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programs I've done all over the world on surgical smoke," says Ms. Ulmer. Having access to a world- wide expert on smoke safety was a blessing for Ms. Hohn, especially when she discovered what Ms. Ulmer and the Georgia Council of Perioperative Nurses Legislative Committee were try- ing to accomplish: getting a state law passed that would require healthcare facilities to install and use surgical smoke evacuation systems. At the time, Ms. Hohn had no idea she'd play a starring role in that effort. Ms. Ulmer's initial lobbying for surgical smoke safety began in the 1990s on the national level. She spent signifi- cant time in Washington working on language with OSHA representatives for a bill that would have required the evacuation of surgical smoke in ORs across the country. The legislation was introduced, but ultimately died in Congress. Two decades later, a national ban on surgical smoke is no closer to becoming reality. The good news, says Ms. Ulmer, is that local leg- islation can be just as effective. "Nurses and techni- cians have grown tired of nothing happening, which is why you're seeing so much activity at the state level," she says. Smoke safety is a personal issue for Ms. Ulmer as well. After she joined AORN's board in the 1990s, she'd work in the OR only once per month. "After one day of high-smoke-producing cases, my nose burned, my throat hurt, my chest was tight and I felt nauseous," says Ms. Ulmer. She felt fine the next day, but experienced the same symptoms a month later after a full day spent in the OR. "I made the connection that when I'm away from the smoke, my body starts to feel normal again," says Ms. Ulmer. "I decided then that surgical smoke was really bad for your health, and that's what started me on this journey." When Ms. Ulmer stopped working in ORs full-time in 2012, her primary care doctor said she had a "90-day cough," and an allergist diagnosed her with adult-onset asthma. "I had a lot of respiratory issues," she says. Ms. Ulmer knew her story wasn't unique, as the unusually high rate of perioperative nurs- es with respiratory illnesses had been well-documented. Her own health history, the reported problems of fellow nurses and smoke evacuation legislation passed in Rhode Island and Colorado inspired Ms. Ulmer to begin working toward getting a similar law passed in Georgia. After pro- posing the initiative to Georgia Council Chair Pat Thornton in 2019, she was asked to chair the coun- cil's legislative committee. She and a small core group started contacting local legislators to seek support for smoke legislation. Their persistent efforts eventually resulted in gaining the support of Senator Gloria Butler. However, it would take a serendipitous encounter to make it happen. Senator Butler's annual fish fry was scheduled to take place in October 2019, and Ms. Ulmer made it a point to attend. She had been calling the senator's office so often to discuss smoke evacuation legisla- tion that her staff knew her by name. Still, her calls went unreturned. At the fish fry, Ms. Ulmer walked right up to Senator Butler. "I held out my hand and said, 'I'm Brenda Ulmer,' and she said, 'I know about you!' So she had gotten my messages!" Ms. Ulmer gave Senator Butler materials from AORN about smoke evacuation, which she held in her hand as she addressed the crowd. After the fish fry, though, Ms. Ulmer didn't hear from the senator, so she and the legislative committee continued contacting and meeting with other legislators in the Georgia Senate and House. The legislative commit- 2 2 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 2 1 POWERFUL ALLY Brenda Ulmer (right) and her team worked extensively with Georgia State Sen. Gloria Butler (left).