by Kate W. Flewelling

A colleague recently dubbed me the “nomadic, geriatric librarian.”  At 32, I am hardly geriatric, but I do provide information support to those who treat our hospital’s oldest patients, and I leave my office (and the library) as often as possible.  I am mobile, and busy clinicians and students need me to be where they are.

At my institution, an academic medical center, the “ACE Team” (Acute Care for the Elderly) meets once a day in a hospital conference room (geriatrics patients can be on any service–cardiology, neurology, medicine–making bedside rounds impractical).  ACE Team members include an attending physician, a post-residency fellow, a nurse practitioner or physician assistant, a pharmacist and residents/medical students on two week geriatrics rotations.   As cases are presented, I listen for clinical information needs.  Often, attendees will have additional literature search requests or a request for “one good article on….” or “clinical practice guidelines for….”  If I think a question can be answered in less than five minutes, I look it up on the spot on an iPad (I have also used an iPod Touch).  Other questions are taken back to the library for prompt response.

Schedule permitting, I have been attending rounds twice a week since October 2010.  In that short time, I have been accepted wholeheartedly into the ACE Team, including being invited to the division’s holiday potluck.  I send welcome emails to residents and medical students as they start their rotation.  The welcome emails contain a link to a reading list on RefShare that I created in consultation with the team.  I have received questions from all members of the team and have had in-office consultations with a number of them.

While I feel like I am providing a valuable service, I am constantly learning myself.  Going to rounds is like visiting another country whose language I can read but am not yet fluent.  I have a much richer understanding of the context in which clinicians work and am able to hear in real time their thought process.  I am a better librarian to all my health sciences professional patrons as a result.  I have also gained invaluable life lessons on what kind of “old age” I want for myself and family members.

Some advice for those who would like to start rounding:

• Ask for a meeting with the department chair to discuss how the library might better serve the department and mention rounding as an option.
• Before the meeting, do some reading on the specialty and current issues.  Attend the department’s grand rounds a few times.
• Become an expert on point-of-care databases, especially those with mobile versions.
• Be as mobile as you can with available technology.
• Be prepared to explain what you are doing there and the services you provide.
• Listen, listen, listen.

Kate W. Flewelling is Coordinator of Instruction at the  Upstate Medical University Health Sciences Library, Syracuse, NY.  Her email address is flewellk@upstate.edu.