Cannabis Nursing with Alicia Schaal

With the explosion of cannabis use in the U.S., Alicia Schaal saw a gap in knowledge for healthcare professionals. Without much evidence-based information to find, she decided to educate herself so she could share that knowledge with others, namely the nurses and physicians that were unsure how cannabis impacts the our patients and the care that we deliver.

Alicia is currently taking pharmacology and other related courses to arm herself with the most up to date research. She recently  formed Midwest Cannabis Professionals, a consulting and education business. On her website, her goal is to “help improve your quality of life with medical cannabis”. Anyone can reach out to her for information so that they can make educated decisions for their own care. She also works with healthcare professionals so that they may feel more comfortable making decisions about their patient’s care regarding cannabis use. 

Alicia is very knowledgeable when it comes to cannabis and if she doesn’t know the answer to a question, you can bet that she will find the answer to best help her customers. This is a much needed service in a time when there is such little information. Alicia is certainly moving us in the right direction..

ABOUT ALICIA

Alicia Schaal is the owner and CEO of Midwest Cannabis Professionals, LLC, a medical cannabis healthcare consulting company. Alicia has been a nurse in Minnesota for over 23 years in many different specialties, including solid organ transplant, interventional radiology and, most currently, as an operating room circulator. She is pursuing a master’s in medical cannabis science and therapeutics through the University of Maryland-Baltimore. As a lifelong learner, she is excited to apply her practical nursing skills in the new arena of cannabis nursing. Alicia is enthusiastic about bringing an additional option for people to enhance their wellness.

LINKS

  • Beth Quaas

    Hello everyone and welcome back to Don’t Eat Your Young. I'm your. Host Beth Quaas. Today we have Alicia Schaal on the show. She is a cannabis nurse and she's going to talk to us about how she got into that, what she is doing now. As part of that, and then explore other positions that might be available. If you are interested in cannabis nursing, welcome to the show, Alicia. Hi, Alicia. Thanks for being on the show.

    Alicia Schaal

    Hi, Beth, how are you?

    Beth Quaas

    I'm really good. Tell us a little bit about yourself.

    Alicia Schaal

    So I have been a nurse for the last 20-3 years and I have had a bunch of different specialties in that time period. When I first became a nurse in 2001, it was a little tight to get into the hospital, so I pretty much took any job I could and I started out in solid organ transplant at the University of Minnesota. With both pediatric and adult patients. So I really had no idea what I was getting myself into, but it was an excellent, excellent learning experience. After I was done and solid organ transplant, I felt they needed a little bit of a change and a just a little bit of a schedule change and I moved to interventional radiology also at the the University of Minnesota. I spent probably about 21 years all collectively at the UI did interventional radiology. A long time. Really enjoyed it. Loved it. The hours got to be a little hard, as nurses can testify to every once in a while, you need to switch it up for your own sanity. So I ended up opening up the clinic and surgery center, their imaging center at the you for a little bit more of an administrative role bridged into some leadership positions. And then just managed nurses, which is the best part. And from there I, my child got old enough and I figured it was time for a challenge. Dan and I actually moved to the Regions Hospital or which is a level 1 trauma center. So I figured between my experience and the teaching hospital going to a Level 1 trauma center, that's also a teaching hospital would be pretty amazing experience. That's the benefit of living in the twin city. So the last few years. My my big endeavor has been venturing into cannabis nursing, nursing, which during. COVID is a little. Tough and and the benefit because since everything became webinar based and zoom meetings and everything, I think a lot more information. Started to come out as to what the possibilities could be for cannabis nursing. So that has been my passion now probably for the last two or three years and more aggressively probably in the last 6 to 8 months. I applied for and I'm taking a masters program from the University of Maryland. Baltimore out of their College of Pharmacy. So it's a medical cannabis science and therapeutics master. In hopes of trying to actually have those credentials and education to be able to pass along to peers, colleagues, and then eventually independent healthcare consulting. So that leads to the other thing I'm pursuing right now as I have started a business just this July of. The plan will be for independent healthcare consulting on a formal basis. For independent clients, as well as having some sort of formal training to the young doctors in the Twin Cities, fellow nurses pretty much anyone that will listen cannabis is here. So you know, nurses, doctors, everyone need to just pretty much collaborate and. And figure out how we how we manage this and how we incorporate this into our patient care. It will change a lot of different areas especially as patient. Friends and clients feel more comfortable revealing that they're using cannabis for whatever reason in their daily lives, or once a month, once a year or something like that. As patients now feel more comfortable, I feel that. One of my. Biggest goals is to be. Able to do peer education every day. Uh, you know, at least a few times a week when I encounter colleagues or physicians for various things. I mean, they just kind of have a look of wonderment on their face of they really aren't sure how they feel about it. And so I have kind of taken on that chart. George, as as a nurse, since that's all we do, is educate our providers and our patients is that that would be my my goal going forward is to help be an advocate for patients for their cannabis choices and then help educate providers to be more accepting of those. Cannabis choices.

    Beth Quaas

    Before this I didn't even know that there was a degree in that, so that's amazing.

    Alicia Schaal

    Yes, there are three programs in the country. I believe two are on the East Coast and one is in Denver. Other than that, there a lot of colleges are. Now starting to offer. Coursework like a semester long class. A couple classes there I think are some colleges that are offering minors and various things, but there are only those three programs in the country that are offering a graduate level class as of I've last checked. I don't believe there's any undergraduate classes in just Canada.

    Beth Quaas

    So with that degree, getting a masters degree. In that education, can you prescribe cannabis?

    Alicia Schaal

    No, you still can't, knowing that this structure can prescribe cannabis, it's still a schedule one drug, so all anyone can do is advise. And if you talk to. Most people, even people. That have been in medical cannabis in the space in some variety or. Another a lot of people. Still feel like impostors because there is no rigid. I'm going to prescribe X for seven days and you'll. Feel better. So there no. One at this juncture has prescriptive powers.

    Beth Quaas

    OK so. You, as in a consulting role, yes, I understand the education to healthcare providers because we know it's in the literature right now that it's a much needed thing because. They don't know. When how much who? What route, right? On the patient end. You will be helping patients decide what.

    Alicia Schaal

    So there are a lot of different roles. There are other cannabis nurses throughout the country, especially on the West and. East Coast so. I'm not pioneering it, at least from scratch completely, but my role would be if someone was referred to me or came in contact with me. It would be a regular. Intake as far as what other medications do you have? What other diseases do you have? There are some resources, sometimes limited, but there are some resources on interactions or hypothetical interactions with other medications that would maybe. Cause for a little bit of additional risk potentially with using medical cannabis and there are some people that are just absolutely not candidates for various reasons. So it would be to guide them what do they want to take most? Most people, if they're, if they're looking for a medical consultation. Or if they're walking into a dispensary for the first time, they have absolutely no idea what they're looking for. They just I have arthritis and my hip and shoulder. I can't sleep at night, I don't want. To take opioids. What are my other options and at this juncture you're going to walk into a dispensary and flip a coin as to how knowledgeable the person that? You're talking to what kind of background they have, and to be honest, a lot of it is their own personal trial and error. There aren't very many people that are very educated, so it falls on. It falls partly on the person working in the dispensary, as well as the person that owns the dispensary, so very few I think, are really requiring any formal training programs, so it falls on me to say. OK, Beth, you know, I think based on what we've talked about, I would recommend CBD and my ultimate goal primarily also within the twin. Cities is to be able to know where to send you where I think that person has or that dispensary actually makes a valid product, a reliable product that I feel comfortable, you know, encouraging you to go and find. So it it kind of comes back then we work through it as far as, OK, you've started taking this, keep me updated. We'll talk in 30 days. And then it just marches out based on what that person feels that they need. Are they getting relief? Do we need to talk about other options? Since you know, cannabis in general is such a personalized medicine which is so atypical to our Western medicine really. It just makes it more challenging. So it's almost as a guy.

    Beth Quaas

    Right, I I've did my own little bit of research on cannabis because it I gave a presentation at a meeting a couple weeks ago, which is where I met Alicia. It's amazing to me. The the strains out there that are available, the routes that you can take cannabis before we get into that, what kind of liability is there in? Consulting with patients in what to to is there liability? There's.

    Alicia Schaal

    So I have spoken there are actual cannabis attorneys, and so they're just like anything else you're seeing all these specialties, there's cannabis attorneys, cannabis accountants. I've spoken to a couple cannabis attorneys. And pretty much my current it's a Gray area and actually the a CNA and the American Association, I apologize that a CNA is the American Cannabis Nurses Association, they are evaluating going forward. What type of liability is there and the fact that it is still a schedule one, so a federally illegal medication that it varies from state to state, so there are minimal. Protections it's almost just based on loopholes. If I'm not prescribing it really is just a consultation, I'm not telling you to go out and get it. We're just working through it. So that's kind of the Gray area. I my business is registered as such that I don't use my nursing. License my nursing license is completely kept out. Of the business, it's only that I personally hold those credentials so I don't have a professional based LLC company that you would actually have to put forward your license and potentially put my license at risk. So when I've spoken to them, I've kept those two things separate. At this point, you don't need. Qualifications to consult with someone or coach someone on cannabis whatsoever, I mean. And my 21 year. Old could get a job doing it and and be considered on the same. Level so I. Think for right now anyway, there's just so much Gray area that we're last. You know, we're last to the conversation as to what the liability would be going forward if you're actually embedded into. More of a care system, which is what? I hope for. Then it probably has to. Shake out and see where it falls right now. I think it's just not even part of the conversation. It's just kind of exactly like you have just like that a little bit in the back of your mind. Could this be a problem? And I think as long as everything is. Stamped out and it's a disclaimer, this is just an advice. It's not. Anything I'm mandating that you do? And if you go against these things, that's against what we are discussing. So I for my benefit, I believe there can still be some really airtight disclosures that I would not at this point need medical liability insurance, at least not that it's come up in the Community. I think it's such a small percentage of nurses. That are a doing it and B being vocal about it that it just doesn't have enough momentum or attention yet to warrant whether or not we need any additional coverage. I would believe it's probably coming, but I I don't know what that look.

    Beth Quaas

    I love though that you're getting out there and you're educating people because like you said, and I've walked into dispensaries and it is. Amazing. Yes on the walls. And you're supposed to try to decide. And the names and. Where do you start with that when you're? Talking to someone.

    Alicia Schaal

    So you it. Is difficult. I mean a lot of times I get asked in the middle of a restaurant, you know, when I'm out to dinner. Ohh by the way. And it it's just a really awkward setting. So you almost just have to evaluate. What's their history? With it is this the first time? Have they ever tried it? Did they ever try it before and if so, what was their reaction? A lot of the data is really kind of is pointing to more of the non psychoactive components and more the CBD versus the psychoactive component, the THC. So my point is that at this point. You're a little bit safer, but you always start. Kind of really slow. So the the model is slow and slow. I mean you just start someone very slow. I just heard this weekend that there was a woman that took 1 milligram. It was shaved off a gummy and was just out of it for the whole rest of the day. You know, lightheaded did not respond well. And so, you know. My initial recommendation, you know through that friend of a friend is she should not take it. And based on what she was looking for anyway, she should have been taking CBD, or at least.

    Speaker

    Right.

    Alicia Schaal

    Should have tried. It so you really have to gauge it's very. It's much more personalized medicine, I think, than what we're always used to, especially recently, you know, I mean, we're all so busy as nurses and and providers that you don't necessarily have the time to ask those questions if it's not on your computerized checklist or something piques your interest that you have to ask it. It just gets glossed over, so this is a little bit more in detail. You know, what are they willing to try? What do they want to try? What have they ever tried anything? You'll hear a lot of. I tried one of my grandsons, gummies and didn't feel so. Feel good. You just have to really do a good history.

    Beth Quaas

    And I think what's also amazing about what you're doing, you're not only teaching them. You are going out to the dispensaries and you are finding maybe the. Where you feel comfortable that they're doing a good job, that they're legit. So I think you're also serving a dual purpose, not only in educating them but possibly sending them to.

    Speaker

    Right.

    Beth Quaas

    The right place.

    Alicia Schaal

    Correct. And a lot of those places, I since I've opened my business, that's really what I have focused on. More especially while I've been working on my masters, is since it is newly legal in Minnesota as of August 1st, the community has really started to come out from underground. The people that just had pockets together. I have known each other a long time, but it really highlighted for the rest of the people to start. Showing their face and doing a little bit more investigation, myself included, only because I've had more time over the. Summer so it it. Is kind of a grassroots group of people, since it's and that is really what I would like. I don't really want to send someone to a place I don't think is very reputable. I just asked someone this weekend. I said, well, how do you know that you're getting good product? And they said, well, he drives a Porsche and she drives a BMW. And I said well. So drug dealers, you know, I mean you have to know a little bit more about you know what you're buying. There are people that are not selling things to really make you better or help. It really is purely for profit. So I want to fetch out who those people are or who's willing to work with me. I spoke to somebody over the weekend. That I will meet up face to face, but he said please review my website and see what products I need and see what I'm missing so the the people right now are are willing to work with what the community needs, what other people think they need. Their their hearts are seemingly in the right place at this point, you know? So that's really, really helpful. And the more receptive they are faced at it, a lot of them want me to come in and do education sessions to their customers. It brings people in the door that are even just curious.

    Beth Quaas

    Which is fantastic. Because cannabis as we know it is a schedule one drug and nurses know that you know that. Very under wraps. You can't. It's not easy to get. You have to check it out. And I mean, if we were to use it in the hospital, we we associate opioids. With that.

    Alicia Schaal

    Right.

    Beth Quaas

    But now there's discussion about trying to turn this into a Level 3 drug, which would be easier to get less restricted. Can you talk a little bit about how that would affect? Maybe what's going on?

    Alicia Schaal

    So there are two schools of thought on the rescheduling. If you or de scheduling, depending on who you talk to. I myself. And another group feel that even if the if medical cannabis was scheduled to a Schedule 3 drug, it's still classified with things such as ketamine, antibiotic, steroids.

    Speaker

    So it is still.

    Alicia Schaal

    Classified with medications that aren't or drugs that really aren't. Used daily by the. Average population, but like you mentioned, it does allow for research to be done. It it allows for physicians to somewhat be in the. Name, but I still think that it will have a little bit more of a hands off approach by the physician groups unless you have physician groups that are are really interested in making an effort. I don't really see the internist or primary care doctor that's not interested with all they have to know and what's going on with their current. Patients that they're going to then want to go back and teach themselves the the INS and outs of of cannabis. I just spoke to another physician a couple weeks ago and he was prescribing or he was certifying his patients these, these elderly patients for arthritis and whatnot. And he was telling them that they should take these THC products instead of CBD products. And I said, well, you're making. All these old people high based on what you're recommending, which I'm I'm not saying is a bad thing, but if that's not really what they're look. Before and, he said, well, I I thought CBD would make them all asleep and sedated, and I had to educate him. No, that's not the case. And that's probably what you should be starting with with these older people, with chronic pain. And so he was willing. He was very interested. Thought it was a great idea, definitely all for alternative medicine, but. Didn't have the appropriate information, so I think with schedule three you will maybe find an Open Access, but you're not necessarily always going to find people that are are really still going to accept it and want to educate themselves on it. As far, so that's kind of one class. I'm all for expand the research at least downgraded a little bit. It opens up a conversation and it. Opens up the doors. There is another large population and they tend to be a lot of growers, cultivators, people that are in distribution. They would prefer that it become completely descheduled, that it isn't even on there at all. So it would pretty much be like caffeine. Caffeine isn't really regulated. You know, perks some. Eyebrows. If it's too high, but. They prefer that by it becoming descheduled. There's less fingers in the pot. It doesn't make it such a high commodity. The fact of schedule three, they feel that Big Pharma will get involved and take over a lot of that research take over a lot of what then becomes mainstream and. And and maybe commercializing it and sterilizing it a little bit more than what a lot of times the cannabis community feels is necessary and it's big profit and a lot of the states, some are successful, more than others, don't necessarily want those big pharma or large. Corporations taking over. So they would prefer we're just, yeah, they would just prefer. It was descheduled and full game to everybody. Everybody can research, everybody can collect data, trial and error and that it then puts less constraints on the actual dispensaries.

    Beth Quaas

    That's probably a smart thing.

    Alicia Schaal

    They a lot of the states still have required testing required certificate of analysis that's very state dependent. Sometimes the accuracy varies but there would have to be some caveats with both. And I just look at it that it would be amazing to just have more research available at this point. You can only do cannabis research if it has anything to do federally. You can only get the cannabis strain that the University of Mississippi grows, and that is the only place in the. United States. That you can get federally approved cannabis to run any kind of study. So it's kind of wild when you think about it. You know, these are plants, so growing a plant in a lab in one place does not really constitute.

    Beth Quaas

    I did not know that.

    Alicia Schaal

    You know, meat growing a plant in my backyard in Minnesota with, you know, my own little biodome of of fuel and and soil, you know. So I think there would be a lot of things. There's a lot of things to hash out before that that happens and you will get somewhat of an argument. I believe normal, which is the one of the main organizations for the National Organization for Marijuana Marijuana laws. I I think they're pushing a little bit more for D schedule, but. I I know quite a few people that are just descheduling it, you know, do schedule it, make it done and.

    Beth Quaas

    So de scheduled doesn't mean that it won't be regulated.

    Alicia Schaal

    I nobody knows, I would imagine that the states would have to. I still think the states would have some sort of control power over it. Even currently now in the state. Of Minnesota there. Was an article in the state of Minnesota, as is a lot of other states, but you can grow hemp. In the state of Minnesota under a 2018 agricultural farm bill. And so there are people that are selling hemp and hemp Dr. products that some contain THC and they grow them and depending on also what they call themselves, if they call themselves a cannabis farmer, then they fall under the agricultural bill and there's a byline or a amendment and. The Minnesota Constitution that says if you as a farmer grow something, you are entitled to peddle your wares so you can go ahead and sell your products. For that farm bill, then, you don't really have any oversight. Now the argument is, is that when that Bill was written, it did not have cannabis in mind, so that they're still trying to push that. That is not what the bill was in or the not what the amendment was intended for. So there's always this constant. Play back and forth. You know of if you show me one study that it says it's great, I can show you two that it's not, you know, it's just this power play. So it's super difficult once you get into the actual politics behind it and the motivators.

    Beth Quaas

    Yeah. So, you know, the legalization in Minnesota just means now that you can possess it. It it from my understanding over the next two years, the. Office of Cannabis Management, if that's what I. Think it's. Yeah, we'll set up the framework of how it's sold in Minnesota, is that correct?

    Alicia Schaal

    Yes. So as of right now, it is legal for you to possess it. You can have a total as an individual. You can have a total of eight plants, you can have four mature plants that you could harvest and do it. You will and you can have four non mature plants. So that at any given time pretty much you could cycle. Through and have more for mature plants. As far as any you can buy all sorts of hemp derived products because that's falling underneath that farm Bill. So there are a lot of places that are currently setting up shop, literally, that they have hemp derived products which you only needed to have sent in a authorization or registration form. By just this last October 1st and that was it. Now if you choose to a lot of them, then we'll apply for these cannabis licenses for Minnesota. And if they have a cannabis license, they can sell both hemp derived product and cannabis. Products. So as far as being able to walk into a dispensary and buy a cannabis derived product just like you would in some of the other Denver, some of the legally recreational states that is proposed to be probably after the first quarter of 2025. A lot of the medical dispensaries are being told that it's March 1st of 2025. However, there is still no director of the Office of Cannabis Management, so we're being told, as you mentioned, that the framework is still being. Put forward and established based on the interim director. However, as you mentioned then no one is quite sure what that exactly is going to look like. There are some proposed things that a lot of people give kudos for that they took some of the growing pains from other states, changed it. And try to make it a little bit more functional for Minnesota, Zach Stephenson, who is the Anoka representative that actually. Authored the bill that HF 100 was at a conference. I was at a few weeks ago and he said we laid the framework and we know that there will probably have to be legislative amendments to the to the bill as the kinks. Are worked out. It really is just one of those industries. That it it just. Is finding its own growing pains and cracks and and you try to learn from those cracks as best you can and.

    Beth Quaas

    We we know that. The we're going to see more and more patients in the hospital that are using cannabis acutely for sure, but on a chronic basis. And you're right, healthcare providers, physicians, nurse practitioners, nurses. Don't really have any guidelines to follow, so your education is incredibly time.

    Alicia Schaal

    I just was speaking to there is in Minnesota a plug for the Minnesota Cannabis College is a nonprofit that tries to put education together for just the general public as well as people in dispensaries, retailers, etcetera. But we were talking and he said. I think that the. The Medical Group needs to know that if someone tells you that they smoke three joints a week, that that's not a big deal as far as even just the actual milligram consumption that, that, that there needs to be some guidelines. I think that's what they're looking for, that's what that's what I'm hearing from some people in the community. That, you know, they think it's great they they have been really passionate about the plant. They have seen it work for themselves, for their families, other people they. Worked with. They just want to make sure that there's recognition of what's normal. I guess if for lack of a better word, that's indefinite quotes, you know what's what's normal perceived from 55 year old surgeon who has never smoked pot. Really maybe does or doesn't interact with chronic pain per say based on what their specialty is. And like you said. And then when they're faced with someone that says. You know, I smoke my bong three times a day, and that's the only way I can get my tremors to calm down and my hip. Pain to. Go away. They have to realize that there are other factors that go into that. How long have they been taking it? What exactly are they taking? You know, everyone inhales a little bit differently. As you know, Bill Clinton said either you did or didn't inhale.

    Beth Quaas

    You know that's right.

    Speaker

    It's a, it's.

    Alicia Schaal

    A personal it's a personal thing and you know, I had a surgeon look at me today when I told him what I was doing now and he just kind of stopped and. And I don't think he knew what to say, you know. It just just kind of. Oh, oh, oh, OK. Well, I'll be right back, you know.

    Speaker

    It was. Just you know.

    Alicia Schaal

    It's just leaving some people speechless. But you know, a lot of physicians are really looking at it as a potential lifeline. You know, the ones, the people that I talked to that. That are a little bit, maybe more progressive or I think sometimes they deal with the more desperate of the desperate. To be honest, you know, rheumatologists pain, chronic pain providers. You know, there's instituting rules that they won't see new patients without primary care providers in the system because they're tired of getting. Patients that other systems don't want to deal with with their opioid management and and these people are just bouncing around, you know, no one wants to deal with. That chronic pain and just prescribing more and more opioids. So I think even they are looking for other options. You know, sometimes you can only manipulate what you have in front of you of the the same old toolbox of drugs is so many times, you know it's just. We could alter this just tiny bit and augment this and augment that and you know, you just have these people that are are just exhausted, right? You know, I had another gentleman tell me a week ago that he said we were another colleague of mine was giving a talk. And she said she's also a nurse. And she said, you know, make sure though that you. Ask questions and she said tell your providers because as some people do trial and error, there are some complications or some things to maybe be a little bit more aware of. And he said, I appreciate that you have to say that, but I will never tell my doctor. He said he will give. Me the worst. Look and stink eye and he said I. Feel great using it, but I would never tell him because I think I wouldn't be well received and this was a 77 year old man, you know, I mean.

    Beth Quaas

    Sigma is real.

    Alicia Schaal

    It is definite, definitely real, so I think. They definitely some want the education and they would love it kind of, you know, managed for them, for lack of a better word and and some I think are on the fence, you know it's it's a real it's it's having a foot in each in each space is is personally what I think.

    Beth Quaas

    Another question that I've gotten now that cannabis is. Legal. What does that mean for people like us as nurses that hold licenses?

    Alicia Schaal

    Now there so it as I understand it, there is kind of a. As it it just seems to always be 1 Gray Gray area after another. I, as I've last heard, is that you could have a medical certification as a quote UN quote employee and a medical certification would safeguard your position. Unemployed would have to say Beth. You look goofy today. You're not acting right, you know, maybe we should test you now. That obviously puts you at a disadvantage if anyone were to know that, because then obviously it highlights, you know, oh, that's not doing right, not right. So it's probably the. Weed, you know. And but you would be safeguarded unless you were showing up in, in inhibiting others now for what they're referring to as frontline people or people in a a position of power over someone else. It is you could still lose your job that as of now. It it hasn't really been. I've looked kind of around and I I've not really seen a lot of UM. A lot, I'm. Not really seeing a lot of cases, essentially, where nurses in particular have lost their jobs over it. I think it's just it's it's mum's the word, you know, really, I mean.

    Beth Quaas

    I've looked on the Minnesota Board of Nursing website. I cannot find anything other than how to care for patients on medicinal cannabis. It doesn't speak to us.

    Alicia Schaal

    As nurses, no, it really. I the best. The best definition I've gotten is just it's. It's EMT's. It's anyone that's dealing with direct patient contact now, you know, and there's various jobs that you could make an argument that you can most definitely still be a nurse and not necessarily have direct patient contact with someone. I I I think that's where that stigma comes into play, is that, you know, someone could be taking. A very low dose THC product or even a high dose based on what someone? Houses current levels are intolerances, and it does not make them impaired, which is why it's really an argument with a lot of law enforcement is that they aren't really sure either how to assess people you know you could be fully functional, however, you know they they smell it. So I'm sure that's what impaired you and a lot of times it's not taking into consideration that it was the 12 beers you had, you know, before you drove home. But since they smell weed, of course, then that must be what it is is that, you know, you're high driving down the. Street. So I think it's like anything else, I the only thing I ever see as far as the the nursing component is that you know, if we're found to be using illicit drugs, you're not automatically you don't necessarily automatically lose your license. Anyway, you can be put on a program or put into some sort of contract, you know, so I. I think there's a slight safeguard. It's just really, truly. What kind of? Sneaky Tetris game do you want to play? And that's the unfortunate piece really.

    Beth Quaas

    And I. Each facility would have their own policies on that as well.

    Alicia Schaal

    Yes, yes. And a lot I I. Do see though that most. Most facilities and most employers are pulling testing for drug testing prior to or at least drug testing for cannabis products. I think due to they wouldn't find any workers. You know, there's so many people and you know due to the fact that THC stays in your body for so much longer. Or can per their your past usage. You know could have been a week ago. You're not impaired. It's still from a week ago. So if you're tested well, that just shot your job for them and you, right. So I do believe there's been national relaxation on a lot of those pre employment testing. I I keep reading more and more which Fortune 500 companies are dropping it. And and which groups are dropping it. There are gonna be some, truthfully, some real challenges going forward I think because as of the 28th of September, it was announced and recognized that the that cannabis nurses is is actually recognized by the American Nurses Association. As a specialty, now it's being recognized as a specialty. You won't necessarily be able to be certified in that for at least, I would say 2 years as their goal because they have to now that they've even been recognized as a specialty. Build the program and the certification program and what that looks like going forward. But as of now, that's really only the only group that's being recognized medically as a CARBO. I mean you, you know, there are doctors that specialize in cannabis medicine, kind of, you know, those usually tend to be the ones that are doing those. Drive by certifications. You don't necessarily tend to find you know someone in your family practice clinic that's, you know, study it up on cannabis. That's really going to be able to help you and answer your questions.

    Beth Quaas

    What do you see? A certification for cannabis? No. Thing what can nurses do with that? How do you see that fitting into our profession?

    Alicia Schaal

    So how they've built that up? I actually just was watching a presentation this morning, how they've built that up is that it's similar to other specialties. I know I was certified in solid organ transplant and you had to have the experience with it. You had to know common drugs, common doses. Common side effects. You know, what were the pitfalls of receiving a a kidney transplant 10 years out? I mean, you just have to to know what surrounds. That that specialty. So for the cannabis group, it really doesn't look much different, at least in their their stepwise outline. You know, they they want to make sure that you are providing holistic care, that you're looking at the whole patient, which that's not anything new to nurses. You know, it's the foundation. That you're familiar with the endocannabinoid system. I mean, that was founded in 1996 and while I was in nursing school, it was never mentioned once, you know.

    Speaker

    You know. So for those of us.

    Alicia Schaal

    Up an education piece. You know what? What exactly is that? And have you learned about it? I mean, it's. It's a pretty. Overwhelming system, to be honest, more so than some of the others.

    Beth Quaas

    Right, that's the system. In our body and they found it by studying the effects of marijuana. Realize it.

    Alicia Schaal

    Yeah, right. Right. Isn't that wild I?

    Beth Quaas

    Until they were doing research on patients that used marijuana.

    Alicia Schaal

    And the and the receptors are, I mean they are everywhere. I mean it's you have a ton in your brain, a ton in your gut. I mean, you know and those are the things when you even just practically think about cannabis. Those are the things that we think of, you know? Ohh you're you're going to be. Quote UN quote high while you're, you know, augmenting those neurotransmitters in your brain. Well, you don't feel sick and you have the, you know, laughable munchies. Well, I mean, that's why we promote that for cancer patients. So when you actually look at all the little dots on the on the map of the endocannabinoid system, I mean, you just see kind of how how potentially it would have worked. And then you see the map out of where some of these other receptors are, and that's where, like you said, that's where the research piece comes into. So is, you know, I'd like a formal study on how does it, how does it affect a thyroid, how does it affect cancer cells? There's all sorts of it's data out there on, on various things. You know, people are using it on on small scale, 12 to 20 patients, 10 rats, that kind of thing. So the questions are out there. I I think that once some of that science. At least can come to the the forefront a little bit more, I think then nurse. We'll we'll jump on board. I mean, I just have to honestly think that, you know, nurses are your they're the most trusted profession. We learn a lot. We know a lot. We have to deal with people a lot and we listen. If you're a good nurse, you have all those things. So I think how can you, what bothered me? Is it's like. Well, how could I not then include that? Or how could I be off putting or judgmental anymore? And I will be honest, I was 20 years ago. Those were the patients. You didn't want the one that reached from head to toe. You know, smelling of weed, walking, talking, funny. It didn't matter, you know, they were. Oh, I have to have that patient, you know. But it really undercut what else was going on with them, you know? I mean, what else was really the true picture, you know? And so looking back, you know, I'm a little irritated with myself as far as, you know. I mean, I think we all have some sort of judgment and bias just on something, you know, it's just it's hard when I'm I'm definitely human, but looking at it now, I just. Look at it and. Like, well, well, why are you using? You know what? What exactly are you using and how much are you using? And maybe that's causing you to fall down the step and that's why you just broke your knee. So scale that back a little bit, right? You know, none of us really had that knowledge. And to be truthful, even if you had that knowledge from personal experience or dealing with anyone, I mean, you certainly weren't going to necessarily start. Educating quote UN quote a patient about it and your physicians were and are not maybe going to support you in it, right?

    Beth Quaas

    Now, yeah, I think what you're doing is. Incredible and much needed. And I think you are forging a path for so many nurses to follow. So what would you? Tell nurses right now what we want them to know.

    Alicia Schaal

    So what I would want them to know definitely is, you know, explore it, if not even just for learning for yourself personally, definitely for your patience. I mean, it doesn't need to be a a masters program like myself. There are six month certificate programs out there. If you're super interested or even just want to champ. In it for your health system, you know, it's like anything else. If it pertains to people and it's something that they're using and there's something that they're doing and some people are seeing pretty amazing results. I I encourage people to just investigate it. Just Google it, just sit down and Google what's out there. And I would almost guarantee you would be a little surprised. And if no nurse has ever been to a dispensary. I suggest you at least just go in or go in with a friend and just go in the middle of the day when you have a day off from an evening night shift, something when it's maybe a little less busy and just go in and see what it's about. I've gone in and one of them that my husband and I have gone to and my husband. Yeah. So I'm the youngest person by, you know, 20-30 years. I mean, it's just not necessarily what you're thinking of. You know, it's it's a lot of people with…

    Speaker

    A lot of.

    Alicia Schaal

    Issues and I think that's what nurses are good at, is issues. So I think it's just another component to personal and professional aspects of of nursing life. So and I am available for any information to direct collaboration. Any questions whatsoever.

    Beth Quaas

    You will definitely be able to find Alicia. We'll have all of her links in the show notes so that if you want to reach out to her, you certainly can. I think you were doing very important work, Alicia, because we are going to see more and more and more of this, and I applaud you for what you're doing.

    Alicia Schaal

    Well, thank you. I appreciate it. I appreciate you. You know, even bringing the topic up a couple of weeks ago, it was amazing. So I saw it and. Saw you out. And thought finally you know, someone starting the conversation. So thank you for bringing it to the forefront and and having me on, that's wonderful. I appreciate it.

    Beth Quaas

    Oh, you're welcome. I know this will not be the last time that we have you on the show because. We will. We will want to follow up with you and see where we're at as time goes on, especially in Minnesota, since it's kind of a new thing here.

    Alicia Schaal

    Yes, definitely. Yes, yes, I would love to do that, it would be great.

    Beth Quaas

    Great. Well, I appreciate Alicia, thanks for coming on today.

    Alicia Schaal

    Thank you so much.

    Beth Quaas

    Thank you so much to Alicia for being on the show today. That is so much timely information. I encourage you to reach out to Alicia if you have any questions about cannabis nursing or how you can get more involved in education. She is so smart and she knows so much about what she's talking about. So thanks again for listening. We'll be back next time.

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