Article from the Boston Globe’s On Call Magazine, September 2001

By Helen Osborne, M.Ed., OTR/L
President of Health Literacy Consulting

Whenever you begin a new project, one of the first places you should go is a medical library. Regardless of whether you want to learn about a new clinical intervention, find out about the latest trend in quality assurance, or prepare for a presentation, the medical library invariably has the information you need to get started.

Ellen Fulton, RN, MLS-AHIP is the medical librarian at the Deaconess Waltham Hospital. She brings a rare combination of skills to this position, with degrees in both nursing and library science. As a nurse, Fulton understands the type of information that health professionals need. As a medical librarian, she knows how to help health professionals gain access to that information.

For example, a nurse educator was preparing to teach nursing assistants about fall prevention with patients who have dementia. She asked the medical librarian to help her find relevant journal articles and guidelines of accepted practice. The librarian first searched the medical and nursing literature and retrieved more than 200 journal citations from which she selected twenty-five recent major articles. She didn’t stop there, however. The librarian also searched the Internet for additional resources and found seventy-seven guidelines of standard practice as well as videotapes the nurse could use in her teaching.

Some, but not all, of these resources were available at no charge. Mindful of the budget, the librarian contacted public and medical library networks and found out where the nurse could borrow most of the necessary materials. Ultimately, the librarian found all the information at a price the nurse said she could afford. Now when the nurse speaks to groups of health professionals, she always advises, “First thing, get to know your medical librarian.”

Good Advice Is Worth Taking

Take that nurse’s advice. Get familiar with your medical library and work with the librarian to find information you need. Here are some ways to get started:

Find a medical library you can use. There are medical libraries at most hospitals across Massachusetts. If you work in healthcare, find out what your facility offers for services. Find out if there is a digital library you can access from your computer at work or home. Many colleges and universities also have extensive collections of health-related information. Health professionals who do not have access to a medical library can register with “Loansome Doc,” a program offered through the National Library of Medicine. This program connects health professionals with a regional medical library where they can receive full-text copies of journal articles. In Massachusetts, the regional medical library is at the University of Massachusetts Medical School in Worcester. For more information about Loansome Doc, call (800) 338-7657.

Don’t be timid about asking the medical librarian for help. Whether you meet the librarian face-to-face or communicate by e-mail, telephone, or the fax machine, feel free to ask for help when researching a topic. Librarians often get asked the same questions about a topic and so build up a fund of knowledge they can call upon as needed. This means that sometimes librarians will help you locate relevant information that you didn’t even ask for. They may even continue sending you new articles about your topic as they are published.

Get help to learn how to use selected databases to search for information. Ask your medical librarian to help you access the right database for the kind of information you need. Start by asking for help to use any of the following:

• CINAHL (Cumulative Index to Nursing and Allied Health Literature) is widely considered to be the premiere searching database for nursing and allied health information with an index of more than 1,200 journals. If CINAHL is not offered by your employer, check out subscription access at www.cinahl.com.
• MEDLINE indexes about 4,000 biomedical journals. MEDLINE is sponsored by the National Library of Medicine and is available for free via PubMed at www.nlm.nih.gov.
• The National Guideline Clearinghouse(www.guidelines.gov) is also a great place to search for clinical practice guidelines.

Fulton recommends that health professionals expand their literature searches beyond the latest books and journals. “Knowledge is built up over the years,” says Fulton. “Don’t dismiss information just because it was published a few years ago.”

Allow sufficient time to look for information. While you can sometimes find the information you need in just a few minutes, most likely it will take longer than that. A search which produces just ten relevant articles, for example, may often take an hour or more. When you ask a librarian to help you in a thorough search of the literature and to obtain articles, Fulton recommends that you allow a lead time of at least two to three weeks.

Be prepared to pay for some materials. If you are not affiliated with an institution which absorbs borrowing costs on your behalf, ask a librarian to help you obtain these resources at the lowest cost possible, perhaps through the interlibrary loan service at your public library.

Another Professional Path

Ellen Fulton is enthusiastic about being a medical librarian. She sees her role as an “information intermediary,” helping health professionals, patients, and families make connections to the medical information they need. She feels that that her nursing background provides her with an invaluable frame of reference that she draws on every day.

Fulton sees a growing demand for librarians who have medical backgrounds, and encourages fellow health professionals to consider this as a career option. “There’s a lot of job satisfaction in being a hospital librarian,” she says. “People are always saying thank you.”

How to Find Out More

To learn more about medical libraries and professional opportunities, use the following resources:

Ellen Fulton, RN, MLS-AHIP, is the medical librarian at the Deaconess Waltham Hospital. She is credentialed through the National Library of Medicine’s Academy of Health Information Professionals and is a member of Phi Beta Mu, an international honor society for librarians. You can contact Fulton by e-mail at: efulton@caregroup.harvard.edu

Publications

• Brazier, H, Begley, CM.  “Selecting a database for literature searches in nursing: MEDLINE or CINAHL?” J Adv Nurs. 1996 24(4): 868-75.
• Fulton E. “Shhh! Nurse on duty in the medical library.” Nursing Spectrum. April 20, 1998.
• Modrcin,-McCarthy, AM, McGuire, S, King, A. “Perioperative nurses’ guide to the library” AORN Journal. March 1997, Vol. 65, No. 3: 605-613.

Web Resources

• Simmons College, Graduate School of Library and Information Science: glis@simmons.edu
• CINAHLdirect database: www.CINAHL.com
• MEDLINE/PubMed (Offered free through the National Library of Medicine): www.nlm.nih.gov
• National Guidelines Clearinghouse: www.guidelines.gov
• Medical Library Association, an association of health information professionals: www.mlanet.org/career//index.html