In my previous library life I was a medical librarian for a community hospital. When I applied for that position I discovered that it was the perfect match for me at that time in my life. They needed/wanted to take that next step and get their library online and I wanted/needed experience in other areas of medical librarianship. Prior to that position I had worked at large medical institution where every librarian had a specific role. I needed to spread my wings and the position at the community hospital provided that opportunity.

I knew it wasn't going to be easy when I took the job. The library had a c-a-r-d catalog. Yes you read it right, a card catalog. Not an online catalog that we sometimes accidentally still refer to as a card catalog, but the good ol' fashion one where you flip through the actual cards. Nobody knew how to use it, the medical students and residents only exposure to one was through Pottery Barn. In addition to the card catalog, the library had only two online journals (NEJM and JAMA) through Ovid. There were no links to open access journals, and they had not even activated their online free with print paid subscription. The library's Intra and Internet sites were nonexistent.


However, I wasn't completely starting from scratch. They had a subscribed to a solid group of online databases and the administration was interested and enthusiastic with taking the library to the next level. I had an assistant who handled some of the day to day things like ILL, two good volunteers to do photocopying and shelving, and library school down the road that furnished me with students eager to do practicums.


Within the first year and a half I got a union online catalog up and running with three other affiliated hospitals. (Thank you to all of those library students who helped catalog the books.) I activated all of the online journals that came free with a print subscription. I created a very rudimentary A-Z online journal list on the library's Intranet page, it included the online journals as well as a few popular open access or embargoed titles. I also added our titles to PubMed's LinkOut. Gradually bought a few relatively cheap online journals. I entered into consortia agreements to help pay for online access to books and journals such as NEJM, JAMA, and AccessMedicine.

How did I pay for all of this? The first year I had no extra budget, I inherited a library budget already in place prior to being hired. So I had to get creative. I saved a lot in ILL costs by reworking the Docline tables to include the Freeshare libraries at the top. That saved enough money to offset the majority of the new online catalog. In the case of AccessMedicine, I decided not to buy some of the printed versions of the books that were also in the AccessMedicine collection. I actually saved money by dropping NEJM and JAMA from Ovid and joining a group of other libraries that purchased them from the publisher.

In the second year I looked at printed journal usage and bought a few slightly pricier online journals. (I realize the definitions of cheap and pricey are somewhat subject to the library and the budget.) My big accomplishment, I got a grant to fund the library's purchase of an A-Z product, a link resolver, and Athens off campus authentication system. The A-Z product opened up access to a whole slew of open access journal titles and it easily listed and maintained links to online journals I had purchased as well as those that were full text through our subscribed databases. The link resolver worked within PubMed and Ovid and patrons were able to easily access the full text or request an article using an ILL form (which came to the library assistant as an email). For the first time library users were able to access almost all of the hospital's library resources from off campus through the use of just one username and password. Athens made this possible. I know longer had to print out a large list of usernames and passwords to the various online resources and distribute it patrons.


In addition to the technological improvements I walked and talked my little butt off, singing the praises of what the library had and could do. I talked to just about anybody who would listen. I talked a lot with the IT department and the IT people, because a lot of what I was doing was new to them. I did in service trainings, I did one on one instructions, I gave mini lectures, and taught hands on library instruction classes. I pimped my library.


The beauty of it all was that I began to see real results. It came in many forms: The head of pharmacy told one of his colleagues that the journal list (A-Z) was like an all you can eat candy store. Doctors I had never seen before came into register to access resources from home using Athens. Somebody within the IT department told another colleague, "Oh yes, I know that Michelle, she is always doing something."

The results were also reflected in the online usage statistics. Administration loved getting this information. All of the anecdotal evidence was just the icing on the cake of statistics. In the first year we had approximately 800 full text downloads. The second year ended with over 1400 downloads, and the third year ended with over 3000 full text downloads. Some of the difference between the first and second year numbers could be attributed to the increase in online journal acquisition. But the library did not buy a whole lot of online titles within that time, less than 10. I would say that most of the usage could be attributed to making access much easier and more available.


At the end of my third year, I accepted a new librarian position at another institution. I loved what I was doing, but the new job was just too good to pass up. I felt confident though that I was leaving the library in good shape for the next librarian. There was still a lot of outreach to do and the print collection still needed a lot of weeding and adding to. But the heavy lifting of getting a library online was accomplished.


Despite leaving the library in good shape, I am sad to say that it has deteriorated significantly and I worry about its future. The librarian who replaced me did not even stay a whole year in the position. Perhaps she was a square peg and the library was a round hole, I don't know the entire details nor would I like to speculate. But one thing is for sure, without a knowledgeable librarian maintaining the electronic resources and promoting them, usage dropped for the first time. How do I know this? When the librarian left, my previous library asked that I help them out until they could find a replacement. I agreed. I had poured so much of my librarian soul into that library, that I felt I had an obligation to try help out until a replacement was found.


Working full time in another institution, I can only do so much to help. I am not on their IP ranges, I don't have access to the files, license agreements, etc. Really I can only serve as contact person for vendors and the library. I have noticed that things are breaking, linking is not always working, and off campus access is spotty for certain users and certain resources. I try and trouble shoot the problems to the best of my time and ability, but really the library needs a new full time tech savvy librarian to take the reigns. Worse yet I don't see this happening in the near future. They still have not posted the job and I fear that my sense of duty and helping has enabled them to stall the recruitment process.

Walking by the library you would never notice, people still go in the library and use it. But unlike printed books and journals sitting on the shelves, the slow decay of the online collection goes unnoticed by the regular outside world. If a link is broken or an online resource is mysteriously gone, it isn't as obvious as seeing bare shelves. However, the impact is just the same as if the material was missing from the shelves. Unavailable is unavailable.


The Duke Magazine Article, Brave New World, by Jacob Dagger said, some of the traditional methods of library collection, development, and education are changing and have changed with technology. Just because it can be found online by students doesn't mean that it is the best or right resource. I think that is especially true with medical resources. The people are accessing things online, the librarian needs to be at the forefront of this. Because if the library resources aren't available online, searchers are going to find it from another online resource which may or may not be a good one.

The online library is just as important as the physical library people see every day. Just like the physical collection it requires a certain amount of maintenance and work. Just because it is online doesn't mean that a library doesn't need a librarian anymore. Who works on the license agreement, sets up access, maintains access, fixes problems, enhances access, promotes access (nobody wants to pay money for something that isn't used), and works to get better resources online? A librarian. Just because librarians aren't seen stamping, shelving, and copying books doesn't mean they aren't doing their jobs. The role of the librarian has changed, it has become more of an online facilitator to information. The work is more behind the scenes and not immediately apparent. Just because people haven't heard of any problems regarding online access doesn't mean it is all free or easy, it just means librarians are doing their jobs and so that it appears easy and available. Just because people see the physical library doesn't mean that they see the entire amount of library resources.

The library is more than just the books on the shelves, unfortunately that still many people's perception. That can unhinge even the best of efforts, plans, and libraries.

Labels: Hospital Libraries