Elisabeth Marrapodi, Trinitas Regional Medical Center 
Heidi Sue Adams, Logan Health 

Editor’s note: The health sciences librarians and healthcare professionals we work with are on the front lines responding to the COVID-19 pandemic. We are honored to be able to bring you some of their accounts about what those efforts look like. In this article, we hear from two librarians we originally profiled toward the end of 2020.  

Originally published in the BMJ Insider’s newsletter in March 2021, this article is under copyright and used with the permission of BMJ. 

“I think the library proved its resiliency.” 

During the Summer of 2020, we spoke with a few hospital librarians about how COVID-19 was affecting their library and how they were adapting to the “new normal.” One year later — and more than 18 months into the pandemic — we followed up with two of these librarians to see how they are continuing to meet the various challenges and stay positive. 

Elisabeth Marrapodi, BA 

Library Director 
Trinitas Regional Medical Center, New Jersey 

 
Read the original profile 

Q & A 

Last year, you mentioned that the activity level in the library had significantly reduced. Is that still the case, and how does your library continue to adapt to meet the changing needs of students, residents, and hospital staff? 

 
Elisabeth: There are certain events we experience in our lifetimes that we vividly remember. For me, it was the Beatles appearing on the Ed Sullivan Show, the moon landing, the assassination of President 

Kennedy, the Challenger explosion, September 11th, and more recently, the COVID-19 global pandemic. 

Professionally, the pandemic has definitely made an impact. In the beginning, after lockdown was declared in my state by the governor in mid-March 2020, my library quickly felt the effect of this decision. Our medical students were recalled by their schools and the residents and attendings who normally used the library on a daily basis became engaged with our ever-increasing load of COVID-19 patients. 

After that initial shock to the system, it only took a very short time to settle into a “new normal” level of activity. While our medical students didn’t return for almost a year, clinical staff soon filled the library seats again — well, every other seat, that is. Social distancing requirements and room capacity limits were strictly enforced until recently. 

Everyone has successfully adapted to this new pattern of living and working over the past 18 months. New standards of operation have blended into the old ways and our library has not only survived but thrived. Our activity levels have basically returned to pre-pandemic days. 

One of the first positive signs of a reset to quasi-normalcy was last Spring when the medical students returned. Around that time, teaching rounds also resumed in the library. After the vaccine became available, we were able to reverse some of the drastic changes from the early pandemic days. We know that things can change at any given moment with this pandemic, but for now, we are able to relax some of our guidelines. 

Do you think any of the changes made to the library — in response to the crisis — may become permanent? 

 
Elisabeth: All the computer stations are once again available and restrictions on social distancing and patron limits have also been lifted. That said, there are a few remnants left to remind us that we are still living in a pandemic era. With the emergence of the Delta variant and increasing case numbers, the universal masking rule has gone back into effect at the hospital. The plexiglass barriers remain up at the reference desk and study tables and hand sanitizer dispensers and wipes are abundant. These changes will most likely become permanent fixtures since patron feedback has indicated these things make them feel more comfortable. 

One of the most beneficial changes in the library was the migration of our large print collection to electronic format. Early in the pandemic, there was a sense of urgency to accomplish this task in order to accommodate patron needs and reduce high touch materials at the same time. This proved to be a huge project, but it was worth it since this resulted in high ROI with patron satisfaction. 

Attending to the information needs of our virtual patrons also continues. The virtual health COVID-19 information hub in Second Life (*access details below) has had a lot of activity and growth over the past year. To date, nearly 1,300 people have visited it. I recently co-presented at CogniCon held within Second Life with a neuro researcher about the effects of COVID-19 on the brain. It was well attended and, as a result, some attendees asked if a support group for long-haul COVID-19 survivors could use the information hub as a meeting place. Many hours have been dedicated to keep this site updated with the constant changes of the pandemic and subsequent government policies. 

You anticipated a budget reduction due to the shutdown of revenue-producing activities for the hospital. Was your library affected? 

 
Elisabeth: I’m happy to report this was not the case. I think the library proved its resiliency and ability to thrive by thinking out of the box during a novel crisis and I’m optimistic the library will remain a vital piece within the hospital’s teaching mission and remain adequately staffed and funded. In January 2022, we will be merging with a large, multihospital system so fingers crossed that we have proved our worth. I believe we have. 

Any new coping tips to share with your librarian colleagues during this – continued – uncertain time? 
 

Elisabeth: Keep smiling and if needed, reach out and don’t be afraid to seek support. Don’t forget to lean on friends, family, and colleagues, too. We are all in this together. I keep a note posted on my desk from Socrates that says, “The secret of change is to focus your energy, not on fighting the old, but on building the new.” I think that says it all during these uncertain times! 

Heidi Sue Adams, MS, AHIP(D), 

Lead Medical Librarian 
Logan Health, Montana 

 
Read the original profile 

Last year, you mentioned that transformation has been a constant at KRH. Has that slowed down at all? How has the library — and its services — been transformed because of COVID-19 and its variants? 
 

Heidi Sue: Yes, transformation is still a constant for our organization. With ongoing direction from our dynamic visionary CEO, the hospital has changed names; we are now Logan Health (previously Kalispell Regional Medical Center). 

Our small community has swelled exponentially with many new transplants to the area. It was reported in one local newspaper that over 30,000 people moved to this area in 2020. Not too far from us, in another part of Montana, a small airport has had more check-ins than LaGuardia airport, according to a United Airlines employee in the know. 

What used to be a quiet community where everyone knew everyone is now jam-packed all year long; we are rivaling cities with daily traffic snarls. Our community infrastructure is in dire need of expansion to handle this unprecedented, sustained growth. We previously were known as a tourist location with low-income wages. Now, those who make big city wages with the ability to work remotely subsequently have the amazing opportunity to live in a beautiful location, in what still feels like a small town to them, perhaps with a lower cost of living compared to their previous residence. We are experiencing housing shortages, labor shortages, and supply shortages. These situations affect the provision of healthcare.  

There is an underlying currency of frustration felt by many in our community; our values are changing with others bringing different values here, toppling the long-established small-town values. Those used to making an appointment to see their healthcare provider within a week are now having to wait several months. One physician wondered out loud: “Are there any new doctors moving here too?” 

Because of the influx of vastly different driving habits, along with the effects of our world’s events and changes, we are also experiencing high trauma volumes involving motor vehicle accidents and mental health exacerbation calls. 

We were noted as a CDC hot spot, and our hospital has been busy with a surge in positive COVID patients. We are also faced with staffing shortages as our highly regarded, long-term employees experience burnout.  

Our marketing department has made it possible for our employees and local media to learn our current COVID census combined with transparency regarding vaccination status. This information is available on our website and our social media channels as a solution for telling the story about the prevalence of COVID in our community. At the moment, the vast majority of our current COVID cases are in unvaccinated patients. 

As for the medical library, our PRN Medical Librarian was successfully hired and has been wonderfully handling our many literature search requests in the allotted time budgeted. Clinical requests have been steady. We are fielding many more requests relating to establishing telehealth services for various medical disciplines, updated COVID treatments and vaccination efficacies, and a variety of evidence-based nursing projects. Our one volunteer still has not returned, but there are plans to have more of the hospital’s volunteers return in late September. My temporary labor-intensive tasks of doing the hospital-wide mail rounds and transportation of surgery binders are now dwindling to a few days a week, instead of every day of the week including my days off. 

Soon, I will be able to dedicate my entire shift time attending to medical librarianship duties. I am overwhelmed with numerous emails and outstanding requests and have not checked my voicemail in several months. I’m operating in reactive mode instead of being proactive as preferred.  

There is a steady stream of new providers coming here to work with us. I am delighted to meet them in person for their orientation to the medical library and have already been cultivating new physician champions. We are trialing a new highly specialized online product for which I received a personalized, rave review from one of our long-established physicians. I am excited to make this a permanent addition to our collection of resources.  

Our name change also includes other facilities that are part of the Logan Health system, and we are the only medical library to service those locations. So, I am figuring out how to strategically centralize medical library services and resources for those additional facilities. Our budget planning season is soon arriving. There is a lot to do. 

You reported moving to a productivity reporting style, which has its challenges. Have you discovered any new ways to better tabulate your stats for non-library entities?  

 
Heidi Sue: Recently, on the hospital librarians list, there was a thread about productivity reporting. I’m very grateful to the librarian colleagues who have shared their templates and examples with me. I have not yet been able to delve into that material to revitalize the way we do our reporting. Our fiscal year starts in April, so I am hoping to accomplish a new way of reporting productivity before then. Sometimes I wish someone would just do this for me. I appreciate those vendors and librarian entrepreneurs who recognize a need and immediately take the time to provide a creative solution fulfilling that need. 

Any new coping tips to share with your librarian colleagues during this – continued – uncertain time? 
 

Heidi Sue: I still continue to do all the things I mentioned in the previous column, although not all of them every day, just when those moments of opportunity appear. Definitely at least three of those activities per day. Here are further suggestions: 

• Continue to prioritize those “feel-good activities.” 
• Seek creative ways to incorporate feel-good moments in your work environment. 
• I continue to intentionally improve and expand my repertoire of high-vibrational words and uplifting thought patterns. 
• I continue to practice my personal self-development techniques, even if it is only for five minutes that particular day. 

• Continue to gift yourself with nourishment 
• Nourish your appetite with healthy foods and abundant hydration. 
• I’m trying a new Ayurveda nutrition regime tailored for my body type, along with drinking coconut water, which I have never done before. 
• Nourish your body with salt baths, oil rubs, abundant sleep time. 
• Nourish your mental state with quality time with friends, family, colleagues, or a kind stranger. 

• I continue to share my unique gifts with others in nourishing their lives, which in turn nourishes mine. 
• I also continue to embrace quality time with a few precious friends and family, which nourishes my mental state. 
• I am attempting to incorporate more physical activity such as power walking a few times a week, and giving myself space and patience in incorporating a new lifestyle. 
• Most of all, find or create that one moment which you define as an Exquisite Moment each day! 

Yes, I have my moments of challenges…I continue to practice a combination of Ho’oponopono along with my own adapted techniques in forgiving myself for those moments when I’ve lost my cool. I also embrace the opportunity to be the one to help others “let go of their frustrations,” knowing that we are all still precious people underneath all this. 

*Second Life is open to anyone over 18 years of age. To visit the Health Hacienda, an SL viewer must first be downloaded in order to open the program. When that is completed, create a free basic account and choose an avatar. Once in-world, search the destination directory for the Health Hacienda located at Whole Brain Health and teleport: www.secondlife.com