Awakened Anesthetist

Pre-AA to CAA [PROCESS] Part 4. Britton Finishes First Year of AA School

• Mary Jeanne, Certified Anesthesiologist Assistant • Season 5 • Episode 95

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This new take on the PROCESS series is at the core of what I love to share, the messy middle. What if you could witness the making of a Certified Anesthesiologist Assistant in real time, not as a polished highlight reel, but as it is actually unfolding? In all things, I care far less about the end result and far more about who you are in the becoming.

This Pre-AA to CAA PROCESS series follows Britton Robinson as her journey unfolds from 2024 through 2028, an ongoing conversation that captures the growth, the pivots, the waiting, and the wins along the way. It is about honoring growth as it happens and having the courage to tell your story before you know how it will end. This is the Pre-AA to CAA [PROCESS] of Britton Robinson.

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SPEAKER_00

Welcome to the Awakened Anesthetist Podcast, the first podcast to highlight the CAA experience. I'm your host, Mary Jean, and I've been a certified anesthesiologist assistant for close to two decades. Throughout my journey and struggles, I've searched for guidance that includes my unique perspective as a CAA. At one of my lowest points, I decided to turn my passion for storytelling and my belief that the CAA profession is uniquely able to create a life by design into a podcast. If you are a practicing CAA, current AA student, or someone who hopes to be one, I encourage you to stick around and experience the power of being in a community filled with voices who sound like yours, sharing experiences you never believed possible. I know you will find yourself here at the Awakened Anesthetist Podcast. Welcome in. Welcome back to the Awakened Anesthetist Podcast, where we expand our understanding of what's possible within the CAA profession. I'm your host, Mary Jean, a longtime practicing certified anesthesiologist assistant, an AA educator, and now a doctoral student focused on researching the art of anesthesia. This series is a slightly different perspective on our normal process episodes because it's really created for the ever-increasing number of pre-anesthesiologist assistants who are here and have found the Awaken Anestus podcast because they're searching for insight and some understanding of what their future will hold. And by the way, if that's you, I'm really glad you're here. This process series is a long form passion project that I started in 2024, where I highlight the journey of one pre-anesthesiologist assistant as she applies, interviews, is accepted, and becomes a practicing CAA. This series was created with future CAAs in mind so you can hear what this season actually feels like while you're in it too. And for those of us who are further along, it's an invitation to remember, to reconnect with that vulnerable stretch of time, wanting something deeply, but not yet knowing if it's going to happen, not yet knowing what school will hold, or if your CAA dreams will come true. This is the process of Brittany Robinson from pre-AA to practicing CAA. Let's dive in and see where she is on her journey to become a practicing certified anesthesiologist assistant.

SPEAKER_01

Sorry, go ahead and go.

SPEAKER_00

Yeah.

SPEAKER_01

Okay. My name's Brittany Robinson. I'm a first-year AA student entering my second year pretty soon. I'm halfway through my fourth semester, and I'll be starting my second year in August, where I'll be doing full-time clinicals for 12 months.

SPEAKER_00

And today is what did you say? June 27th of 2026. So we've been following Britain now for a little under two years. And if you are fully caught up, you will know that we left Britain in January of 2026. You were about to start your third semester at Nova Tampa. And now you're about to start your 12 months of purely clinical. So I really want to make sure we talk about how you're preparing for that, maybe what the tone is like in school, like how is it changing? Um, but let's rewind a little bit and go back to maybe third semester, fourth semester. Talk to us about that change in going from less and less didactic and then onboarding more and more clinical. How did that feel in terms of your routine?

SPEAKER_01

So third semester was definitely a big doozy because it felt like second semester in terms of the school load and then just tacked on clinical on top of that. So it was definitely a huge adjustment for me having to go to work for eight hours and then coming home and studying. But it was definitely a good time of like combining what we're learning in school with what we're doing clinically, and things started to click a lot more because it's one thing to read something in a textbook, and then it's a whole nother thing to see it actually applied in person. And things definitely got super real for me. Like, okay, it's actually important to remember everything we learned in the textbooks because we're applying it to taking care of real human lives. Um, so it has definitely been super crazy the transition from even my first week to now. I was scared to even put my fingers in the patient's mouth to like scissor the mouth to intubate. I was scared to suction, I was scared to put in an oral airway because they preached to us to be super gentle with their teeth and everything. And I was just scared to do everything. Um, but I was trying to absorb all the information I could, and now I can pretty much run a whole case by myself, a simple robotic case right now. Um, but I have my like induction down and I'm starting to get my flow of emergence that's a little bit more of an art in anesthesia. Um, but the progress I've made since January has been absolutely insane, and it's just makes me really proud of myself. I still have a really long way to go, obviously. It takes years to perfect anesthesia. I mean, there's no perfecting it even in the end. Um, but it's been really good, and I've had some really good preceptors who remember exactly what it's like to be a first-year student, and sometimes I'll get down on myself and be like, oh, why did I do that? Or like that wasn't the smoothest emergence ever. And they're like, it's okay, you're right on par for where you should be as a first year, and that encouragement really just drives me to keep working harder and motivates me for sure.

SPEAKER_00

Mm-hmm. Do you have any specific memories of a time when it clicked where that fear sort of didn't emerge every time you went to put in an oral airway or scissor in the mouth? Like any memories of that?

SPEAKER_01

I don't feel like there was like one moment where it just clicked and felt a lot better. I think it was just slowly building on each experience I had, where like I do put in oral airway and it's fine. No teeth get knocked out or something crazy. Um, and then I do it again and I do it again, and then it's like, okay, it's okay. I know what I'm doing. Um, and just building on each experience, I think, made me more comfortable and confident.

SPEAKER_00

Mm-hmm. What is your routine with preceptors? Are you seeing I'm asking because I think there's a lot of fear as a student going into the operating room? And not only are you performing, but you're performing on a real human being in front of a preceptor who's judging you, who's evaluating you. Like, what did you tell yourself going into those experiences? How comfortable were you? Did you see the same preceptors over and over? Like, give us some more details on that.

SPEAKER_01

So at both the hospitals I've rotated at so far, I've pretty much been with very similar preceptors like each time. Like, I'll end up with the same preceptor three, four, or five times. Um, and then there'll be preceptors that I haven't worked with yet. So I think that hospitals tend to do that, like keep you with a certain group of preceptors, which I really appreciate because then I get to know them and what they like and get comfortable with them pretty quickly. It is definitely really intimidating, like doing intubation and induction when not only your preceptor's watching you, but also your attending and sometimes your surgeon. Like even yesterday during induction, we had three residents in the room. So there was like two of the residents that were there for induction, and the surgeon was there, and my attendee was there, and my preceptor was there all while I was intubating, and I couldn't get a view, and I was like, Oh, I'm gonna let my preceptor take a look. And it's just definitely high pressure having everybody watching you, but for the most part, people are very nice, and it's kind of helpful when they're all watching you because they notice things that you're doing that you don't notice. So, yesterday, like one person told me, like, I think you need to stand up straighter when you're intubating, or like that I was like kind of leaning back, and I didn't notice that. So, it's sometimes kind of nice having a lot of people watching you because they have a lot of good feedback, and nine times out of ten, it's not told in a negative tone or anything like that. Um, but sometimes you will have a preceptor tell you stuff that kind of stings a little bit, and so I think it's just really important to remind yourself that they're just trying to make us better providers, it's not a personal attack. They just want you to be a good AA and represent the profession very well. So I think just telling myself every day it's not personal. Um, any feedback you get is just to make you a better provider and has nothing to do with like who you are as a human.

SPEAKER_00

Mm-hmm. That is really good advice and practically very hard to implement. I I don't know if you would agree because it feels like it feels like this is personal. I can tell myself a million times, like it's not personal, it's not personal, but it still can stay a little bit sometimes. For sure. For sure. And I think having this conversation where we're openly talking about like it is going to hurt your feelings, but you then need to come in and have the emotional maturity to give yourself some compassion to see the bigger picture. And also to find, even in those stinging comments and that stinging evaluation, that there is probably something you could take away to be a better practitioner. And and I also think not to exclude the fact that sometimes your preceptor's in a bad mood and you're not gonna get great feedback and it's not gonna be a great day, and it's just chalk up as a loss. Have you had many or any of those experiences? Definitely. I had one really bad day at clinicals.

SPEAKER_01

I don't know what happened, but I was just so upset by the day, and I was like, Oh, I'm just so ready to go home. I feel like I'm not learning anything. And then I ended up talking to my program director, Professor Carter, about it the next day. And she had really good advice. She was like, It's okay, like you're just starting. Um, mistakes happen, but she was like, What's the most important thing? It's that you learned one thing from that day. Like, you if you take away anything, like let it just be one thing and not stick with you forever. And so I definitely was able to like take lessons from that day, even though it was a horrible day. I feel like I learned nothing in the end. Like I still learned an important lesson, and that's how to handle like negative feedback and improving communication and things like that.

SPEAKER_00

Professor Carter, great advice.

SPEAKER_01

That's I love that advice. She had she made me feel so much better about it. I was like, oh, okay. If she if she has these encouraging words for me, then it's it's okay.

SPEAKER_00

Mm-hmm. And I also appreciate the fact that you went and spoke to someone, a mentor. This happened to be the program director. That's awesome that a student can go to the program director because all program directors are also CAAs and they have also been where you are. So it's a really it can be a very useful relationship if you cultivate that, which it sounds like you have. You even talked about her like in your interview that you and her had kind of like some banter and stuff. So that's awesome. Okay, yes. So let's talk about transitioning through your fourth semester, which you are in the middle of right now, and then seeing the future coming, which is starting fifth semester, you have all clinical 12 months of pure clinicals. So I would love to know how that feels. Like, what's the energy of your first year class? Is it changing? Are they preparing you in in different ways? And then also, I want to get into the nitty-gritty of where you're actually going, if you know that yet.

SPEAKER_01

I do. I just got my schedule, which has made things very real. I know where I'm going. I'm starting to figure out where I'm staying for these rotations. Um, this semester, fourth semester, has very much been like a reality check. Like, we're about to leave and be on our own. We're not all gonna come back to each other in the afternoons to have class. We're not gonna be on campus. We're gonna be on our own doing anesthesia by ourselves. And so I think this semester has been a big pushing point for us to now is the time to get everything together so that you go into your clinical year being the best provider you can be. So I'm definitely trying to take full advantage of my clinical days. Um, not just trying to learn like the nitty-gritty details and like refining academic information. It's more I'm trying to get down my flows, remembering everything, perfecting my communication with OR staff and preceptors, working on my like pre-op evaluation, how I talk to patients, and just trying to be ready to do four to five days a week of purely clinicals and working like 50, 60 hour weeks. Um, so it's definitely very real. I'm really excited to go into this clinical year. Um, yeah, it's just an exciting but scary time. Where are you going the first couple months? Okay, so my first rotation will be in Albany, Georgia. And then I go to Athens, Georgia, and then a surgery center in Destin. Um, and then I go to Macon for three months, which I'm really excited about. I know that's a pretty large hospital, and I'll get OB, Cardiac, and Pete's there, and then I'll be going back home to Tallahassee for two months, which I'm really excited about, and then Shans for two months, and then my last rotation will likely be wherever I end up signing.

SPEAKER_00

So they give you the full 12 months all up front, you know where you're going.

SPEAKER_01

Mm-hmm.

SPEAKER_00

Oh, wow. Yes, yes, which I really like. Yeah, totally. So you talked a little bit about starting to plan housing. Tell the listeners kind of that transition. Maybe people aren't realizing that you have to live somewhere in these um out of location rotations.

SPEAKER_01

I think a lot of people have questions about how the housing and living works second year during your full clinical year, where you could end up pretty much anywhere in the US. Like you could end up in Washington or Nevada, you could end up up north, um, you can end up in Texas. There's so many different states you could end up in. I got lucky to be pretty close to home. I'm gonna be in Georgia and Florida for all my rotations. So for Albany and Macon and Athens, um, since those aren't where I'm from, I'll be doing an Airbnb or a furnished finder. Um, Nova does offer housing for some of their locations, like Macon has student housing, which is an option. I'm not sure if I'm gonna stay there yet or not, but it is free, which is really nice.

SPEAKER_00

Yeah.

SPEAKER_01

But then when I go home to Tallahassee, I'll be living with my parents. Um, very excited about that. And then for Shan's, um, my sister goes to UF, so I'll actually be staying with her at her apartment, which is perfect. So it's kind of just figure it out on your own. Your school might have um free housing available for some rotations, but that's still not even guaranteed. Some people get a really interesting schedule. Like I have classmates who most of the rotations are here in Tampa, so they're just keeping their apartment and staying there, which is really convenient. Um, so it kind of just depends for student to student.

SPEAKER_00

Do you get any say in where you go? Like, let's say you have a family. Could you say, I would love to stay in Tampa where my family is?

SPEAKER_01

So you can request pretty much whatever you want, but they do tell us time and time again, like this is just one year. We're gonna do our best to make everybody happy. But our clinical scheduler does the schedules for all of the Nova campuses, so that's like 250 students, maybe more now that Nevada's opened up, um, to make schedules for. So there's it's very hard to fit all the puzzle pieces together and make sure everybody has rotations for all 12 months. So the way that it works is you get to request three states. Um, and then if you request Florida, you request a region of Florida. So I requested North Florida, and then my second state was Georgia, and then my third state that I requested was South Carolina. So you get to request states, and if you have like a very specific scenario, um, like you have young kids, they usually try to keep you close to your young kids. But if you're just married or have a long-term partner, they're usually just like, you can deal with being wherever for 12 months, um, which is totally understandable and fair. And then I was able to request that I really wanted to go back to Tallahassee since that's where I'm from. And luckily I got that rotation, but nothing's guaranteed. And I'm just so thankful that I go to a school where they do all of our clinical scheduling for us because I know that's not the case for all schools.

SPEAKER_00

Mm-hmm. Very true. And we talked about this a little bit in one of your past episodes, but you can figure that out when you're applying to AA school. Like you can ask even in your interview or talking to students, like, how much does the school find these locations for you and how much effort you have to put in? Um, I know we may, you know, people maybe have a nurse practitioner friend, and it is very normal in that culture that in nurse practitioner school you have to find every single one of your rotations. And that is a huge burden. Um, and so AA school is not like that, but some schools will find everything for you, and and some schools only find some. So good tip that really, really matters that I feel like you wouldn't know unless you were this close to the profession. So thank you for taking on that.

SPEAKER_01

And I was speaking to one of my friends in my class about how that works. And I was thinking about how when I first started AA school and was interviewing, clinicals felt like so far away. So I wasn't even on my radar to ask about that. But now that I'm actually starting my clinical rotations, it means a lot to me that my school did all of that scheduling for me. So definitely important for um prospective students to take into account, even though it feels like clinic year is so far away.

SPEAKER_00

Yes, it goes quickly. It goes quickly. And and to that end, I would love to hear, like when I say what was the the lowest low of your uh first year of AA school, which you are over, right? You've done a full 12 months. Um and then the highest high?

SPEAKER_01

I have to think about it for a second. I would say that the lowest low was just the trenches of exams during third semester, because third semester to me was definitely the hardest because the academic load is very heavy. Um, it's complex information, and on top of that, you're balancing clinicals twice a week for 16 hours a week. So it's just a huge balance, and exams come up, and every exam is cumulative over everything you've learned that semester. Plus, you have clinicals. It was just really, really tough studying for all of those exams and going to clinic and trying to be the best provider I could be while I was at clinic, but also trying to pass all of my classes. Um, so that was definitely very challenging. I feel like I probably haven't experienced my highest high yet. I would expect I will probably be like on the moon whenever I'm starting my second year rotations and I'm like moving out of Tampa, going home, and realizing that this is real and I'm about to be on my own doing anesthesia. I think that's gonna be really exciting, even though it will be very scary.

SPEAKER_00

What interaction do you have with the second years, the current second years, or let me even call them the current people who are in their clinical year in terms of giving you advice, preparing you for different locations, like what does what does peer-to-peer do? And then does your school do anything to help you prepare for these away rotations?

SPEAKER_01

So I think I've spoken on this before, but we have a mentor mentee system. It's kind of confusing referring to each class right now because this is the only time of year where Nova has three classes. Yes. But even though I'm in my second year, I'm still considered a first year until I start clinicals. So technically there's three classes. There's like the incoming first years who just came, my class that's like 1.5 years, and then the second years who are about to graduate. So I have a mentee right now, but I also have a mentor. And so I still text my mentor pretty regularly, and he texts me to check in, see how clinic is going. Um, will give me any advice he has. I'll ask him about upcoming exams. Um, and so we've been able to talk about his clinical experience, and he's been able to give me advice online. And then I also have friends in other programs. Um, I've talked about Maddie before. I text Maddie all the time about how her rotations are going. She's at Nova Jacksonville. Um, so I've been able to speak with her to get advice on the clinical year. So definitely Nova sets us up with having that mentee mentor system. But then also am lucky to have friendships with other people who are going through what I'm about to go through.

SPEAKER_00

What about some of those big heavy-hitting rotations like your OB rotation, your cardiac rotation? What is the prep there in terms of peers and then how the school helps you prepare?

SPEAKER_01

So we have this class on Canvas that's our clinical class, basically. And you can go on there in all the hospitals that we have rotations at. There's discussion boards. So people who have rotated there before, as Nova students, will go on there, give advice for how to prepare for certain types of cases, what a day-to-day looks like at that hospital, what certain preceptors prefer. Um, and so I've been able to go through and read on that for all my rotations, and that has definitely really helped to be able to hear from other students. And then if I know them or follow them on Instagram, I can send them a DM and ask them a question. So it's really nice to get like a diary entry basically as to what a clinical rotation is like. Love that. Additionally, this semester, our school does specialty labs. So I've already had my OB lab, I have my PEETS lab coming up, my neurolab coming up, I've had my cardiac lab already, I've had my vascular lab, and then I have a trauma lab as well. So those are gonna help us prepare for these specialty cases and the rotations we have coming up.

SPEAKER_00

Any rotations that you're particularly looking forward to?

SPEAKER_01

I'm definitely excited to go back home to TMH and rotate there, not only because I'll get to be with my family, which I love my family. I've said that a million times, I feel like, um, but also because TMH has a lot of high acuity patients and interesting cases. Like we do a lot of traumas because it's level two trauma center. We do a ton of cardiac. Like TMH is known for being a cardiac hospital, a vascular hospital. Um, so I'm very excited to challenge myself with those cases because those are kind of hard to come by. So I'm very excited for my rotation at TMH. And I've worked with that group for a really long time when I was in college as an anesthesia tech. So it's really exciting to go back and be an anesthesia provider.

SPEAKER_00

Yes. Yeah, that is gonna be a cool experience. Okay, final question, I think, Britton, for this episode. And I'm excited to keep tracking your progress. It's this is really fun. But when you look back now, hindsight, of course, is 2020. What do you wish you could have told Brittany, who was just starting her first year, you know, with all the excitement? Like, what is there anything that she could have known that would have made it better, easier, more present? Choose your word.

SPEAKER_01

I would have told her not to stress so much about the little things. There's a lot of information you're learning first semester, and it's all super overwhelming. And I remember it was really easy to get worried about things that were just not that important in the scheme of things. And so I think just telling her to remind herself that we're here to become a really good anesthesia provider, focus on the important stuff, and don't worry about the little things, and do your best, and you're gonna get through and you're gonna come out of it a really strong provider. But just focus on what's important. What are the little things you stressed about? I remember, for example, like in our intro class, we had to memorize like all the history of anesthesia, the first anesthesia providers, dates, and stuff like that. And I was like, Oh yeah, I know. I was looking at the PowerPoint last night actually, because I've been going through old information and just like refresh my brain. And I was like, oh my gosh, I was so worried about memorizing all of this. And I did have to memorize it for the exam, but in the scheme of things, that's not something that your preceptor is gonna be pimping you on in clinics. So I was definitely worried about that. I remember stressing about putting in an LMA because like our professors all do it differently, and I remember being worried about how one professor does it versus another and like getting the best grade I can get, and in the scheme of things, like the important thing is to pass and retain the knowledge to be a good provider.

SPEAKER_00

Yes, it is very easy to get stressed over the nuances because the nuances are important, but the difficult thing is when you're first learning, everyone tells you the nuances and you get bogged down with it as opposed to like, here's the big skill, put the LMA behind the top. I don't care how it happens. But yeah, it is only hindsight really can tell you that. And so that's one of the things I hope this journey, like you sharing your journey here for every pre-AA who will follow you, is hearing some of these hindsights before you're in to help ease that burden of like everything's so important, I have to do this or I'm gonna die. Like it feels like that. Like it's not actually. It does.

SPEAKER_01

Yeah. Yeah, exactly. Exactly. Do what you need to do to get the good grade on the exam, but in the end, like focus on what's actually important for anesthesia. Mm-hmm.

SPEAKER_00

Again, it's that emotional maturity because you have to be able to sift through, like, wow, this all feels really, really heavy, but I can see the bigger picture. Yeah, totally. And I think that comes with experience more than anything. Yes, totally. I I a hundred percent agree. I do think we could be led to the to the watering trough a little bit more um in some of our training or early training. Certainly, I'm particularly interested in that, but it's like give me the base skill so that when I get into AA school, I can like, oh, I see what they were talking about, and I can kind of let this go and focus here. And that would make it a lot easier. Yes. Um, okay, so let's leave off with again, it is June of 2026. You are in the middle of your fourth semester, you're going into your fifth semester. And when do you want to talk next? Maybe like the end of 2026. Maybe we check in and see how the full clinical growth is happening and how it feels to do these away rotations. Does that sound good? Yeah, that sounds good. Okay, amazing. All right, Britton. Well, thank you so much, and I'm excited to continue the conversation. Me too. Thanks for listening to Awakened Anesthetist. If this episode resonated with you, share it with a CAA friend, an AA student in your life, or a perspective, and let them know why you loved it. It's the most important thing you can do to support this podcast and its mission. You can always find more ways to connect with me and this CAA community at awakenedanesthetist.com. And while you're scrolling the website, check out my trusted CAA partners who make this podcast possible with a special thank you to my season five sponsor, Harmony Anesthesia Staffing. Talk soon.

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Mary Jeanne Roberts, CAA

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