh, that's kind of
interesting to me.
What would you know?
How did they get?
There is sort of how thesestart and I have a discovery
(27:03):
call with them and then we Icreate a little storyboard and
then we do the podcast off ofthose storyboards.
And when I first met Nicole,she was talking about how you
wanted your legacy as Quadepresident to be.
That the Quad A members feltlike Quad A gave them something
like gave them more, or theycould really reach out and be
(27:26):
like okay, this is what Quad Ais doing for me.
Can you describe that a littlebit more?
Or maybe what your hopes arefor this year?
Speaker 2 (27:33):
Yeah.
So I feel like we're in areally unique and almost tough
position, but it's a great onein that we're growing so fast
that it's almost hard to kind ofkeep up with how things are
changing, in the sense that, youknow, 10, 15 years ago it was
such a small group of peoplethat it was really easy to know
(27:54):
everyone and know exactly whatwas going on.
And you know if a state wasgoing through things, it was
really easy to kind of manage,know exactly what was going on
and you know if a state wasgoing through things, it was
really easy to kind of manageall of those things.
Fast forward to now we have,you know, double digit states
that are trying to submit billsfor licensure and you have to
keep track of them all.
And we're bigger, we have morepeople, we have so many students
, which is phenomenal and it'skind of how do you really take
(28:18):
all of those people and reallygive them the benefit of being a
member right?
And how do you keep peoplewanting to come to what's now
this just growing thing outsideof just?
You know you should do it tosupport the profession.
What can we really offer?
And so you think of obviousthings like CMEs and things like
that at the annual conferencethat everyone needs to get their
(28:41):
recertification.
But I think what we're reallytrying to do this year and my
hope is that we can really kindof dive into what do members
want from the quality that wecan realistically give them.
And so, whether that's supportin their workplace when they run
into you know a problem of youknow my workplace is doing this
(29:02):
and it seems a little off, orthey're having problems billing
for us, or things like that,that the members really feel
empowered to come to thecommittee chairs or leadership
and say, hey, what have we donefor this in other states?
Because those are resources thatwe can really give out if we
know about it but that we don'tnecessarily always know about.
And so it's things like that orthings like the mentorship
(29:24):
program that I'm actually reallyexcited to see where it goes
and kind of channel all of thesenew bodies that are coming into
the profession and really givethem a chance to grow and learn
what the profession's about andrely on more experienced AAs.
And so this year I think wehave 12 pairings, which I'm
excited to start.
It'll be a nice small group forus to really kind of see what
(29:47):
people want out of it and how itgoes, and so I'm really excited
to give that to members and tryto channel what they want and
how they could see membershipfrom Quad A benefiting them and
just really dive into that.
Now that we've got more people,we're growing the conference,
we're doing all these things,what can we really set up?
for them to want to come and bea part of it, outside of just
(30:10):
this space for these four days,yeah.
Speaker 1 (30:14):
I have a hard question.
Oh boy, that I did not tell youabout I have a hard question
that I did not tell you about,but I was thinking like as a CAA
and you had said what the QuadA can realistically do.
What are keeps the quad A frombeing able to do things Like
what are the constraints?
Is it money?
Is it that everyone's avolunteer?
Is it time?
Speaker 2 (30:34):
Yeah, it's a combination of everything that
you just mentioned, right.
So money is obviously a bigfactor in a lot of things.
Everything that we want to growinto and do costs some form of
money to get it done, and soit's kind of balancing out when
is the right time to do allthose things.
Our new membership portal was abig one, right.
(30:55):
We had talked for a littlewhile about how we didn't love
the membership portal we were on, but it's going to be this big
endeavor of money and time andstaff needs to learn how to use
it and all of these differentthings, and it's kind of you
have to gear up to be able tomake those changes that, in the
long run, are going to be worthit.
But it's really going to be astruggle in that transition
(31:17):
period, which, thank you toeveryone listening that dealt
with all of the emails that wesent out about Fonteva and our
transitions, but in the end itmakes it work.
It's better for a member to beable to go in and do their own
things and manage it themselves.
So it's a lot of that and it'sa lot of just navigating places
we haven't been before, becausewe've been a really small group
(31:41):
of people able to either attendthings or do things or have
experience outside of theanesthesia world that they can
bring in.
I think that's really wherewe're going to be able to
experience more growth andbenefits, just because now we
have more possibilities where wedidn't have that before.
(32:03):
And it's really navigating.
How do we take all these ideasand put them into something that
is a good product for people?
We don't want to throwsomething out there, that's.
We want it, but it's not doneright.
Speaker 1 (32:15):
Yeah.
Speaker 2 (32:16):
So yeah.
Speaker 1 (32:18):
Yeah, and I think it's interesting too that we can
look you know, we're almost ina great spot because we're small
and nimble and we can maybemake easier changes than we can
look to the ASA, and we can lookto the ANA and see what they've
done and sort of improve uponit or, you know, find our own
way that serves our communityand not have to, you know, maybe
(32:39):
do as many hoops as they had todo.
Speaker 2 (32:41):
Definitely definitely .
We definitely look at thingsthat the ASA does that we're
like, oh, that's great, we wouldlove to come up with something
like that, or I mean even theAA&A.
As much as you know, there aresome things we disagree on.
There are things that they dothat we're like, okay, maybe we
can channel that into our ownway and think of a you know way
to do something.
And so, yeah, we take the PAswe've kind of looked at, and so
(33:04):
it's all of these differentthings that we'll look at and
see how are these organizationsthat are bigger than us right
now?
How do they do it?
Can we kind of look to them toform how we handle this as we
grow and get bigger?
Speaker 1 (33:18):
Well, speaking of the AANA, I'm wondering, as the
Quad A president and because youdid the legislative effort in
Virginia, I'm assuming you heardyou know the rebuttal against
AAs what would you want CRNAs tohear the Quad A president say?
Like, what do you want to sayabout CAAs to the CRNAs?
Speaker 2 (33:39):
I think the biggest thing that I personally feel
like I always want to say inthose harder moments is like
we're just people too right.
We're just people too right.
And when you break down,anybody that's in any sort of
workplace, they go home to afamily, they go home to a life
(34:00):
outside of work and they're justpeople.
And so all of us are peoplethat got into a profession just
to help patients.
For the most part, I would say,if you ask 95% probably of all
of the students that are outthere the A's that are out there
of why did you get into theprofession?
It's somehow going to boil downto I wanted to help patients
and I wanted to do patient care.
And I think that's wheresometimes in these legislative
(34:23):
efforts and this back and forth,we get somewhat lost, in that
all we're really trying to do isimprove patient care and offer
patient care, and so I reallywould love to sometimes just be
like we're just these peoplethat just want to go in and do
our jobs.
We want to work with you Likewe want to be colleagues Some of
my best friends are CRNAs andwe just want to be a friendly
(34:46):
face at work that does a job,does it well and, you know,
provides good patient care, andsometimes I think that starts to
get a little lost in the heatof legislature.
Speaker 1 (34:55):
Yeah, and I can imagine that when you are so
focused on the legislativeeffort that you lose sight, like
you lose that touch point of ohwhy did I, the CNA or I, the
CAA, go into this?
How do you stay connected towhy you want CAAs in every state
, why you wanted the Virginialicense to pass, like how does
(35:17):
that?
How do you stay grounded inthat?
Speaker 2 (35:19):
Yeah, so it's definitely little moments with
the patients.
I think sometimes you forget youknow, in the grand scheme of
things, why you wanted to do thejob and you kind of get in the
day in and the day out.
So you know you go to the ORyou go home, you go to the OR
you go home, and it's a coupleof little moments where you know
they say thank you so much andthey're really nervous in the
(35:39):
pre-op bay or you take thoseextra couple of minutes to make
them feel a little better andyou're like that's why, why I
came into, what I came into wasto be the comforting face and be
somebody that, in an otherwisescary time, can be, you know, a
little bit of a relief for themon that day, and some patients
(35:59):
just will stick with you for awhile.
I think we all have oursituations where you know we
really bonded with a patient forwhatever reason, and I actually
just recently had one this pastfall who was up in labor and
delivery with me.
She was an add-on C-sectionthat we were doing.
I was working, you know, one ofmy 24-hour shifts and she was
(36:25):
getting put on for I can't evenremember what, to be honest.
But she had twins and I willsay with everyone I have talked
to her since and she's okay withme kind of telling her story.
So she came in, we started herC-section somewhere around 1030,
11 o'clock at night and yourusual uneventful, you know,
(36:45):
spinal.
They were so excited, talkingabout the baby names and kind of
disagreeing on them anddeciding how they were going to
do.
And after babies were born theywere closing and she actually
threw a PE and cardiac arrest onthe table, me in my own OR, and
(37:15):
I was terrified for her.
I mean, we did ACLS, we got herback, we took her down to CT
and you know she was managedvery well at our hospital and
the hospital she went tosubsequently was in the ICU and
intubated for days and ended upextubated, spent lots of time in
the hospital.
But I had never chart checkedsomeone so frequently after and
just kind of rememberedeverything about her because she
(37:38):
was saying, you know she was sonervous but so excited and I
thought about her a lot.
But it was really the momentwhen she came back to the
hospital randomly when I was onanother night shift just to
visit they had been at apediatrician appointment down
the road and decided that theywere going to come visit.
And she doesn't rememberanything, so she has no idea who
(37:59):
I am, but it was still the justlike thankfulness in her eyes
to someone that took care of herin such a big moment when she
really had no recollection of me.
We had conversations that Itold her about and she was like
I don't remember you know,telling you what I was going to
take my babies.
I don't remember any of this,but her husband since it was a
(38:20):
C-section was obviously in theroom too and he remembered and
was so thankful.
But she sticks with me a lotand she is somebody that now I'm
like when I need thosereminders I go.
She's why, you know, I do it.
And I actually connected withher outside of this.
On social media.
She got a lot of news attentionbecause she's been spreading
(38:41):
awareness about PEs andpregnancy, and so I connected
with her and have gotten to talkto her and kind of follow her
life after, which is somethingwe don't usually get to do.
As anesthesia providers, weusually see our patients, so we
see them in the recovery room,maybe a couple of days later if
they're still in the hospital,but we really don't get to see
what happens to them after.
(39:01):
And so getting to kind of seeher now and kind of follow along
in her journey and watch whatshe's been doing to educate
people is really a big groundingpiece for me.
Of you know, I got to help herin that moment where if it had
been any other moment it may nothave turned out like that, and
so I think that's really a bigthing that kind of keeps me
(39:21):
motivated and reminds me of whyI work so hard and why we do.
What we do when we go throughthe training we go through is
just to kind of have thosemoments and be present for those
things when people need us.
The most.
Speaker 1 (39:34):
That's incredible and I appreciate you sharing that
story.
And, yeah, let me know if wecan support her in any way.
Maybe we could link tosomething in the show notes, but
we'll talk after about that, ohyeah.
Speaker 2 (39:46):
Her name's Aaliyah Walker.
Again, she let me you know.
I asked her.
I said if I you know, they'lltalk to me a little bit.
Am I allowed to share with you?
Know people that ask?
And she said yes, by all meansshare the story.
She's been a big advocate andreally trying to just get the
word out there for people thatotherwise wouldn't know.
So we'll talk after and get yousome information to put in
(40:06):
there so that people can followalong with her.
Speaker 1 (40:13):
Great, you know this is what it's about.
Like a human to humanexperience.
Like you are trained to helppeople in this very specialized
way and if you weren't there,you know she wouldn't have got
this level of care, and justthat.
At the end of the day, itdoesn't matter if you're the
anesthesiologist, the CRNA orthe CAA, like we're working
together to do this thing.
Like she doesn't care who youare, she just wants you to give
her the best care possible.
Speaker 2 (40:32):
Like everybody talks about.
I feel like how they have likeone patient that sticks with
them and they can always tellthe story and I think for the
rest of my life she will be theperson that I like can vividly
remember and look back on and belike okay, this is.
It was crazy.
We were like if we hadn't, youknow cause, everybody, even the
OB, and everybody was likeshould we have taken her earlier
(40:54):
?
Cause we waited, cause she hadeaten, and so we're like we kept
her NPO.
And everybody was like shouldwe have gone earlier?
Like would this not havehappened?
And like, after the fact, whereyou were all talking and we
were like, no, it's like ithonestly happened in the best
way that it possibly could havehappened, because that clot was
there, it would have moved atsome point.
(41:14):
It was like if it had movedafter the C-section, when she
was in a recovery room, like wewould have been there fast
enough.
So it was just wild.
It's like wild to think back on, but anyways.
Speaker 1 (41:27):
Wow I bet you know everything there is to know
about PEs and embolisms.
Speaker 2 (41:35):
I'm like, oh, I'm like, do I need to go get an
ultrasound scan of my own legs?
Speaker 1 (41:40):
Yeah, I mean it is.
It's an interesting way tolearn too, because, as you said,
you had never done, or youmaybe had you never seen a
cardiac arrest, or you had neverseen a PE to cardiac arrest in
the OR before.
Speaker 2 (41:53):
I had never had my own.
So I responded to codes in theOR and, obviously, like, I teach
them lab and we go through itall the time and but it was the
first time that I had everactually had to call a code on
my own patient, which was one ofthose kind of like oh my God,
is it?
Like is this really happening?
(42:16):
Is what I think I'm having.
Like, um, so there wasdefinitely that moment of like
oh my God, no, this is actuallyhappening.
Speaker 1 (42:21):
Yeah, I think that's really um, what I was going to
say is that in our training youknow, when you go to AA school
they can't guarantee that you'regoing to see a cardiac arrest
in OB, like that's not.
Like, oh, check mark, great, welearned that.
And so of course that's whenSim Lab comes in to help fill in
some of those like sentinelevents that you may or may not
get to see.
But it's interesting how youknow the training that you do up
(42:45):
to that point with all theother patients.
And then of course, aclstraining like does come together
in the moments that you need itand it's wonderful to know that
.
I'm sure one of your firstcalls was like let's get the
anesthesiologist in here, let'sget more anesthesia help in here
that we don't have to do italone, like that's such a
beautiful you know exercise inthe anesthesia care team model
(43:06):
really.
Speaker 2 (43:07):
Yeah, it was, because I mean, we were you know, it
was nighttime and OB I think myattending was either had gone to
do epidurals or maybe try tolay down in between, you know, a
busy night.
Everything had been going greatand it was the first thing I
told my nurse, when I thoughtthings were starting to go
downhill and she didn't lookgreat, was I need you to call.
(43:28):
You know, I named my attendingright now and she came in the
room within a matter of minutesand then it was.
Yeah, you just fall back on whatyou go through in those sim
labs, which is crazy, becauseit's things that in training
you're like why are you know?
Why are we doing this so much?
Why are we doing this so much?
But it's because you don't seeit all the time.
(43:49):
It took me what?
Eight years to have it kind offall right in front of my face,
and for some people it takeslonger.
And so you just have to kind ofrely on what is ingrained in
the back of your head from allof that training and it just
naturally comes out and it, youknow, and that's what you rely
on.
Speaker 1 (44:08):
Yes, yeah, there's.
There's a lot more we could saythere, but I just love that you
have that as your or one ofyour grounding moments, because
that's what we're doing, that'swhy we're here, that's why we're
fighting for legislation,that's why patients deserve
physician-led anesthesia care,like that is because when these
things happen, you need anexpert team.
(44:30):
You know there to make it seemlike oh yeah, we just took care
of you, no big deal, like sheremembers you know nothing like
A president, stuff on yourbreaks and everything.
How do you recharge or touchback into who Nicole is, outside
of being a CAA, outside ofbeing the president?
Speaker 2 (45:05):
Yeah, it really is my husband, ryan and our dogs.
It's kind of putting down and Iwould argue Danny and Emily will
completely disagree with mebecause they say I don't do it
putting my phone down, notanswering a text or an email and
just kind of spending time,whether it's, you know, watching
a show that we watch every week, like we do Survivor, we do
Amazing Race, we do these things.
You know that kind of air everyweek and so whether it's sitting
down and just doing that andnot thinking about it for a
(45:28):
minute, or going for a walk is areally big one.
I love to go out and just kindof walk and I find it to be very
grounding.
I also get a lot of thinkinginevitably done about whatever I
was trying to walk away from,but it's at least my own
thoughts and kind of gives me achance to organize them a little
(45:49):
bit.
But yeah, it's really leaningon, I think my home support
system and you know, the dogsagain always have that second
sense of they're like I need togo like look at mom, real cute
and cuddle, so that she forgetsabout whatever she's doing.
But yeah, they're huge and kindof unwinding and coming back to
(46:10):
reality.
Yeah, totally.
Speaker 1 (46:12):
Let me see I have a final question, but I have a
couple fun ones.
So let me ask you what wouldsurprise someone if they knew
about you?
Speaker 2 (46:23):
Let's see, I think actually a lot of people are
always surprised to learn I havequite a large bourbon
collection, which alwayssurprises people when we talk
about it.
I grew up mostly in Cincinnatiand so my dad ended up into
bourbon and so we had it aroundthe house a little bit as I
(46:44):
started to, you know, get olderand come home from college and
whatnot, and then did thebourbon trail down in Kentucky
and have just slowly startedcollecting bourbon and that's
always very surprising to people.
Speaker 1 (46:57):
They're like you have a lot of bourbon.
Speaker 2 (46:59):
Or they come over to the house and they're like oh my
gosh.
And I'm like oh okay, maybe notthe best thing, but I'm
painting a certain picture.
Most of the bottles are full.
I promise painting a certainpicture.
Speaker 1 (47:10):
Yeah, most of the bottles are full, I promise.
I think this is interesting.
Speaker 2 (47:18):
What do you think you would be doing if you weren't a
CAA?
Oh gosh, so I actually mydegree from undergrad is
engineering.
Both of my parents areengineers, and so I actually
really enjoyed learningengineering when I was in
undergrad, and so I think Iprobably would have stuck with
it and done some sort of projectmanagement for engineering.
(47:39):
I don't think I could ever be alike nine to five desk job, as
much as I envy it sometimes whenwe're at work on the holidays
and I'm like why did I not do?
Speaker 1 (47:51):
some sort of office job where I would be off work
right now.
Speaker 2 (47:54):
So probably some sort of like engineering related
project management thing.
Speaker 1 (48:00):
Do you have big plans for next year, when you're done
with this presidency?
Reign 2027, I guess.
Speaker 2 (48:07):
I don't.
Hopefully we're in Virginia andhopefully we can like settle
down and kind of figure out whatthat next phase of life is.
I always joke that who knowswhat I'll be doing, because I
have a hard time not doing morethan my like 40 hour work week.
Speaker 1 (48:23):
You like to be busy?
Yeah, exactly.
Speaker 2 (48:27):
Can't have too much free time.
I'm like, what do I do withmyself?
Can't have too much free time.
I'm like what do I do withmyself.
But I'm really actually hopingto take a step back, at least
for a couple years, and justreally kind of enjoy life and
not be worried about what'sgoing on or troubleshooting
things or answering an email,and just kind of have a couple
years before I inevitably, I'msure, jump back into something
(48:50):
somewhere yeah.
And just kind of enjoy whatlife brings.
Speaker 1 (48:55):
Yeah Well, I'm looking forward to seeing that.
My last question is the ethosof this podcast, which is to
help CAAs realize that theyalready have everything they
need to create their life bydesign, to create their dream
life, whatever that means forthem.
And I'm just always curious ifyou, if my guest, if you would
(49:16):
agree with that, do you feellike that resonates with you and
, if so, how do you feel likethat's played out in your life?
Speaker 2 (49:24):
You know what I do think I agree with you in that
sentiment.
I don't think you know it, Ithink a lot of us don't think
that and I think if you asked mea couple years ago I wouldn't
agree with it.
Just by kind of looking atrandom things.
And if you had told me fiveyears ago that this is the
(49:44):
position I'd be in and I had allthe tools to do it, I would be
like you're crazy, there'sabsolutely no way.
But I think it kind of goesback to what you had said
earlier of you just have to beopen to what happens and be
curious about it.
Never in my CAA schooling wouldI have thought that I would ever
(50:05):
be Quad A resident or have anydesire to do it.
Yeah, to be completely honest,when I was in school and kind of
going through everything, I waslike I'm so excited to get to a
place in my life where, like Ican go to work and I can come
home and I can not do anything.
And then it just kind of tookrandom people in my life that
had been involved to be like,hey, you know, we need some help
(50:27):
.
Do you have any interest in it?
Would you be willing to do itand, being somewhat of a people
pleaser that I am, I was like,oh sure, and it just kind of
worked out that it taught methat I really liked that and I
had all of these skills to goabout and do a job that I
otherwise really had nointention or thought would ever
(50:50):
be kind of in my realm of thingsto do.
Speaker 1 (50:53):
Yeah, I mean, how many people think they're going
to be the Quade president?
I don't know, not many.
Speaker 2 (50:58):
Hopefully somebody out there, thinks they will be.
Speaker 1 (51:01):
Yes, exactly Wait a minute, wonderful.
Well, I am so grateful that yousaid yes to this live interview
and thank you all so much forcoming, yay.
Speaker 2 (51:09):
Thank you, you, this was fun all right, everyone.
Speaker 1 (51:25):
That's a wrap on season four of the Awakened
Anestis podcast.
Woohoo, we did it.
Thank you so much for listeningand an extra special thank you
to everyone who joined me liveat the Quad A 2025.
It's been such an honor toshare these CAA stories with you
this season.
I'll be taking a break for thesummer, but I will be back in
(51:48):
fall of 2025 with all newconversations, all new process
episodes, some new CAAminiseries episodes and just
some more fun for season five.
In the meantime, I invite youto catch up on any of the
episodes you've missed and ifone of them moves you and you
really love it, I encourage youto share it with a fellow CAA,
(52:09):
aa student or someone who is CAAcurious.
These stories are meant toripple through our community, to
connect us and impact for yearsand years to come, I hope, as
long as the podcast is up and inthe airwaves.
You can also stay connected byjoining my mailing list.
(52:29):
By using the link in the shownotes.
You'll be the first to knowwhen I decide on the season five
premiere date.
You can also follow me onInstagram at AwakendAnesthetist.
I'm on there somewhatfrequently sharing some behind
the scenes and just some lifeupdates of me going about living
my life by design, and let'ssee what else.
(52:51):
I'm always approachable onemail at awakenedanesthetist, at
gmailcom, but if you want toget a really fast response, you
can DM me, and I love to leave alittle voice note.
Those are super easy andapproachable for me, so I really
encourage you to follow me onInstagram at awakenedened
Anesthetist.
It's easy for us to chatquestions over there, and I
(53:13):
think that's it.
So until next time, let meleave you with this question
what would it look like to liveyour life by design, not by
default?
All right, everyone, staycurious, stay awake and we'll
talk soon.
Welcome to the Awakened Anesthetist podcast,
the first podcast to highlightthe CAA experience.
I'm your host, mary Jean, andI've been a certified
anesthesiologist assistant forclose to two decades.
Throughout my journey andstruggles, I've searched for
guidance that includes my uniqueperspective as a CAA.
At one of my lowest points, Idecided to turn my passion for
(00:28):
storytelling and my belief thatthe CAA profession is uniquely
able to create a life by designinto a podcast.
If you are a practicing CAA,current AA student or someone
who hopes to be one, I encourageyou to stick around and
experience the power of being ina community filled with voices
(00:49):
who sound like yours, sharingexperiences you never believed
possible.
I know you will find yourselfhere at the Awakened Anesthetist
Podcast.
Welcome in, welcome AwakenedAnesthetist listeners to this
special episode replay.
This was previously recordedMarch of 2025, live at the Quad
(01:13):
A 2025 in Charlotte, northCarolina.
I'm really grateful to everyonewho was able to join us in the
room that day.
Your presence really helpedshape this conversation and if
you didn't have a chance to bethere live, I wanted to be sure
you still got the opportunity tohear from our current Quade
President, nicole Moore.
So let me introduce Nicole alittle bit and tell you some
(01:36):
more about her in this timeout.
Nicole Moore, of course, is acertified anesthesiologist
assistant.
She graduated in 2017 from CaseWestern Reserve University's
DCAA program and she currentlypractices full-time, still in
Washington DC.
Nicole has intentionallydesigned her schedule to support
(01:57):
both her clinical work and herprofessional leadership work,
which I think is really heroic.
She works 40 hours a week work,which I think is really heroic.
She works 40 hours a week,takes Wednesdays off to teach
Sim Lab at Case DC and then sheworks a 24-hour in-house shift
every other Thursday, whichfrees up every other Friday
where she can focus on heradvocacy and, of course,
(02:20):
presidential work.
In this conversation, nicoleshares how she's expanded her
professional impact throughteaching, through advocacy,
through leadership.
She really shares theprogression of her leadership
roles, which I think is superexpansive to hear how the Quad A
president started in smallerroles, and she also shares some
(02:43):
of her failures, which I'm sograteful for, because that is
the truth and the reality, butalso the part that oftentimes we
don't get to hear.
I also want to point out thatduring this episode, nicole
reflects on a really powerfulclinical moment she had from
fall of 2024.
Nicole was in a high-risk OBemergency case where she was
(03:06):
caring for a parturient whosename is Aaliyah, and Nicole has
since been given permission toshare Aaliyah's story.
Aaliyah herself is trying toeducate from her own platform
about PEs and PEs in pregnancy,and you can go to the show notes
if you want to learn more aboutthe story that Nicole shares in
(03:28):
this episode, learn more aboutthe educational efforts that
Aaliyah is making about PEawareness, and Nicole talks
about how this experience reallygrounds her back into her, why
for clinical work, and remindsher why she chose the path of
being a CAA, which helps keepher motivated and grounded when
(03:50):
she's doing all of the somewhattedious jobs of presidency and
legislative efforts, wheresometimes it can feel like you
are taking two steps forward,three steps back.
I'm so grateful I had the chanceto interview Nicole live at
this year's Quad A.
If you are listening andnavigating what it means to lead
as a CAA, to continue growing,or you're wanting a reminder as
(04:14):
to why we chose to become CAAsin the first place, why you
chose to do what you do, thenthis episode's really going to
land and impact you episode'sreally going to land and impact
(04:38):
you and I hope you enjoy hearingfrom our current Quade
president, mrs Nicole Moore.
She just got married.
Okay, we good, awesome, well,welcome everyone to Awaken
Anestis podcast.
This is the second time I'mgetting to interview the Quade
president live.
I actually interviewed threeQuade presidents you're my third
(04:59):
, but then Quade finally let medo this in person.
So I'm grateful to be here andI'm really excited to get to
know you, nicole, better.
The point of Awaken Anestispodcast overall is just for CAAs
to really become aware ofwhat's possible for each of us,
as opposed to thinking that wecan only do what we immediately
(05:20):
see around us.
And so interviewing people likeleadership and the Quad A
president is really expansive.
To know that if Nicole can doit, you know we can do it.
So I really want to learn aboutthe human behind the presidency
.
That's really what I'minterested in.
So let's dive in with the rapidfire, which is my oh so
favorite.
I don't know that anyone elseloves it as much as me, but I
(05:41):
love asking little pryingquestions.
So, nicole, are you a night owlor an early bird?
Oh gosh.
Speaker 2 (05:50):
Probably an early bird, not necessarily by choice,
but definitely have turned intothe early bird.
Speaker 1 (05:55):
Yes.
Speaker 2 (05:55):
What time do you get up?
Work days, obviously like 5,530.
And two, unfortunately, theweekends is also like.
I'm lucky if I sleep in past630 and my husband wants to kill
me all the time but yes we'velearned to work with it yes,
well, you mentioned your husband, so you're newly married, newly
wed.
Speaker 1 (06:13):
When was your wedding and where was it?
Speaker 2 (06:14):
so it was January 18th um so just a couple months
ago and we did it in Kent Islandin Maryland, so just up the up
the road from DC.
So we actually just got all ourwedding photos back, so I've
been swiping through them all.
It's been fun.
Speaker 1 (06:28):
Yes, I've seen a few on Instagram.
Thank you for sharing.
Let's pick another good one.
What's your guilty pleasure?
Tv show or series?
Speaker 2 (06:38):
Oh gosh, recently it's been a lot of Bravo.
My friend got me into the wholeVanderpump scene Okay, that I
had never, ever been at allinvolved with, and so I have
successfully binged all of theVanderpump rules and like one or
two spinoffs at this point Idon't know if I'm happy to admit
(07:00):
that to the entire people thatwill listen to this.
Speaker 1 (07:03):
We love it.
We love that you're hereAwesome, okay, last one, one
word to describe what it feelslike right now to be the Quad A
president at Quad A 2025.
Speaker 2 (07:16):
Oh gosh, I'm going to pick two, because I can't
decide between the two Excitingand a little nerve-wracking.
Yeah, that's real.
Speaker 1 (07:24):
Totally Okay.
Well, I love to jump in andhear how my process guests,
which you are, found out aboutthe CAA profession, and then
what intrigued them most aboutbeing a CAA that drew you in.
Speaker 2 (07:38):
So I actually found out about it on Google.
I was really interested inmedicine, specifically
anesthesia, when I was anundergrad and I had every
intention of going to medicalschool and residency and doing
the whole road to becoming ananesthesiologist.
And about three years into whatwas an engineering degree, I
(08:02):
panicked and was like I don'tknow that I want to do all of
medical school and residency.
Looking at timeline of life, Idon't know if I want that much
more schooling in my future.
And so I literally Googled jobsthat involve the operating room
, that don't involve medicalschool, and I got a list of a
lot of different things andanesthesiologist assistant was
(08:25):
one of them.
And so when I kind of deepdived a little bit further into
it, I found out more about itand started applying and decided
that it was a good fit.
Did you have to go back to getactually was statistics, because
(08:45):
I was already on a pre-medicaltrack, I had already met most of
the requirements or had themslated into my school schedule.
But statistics, for whateverreason, was the one that sticks
out and I mean it was fine.
I didn't love having to go takeit, but no we did it, we
(09:05):
survived.
And where did you go?
What AA school did you go to?
I went to Case Western in DCOkay, graduated in 2017.
Speaker 1 (09:12):
All right, and tell us about that application
process.
Were you thinking it was CaseDC?
Were you open to?
Speaker 2 (09:18):
other schools pretty open.
To be honest, there were backwhen I applied I think we only
had six programs or so at thetime, three of which were case
programs Cleveland, houston andDC and I was in Columbus, ohio,
for undergraduate at the timeand so I really wanted to stay
in Ohio, be close to family, andso I had applied to every AA
(09:41):
program.
To be honest, I was kind oflike I'm going to take what I
can get, because I just wantedto be in the school and do the
career and I interviewed up atCase Cleveland and got kind of
waitlisted for lack of a betterterm there, but I had ranked the
other programs saying I waswilling to go.
I actually got a call fromShane on New Year or Christmas
(10:05):
Eve.
Speaker 1 (10:06):
Who's the program director for Case DC?
Speaker 2 (10:09):
And he said I know you wanted to be in Cleveland,
but we've got a spot for you inDC, if you're willing to come
out here.
And I was like you're going togive me a spot, I'm going to
take it.
So I went to DC and that's howI ended up there and I'm still
there, amazing.
So I went to DC and that's howI ended up there, and I'm still
there.
Speaker 1 (10:26):
Amazing.
And you're working in the DCarea still, yep, so I'm still in
DC.
Speaker 2 (10:32):
I've moved to a couple different hospitals over
the years, but still in thedistrict.
Speaker 1 (10:37):
Wonderful, awesome.
So you must have liked it.
Speaker 2 (10:39):
I did Surprisingly.
I thought I was going to hateit and not enjoy a big city and
want to move back to the Midwestand go back home and I loved
the city, all there was to do.
It helped that a lot of myfriends from class, a lot of my
classmates, stayed that year inDC and so staying with the
familiarity of classmates andfriends that I had made through
(11:01):
the program kind of solidifiedstaying- I think it's
interesting to be talking tosomeone who I know has a lot on
their plate and then alsothinking, oh, this person has to
go to the OR nearly every dayas well.
Speaker 1 (11:15):
Can you tell us a little bit about your work
schedule now, because you'restill full time, correct Yep,
still practicing full time as aclinical CAA, and then you're
also volunteering every year?
I want to say volunteering asthe Quad A president.
Every role in the Quad A is avolunteer position.
And tell us how you're managingthat just time-wise.
Speaker 2 (11:36):
Yeah, so I still work a full-time job, so 40 hours a
week, 80 hours, you know, everytwo weeks technically.
So I actually switched myschedule a little bit.
My work was gracious enoughthat it was kind of a mutually
beneficial thing.
So I now work a 24-hour shiftevery other week to get a big
chunk of my time at clinicaldone, to really free up my
(11:59):
afternoons and evenings so thatI can take calls and do meetings
and all of those things.
If you ask any of my other quadA leadership, my response rate
really depends on kind of my ORday.
If it's a nice friendly OR daywhere I'm not bouncing between
you know 100 endo cases I canrespond to emails, you know, in
(12:20):
our downtime while we're waitingfor a surgeon or the room to be
ready or whatnot.
But there is a lot of that.
Every moment is usuallyaccounted for and then you have
to try to fit to what you weretalking about earlier your own
well-being into all of that is alot.
But yeah, finding the rightwork schedule and having a
supportive family, household athome to kind of let you do
(12:41):
things when you're not at workis really helpful at home, to
kind of let you do things whenyou're not at work is really
helpful.
Speaker 1 (12:50):
Yeah, and one of the other things I learned about the
Quad A presidency is that it'sa three-year commitment, and so
the first year is help me withthe language President-elect,
president-elect.
Now you're the president andthen you're the past president.
Correct, immediate past.
Immediate past president.
So when you're signing up orputting your hat in the ring to
be elected right, it's anelected position you know that
it's going to be a three-yearcommitment.
(13:11):
Correct and talk to me abouthow you knew that this was the
right time in your life, knowingthat you were still going to
work full-time and have awedding to plan and then perform
and do.
Why you picked right now.
Speaker 2 (13:23):
So it was a lot of discussion with my now husband
of you know I love beinginvolved and I've loved what
I've done with Quade and StateAcademies in the past and I knew
I wanted to do it.
And when we looked at kind ofthe timeline of what does life
look like from our family sideof things, it was we can do it
(13:45):
now and, yes, we're going toplan a wedding or we can do it
in 10 to 15 years from now,because really we want to start
to settle down, hopefully havekids, things like that.
And he is by far one of themost supportive people with the
schedule and the calls and theemails.
But he rightfully so was likewhen we have kids, I want, you
(14:10):
know, especially a baby issomething that you can't just be
a million places all at once.
So he was like we just reallyneed to think about it.
And so it was kind of like nowor revisit in 10 to 15 years.
And I was already in the swingof things doing various
legislative things, and so wesaid, all right, let's go ahead
and do it.
Do it now.
And so, lucky for me, he wasvery supportive of the idea and
(14:32):
we just kind of went for it now.
Speaker 1 (14:35):
But I think that's very real, to hear that
sometimes you have to say yeseven though you're not quite
sure exactly what it's going tohold, and that there is this,
you know, and particularly withthe presidency, there's people
on both sides of you to help.
But yeah, I just think tovolunteer to lead our community,
our profession, is such a hugeundertaking that I just, I hope
(14:59):
other people hearing how you'remanaging it allows them to think
, OK, maybe I can do that too.
You know, I don't have to haveample you know I don't feel like
I have all the time in theworld to be able to still do
this and still contribute.
Speaker 2 (15:10):
I think I think that's a really fair point.
I think it's very overwhelmingwhen you look at it from the
outside, but, even being so, wedo these three year commitments
right.
As president, elect president,immediate past president.
The two years now going on tothe second, this year looks very
different than it did last year, and it's somewhat nice because
(15:30):
, depending on you know who thattrio is that makes up those
presidents.
We very much work as a threesome.
It is really not a one personand then two kind of outsiders.
We very much all three worktogether.
Danny and Emily, who areimmediate, past and incoming
president or president-elect,are on almost every phone call.
(15:52):
It's always kind of the threeof us and so, based on whoever's
clinical schedules, it canchange right.
So staff has been great.
They work around whatever theschedule happens to be, and so
for people that I think arereluctant to get involved
because of things like that,it's nice to know that you can
make any schedule work.
(16:13):
You have to be flexible and bewilling to give up.
You know your own personal timeand some hours you might not
normally, but you can make anyschedule work with the people
you're doing it with, which isnice.
Speaker 1 (16:25):
Yeah, that's encouraging.
How different was.
I love your story of being thelegislative chair and how you
got there.
Speaker 2 (16:32):
I want you to tell that a little bit.
Speaker 1 (16:34):
Some more details.
And then also, how different isit being the legislative chair,
which I assume is one of thebiggest committee positions,
versus being the quad Apresident?
How well that prepared you tobe the president now.
Speaker 2 (16:47):
Yeah.
So, like you said earlier, butobviously I guess our podcast
listeners won't have been inyour speech necessarily.
So I actually ran for a boardseat in what would have been
like the fall of 2020 electionsto kind of go into the 2021 year
, 2020 elections to kind of gointo the 2021 year.
(17:08):
I ran for a board of directorsseat because I had been involved
in state academies with DC andjust sort of Virginia and just
had really liked it and I hadbecome friends with some of the
leadership and was like I thinkI really want to be involved and
start to learn a little bitmore.
So I ran for a board seat, kindof honestly out of nowhere.
To be completely honest, I justsaid why not?
Let me put my name in the ringand see what happens?
And I didn't get it, which isfine.
(17:31):
And Crystal Cam was actually, Ibelieve, the president or
president-elect at the time andshe reached out to me and said
you know you didn't get electedfor the board seat, but we have
a legislative committee chairopening because our chair just
resigned from the position.
Do you have any interest inthat?
You had said you know thesecommittees interested you and I
kind of hemmed and hawed and waslike I don't know, that sounds
(17:52):
like a big responsibility.
But you know, if you guys aregoing to be there to support me,
like, oh sure, I'll give it atry, not really knowing anything
about legislative things I didnot come from a legislative
background it was a whole newthing to learn.
But they helped me with it andkind of guided me through it and
I fell in love with it and so Idid that for about three years
(18:15):
for Quad A before I ran forpresident-elect.
The difference between the two,I think, is just legislative
committee chair is so much workand Brie Siekford, our current
committee chair, is doing aphenomenal job with that.
But it's in one realm and soyou kind of get to focus on just
(18:38):
that realm of things, whichmakes it, I think, a little bit
more digestible.
It's also, for the most part,timing it's busy in one section
of the year and then kind ofdies down.
You always have your grassrootsand things that you're doing to
kind of prepare for the nextlegislative session, and that's
just as important as the actualsession itself.
But it definitely becomes moreof a manageable time commitment
(19:02):
as the year kind of goes on, asopposed to the first couple
months of the year whereeveryone's in session and
hearing bills and all of this,whereas the president I think
it's just consistently busy allthroughout the year and you have
those different silos of things.
You have the meeting, you havepractice, you have legislative,
you have membership and you havekind of all of these different
(19:25):
areas in the committees that areall great at what they're doing
but ultimately come back to youand the board to ask guidance
or approval and I think I kindof underestimated how much went
to the presidents until I wasinvolved in the doing of it I
was like oh wow, yeah, we do alot yeah.
Speaker 1 (19:45):
I imagine so, because from the outside, I think the
community is probably onlyrecently starting to hear a lot
more of the legislative effortsand maybe that social media that
we're just seeing more of thework that it takes behind the
scenes.
And for you to say that youdidn't know much about the state
legislative process is so true,because the first time I
learned about it I'm like, ok,let's break it down.
(20:07):
It's like the Senate and thenthe representatives, and you
feel so inadequate that youdon't know.
But it is this whole otherworld in language it is.
Is this whole other world inlanguage it is.
And I would love to ask abouthow the legislative process in
Virginia started, because youwere the legislative chair when
it started, correct?
Speaker 2 (20:26):
I actually was still in school when it very first
started.
But, yes, I so they had effortsgoing all the way back.
The first one that comes tomind is 2017.
And I know they did some workbefore that, so I apologize to
all the Virginia folks that didthings before that.
But 2017 was one that I reallyremember because I was a second
year student at KSDC and I wasactually living in Virginia,
(20:49):
right across the river at thetime, and they had kind of
pushed for it and they did astudy that ended up not coming
out in our favor and kind ofderailed the efforts and fast
forward to, you know, covid, andnow we have all these work
shortages and they pushedlegislation again.
I believe 2022 was the year andwe actually heard from a
(21:13):
hospital system that's prettyprominent in Northern Virginia
that was like we're short peopleand we need to run our ORs, and
so they were very much kind ofthe re-ignition of these bills
to help with their staffing, andwe legislated a little bit.
It ultimately came to thedecision that they were going to
(21:34):
do a new study.
To see, you know, nowpost-COVID, a lot of things have
changed since the one that hadwere going to do a new study to
see, you know, now, post-covid,a lot of things have changed
since the one that had been donein 2017.
Speaker 1 (21:42):
Can you say more about the study, because I think
that is an interesting point inthe legislative process that I
don't know that peopleunderstand?
Oh yeah, but I've heard thatseveral times from other states.
Speaker 2 (21:51):
Yeah.
So some states every state's alittle bit different.
Some states do what's calledlike a sunrise review, where you
fill out basically what is thiscareer, how would it help the
state, why does the state needit?
And it's just kind of questionand answers.
Other states do actual likeworkforce studies from either
the Department of Health or theone in Virginia just recently
(22:11):
was the Joint Commission didtheirs, and they look at, you
know, are there shortages?
How would licensure of CAsaffect the shortage?
Would it actually help them?
The other thing they lookedinto was CRNAs and kind of how
would expanding their practicehelp or not help the workforce
shortage, residency slots?
(22:32):
So they looked at kind of allof these different options and
see which one would actually behelpful.
And so they had tabled our billto do this joint commission
study and it came out at the endof 2024, kind of fall into
winter.
They presented their findingsand they found unanimously of
(22:53):
the joint commission that theywere short-staffed and that
licensure of AAs would help withthe shortage.
And so it was a unanimousrecommendation from the Joint
Commission of Virginia that AAsbe able to have licensure, and
so that was really kind of whatpicked up the ball in 2025.
(23:14):
We got really good support fromit was actually the Virginia
Society of Anesthesiologists the.
VSA reached out to the VAAA, theAcademy of Anesthesiologist
Assistants even I still stumbleover all of our words and said
you know, we have this study nowand we have bill sponsors.
We really think it's a greattime for you guys to put forth a
(23:38):
lot of effort to this.
We think we're settingourselves up for a really good
year.
And so with that we talked toour legislative team and our
director of government affairs,with McGuire Woods, and they
kind of did their own littleresearch and ultimately the
decision came to hire our ownlobbyists on the AA side of
things.
That worked phenomenally withthe VSA lobbyists as well.
(24:01):
And so the two of them workedtogether and we went down and we
did testimonies and we wroteall of our letters that I'm sure
lots of you saw me email andpost about and just kind of
trekked our way through theHouse and the Senate and to the
governor's desk and hegraciously signed it on Monday
before we came here, which wasthe best surprise to the
governor's desk.
Speaker 1 (24:19):
And he graciously signed it on Monday before we
came here, which was the bestsurprise in the world Very
convenient, yeah.
So like pre-2017-ish to 2025 iseight years plus of
disappointments.
Honestly, it sounds you knowups and downs, but I don't know
that.
That's a super unique story.
Even I think probably somestates are fighting that same
(24:41):
battle.
How did you, since you wereinvolved in that on the
legislative side, stay motivatedthrough all those years of
trying and trying and trying?
Speaker 2 (24:51):
until you succeeded.
It's really, I think, looking atother states, honestly we in
the last couple of years havesuccessfully gotten a few states
between Utah, nevada,washington, and so seeing those
successes are reminders.
You know that it is possibleNevada had been in the works for
(25:11):
years and years and years andjust kind of waited for the
right time to finally get itpassed, and just kind of waited
for the right time to finallyget it passed, and so I think
looking at all of those is justa reminder of it takes so much
time and although it seems likewe're not maybe doing anything
or making any progress, it wasreally relying on the
relationships that I had startedto form and built, and so I
(25:34):
actually don't know that a lotof people know this.
I went to so many different VSAmeetings.
They were gracious enough toinvite us to send a
representative and talk aboutwho AAs are and educate their
residents and their membership,and it was really cultivating
those that then kept theirinterest in it and their support
.
That way when they neededsomething they knew who to come
(25:57):
to.
And so then we were involvedwhen the time came, and so it
was really leaning, I think, infostering those and then hearing
their support.
Even though we weren't makingprogress in the legislative
chambers per se, we kept gettinginvited to these things and it
was like there is support in thestate from the physicians and
from different people.
So it will come.
(26:18):
It's just when is the righttime that it will all fall into
place.
Speaker 1 (26:22):
Yes, legislation sounds a lot like finding the
right time.
Correct.
It doesn't A hundred percent,it's almost like it doesn't
matter what you're fighting for.
You just have to have the rightsynergy of parts to put in that
finally gets you the outcomeyou want.
Speaker 2 (26:36):
Yeah, exactly, it's a lot of timing.
A lot of timing Interesting.
Speaker 1 (26:40):
Well, I want to switch gears a little bit.
Oh, we are so good on time.
You told me in our discoverycall so how these process
episodes work is that I findpeople who are interesting and
are doing something different orsomething that oftentimes these
are things that I want to doLike, oh, that's kind of
interesting to me.
What would you know?
How did they get?
There is sort of how thesestart and I have a discovery
(27:03):
call with them and then we Icreate a little storyboard and
then we do the podcast off ofthose storyboards.
And when I first met Nicole,she was talking about how you
wanted your legacy as Quadepresident to be.
That the Quad A members feltlike Quad A gave them something
like gave them more, or theycould really reach out and be
(27:26):
like okay, this is what Quad Ais doing for me.
Can you describe that a littlebit more?
Or maybe what your hopes arefor this year?
Speaker 2 (27:33):
Yeah.
So I feel like we're in areally unique and almost tough
position, but it's a great onein that we're growing so fast
that it's almost hard to kind ofkeep up with how things are
changing, in the sense that, youknow, 10, 15 years ago it was
such a small group of peoplethat it was really easy to know
(27:54):
everyone and know exactly whatwas going on.
And you know if a state wasgoing through things, it was
really easy to kind of manage,know exactly what was going on
and you know if a state wasgoing through things, it was
really easy to kind of manageall of those things.
Fast forward to now we have,you know, double digit states
that are trying to submit billsfor licensure and you have to
keep track of them all.
And we're bigger, we have morepeople, we have so many students
, which is phenomenal and it'skind of how do you really take
(28:18):
all of those people and reallygive them the benefit of being a
member right?
And how do you keep peoplewanting to come to what's now
this just growing thing outsideof just?
You know you should do it tosupport the profession.
What can we really offer?
And so you think of obviousthings like CMEs and things like
that at the annual conferencethat everyone needs to get their
(28:41):
recertification.
But I think what we're reallytrying to do this year and my
hope is that we can really kindof dive into what do members
want from the quality that wecan realistically give them.
And so, whether that's supportin their workplace when they run
into you know a problem of youknow my workplace is doing this
(29:02):
and it seems a little off, orthey're having problems billing
for us, or things like that,that the members really feel
empowered to come to thecommittee chairs or leadership
and say, hey, what have we donefor this in other states?
Because those are resources thatwe can really give out if we
know about it but that we don'tnecessarily always know about.
And so it's things like that orthings like the mentorship
(29:24):
program that I'm actually reallyexcited to see where it goes
and kind of channel all of thesenew bodies that are coming into
the profession and really givethem a chance to grow and learn
what the profession's about andrely on more experienced AAs.
And so this year I think wehave 12 pairings, which I'm
excited to start.
It'll be a nice small group forus to really kind of see what
(29:47):
people want out of it and how itgoes, and so I'm really excited
to give that to members and tryto channel what they want and
how they could see membershipfrom Quad A benefiting them and
just really dive into that.
Now that we've got more people,we're growing the conference,
we're doing all these things,what can we really set up?
for them to want to come and bea part of it, outside of just
(30:10):
this space for these four days,yeah.
Speaker 1 (30:14):
I have a hard question.
Oh boy, that I did not tell youabout I have a hard question
that I did not tell you about,but I was thinking like as a CAA
and you had said what the QuadA can realistically do.
What are keeps the quad A frombeing able to do things Like
what are the constraints?
Is it money?
Is it that everyone's avolunteer?
Is it time?
Speaker 2 (30:34):
Yeah, it's a combination of everything that
you just mentioned, right.
So money is obviously a bigfactor in a lot of things.
Everything that we want to growinto and do costs some form of
money to get it done, and soit's kind of balancing out when
is the right time to do allthose things.
Our new membership portal was abig one, right.
(30:55):
We had talked for a littlewhile about how we didn't love
the membership portal we were on, but it's going to be this big
endeavor of money and time andstaff needs to learn how to use
it and all of these differentthings, and it's kind of you
have to gear up to be able tomake those changes that, in the
long run, are going to be worthit.
But it's really going to be astruggle in that transition
(31:17):
period, which, thank you toeveryone listening that dealt
with all of the emails that wesent out about Fonteva and our
transitions, but in the end itmakes it work.
It's better for a member to beable to go in and do their own
things and manage it themselves.
So it's a lot of that and it'sa lot of just navigating places
we haven't been before, becausewe've been a really small group
(31:41):
of people able to either attendthings or do things or have
experience outside of theanesthesia world that they can
bring in.
I think that's really wherewe're going to be able to
experience more growth andbenefits, just because now we
have more possibilities where wedidn't have that before.
(32:03):
And it's really navigating.
How do we take all these ideasand put them into something that
is a good product for people?
We don't want to throwsomething out there, that's.
We want it, but it's not doneright.
Speaker 1 (32:15):
Yeah.
Speaker 2 (32:16):
So yeah.
Speaker 1 (32:18):
Yeah, and I think it's interesting too that we can
look you know, we're almost ina great spot because we're small
and nimble and we can maybemake easier changes than we can
look to the ASA, and we can lookto the ANA and see what they've
done and sort of improve uponit or, you know, find our own
way that serves our communityand not have to, you know, maybe
(32:39):
do as many hoops as they had todo.
Speaker 2 (32:41):
Definitely definitely .
We definitely look at thingsthat the ASA does that we're
like, oh, that's great, we wouldlove to come up with something
like that, or I mean even theAA&A.
As much as you know, there aresome things we disagree on.
There are things that they dothat we're like, okay, maybe we
can channel that into our ownway and think of a you know way
to do something.
And so, yeah, we take the PAswe've kind of looked at, and so
(33:04):
it's all of these differentthings that we'll look at and
see how are these organizationsthat are bigger than us right
now?
How do they do it?
Can we kind of look to them toform how we handle this as we
grow and get bigger?
Speaker 1 (33:18):
Well, speaking of the AANA, I'm wondering, as the
Quad A president and because youdid the legislative effort in
Virginia, I'm assuming you heardyou know the rebuttal against
AAs what would you want CRNAs tohear the Quad A president say?
Like, what do you want to sayabout CAAs to the CRNAs?
Speaker 2 (33:39):
I think the biggest thing that I personally feel
like I always want to say inthose harder moments is like
we're just people too right.
We're just people too right.
And when you break down,anybody that's in any sort of
workplace, they go home to afamily, they go home to a life
(34:00):
outside of work and they're justpeople.
And so all of us are peoplethat got into a profession just
to help patients.
For the most part, I would say,if you ask 95% probably of all
of the students that are outthere the A's that are out there
of why did you get into theprofession?
It's somehow going to boil downto I wanted to help patients
and I wanted to do patient care.
And I think that's wheresometimes in these legislative
(34:23):
efforts and this back and forth,we get somewhat lost, in that
all we're really trying to do isimprove patient care and offer
patient care, and so I reallywould love to sometimes just be
like we're just these peoplethat just want to go in and do
our jobs.
We want to work with you Likewe want to be colleagues Some of
my best friends are CRNAs andwe just want to be a friendly
(34:46):
face at work that does a job,does it well and, you know,
provides good patient care, andsometimes I think that starts to
get a little lost in the heatof legislature.
Speaker 1 (34:55):
Yeah, and I can imagine that when you are so
focused on the legislativeeffort that you lose sight, like
you lose that touch point of ohwhy did I, the CNA or I, the
CAA, go into this?
How do you stay connected towhy you want CAAs in every state
, why you wanted the Virginialicense to pass, like how does
(35:17):
that?
How do you stay grounded inthat?
Speaker 2 (35:19):
Yeah, so it's definitely little moments with
the patients.
I think sometimes you forget youknow, in the grand scheme of
things, why you wanted to do thejob and you kind of get in the
day in and the day out.
So you know you go to the ORyou go home, you go to the OR
you go home, and it's a coupleof little moments where you know
they say thank you so much andthey're really nervous in the
(35:39):
pre-op bay or you take thoseextra couple of minutes to make
them feel a little better andyou're like that's why, why I
came into, what I came into wasto be the comforting face and be
somebody that, in an otherwisescary time, can be, you know, a
little bit of a relief for themon that day, and some patients
(35:59):
just will stick with you for awhile.
I think we all have oursituations where you know we
really bonded with a patient forwhatever reason, and I actually
just recently had one this pastfall who was up in labor and
delivery with me.
She was an add-on C-sectionthat we were doing.
I was working, you know, one ofmy 24-hour shifts and she was
(36:25):
getting put on for I can't evenremember what, to be honest.
But she had twins and I willsay with everyone I have talked
to her since and she's okay withme kind of telling her story.
So she came in, we started herC-section somewhere around 1030,
11 o'clock at night and yourusual uneventful, you know,
(36:45):
spinal.
They were so excited, talkingabout the baby names and kind of
disagreeing on them anddeciding how they were going to
do.
And after babies were born theywere closing and she actually
threw a PE and cardiac arrest onthe table, me in my own OR, and
(37:15):
I was terrified for her.
I mean, we did ACLS, we got herback, we took her down to CT
and you know she was managedvery well at our hospital and
the hospital she went tosubsequently was in the ICU and
intubated for days and ended upextubated, spent lots of time in
the hospital.
But I had never chart checkedsomeone so frequently after and
just kind of rememberedeverything about her because she
(37:38):
was saying, you know she was sonervous but so excited and I
thought about her a lot.
But it was really the momentwhen she came back to the
hospital randomly when I was onanother night shift just to
visit they had been at apediatrician appointment down
the road and decided that theywere going to come visit.
And she doesn't rememberanything, so she has no idea who
(37:59):
I am, but it was still the justlike thankfulness in her eyes
to someone that took care of herin such a big moment when she
really had no recollection of me.
We had conversations that Itold her about and she was like
I don't remember you know,telling you what I was going to
take my babies.
I don't remember any of this,but her husband since it was a
(38:20):
C-section was obviously in theroom too and he remembered and
was so thankful.
But she sticks with me a lotand she is somebody that now I'm
like when I need thosereminders I go.
She's why, you know, I do it.
And I actually connected withher outside of this.
On social media.
She got a lot of news attentionbecause she's been spreading
(38:41):
awareness about PEs andpregnancy, and so I connected
with her and have gotten to talkto her and kind of follow her
life after, which is somethingwe don't usually get to do.
As anesthesia providers, weusually see our patients, so we
see them in the recovery room,maybe a couple of days later if
they're still in the hospital,but we really don't get to see
what happens to them after.
(39:01):
And so getting to kind of seeher now and kind of follow along
in her journey and watch whatshe's been doing to educate
people is really a big groundingpiece for me.
Of you know, I got to help herin that moment where if it had
been any other moment it may nothave turned out like that, and
so I think that's really a bigthing that kind of keeps me
(39:21):
motivated and reminds me of whyI work so hard and why we do.
What we do when we go throughthe training we go through is
just to kind of have thosemoments and be present for those
things when people need us.
The most.
Speaker 1 (39:34):
That's incredible and I appreciate you sharing that
story.
And, yeah, let me know if wecan support her in any way.
Maybe we could link tosomething in the show notes, but
we'll talk after about that, ohyeah.
Speaker 2 (39:46):
Her name's Aaliyah Walker.
Again, she let me you know.
I asked her.
I said if I you know, they'lltalk to me a little bit.
Am I allowed to share with you?
Know people that ask?
And she said yes, by all meansshare the story.
She's been a big advocate andreally trying to just get the
word out there for people thatotherwise wouldn't know.
So we'll talk after and get yousome information to put in
(40:06):
there so that people can followalong with her.
Speaker 1 (40:13):
Great, you know this is what it's about.
Like a human to humanexperience.
Like you are trained to helppeople in this very specialized
way and if you weren't there,you know she wouldn't have got
this level of care, and justthat.
At the end of the day, itdoesn't matter if you're the
anesthesiologist, the CRNA orthe CAA, like we're working
together to do this thing.
Like she doesn't care who youare, she just wants you to give
her the best care possible.
Speaker 2 (40:32):
Like everybody talks about.
I feel like how they have likeone patient that sticks with
them and they can always tellthe story and I think for the
rest of my life she will be theperson that I like can vividly
remember and look back on and belike okay, this is.
It was crazy.
We were like if we hadn't, youknow cause, everybody, even the
OB, and everybody was likeshould we have taken her earlier
(40:54):
?
Cause we waited, cause she hadeaten, and so we're like we kept
her NPO.
And everybody was like shouldwe have gone earlier?
Like would this not havehappened?
And like, after the fact, whereyou were all talking and we
were like, no, it's like ithonestly happened in the best
way that it possibly could havehappened, because that clot was
there, it would have moved atsome point.
(41:14):
It was like if it had movedafter the C-section, when she
was in a recovery room, like wewould have been there fast
enough.
So it was just wild.
It's like wild to think back on, but anyways.
Speaker 1 (41:27):
Wow I bet you know everything there is to know
about PEs and embolisms.
Speaker 2 (41:35):
I'm like, oh, I'm like, do I need to go get an
ultrasound scan of my own legs?
Speaker 1 (41:40):
Yeah, I mean it is.
It's an interesting way tolearn too, because, as you said,
you had never done, or youmaybe had you never seen a
cardiac arrest, or you had neverseen a PE to cardiac arrest in
the OR before.
Speaker 2 (41:53):
I had never had my own.
So I responded to codes in theOR and, obviously, like, I teach
them lab and we go through itall the time and but it was the
first time that I had everactually had to call a code on
my own patient, which was one ofthose kind of like oh my God,
is it?
Like is this really happening?
(42:16):
Is what I think I'm having.
Like, um, so there wasdefinitely that moment of like
oh my God, no, this is actuallyhappening.
Speaker 1 (42:21):
Yeah, I think that's really um, what I was going to
say is that in our training youknow, when you go to AA school
they can't guarantee that you'regoing to see a cardiac arrest
in OB, like that's not.
Like, oh, check mark, great, welearned that.
And so of course that's whenSim Lab comes in to help fill in
some of those like sentinelevents that you may or may not
get to see.
But it's interesting how youknow the training that you do up
(42:45):
to that point with all theother patients.
And then of course, aclstraining like does come together
in the moments that you need itand it's wonderful to know that
.
I'm sure one of your firstcalls was like let's get the
anesthesiologist in here, let'sget more anesthesia help in here
that we don't have to do italone, like that's such a
beautiful you know exercise inthe anesthesia care team model
(43:06):
really.
Speaker 2 (43:07):
Yeah, it was, because I mean, we were you know, it
was nighttime and OB I think myattending was either had gone to
do epidurals or maybe try tolay down in between, you know, a
busy night.
Everything had been going greatand it was the first thing I
told my nurse, when I thoughtthings were starting to go
downhill and she didn't lookgreat, was I need you to call.
(43:28):
You know, I named my attendingright now and she came in the
room within a matter of minutesand then it was.
Yeah, you just fall back on whatyou go through in those sim
labs, which is crazy, becauseit's things that in training
you're like why are you know?
Why are we doing this so much?
Why are we doing this so much?
But it's because you don't seeit all the time.
(43:49):
It took me what?
Eight years to have it kind offall right in front of my face,
and for some people it takeslonger.
And so you just have to kind ofrely on what is ingrained in
the back of your head from allof that training and it just
naturally comes out and it, youknow, and that's what you rely
on.
Speaker 1 (44:08):
Yes, yeah, there's.
There's a lot more we could saythere, but I just love that you
have that as your or one ofyour grounding moments, because
that's what we're doing, that'swhy we're here, that's why we're
fighting for legislation,that's why patients deserve
physician-led anesthesia care,like that is because when these
things happen, you need anexpert team.
(44:30):
You know there to make it seemlike oh yeah, we just took care
of you, no big deal, like sheremembers you know nothing like
A president, stuff on yourbreaks and everything.
How do you recharge or touchback into who Nicole is, outside
of being a CAA, outside ofbeing the president?
Speaker 2 (45:05):
Yeah, it really is my husband, ryan and our dogs.
It's kind of putting down and Iwould argue Danny and Emily will
completely disagree with mebecause they say I don't do it
putting my phone down, notanswering a text or an email and
just kind of spending time,whether it's, you know, watching
a show that we watch every week, like we do Survivor, we do
Amazing Race, we do these things.
You know that kind of air everyweek and so whether it's sitting
down and just doing that andnot thinking about it for a
(45:28):
minute, or going for a walk is areally big one.
I love to go out and just kindof walk and I find it to be very
grounding.
I also get a lot of thinkinginevitably done about whatever I
was trying to walk away from,but it's at least my own
thoughts and kind of gives me achance to organize them a little
(45:49):
bit.
But yeah, it's really leaningon, I think my home support
system and you know, the dogsagain always have that second
sense of they're like I need togo like look at mom, real cute
and cuddle, so that she forgetsabout whatever she's doing.
But yeah, they're huge and kindof unwinding and coming back to
(46:10):
reality.
Yeah, totally.
Speaker 1 (46:12):
Let me see I have a final question, but I have a
couple fun ones.
So let me ask you what wouldsurprise someone if they knew
about you?
Speaker 2 (46:23):
Let's see, I think actually a lot of people are
always surprised to learn I havequite a large bourbon
collection, which alwayssurprises people when we talk
about it.
I grew up mostly in Cincinnatiand so my dad ended up into
bourbon and so we had it aroundthe house a little bit as I
(46:44):
started to, you know, get olderand come home from college and
whatnot, and then did thebourbon trail down in Kentucky
and have just slowly startedcollecting bourbon and that's
always very surprising to people.
Speaker 1 (46:57):
They're like you have a lot of bourbon.
Speaker 2 (46:59):
Or they come over to the house and they're like oh my
gosh.
And I'm like oh okay, maybe notthe best thing, but I'm
painting a certain picture.
Most of the bottles are full.
I promise painting a certainpicture.
Speaker 1 (47:10):
Yeah, most of the bottles are full, I promise.
I think this is interesting.
Speaker 2 (47:18):
What do you think you would be doing if you weren't a
CAA?
Oh gosh, so I actually mydegree from undergrad is
engineering.
Both of my parents areengineers, and so I actually
really enjoyed learningengineering when I was in
undergrad, and so I think Iprobably would have stuck with
it and done some sort of projectmanagement for engineering.
(47:39):
I don't think I could ever be alike nine to five desk job, as
much as I envy it sometimes whenwe're at work on the holidays
and I'm like why did I not do?
Speaker 1 (47:51):
some sort of office job where I would be off work
right now.
Speaker 2 (47:54):
So probably some sort of like engineering related
project management thing.
Speaker 1 (48:00):
Do you have big plans for next year, when you're done
with this presidency?
Reign 2027, I guess.
Speaker 2 (48:07):
I don't.
Hopefully we're in Virginia andhopefully we can like settle
down and kind of figure out whatthat next phase of life is.
I always joke that who knowswhat I'll be doing, because I
have a hard time not doing morethan my like 40 hour work week.
Speaker 1 (48:23):
You like to be busy?
Yeah, exactly.
Speaker 2 (48:27):
Can't have too much free time.
I'm like, what do I do withmyself?
Can't have too much free time.
I'm like what do I do withmyself.
But I'm really actually hopingto take a step back, at least
for a couple years, and justreally kind of enjoy life and
not be worried about what'sgoing on or troubleshooting
things or answering an email,and just kind of have a couple
years before I inevitably, I'msure, jump back into something
(48:50):
somewhere yeah.
And just kind of enjoy whatlife brings.
Speaker 1 (48:55):
Yeah Well, I'm looking forward to seeing that.
My last question is the ethosof this podcast, which is to
help CAAs realize that theyalready have everything they
need to create their life bydesign, to create their dream
life, whatever that means forthem.
And I'm just always curious ifyou, if my guest, if you would
(49:16):
agree with that, do you feellike that resonates with you and
, if so, how do you feel likethat's played out in your life?
Speaker 2 (49:24):
You know what I do think I agree with you in that
sentiment.
I don't think you know it, Ithink a lot of us don't think
that and I think if you asked mea couple years ago I wouldn't
agree with it.
Just by kind of looking atrandom things.
And if you had told me fiveyears ago that this is the
(49:44):
position I'd be in and I had allthe tools to do it, I would be
like you're crazy, there'sabsolutely no way.
But I think it kind of goesback to what you had said
earlier of you just have to beopen to what happens and be
curious about it.
Never in my CAA schooling wouldI have thought that I would ever
(50:05):
be Quad A resident or have anydesire to do it.
Yeah, to be completely honest,when I was in school and kind of
going through everything, I waslike I'm so excited to get to a
place in my life where, like Ican go to work and I can come
home and I can not do anything.
And then it just kind of tookrandom people in my life that
had been involved to be like,hey, you know, we need some help
(50:27):
.
Do you have any interest in it?
Would you be willing to do itand, being somewhat of a people
pleaser that I am, I was like,oh sure, and it just kind of
worked out that it taught methat I really liked that and I
had all of these skills to goabout and do a job that I
otherwise really had nointention or thought would ever
(50:50):
be kind of in my realm of thingsto do.
Speaker 1 (50:53):
Yeah, I mean, how many people think they're going
to be the Quade president?
I don't know, not many.
Speaker 2 (50:58):
Hopefully somebody out there, thinks they will be.
Speaker 1 (51:01):
Yes, exactly Wait a minute, wonderful.
Well, I am so grateful that yousaid yes to this live interview
and thank you all so much forcoming, yay.
Speaker 2 (51:09):
Thank you, you, this was fun all right, everyone.
Speaker 1 (51:25):
That's a wrap on season four of the Awakened
Anestis podcast.
Woohoo, we did it.
Thank you so much for listeningand an extra special thank you
to everyone who joined me liveat the Quad A 2025.
It's been such an honor toshare these CAA stories with you
this season.
I'll be taking a break for thesummer, but I will be back in
(51:48):
fall of 2025 with all newconversations, all new process
episodes, some new CAAminiseries episodes and just
some more fun for season five.
In the meantime, I invite youto catch up on any of the
episodes you've missed and ifone of them moves you and you
really love it, I encourage youto share it with a fellow CAA,
(52:09):
aa student or someone who is CAAcurious.
These stories are meant toripple through our community, to
connect us and impact for yearsand years to come, I hope, as
long as the podcast is up and inthe airwaves.
You can also stay connected byjoining my mailing list.
(52:29):
By using the link in the shownotes.
You'll be the first to knowwhen I decide on the season five
premiere date.
You can also follow me onInstagram at AwakendAnesthetist.
I'm on there somewhatfrequently sharing some behind
the scenes and just some lifeupdates of me going about living
my life by design, and let'ssee what else.
(52:51):
I'm always approachable onemail at awakenedanesthetist, at
gmailcom, but if you want toget a really fast response, you
can DM me, and I love to leave alittle voice note.
Those are super easy andapproachable for me, so I really
encourage you to follow me onInstagram at awakenedened
Anesthetist.
It's easy for us to chatquestions over there, and I
(53:13):
think that's it.
So until next time, let meleave you with this question
what would it look like to liveyour life by design, not by
default?
All right, everyone, staycurious, stay awake and we'll
talk soon.
Popular Podcasts
Bookmarked by Reese's Book Club
Welcome to Bookmarked by Reese’s Book Club — the podcast where great stories, bold women, and irresistible conversations collide! Hosted by award-winning journalist Danielle Robay, each week new episodes balance thoughtful literary insight with the fervor of buzzy book trends, pop culture and more. Bookmarked brings together celebrities, tastemakers, influencers and authors from Reese's Book Club and beyond to share stories that transcend the page. Pull up a chair. You’re not just listening — you’re part of the conversation.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com