If you’ve followed me for any length of time, you know that I’m a solo hospital librarian. You know that I do a lot of research, fill a lot of article requests, make a LOT of copies, and fulfill all the requirements it takes to run a library. Another hat I wear on certain days is that of clinical librarian.
But what is a clinical librarian?
In 1977 two librarians wrote about their brand new program, a clinical medical librarian program. The words that the authors used to describe the program so accurately describe what we do some 30 years later that a definition written by me is unnecessary:
“a medical librarian is assigned to an inpatient service and attends rounds and conferences with the patient-care team. The clinical librarian searches current medical literature for answers to questions relating to patient care and management and provides the clinicians on her assigned hospital service with relevant articles. The review of the actual journal article for its appropriateness sets the clinical librarian apart from a library service that provides a bibliography or a list of citations in response to a question.”
This is exactly what I do today, just with upgraded technology. Before the advent of mobile technology, the librarians would simply write questions and potential avenues for research down, and then answer them when they got back to their office. That would have driven me crazy – having a list of questions that needed to be answered right away but I had to wait!
Thank goodness for my iPad.
My iPad allows me to actually take the library with me on the floor, into the patient wards. I still take notes that will help me answer questions that require more research, but my iPad allows me to answer quick, clinical questions right away. Dosing information, potential complications and interactions for certain drugs, and symptoms of certain diseases are just a few of the things I can provide answers to right away. I love that I can find the answer, hand a doctor my iPad, and allow them to share the information with everyone. I think this is especially helpful because I use a number of resources to answer these sorts of questions, and by sharing the information on the screen, the residents can see what resource answered the question. It’s my way of teaching that google can’t solve everything. 🙂
My hospital is a teaching hospital (but not associated with a university) and twice a week I join one of our in-patient teaching teams. That team is made up of an attending physician, an upper level internal medicine resident, 3 interns, and a pharmacist. Sometimes PharmD students or residents, medical students, nurse practitioners, and social workers are also present depending on the needs and patient loads of the day.
Rounds typically start at a conference table, where the patient list is reviewed, and then the team heads to the floor. Rounds can take anywhere from 2-5 hours, so sometimes the table rounds are all I do. Because I’m by myself, my days are often simply too full to be out of the library for hours at a time. But when my schedule allows it, I follow the team, answering what questions I can, and writing down the ones that I require some digging. I participate in table rounds twice a week, and I try to spend some time rounding 3 or 4 times a month.
When I get back to my office, I sit down with the list of questions that I couldn’t answer and try to find an article, part of a book chapter, image, graph, etc that will provide a good, clinical answer. If the question is say, using anticoagulants to prevent a heart attack or stroke in someone who has already had a stroke, I will send the latest practice guidelines on stroke, but make sure that I point out what part of the guideline will answer the question. With this being a teaching service, I take any opportunity to get the residents to read the most relevant literature. Once I answer all the questions, I send everything in an email.
Participating in the clinical side of things is what I consider to be the most important part of my job. It is also one of the few opportunities I get to see my work actually help a patient. It’s a great feeling knowing that the small piece of information you provided helped the team better treat a patient.
Acari R, Lamb G. The librarian in clinical care. Hosp Med Staf. 1977. Dec. 6(12):18–23.