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Health science librarianship

An opportunity for nurses

Mages, Keith C. PhD, MLS, MSN, RN, AHIP

doi: 10.1097/01.NURSE.0000604716.12708.54
Feature: NEW HORIZONS
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Abstract: Health science librarianship may interest nurses inclined toward research, technology, and education. This article discusses the role of health science librarians as part of the clinical team.

For nurses with an interest in research, technology, and education, health librarianship could be a rewarding career option.

Keith C. Mages is the Norton M. Luger, MD, clinical medical librarian at the Samuel J. Wood Library at Weill Cornell Medical College in New York, N.Y.

The author has disclosed no financial relationships related to this article.

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TWENTY-FIRST CENTURY healthcare demands rapid, dependable access to evidence-based information. As clinical understanding of health, illness, and treatment continues to evolve, so has the technology these professionals rely on. Health science librarianship serves to connect clinicians and patients with high-quality, targeted healthcare information to enable clinical practice, enhance research and quality improvement projects, and empower patients.1 Nurses interested and proficient in research, technology, and education may find this path rewarding. This article discusses the role of health science librarians (HSLs) and offers an alternative career for eligible nurses.

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Librarianship as a second career

Among second-career HSLs, 40% were originally educated as nurses.2 Stress, heavy workloads, long hours, and dissatisfaction with managed care and documentation demands were cited by healthcare professionals as reasons for turning to librarianship. In one survey of second-career librarians with a background in healthcare, over 90% reported being either satisfied (29%) or very satisfied (62%) with the role.2 In a similar survey, those with a health science background cited their comprehension of medical vocabulary, knowledge of the inner workings of healthcare, and skill in interpreting data found in the literature as advantageous in easing their transition into librarianship.3

HSLs function in diverse roles across varying settings. Academic HSLs may liaise with nursing, medical, public health, or pharmacy departments, as well as with schools of nursing to assist with faculty research and student education. Hospital HSLs typically do more work with patients and practicing nurses and healthcare providers. Besides providing traditional reference services in both settings, these professionals may teach evidence-based practices, provide instruction for citation management software, partner with organizations to achieve Magnet® status, serve on institutional review boards, or guide research teams through the systematic review process.

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Opportunity to specialize

More specialized roles often exist within health science librarianship. Due to their clinical knowledge and competence, nurses may find positions as clinical medical librarians (CMLs) or consumer health librarians (CHLs) intriguing. CMLs work primarily with healthcare teams, while CHLs provide information to patients, families, and the general public. (See Librarians in healthcare.)

The CML role was first established in 1971 at the University of Missouri at Kansas City.4 Tasked with supporting a new style of education that eschewed traditional classroom teaching in favor of bedside instruction, library director Gertrude Lamb, PhD, developed a novel model of librarianship to assist medical students at the point of care. Lamb envisioned librarians who attended morning reports and rounded alongside the healthcare staff. Physicians and nurses began asking patient-centered clinical questions, identifying an unmet need rooted in the rapid acquisition of relevant clinical information.5

Today, CMLs work closely with other healthcare professionals, typically embedded within specific teams or units. They search the literature to answer clinical questions in real time as patient care is being delivered.6 Like pharmacists, they may attend departmental morning reports, team huddles, and clinical and interdisciplinary rounds. The presence of a CML has been associated with an increase in the quality and quantity of clinical questions during inpatient rounding.6 Additional research suggests these professionals save time and have a positive effect on quality care, including diagnosis and drug therapy.7

CHLs represent a second specialized role in health science librarianship, which also evolved from observed, unmet needs. In 1969, Kaiser Permanente established one of the first patient health education libraries as a referral point for patient education on illness and disease.8 A combination of the increased prevalence of chronic diseases, the concept of informed consent, and the introduction of the Patient's Bill of Rights by the American Hospital Association enhanced the perceived value of patient education in healthcare during the 1970s.9

In the following decades, similar patient-focused libraries opened in healthcare institutions across the US. In 1996, the Medical Library Association issued a policy statement defining and clarifying the role and expectations of CHLs in patient education, collection management, resource sharing, patient advocacy, research, and access to and dissemination of information.10

Today, CHLs work with patients and their families on many fronts. While many organizations maintain physical space for patient libraries, the quantity of web-based health information has exploded over the past decade. As such, printed and audiovisual materials have been replaced in large part by digital resources. CHLs educate users on the identification and evaluation of credible online sources and help patients to understand their diagnosis and navigate treatment options.11

CHLs do not typically educate patients on diseases or healthcare topics, however; instead, they help patients acquire understandable, reliable information for self-learning and further discussion with the clinical team. They may also assist with access, enrollment, usage, and interpretation of their personal information in the electronic health record (EHR).12 Additionally, CHLs have taken a lead role in patient health literacy efforts, hosting seminars, participating on institutional task forces, and educating on best practices in the development of patient education materials.13

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Qualifications

Careers in librarianship typically require a master's degree in library and information science. Programs vary in length, but most take approximately 2 years of full-time graduate work to complete. Many offer both in-person and online coursework, as well as part-time options. Accreditation is an important benchmark to ensure quality education, and many employers require graduation from an American Library Association-accredited program.14

Typically, foundational library science coursework includes an overview of the role of librarians and library management, as well as information on resource selection, evaluation, and methods. Aside from concentrations in health science librarianship, elective courses are also encouraged on such topics as archives and records management, school library media studies, and digital libraries and online media. Most programs offer credit for practicums and hands-on professional experience at local and regional libraries, similar to clinical rotations in nursing school.

Master's programs vary widely in curricula, so nurses considering a career in health science librarianship should evaluate the coursework carefully. Practicing as an HSL requires a working knowledge of anatomy and physiology, medical terminology, epidemiology, and evidence-based practices. Nurses who choose to pursue this career path will find their prior education and skill sets invaluable. Those interested in an HSL role, particularly in clinical or consumer health settings, will benefit from self-confidence, perseverance, and an inquisitive personality.15

Aspiring CHLs may wish to explore the consumer health information specialization (CHIS). CHIS credentials consist of a two-tiered training method, which requires 12 contact hours in both selected consumer health and patient education core competencies. These include evaluation of health information, knowledge of the health consumer, health literacy, and ethical and legal issues.16

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HSLs in practice

Typically, HSL roles are highly localized to meet individual administrative and clinical cultures. Although often conceptualized as occupying distinct spaces within health science librarianship, the boundaries between CMLs and CHLs may blur in practice depending to the needs of the institution, with daily duties and expectations fluctuating accordingly. For example, CMLs may provide information directly to patients during rounds, and CHLs may occasionally consult with healthcare professionals regarding the most understandable, up-to-date patient-care literature available.

The overlapping roles and responsibilities of these professionals offer a glimpse into the realities of health science librarianship. For example, a team of CMLs at the Samuel J. Wood library serve the information needs of Weill Cornell Medicine, New York Presbyterian Hospital, and the Myra Mahon patient resource center.17,18 The weekly activities of the CML team at the Samuel J. Wood library include the following:

  • Morning reports: CMLs note pertinent patient information, record unanswered questions, and provide digital copies of any articles referenced during discussion. Afterward, they consult with the chief medical resident and investigate any lingering questions. They search and appraise the literature, delivering a synopsis of the highest-quality resources and any findings.
  • Family-centered rounds: CMLs attend rounds on the pediatric floor along with medical students, residents, the attending physician, and the clinical pharmacist. During bedside discussions, they note any basic questions from families about their loved one's diagnosis and offer to provide them with the appropriate literature. After rounds, the attending physician may ask CMLs to investigate outcomes for specific treatments or therapies. CMLs complete any requested searches, email their findings to the clinical team, and return to the floor to discuss pertinent education materials with patients and families. All consumer health information provided is documented in the EHR.
  • Patient-focused lectures: CMLs facilitate patient-centered lectures, assist with registration, liaise with guest speakers regarding any computer and audiovisual needs, provide a formal introduction, and moderate any closing question-and-answer sessions.
  • Nursing research council: Once a month, CMLs guide nursing units as they develop quality improvement projects and evidence-based practices by offering input on the feasibility of research topics, recommended content and structure, and important resources.
  • Pediatric ICU (PICU) family consultation: At the request of an attending physician, CMLs may meet with families of patients recently admitted to the PICU. They work to understand any questions or concerns, recommend reliable resources, and establish a dialog for continued information sharing as treatment progresses. All suggested resources are noted in the EHR and relayed to the healthcare provider to keep the clinical staff abreast of any information provided.
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Satisfying career option

In the digital age, health science librarianship is crucial to healthcare teams and organizations. It not only helps to provide accurate and reliable information to healthcare professionals, patients, and families alike, but it also does so in an individualized and efficient manner. Because the examples and scenarios included above represent only a portion of the available opportunities, nurses interested in becoming an HSL may benefit from further research into this satisfying career option.

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Librarians in healthcare1,6,11

HSLs connect clinicians and patients with healthcare information to enhance clinical practice, research, quality improvement projects, and patient outcomes. These include:

  • CMLs, who typically work with other healthcare professionals directly and address clinical questions in real time
  • CHLs, who typically work with patients and their families directly, educating users on online resources to understand and navigate diagnoses and treatments.
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REFERENCES

1. Sollenberger JF, Holloway RG Jr. The evolving role and value of libraries and librarians in health care. JAMA. 2013;310(12):1231–1232.
2. Fikar CR, Corral OL. Non-librarian health professionals becoming librarians and information specialists: results of an Internet survey. Bull Med Libr Assoc. 2001;89(1):59–67.
3. Raszewski R. A survey of librarians with a health sciences background. J Med Libr Assoc. 2011;99(4):304–306.
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5. Brodman E. Oral History Committee Interview with Gertrude Lamb. Chicago, IL: Medical Library Association; 1985.
6. Brian R, Orlov N, Werner D, Martin SK, Arora VM, Alkureishi M. Evaluating the impact of clinical librarians on clinical questions during inpatient rounds. J Med Libr Assoc. 2018;106(2):175–183.
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14. American Library Association. Directory of ALA-accredited and candidate programs in library and information studies. 1996-2019. http://www.ala.org/educationcareers/accreditedprograms/directory.
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16. Medical Library Association. Consumer health information specialization. 2019. http://www.mlanet.org/page/chis.
17. Weill Cornell Medicine. Samuel J. Wood library. 2019. https://library.weill.cornell.edu.
18. Weill Cornell Medicine. Myra Mahon patient resource center. 2019. https://weillcornell.org/health-resources/myra-mahon-patient-resource-center.
Keywords:

clinical medical librarian; CML; consumer health librarian; CHL; health science librarian; health science librarianship; HSL

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