Tiffany: So today we're talking about clinical experience from where we actually stand as pre-AAs in the middle of all of this. What seems to matter based on what we've read and what we've researched. So where to start if you're coming in without a healthcare background and what we tell our earlier selves.
Adri: Mm-hmm. Mm-hmm. Mm-hmm, exactly. So let's just say it a little directly. So if you're not already working in a healthcare setting, getting your first clinical role is genuinely one of the hardest things to do. And I know you can speak on this, Tiffany, right?
Tiffany: I remember trying to get my foot in the door without any clinical experience. I was a cosmetologist, so I was either denied immediately ⁓ I was asked, ⁓ do you want to do this? It wasn't hard, like it was inconvenient. Like it was genuinely hard. You you're applying for jobs that you want to have the experience in that you don't have yet.
Adri: Mm-hmm. it's, you're stuck between a rock and a hard place. That catch 22 of there are a lot of entry level clinical roles, but even the entry level clinical roles require you to be fully trained, it could be that you have to be a fully certified anesthesia tech before you apply. That's not the case in all areas. And we know people, other pre-AAs who have moved across the country to take that anesthesia tech position to get that experience, which if you can do that, more power to you. Awesome. But that's a big problem. You you can't get in if you don't have the experience, but you can't get the experience if you can't get in,
Tiffany: Yes. then there is the pay. Entry level clinical work ⁓ often significantly less than what someone in a mid-career pivot was making before. I can personally. Going from medical assistant to anesthesia tech, I took a huge pay cut, but I ⁓ really wanted that so I was willing to do whatever it took. that's not a small thing. Luckily, have people who can ⁓ help and support me, but if you're supporting yourself or supporting a family carrying loans on top of that, ⁓ taking significant pay cut to start ⁓ all the bottom of the clinical ladder again, that is a real financial decision ⁓ that everyone can do on a short timeline.
Adri: Mm-hmm. So I think about this a lot and how getting direct hands-on patient care in healthcare at all, and even more so in the anesthesia adjacent context, is something you have to be very deliberate and patient about building because it doesn't happen overnight already when you're mid-career or maybe you're a traditional student,
Tiffany: Yeah, and on top of that, there's also all of that in your already busy life. ⁓ lot of clinical roles are not nine to five. ⁓ looking at shifts, ⁓ ⁓ ⁓ if you already have existing commitments around your current job or your family requiring a lot of your time, ⁓ layering a clinical role like that,
Adri: Mm-hmm. Mm-hmm.
Tiffany: takes a lot of planning and strategy.
Adri: Mm-hmm. Yes. And the reason we're spending the time on this is not to be discouraging, but it's because we think it's genuinely unhelpful when the advice is, just get your clinical hours as if that's like something super simple, because it's not. And I want to normalize that difficulty and that it's part of giving people a realistic and honest picture of the timeline that you're actually working with.
Tiffany: Mm-hmm. Right, if your honest timeline to build meaningful clinical experience is 18 months to two years, that is a very valid timeline. It took me three and a half years as a medical assistant and now a year as an anesthesia tech. All of this is to say you are not behind, you are planning and each hour that you spend with this clinical experience makes you a better provider overall.
Adri: Mm-hmm. Exactly. So Tiffany, ⁓ you've gone through that process, because you had to get that clinical experience from scratch, can you talk a little bit more about the practicalities of how do you get into and what are some roles that can gain us this patient care experience or healthcare experience?
Tiffany: ⁓ experience as a phrase covers a huge range. if you're from no clinical background and trying to build toward AA school, ⁓ there are some that come up often that we've noticed in pre-A communities that are common starting points. They're not guarantees of ⁓ and obviously they're not only options, but we think they're worth knowing about.
Adri: probably worth being honest about what each one actually involves day to day based on our research and understanding because clinical experience as a phrase covers a really huge range. Tiffany, you come from a medical assistant background. Can you start with that one?
Tiffany: Yeah, not to be biased or anything. Medical assistance, ⁓ is a really good one to begin with. While ⁓ know the scope itself varies a lot depending on ⁓ actual practice setting, you're still ⁓ doing vitals, patient intake, clinical documentation support, some depending on the state and the employer, ⁓ I with ⁓ vein procedures, but medical assistant or programs vary in length anywhere from a few months to a ⁓ or more, on whether you're doing a certificate online or in person or an associates your college. ⁓ There was an online accreditation program that I was looking into by advanced clinical e-training, I believe, where you could finish in as little as eight weeks. ⁓ there some employers who will offer on-the-job training, which is what I was lucky to encounter.
Adri: and you mentioned earlier how your day-to-day responsibilities will likely change depending on different settings. I'm guessing that would be very different working in a cardiology office versus working in an urgent care clinic versus working in a hospital outpatient clinic. Because if you're coming into healthcare and you've never been in healthcare you don't necessarily realize that there is such a wide range of healthcare experiences and locations and settings within
Tiffany: Mm-hmm. Mm-hmm.
Adri: healthcare or medicine.
Tiffany: I would to also say that it's very provider dependent. When I was a cardiac MA, my cardiologists saw up to 50 to 60 patients on a clinic day. The other cardiologists I work with, their MAs would help them with only 15 to 20 patients. ⁓
Adri: Mm-hmm.
Tiffany: ⁓ really quality over quantity Your experience is you make it for sure. Can tell us about another job, Adri? I've heard CNAs or certified nursing assistants are really good.
Adri: Yeah. So as a rehab professional, I work very closely side by side with nurses and certified nursing assistants. And another way you can get your foot in the door is becoming a certified nurse assistant. where I'm from in California, some of those programs can be accelerated programs where you can finish your training in as little as four weeks, but generally CNA programs are relatively short. So they're six to 12 weeks in general, and they'd lead directly to patient care work, either in hospitals, in long-term care settings like skilled nursing facilities or other ⁓ rehab settings. So you're doing actual hands-on physical care. So you're taking vitals for that patient. You're logging them, you're tracking them. you're logging food intake, you're logging and helping with individuals, activities of daily living, getting dressed in the morning, bathing, all that sort of stuff. It's a ton of patient interaction, and that is real patient care, and it's really valuable. the work itself is genuinely physically and emotionally demanding. So anyone considering this particular path, yes, it may be an easier way to get your foot in the door as far as patient care experience, but go in with clear eyes and a clear head about what the job actually is, not just what the credential does for the application because you want to be there and care for your patient. So that said, from what I've seen in pre-AA communities and from what I've researched, it's one of the most accessible starting points. for non-healthcare career changers. Tiffany, can you describe the similarities and differences, any, between CNAs and what a patient care tech itself is?
Tiffany: Yeah, so I have had the privilege of being friends with people who are both patient care technician or PCT what I understand is often hospital based and can include more acute care exposure ⁓ than example a nursing home or ⁓ in clinic role.
Adri: Mm-hmm. Mm-hmm. Mm-hmm.
Tiffany: Some hospitals, do hire PCTs with just a CNA credential, while others have their own training programs. I think again, very hospital dependent.
Adri: Mm-hmm.
Tiffany: We seen some places will also use that the ⁓ term PCT with CNA interchangeably. What another path you think, Adri?
Adri: Mm-hmm. EMT is a path that lot of people do take, especially if they're interested in the emergency or the high acuity environments, which can lend really well to anesthesia, emergency medical technician basic level certification is achievable in roughly three to six months. The work is genuinely intense and the exposure to medical emergencies is direct. You are right there. This also could be a bridge to becoming a paramedic But paramedic is a much longer and more intensive pathway that's closer to a one to two year commitment and some pre-AAs have come from paramedic backgrounds as well.
Tiffany: Yes,
Adri: But as far as getting your foot in the door, EMT is just ⁓ a good entry level path. ⁓ So that is very much a viable option. you are currently in the OR. coming from the OR side, what are some of the other positions that you've seen in and around the operating room that people might be able to get patient care tech or healthcare experience in?
Tiffany: From the OR side, anesthesia tech is what I do, ⁓ and I do believe it's one of the ⁓ positions to be in for the specific path because of its to anesthesia practice.
Adri: Tiffany, can expound a little bit on some of the pros and cons of being an anesthesia tech or trying to get that healthcare experience?
Tiffany: Yeah. Yeah, like I said, you get that to anesthesia practice. You ⁓ are able to have direct access to airway equipment that is used to buffer your knowledge of what is used you can ask more about the medications. also are able to be next to the anesthesia provider they make these decisions and while are,
Adri: Mm-hmm.
Tiffany: actively developing care plans for their patients. So I do think that that's very, very beneficial as you navigate your path to becoming an AA. But
Adri: Mm-hmm. Mm-hmm.
Tiffany: I do understand also that anesthesia tech programs are not everywhere the jobs themselves are not uniformly easy to get without prior clinical experience and without certification. It took me ⁓ very to get this position.
Adri: Mm-hmm.
Tiffany: and I was rejected a lot because I wasn't certified in Oklahoma and a lot of the job listings required a certification, which is about a two year program itself. ⁓ And like you've touched on I a lot of people who have had to ⁓ move to get that anesthesia tech job. So.
Adri: Mm-hmm. Mm-hmm.
Tiffany: Sometimes it's more than just step one, step two. There's quite a few steps, especially as someone that might be starting from zero.
Adri: Tiffany, can you describe a little bit about another OR adjacent or connected patient care or healthcare experience job, surgical techs? Explain more about that position.
Tiffany: Yeah. So I work with a of surgical techs. ⁓ That is another OR adjacent role that I've seen come up in these conversations. is a longer training commitment.
Adri: Mm-hmm. Mm-hmm.
Tiffany: usually a two year associate's degree. However, it puts you in the O.R. consistently every day. people in pre-AA communities who have come through that route tend to speak highly of the exposure it gives them. They direct access to the surgical procedures ⁓
Adri: Mm-hmm. Mm-hmm.
Tiffany: That are commonly seen by anesthesiologist assistants. ⁓ talk a bit more ⁓ before we keep moving on about careers, ⁓ the difference between healthcare experience and patient experience.
Adri: Mm-hmm. Yeah, so we've alluded this, we kind of mentioned it a little bit earlier healthcare experience and patient care experience are not the same thing. From my perspective and from what I've read on different program websites, it seems that patient care experience tends to have a greater priority. And ⁓ you can the between a person who is an EMT and they're out in the field doing CPR on a patient that just had a heart attack.
Tiffany: Mm-hmm.
Adri: That's direct patient care. You're hands-on with the patient or a CNA helping with those activities of daily living. That's direct patient care experience. But someone working as a pathologist in a lab in the bowels of the hospital doing that testing to say, ⁓ Are these cells cancerous? Things like that. That's health experience. You're working closely with other health care providers, with, medical professionals. but you are not patient facing. It is ⁓ not one-on-one patient experience. So it's more healthcare experience. So yeah. What do you think about that, Tiffany? What's your on the difference between healthcare experience and patient care experience?
Tiffany: Yeah, no, I 100 % agree with you. I think that distinction does matter for AA applications because programs will specify patient care hours or direct patient care experience and they're drawing that line very intentionally. I think there are gray areas like scribing or medical assisting in certain settings. You know, you're in the room.
Adri: Mm-hmm. Mm-hmm.
Tiffany: you're interacting with patients, but depending on the scope of your specific role, you may or may not be providing direct physical care. So that's where we always emphasize read each program's published language very carefully because they do define it very differently.
Adri: Mm-hmm. Mm-hmm. Mm-hmm.
Tiffany: Now let's get back to careers positions that we think help. How about phlebotomy, Adri? ⁓
Adri: Mm-hmm. So becoming a phlebotomist generally a shorter timeframe to get certified. Now I will say I know this largely because as speech language pathologist when working bedside with patients, phlebotomists will come in all the time. Patients need blood work done. So it is direct patient care experience. ⁓ But timeframe to get certified is sometimes weeks. It's a little bit of a shorter timeframe, know, easier maybe than trying to become a paramedic or something.
Tiffany: Right. Mm-hmm.
Adri: and it's direct patient contact. It's not the depth of some of these other roles, but as a first step into clinical work where you're figuring out your longer term plan, you can use it as a bridge. So I think it's a really great option. Once again, you can compare costs as well as costs of becoming certified, as well as availability of jobs in your area.
Tiffany: For sure.
Adri: Maybe you live in an area that needs a lot of phlebotomists and that may be a more feasible route for you. Tiffany, ⁓ do the next one. Can you talk about medical scribes?
Tiffany: Mm-hmm. Yes, medical scribe is another one worth mentioning here. Victoria, who is an incoming student AA, who we spoke to in episode five, was one It's not hands on care, and we want to be clear about that distinction, but scribing puts you in the room ⁓ with patients providers. ⁓ You are medical terminology, clinical workflows, how providers think and document. for someone starting from completely outside of healthcare, scribing can definitely be a way to dip your toes in to build that clinical fluency while you're working toward a more direct patient care role. it's definitely not a replacement for hands-on hours, but it can help close the vocabulary and comfort gap a lot faster. And one more, and this one doesn't really get talked about in Pre-AA spaces, I've noticed, is volunteering, Adri. You want to tell us a little bit more?
Adri: Yes. So if you're a career transitioner and perhaps working a full-time job and you can't afford to quit, to get a certification, to sustain yourself and your family, there are hospital volunteer programs. There are free clinics, community health organizations. If you're truly starting from zero and you're not ready to commit to a certification program or can't afford it, volunteering can actually get you into a clinical environment. So you're seeing how care teams work. You're getting comfortable around patients and you're building relationships that can lead to references or even job leads in the future. So it may not count the same way as paid patient care hours on an application, but it removes the barrier of I have no clinical exposure at all. It's the real first step for people who need one. So the theme across all of these
Tiffany: Mm-hmm. Mm-hmm. Mm-hmm.
Adri: potential clinical experience careers or paths or pathways that none of them is a shortcut and the right choice depends on your existing situation, your timeline, your finances, your schedule constraints, what's available in your area. And there's no single correct entry point. I think that is one great and beautiful benefit of the CAA profession itself that we do all come from so many different backgrounds. Some may say that that is a weakness
Tiffany: Mm-hmm.
Adri: but that diversity of different backgrounds what increases creativity in the profession itself. It increases diversity. And there research that says that increased
Tiffany: Mm-hmm.
Adri: ability to have those different perspectives from different experiences optimizes and increases and improves patient care in the long run.
Tiffany: Now we've covered the what the roles that can you started. ⁓ now shift to the ⁓ so what once you're building clinical experience, what ⁓ actually seems to carry?
Adri: Mm-hmm. Mm-hmm.
Tiffany: carry the weight to carry you to AA school.
Adri: Mm hmm. Yeah, so obviously I want to reiterate that we are just pre AA's. This is just our personal opinions. We cannot tell you what any specific program requires or prefers. Get that information directly from there's published website materials and by reaching out to them, going to their info sessions, which you very much can do. But what we can't share is what patterns we've noticed in our research and what we've seen discussed across the Pre-AA community, as well as what other CAAs and programs directors and those involved with admissions have said in the past. I want to say that framing does matter. We're reading all the same publicly available information you are and comparing notes with other people going through this.
Tiffany: With that said, direct hands-on patient seems to be what matters most consistently. Not administrative work, ⁓ not observation alone, documentation roles. We seeing that they want physical contact with patients where you're taking vitals, you're encountering procedures, ⁓ you're doing actual patient tasks.
Adri: Mm-hmm.
Tiffany: This distinction between being in a clinical setting and actually providing hands-on care ⁓ seems to come up a lot of how ⁓ programs describe their requirements.
Adri: other pattern I've noticed ⁓ that anesthesia specific exposure, so time in the OR, time observing or working alongside anesthesia providers seems to be regarded differently from the general patient care hours. So not as a replacement for general clinical experience, but as something that demonstrates that you've actually been in the room and you understand ⁓ it is you're kind of getting into.
Tiffany: Mm-hmm. Mm hmm. Yes, I can speak to that from my own experience. There is a huge difference between understanding anesthesia care in theory, and having watched hundreds of inductions. I remember anesthesia easy by Jeff Steiner before shadowing. ⁓ And I going into my shadowing experience previous to getting my anesthesia tech position and trying to absorb everything like a sponge. But there was so much terminology thrown at me that I literally would just leave my shadowing experience not being able to put everything together as opposed to now having been there when a case gets complicated or ⁓ knowing what the does in situations like that or ⁓ how fast things move, ⁓ that context very so reads when you could speak to it specifically.
Adri: Yeah, and that word that keeps showing up and how people describe what seems to matter is intentionality. Intentionality is one of my very favorite words because when you increase your intentionality in anything you're doing, it increases quality. And it's not just the hours accumulated over time. Yes, there is a correlation between you get more hours observing in the OR instead of the bare minimum eight hours.
Tiffany: Mm-hmm. Yes.
Adri: Obviously, you're going to have maybe a little bit understanding and knowledge of kind of what an anesthesiologist assistant does, but how you use those hours, the hours that show that you made the deliberate choices to get closer to that anesthesia practice in the way that you can. So that's something that Tiffany and I have both tried to build into how we're approaching this. Any other thoughts, Tiffany? ⁓
Tiffany: Mm-hmm. Yeah, matters to a point. I discount someone who has worked or who has gotten 80 plus hours of shadowing or who has ⁓ spent that time ⁓ to where they are.
Adri: Mm-hmm. Mm-hmm.
Tiffany: the more exposure you get the more you're able to piece together Pieces of the anesthesia practice, but we're ⁓ saying volume alone doesn't seem to be the whole entire picture ⁓ you to be able to Articulate your experience to whoever asks you whether that be Another CAA or during your interviews.
Adri: Mm-hmm. Yeah. Mm-hmm.
Tiffany: overall what we're saying is alone does not seem to be the whole picture.
Adri: Yes. And one more thing to tack onto this related to specifically is you need to be able to articulate your experiences well. ⁓ whatever you've done clinically, whether it's patient care experience, healthcare experience, or solely observation or volunteer work in a setting, you need to be able to talk about it.
Tiffany: Mm-hmm.
Adri: clearly in your application, potentially in an interview through your personal statement. The person can say specifically what they have observed, what they've contributed, what they've learned is going to a very, different position than someone who lists hours without being able to say about them.
Tiffany: Yes. going off of that, this is something that I wish someone had told me earlier track your hours as you go, not at application time, but as you shadow, sit down after your shadowing experience, track track what you saw, what you what you did that day, all of it.
Adri: Mm-hmm. Mm-hmm. Yeah, so the minimum you want for any role when you're tracking this is write the employer name, your title, your start and end dates, your supervisor's name and a contact so you can actually reach them at a phone number or an email address ⁓ your approximate hours per week. That's it. You do those ⁓ notes You can do it in a spreadsheet a notes app or Google Sheets.
Tiffany: Mm-hmm.
Adri: anywhere that's convenient for you, make it as simple as so you won't forget it and you can use it later.
Tiffany: Yeah, the the contact matters is that some applications ask for verification. If you've moved through multiple roles ⁓ and your supervisor from two years ago changed jobs, ⁓ that's a harder problem to solve ⁓ application time than it is right currently.
Adri: Can you give me an example?
Tiffany: Yeah, let me give you a quick example of what a tracking entry looks like so that this doesn't feel so abstract. From my own log SSM St. Anthony Hospital, anesthesia tech, start date was June 2025, supervisor, I will keep their name out of this, but I have their direct work email and cell, 24 hours per week.
Adri: Mm-hmm.
Tiffany: or how many total hours overall that I've worked. And then a short note about ⁓ the position entails. So cardiovascular and general OR cases, ⁓ anesthesia, provider support, airway equipment set up, patient monitoring. ⁓ it. That's the whole entry. It took two minutes to write and it saves you from trying to reconstruct all of that at the time of your application, especially if it's been a few years.
Adri: Exactly. Exactly. And that little note on what exactly you did, there is that description section within CASA that talks about how, what you learned in that experience, that sort of thing. But it's just a 500 character count box. You can use it in bullet points. You can use it in paragraph format. there may be some opinions out there on which format is better, but you choose what's best for you ⁓ and what you might be good for your application.
Tiffany: Mm-hmm.
Adri: And beyond the logistics, if you're in anesthesia adjacent settings, keep some kind of notes on what you're actually seeing. So those case types, this goes along for when you're observing or shadowing providers as well. Things that really stick with you, things that surprised you, not because you're going to include absolutely everything in your application, but because you're going to be asked to talk about some of this experience.
Tiffany: Mm-hmm. Yes.
Adri: you want that real material to draw from and you're not going to remember every single little detail,
Tiffany: Yeah, ⁓ and if you're to us ⁓ and you haven't any of this yet, do not worry. You can reconstruct a reasonable record. ⁓ You can use old stubs, offer letters, LinkedIn, contact your supervisors. It's obviously work than staying but it's definitely doable to retrace your steps ⁓ and.
Adri: Mm-hmm. Mm-hmm.
Tiffany: you just have to kind of sit down and put in a little bit more work.
Adri: Yes, being a non-trad career transitioner or I can say I didn't go into my career as a speech pathologist thinking I would transition. And now here I am over 10 years later and I am going to have to do some of that digging, which is one reason why I have not submit my application yet. That's going to takes a very long time and that's, that's okay. There's ways to figure it out. It's just being intentional about it.
Tiffany: Yes. Okay takeaways, Adri.
Adri: All right, Yeah. You start takeaways.
Tiffany: Yeah. Yeah, ⁓ experience when you are coming from ⁓ healthcare, power you, it is very hard. The timeline is real. ⁓ Financial are real barriers and we don't think it helps anyone to pretend otherwise.
Adri: Mm-hmm. Yeah. There are accessible entry points. So certified nursing assistants or patient care techs, medical assistants, emergency medical technicians, phlebotomists, and the right one depends on your specific situation. None of these are shortcuts and all of them do require some real time money and investment.
Tiffany: Yes, but overall on our research and what we've seen in the pre-A community, ⁓ direct patient care and anesthesia specific exposure both seem to matter a lot ⁓ different reasons and in different ways. So always verify what specific programs that you are wanting to apply to describe in their own materials.
Adri: Mm-hmm. And lastly, document as you go, if possible. Supervisor name, contact info, dates, hours, even if you need to calculate average hours per week. So hours and number of weeks you were there, what role it was. Don't save this later for application time. Even if you are a year out, two years out, start collecting that, create that spreadsheet.
Tiffany: Yes, or you will regret it. One thing before you close this out, clinical roles that you've held, if you haven't done so already, open a document right now or your notes app, write down ⁓ contact per role who could verify your hours, ⁓ names and how to reach them. that three minute step.
Adri: Mm-hmm. Mm-hmm.
Tiffany: alone protects a lot of the work that you have already put in.
Adri: All right, so looking forward, next up is going to be episode eight. I can't believe it already. Pre-AA perspectives on shadowing. We're gonna get into how to actually get access to shadowing, no matter you're in a CAA-licensed or non-CAA-licensed state. This is PreAA Pathways.
Tiffany: Yes. We will see you in episode eight.
Adri: Mm-hmm. Mm-hmm. Mm-hmm, exactly. So let's just say it a little directly. So if you're not already working in a healthcare setting, getting your first clinical role is genuinely one of the hardest things to do. And I know you can speak on this, Tiffany, right?
Tiffany: I remember trying to get my foot in the door without any clinical experience. I was a cosmetologist, so I was either denied immediately ⁓ I was asked, ⁓ do you want to do this? It wasn't hard, like it was inconvenient. Like it was genuinely hard. You you're applying for jobs that you want to have the experience in that you don't have yet.
Adri: Mm-hmm. it's, you're stuck between a rock and a hard place. That catch 22 of there are a lot of entry level clinical roles, but even the entry level clinical roles require you to be fully trained, it could be that you have to be a fully certified anesthesia tech before you apply. That's not the case in all areas. And we know people, other pre-AAs who have moved across the country to take that anesthesia tech position to get that experience, which if you can do that, more power to you. Awesome. But that's a big problem. You you can't get in if you don't have the experience, but you can't get the experience if you can't get in,
Tiffany: Yes. then there is the pay. Entry level clinical work ⁓ often significantly less than what someone in a mid-career pivot was making before. I can personally. Going from medical assistant to anesthesia tech, I took a huge pay cut, but I ⁓ really wanted that so I was willing to do whatever it took. that's not a small thing. Luckily, have people who can ⁓ help and support me, but if you're supporting yourself or supporting a family carrying loans on top of that, ⁓ taking significant pay cut to start ⁓ all the bottom of the clinical ladder again, that is a real financial decision ⁓ that everyone can do on a short timeline.
Adri: Mm-hmm. So I think about this a lot and how getting direct hands-on patient care in healthcare at all, and even more so in the anesthesia adjacent context, is something you have to be very deliberate and patient about building because it doesn't happen overnight already when you're mid-career or maybe you're a traditional student,
Tiffany: Yeah, and on top of that, there's also all of that in your already busy life. ⁓ lot of clinical roles are not nine to five. ⁓ looking at shifts, ⁓ ⁓ ⁓ if you already have existing commitments around your current job or your family requiring a lot of your time, ⁓ layering a clinical role like that,
Adri: Mm-hmm. Mm-hmm.
Tiffany: takes a lot of planning and strategy.
Adri: Mm-hmm. Yes. And the reason we're spending the time on this is not to be discouraging, but it's because we think it's genuinely unhelpful when the advice is, just get your clinical hours as if that's like something super simple, because it's not. And I want to normalize that difficulty and that it's part of giving people a realistic and honest picture of the timeline that you're actually working with.
Tiffany: Mm-hmm. Right, if your honest timeline to build meaningful clinical experience is 18 months to two years, that is a very valid timeline. It took me three and a half years as a medical assistant and now a year as an anesthesia tech. All of this is to say you are not behind, you are planning and each hour that you spend with this clinical experience makes you a better provider overall.
Adri: Mm-hmm. Exactly. So Tiffany, ⁓ you've gone through that process, because you had to get that clinical experience from scratch, can you talk a little bit more about the practicalities of how do you get into and what are some roles that can gain us this patient care experience or healthcare experience?
Tiffany: ⁓ experience as a phrase covers a huge range. if you're from no clinical background and trying to build toward AA school, ⁓ there are some that come up often that we've noticed in pre-A communities that are common starting points. They're not guarantees of ⁓ and obviously they're not only options, but we think they're worth knowing about.
Adri: probably worth being honest about what each one actually involves day to day based on our research and understanding because clinical experience as a phrase covers a really huge range. Tiffany, you come from a medical assistant background. Can you start with that one?
Tiffany: Yeah, not to be biased or anything. Medical assistance, ⁓ is a really good one to begin with. While ⁓ know the scope itself varies a lot depending on ⁓ actual practice setting, you're still ⁓ doing vitals, patient intake, clinical documentation support, some depending on the state and the employer, ⁓ I with ⁓ vein procedures, but medical assistant or programs vary in length anywhere from a few months to a ⁓ or more, on whether you're doing a certificate online or in person or an associates your college. ⁓ There was an online accreditation program that I was looking into by advanced clinical e-training, I believe, where you could finish in as little as eight weeks. ⁓ there some employers who will offer on-the-job training, which is what I was lucky to encounter.
Adri: and you mentioned earlier how your day-to-day responsibilities will likely change depending on different settings. I'm guessing that would be very different working in a cardiology office versus working in an urgent care clinic versus working in a hospital outpatient clinic. Because if you're coming into healthcare and you've never been in healthcare you don't necessarily realize that there is such a wide range of healthcare experiences and locations and settings within
Tiffany: Mm-hmm. Mm-hmm.
Adri: healthcare or medicine.
Tiffany: I would to also say that it's very provider dependent. When I was a cardiac MA, my cardiologists saw up to 50 to 60 patients on a clinic day. The other cardiologists I work with, their MAs would help them with only 15 to 20 patients. ⁓
Adri: Mm-hmm.
Tiffany: ⁓ really quality over quantity Your experience is you make it for sure. Can tell us about another job, Adri? I've heard CNAs or certified nursing assistants are really good.
Adri: Yeah. So as a rehab professional, I work very closely side by side with nurses and certified nursing assistants. And another way you can get your foot in the door is becoming a certified nurse assistant. where I'm from in California, some of those programs can be accelerated programs where you can finish your training in as little as four weeks, but generally CNA programs are relatively short. So they're six to 12 weeks in general, and they'd lead directly to patient care work, either in hospitals, in long-term care settings like skilled nursing facilities or other ⁓ rehab settings. So you're doing actual hands-on physical care. So you're taking vitals for that patient. You're logging them, you're tracking them. you're logging food intake, you're logging and helping with individuals, activities of daily living, getting dressed in the morning, bathing, all that sort of stuff. It's a ton of patient interaction, and that is real patient care, and it's really valuable. the work itself is genuinely physically and emotionally demanding. So anyone considering this particular path, yes, it may be an easier way to get your foot in the door as far as patient care experience, but go in with clear eyes and a clear head about what the job actually is, not just what the credential does for the application because you want to be there and care for your patient. So that said, from what I've seen in pre-AA communities and from what I've researched, it's one of the most accessible starting points. for non-healthcare career changers. Tiffany, can you describe the similarities and differences, any, between CNAs and what a patient care tech itself is?
Tiffany: Yeah, so I have had the privilege of being friends with people who are both patient care technician or PCT what I understand is often hospital based and can include more acute care exposure ⁓ than example a nursing home or ⁓ in clinic role.
Adri: Mm-hmm. Mm-hmm. Mm-hmm.
Tiffany: Some hospitals, do hire PCTs with just a CNA credential, while others have their own training programs. I think again, very hospital dependent.
Adri: Mm-hmm.
Tiffany: We seen some places will also use that the ⁓ term PCT with CNA interchangeably. What another path you think, Adri?
Adri: Mm-hmm. EMT is a path that lot of people do take, especially if they're interested in the emergency or the high acuity environments, which can lend really well to anesthesia, emergency medical technician basic level certification is achievable in roughly three to six months. The work is genuinely intense and the exposure to medical emergencies is direct. You are right there. This also could be a bridge to becoming a paramedic But paramedic is a much longer and more intensive pathway that's closer to a one to two year commitment and some pre-AAs have come from paramedic backgrounds as well.
Tiffany: Yes,
Adri: But as far as getting your foot in the door, EMT is just ⁓ a good entry level path. ⁓ So that is very much a viable option. you are currently in the OR. coming from the OR side, what are some of the other positions that you've seen in and around the operating room that people might be able to get patient care tech or healthcare experience in?
Tiffany: From the OR side, anesthesia tech is what I do, ⁓ and I do believe it's one of the ⁓ positions to be in for the specific path because of its to anesthesia practice.
Adri: Tiffany, can expound a little bit on some of the pros and cons of being an anesthesia tech or trying to get that healthcare experience?
Tiffany: Yeah. Yeah, like I said, you get that to anesthesia practice. You ⁓ are able to have direct access to airway equipment that is used to buffer your knowledge of what is used you can ask more about the medications. also are able to be next to the anesthesia provider they make these decisions and while are,
Adri: Mm-hmm.
Tiffany: actively developing care plans for their patients. So I do think that that's very, very beneficial as you navigate your path to becoming an AA. But
Adri: Mm-hmm. Mm-hmm.
Tiffany: I do understand also that anesthesia tech programs are not everywhere the jobs themselves are not uniformly easy to get without prior clinical experience and without certification. It took me ⁓ very to get this position.
Adri: Mm-hmm.
Tiffany: and I was rejected a lot because I wasn't certified in Oklahoma and a lot of the job listings required a certification, which is about a two year program itself. ⁓ And like you've touched on I a lot of people who have had to ⁓ move to get that anesthesia tech job. So.
Adri: Mm-hmm. Mm-hmm.
Tiffany: Sometimes it's more than just step one, step two. There's quite a few steps, especially as someone that might be starting from zero.
Adri: Tiffany, can you describe a little bit about another OR adjacent or connected patient care or healthcare experience job, surgical techs? Explain more about that position.
Tiffany: Yeah. So I work with a of surgical techs. ⁓ That is another OR adjacent role that I've seen come up in these conversations. is a longer training commitment.
Adri: Mm-hmm. Mm-hmm.
Tiffany: usually a two year associate's degree. However, it puts you in the O.R. consistently every day. people in pre-AA communities who have come through that route tend to speak highly of the exposure it gives them. They direct access to the surgical procedures ⁓
Adri: Mm-hmm. Mm-hmm.
Tiffany: That are commonly seen by anesthesiologist assistants. ⁓ talk a bit more ⁓ before we keep moving on about careers, ⁓ the difference between healthcare experience and patient experience.
Adri: Mm-hmm. Yeah, so we've alluded this, we kind of mentioned it a little bit earlier healthcare experience and patient care experience are not the same thing. From my perspective and from what I've read on different program websites, it seems that patient care experience tends to have a greater priority. And ⁓ you can the between a person who is an EMT and they're out in the field doing CPR on a patient that just had a heart attack.
Tiffany: Mm-hmm.
Adri: That's direct patient care. You're hands-on with the patient or a CNA helping with those activities of daily living. That's direct patient care experience. But someone working as a pathologist in a lab in the bowels of the hospital doing that testing to say, ⁓ Are these cells cancerous? Things like that. That's health experience. You're working closely with other health care providers, with, medical professionals. but you are not patient facing. It is ⁓ not one-on-one patient experience. So it's more healthcare experience. So yeah. What do you think about that, Tiffany? What's your on the difference between healthcare experience and patient care experience?
Tiffany: Yeah, no, I 100 % agree with you. I think that distinction does matter for AA applications because programs will specify patient care hours or direct patient care experience and they're drawing that line very intentionally. I think there are gray areas like scribing or medical assisting in certain settings. You know, you're in the room.
Adri: Mm-hmm. Mm-hmm.
Tiffany: you're interacting with patients, but depending on the scope of your specific role, you may or may not be providing direct physical care. So that's where we always emphasize read each program's published language very carefully because they do define it very differently.
Adri: Mm-hmm. Mm-hmm. Mm-hmm.
Tiffany: Now let's get back to careers positions that we think help. How about phlebotomy, Adri? ⁓
Adri: Mm-hmm. So becoming a phlebotomist generally a shorter timeframe to get certified. Now I will say I know this largely because as speech language pathologist when working bedside with patients, phlebotomists will come in all the time. Patients need blood work done. So it is direct patient care experience. ⁓ But timeframe to get certified is sometimes weeks. It's a little bit of a shorter timeframe, know, easier maybe than trying to become a paramedic or something.
Tiffany: Right. Mm-hmm.
Adri: and it's direct patient contact. It's not the depth of some of these other roles, but as a first step into clinical work where you're figuring out your longer term plan, you can use it as a bridge. So I think it's a really great option. Once again, you can compare costs as well as costs of becoming certified, as well as availability of jobs in your area.
Tiffany: For sure.
Adri: Maybe you live in an area that needs a lot of phlebotomists and that may be a more feasible route for you. Tiffany, ⁓ do the next one. Can you talk about medical scribes?
Tiffany: Mm-hmm. Yes, medical scribe is another one worth mentioning here. Victoria, who is an incoming student AA, who we spoke to in episode five, was one It's not hands on care, and we want to be clear about that distinction, but scribing puts you in the room ⁓ with patients providers. ⁓ You are medical terminology, clinical workflows, how providers think and document. for someone starting from completely outside of healthcare, scribing can definitely be a way to dip your toes in to build that clinical fluency while you're working toward a more direct patient care role. it's definitely not a replacement for hands-on hours, but it can help close the vocabulary and comfort gap a lot faster. And one more, and this one doesn't really get talked about in Pre-AA spaces, I've noticed, is volunteering, Adri. You want to tell us a little bit more?
Adri: Yes. So if you're a career transitioner and perhaps working a full-time job and you can't afford to quit, to get a certification, to sustain yourself and your family, there are hospital volunteer programs. There are free clinics, community health organizations. If you're truly starting from zero and you're not ready to commit to a certification program or can't afford it, volunteering can actually get you into a clinical environment. So you're seeing how care teams work. You're getting comfortable around patients and you're building relationships that can lead to references or even job leads in the future. So it may not count the same way as paid patient care hours on an application, but it removes the barrier of I have no clinical exposure at all. It's the real first step for people who need one. So the theme across all of these
Tiffany: Mm-hmm. Mm-hmm. Mm-hmm.
Adri: potential clinical experience careers or paths or pathways that none of them is a shortcut and the right choice depends on your existing situation, your timeline, your finances, your schedule constraints, what's available in your area. And there's no single correct entry point. I think that is one great and beautiful benefit of the CAA profession itself that we do all come from so many different backgrounds. Some may say that that is a weakness
Tiffany: Mm-hmm.
Adri: but that diversity of different backgrounds what increases creativity in the profession itself. It increases diversity. And there research that says that increased
Tiffany: Mm-hmm.
Adri: ability to have those different perspectives from different experiences optimizes and increases and improves patient care in the long run.
Tiffany: Now we've covered the what the roles that can you started. ⁓ now shift to the ⁓ so what once you're building clinical experience, what ⁓ actually seems to carry?
Adri: Mm-hmm. Mm-hmm.
Tiffany: carry the weight to carry you to AA school.
Adri: Mm hmm. Yeah, so obviously I want to reiterate that we are just pre AA's. This is just our personal opinions. We cannot tell you what any specific program requires or prefers. Get that information directly from there's published website materials and by reaching out to them, going to their info sessions, which you very much can do. But what we can't share is what patterns we've noticed in our research and what we've seen discussed across the Pre-AA community, as well as what other CAAs and programs directors and those involved with admissions have said in the past. I want to say that framing does matter. We're reading all the same publicly available information you are and comparing notes with other people going through this.
Tiffany: With that said, direct hands-on patient seems to be what matters most consistently. Not administrative work, ⁓ not observation alone, documentation roles. We seeing that they want physical contact with patients where you're taking vitals, you're encountering procedures, ⁓ you're doing actual patient tasks.
Adri: Mm-hmm.
Tiffany: This distinction between being in a clinical setting and actually providing hands-on care ⁓ seems to come up a lot of how ⁓ programs describe their requirements.
Adri: other pattern I've noticed ⁓ that anesthesia specific exposure, so time in the OR, time observing or working alongside anesthesia providers seems to be regarded differently from the general patient care hours. So not as a replacement for general clinical experience, but as something that demonstrates that you've actually been in the room and you understand ⁓ it is you're kind of getting into.
Tiffany: Mm-hmm. Mm hmm. Yes, I can speak to that from my own experience. There is a huge difference between understanding anesthesia care in theory, and having watched hundreds of inductions. I remember anesthesia easy by Jeff Steiner before shadowing. ⁓ And I going into my shadowing experience previous to getting my anesthesia tech position and trying to absorb everything like a sponge. But there was so much terminology thrown at me that I literally would just leave my shadowing experience not being able to put everything together as opposed to now having been there when a case gets complicated or ⁓ knowing what the does in situations like that or ⁓ how fast things move, ⁓ that context very so reads when you could speak to it specifically.
Adri: Yeah, and that word that keeps showing up and how people describe what seems to matter is intentionality. Intentionality is one of my very favorite words because when you increase your intentionality in anything you're doing, it increases quality. And it's not just the hours accumulated over time. Yes, there is a correlation between you get more hours observing in the OR instead of the bare minimum eight hours.
Tiffany: Mm-hmm. Yes.
Adri: Obviously, you're going to have maybe a little bit understanding and knowledge of kind of what an anesthesiologist assistant does, but how you use those hours, the hours that show that you made the deliberate choices to get closer to that anesthesia practice in the way that you can. So that's something that Tiffany and I have both tried to build into how we're approaching this. Any other thoughts, Tiffany? ⁓
Tiffany: Mm-hmm. Yeah, matters to a point. I discount someone who has worked or who has gotten 80 plus hours of shadowing or who has ⁓ spent that time ⁓ to where they are.
Adri: Mm-hmm. Mm-hmm.
Tiffany: the more exposure you get the more you're able to piece together Pieces of the anesthesia practice, but we're ⁓ saying volume alone doesn't seem to be the whole entire picture ⁓ you to be able to Articulate your experience to whoever asks you whether that be Another CAA or during your interviews.
Adri: Mm-hmm. Yeah. Mm-hmm.
Tiffany: overall what we're saying is alone does not seem to be the whole picture.
Adri: Yes. And one more thing to tack onto this related to specifically is you need to be able to articulate your experiences well. ⁓ whatever you've done clinically, whether it's patient care experience, healthcare experience, or solely observation or volunteer work in a setting, you need to be able to talk about it.
Tiffany: Mm-hmm.
Adri: clearly in your application, potentially in an interview through your personal statement. The person can say specifically what they have observed, what they've contributed, what they've learned is going to a very, different position than someone who lists hours without being able to say about them.
Tiffany: Yes. going off of that, this is something that I wish someone had told me earlier track your hours as you go, not at application time, but as you shadow, sit down after your shadowing experience, track track what you saw, what you what you did that day, all of it.
Adri: Mm-hmm. Mm-hmm. Yeah, so the minimum you want for any role when you're tracking this is write the employer name, your title, your start and end dates, your supervisor's name and a contact so you can actually reach them at a phone number or an email address ⁓ your approximate hours per week. That's it. You do those ⁓ notes You can do it in a spreadsheet a notes app or Google Sheets.
Tiffany: Mm-hmm.
Adri: anywhere that's convenient for you, make it as simple as so you won't forget it and you can use it later.
Tiffany: Yeah, the the contact matters is that some applications ask for verification. If you've moved through multiple roles ⁓ and your supervisor from two years ago changed jobs, ⁓ that's a harder problem to solve ⁓ application time than it is right currently.
Adri: Can you give me an example?
Tiffany: Yeah, let me give you a quick example of what a tracking entry looks like so that this doesn't feel so abstract. From my own log SSM St. Anthony Hospital, anesthesia tech, start date was June 2025, supervisor, I will keep their name out of this, but I have their direct work email and cell, 24 hours per week.
Adri: Mm-hmm.
Tiffany: or how many total hours overall that I've worked. And then a short note about ⁓ the position entails. So cardiovascular and general OR cases, ⁓ anesthesia, provider support, airway equipment set up, patient monitoring. ⁓ it. That's the whole entry. It took two minutes to write and it saves you from trying to reconstruct all of that at the time of your application, especially if it's been a few years.
Adri: Exactly. Exactly. And that little note on what exactly you did, there is that description section within CASA that talks about how, what you learned in that experience, that sort of thing. But it's just a 500 character count box. You can use it in bullet points. You can use it in paragraph format. there may be some opinions out there on which format is better, but you choose what's best for you ⁓ and what you might be good for your application.
Tiffany: Mm-hmm.
Adri: And beyond the logistics, if you're in anesthesia adjacent settings, keep some kind of notes on what you're actually seeing. So those case types, this goes along for when you're observing or shadowing providers as well. Things that really stick with you, things that surprised you, not because you're going to include absolutely everything in your application, but because you're going to be asked to talk about some of this experience.
Tiffany: Mm-hmm. Yes.
Adri: you want that real material to draw from and you're not going to remember every single little detail,
Tiffany: Yeah, ⁓ and if you're to us ⁓ and you haven't any of this yet, do not worry. You can reconstruct a reasonable record. ⁓ You can use old stubs, offer letters, LinkedIn, contact your supervisors. It's obviously work than staying but it's definitely doable to retrace your steps ⁓ and.
Adri: Mm-hmm. Mm-hmm.
Tiffany: you just have to kind of sit down and put in a little bit more work.
Adri: Yes, being a non-trad career transitioner or I can say I didn't go into my career as a speech pathologist thinking I would transition. And now here I am over 10 years later and I am going to have to do some of that digging, which is one reason why I have not submit my application yet. That's going to takes a very long time and that's, that's okay. There's ways to figure it out. It's just being intentional about it.
Tiffany: Yes. Okay takeaways, Adri.
Adri: All right, Yeah. You start takeaways.
Tiffany: Yeah. Yeah, ⁓ experience when you are coming from ⁓ healthcare, power you, it is very hard. The timeline is real. ⁓ Financial are real barriers and we don't think it helps anyone to pretend otherwise.
Adri: Mm-hmm. Yeah. There are accessible entry points. So certified nursing assistants or patient care techs, medical assistants, emergency medical technicians, phlebotomists, and the right one depends on your specific situation. None of these are shortcuts and all of them do require some real time money and investment.
Tiffany: Yes, but overall on our research and what we've seen in the pre-A community, ⁓ direct patient care and anesthesia specific exposure both seem to matter a lot ⁓ different reasons and in different ways. So always verify what specific programs that you are wanting to apply to describe in their own materials.
Adri: Mm-hmm. And lastly, document as you go, if possible. Supervisor name, contact info, dates, hours, even if you need to calculate average hours per week. So hours and number of weeks you were there, what role it was. Don't save this later for application time. Even if you are a year out, two years out, start collecting that, create that spreadsheet.
Tiffany: Yes, or you will regret it. One thing before you close this out, clinical roles that you've held, if you haven't done so already, open a document right now or your notes app, write down ⁓ contact per role who could verify your hours, ⁓ names and how to reach them. that three minute step.
Adri: Mm-hmm. Mm-hmm.
Tiffany: alone protects a lot of the work that you have already put in.
Adri: All right, so looking forward, next up is going to be episode eight. I can't believe it already. Pre-AA perspectives on shadowing. We're gonna get into how to actually get access to shadowing, no matter you're in a CAA-licensed or non-CAA-licensed state. This is PreAA Pathways.
Tiffany: Yes. We will see you in episode eight.
