Thank You, My Nurse Colleagues

Writing these blog posts gives me a chance to showcase some of the great work done by our team at NLM, and reflect on the roles I play as part of the NIH leadership team, Director of the National Library of Medicine, a mother-daughter-sister-aunt-friend, and an advocate for self-care management education and support for all people. Yet, nothing compares to the opportunity that this blog gives me to reflect on my chosen profession, nursing.

This year for National Nurses Day, I want to acknowledge the enormous contributions made by all health care professionals in response to the COVID-19 pandemic, particularly by the nurses and members of nursing care teams. I want to express my sorrow and deepest sympathies to the friends, families, and co-workers of nurses who faced health issues or died from work-acquired COVID-19 infections. I am grateful to front line care providers, ranging from nursing home aides to emergency department staff, particularly the nurses whose creative problem solving and attention to complex patient needs helped so many over the past year.

Nurses are well known for their ability to innovate—finding just the right way to make one patient more comfortable or address the respiratory distress of another. The perplexities brought about by the unfamiliarity of the coronavirus infection required innovation at warp speed in nursing units across the country.

I thank you, my nurse colleagues, for what you did over this past year and what you continue to do in the face of tremendous personal risk and self-sacrifice. May your accomplishments give you the strength you need to continue, and your contributions be acknowledged and treasured by those for whom you care.

For my part, I’m not on the front line physically, but the role NLM played this past year was focused on finding ways to support people who are on the front lines of this pandemic. Whether it was providing patient-specific COVID-19 information through our MedlinePlus Connect service, or expanding access to and making available coronavirus-related journal articles to support evidence based practice approaches, NLM has been here for YOU!

We collaborated with publishers to drop paywalls, so that the literature could be available to anyone who needed it. We accelerated processing of genomic sequences to speed up the process of tracking variants and identifying new drug targets. Our team at NLM helped mount the NIH’s response to the COVID pandemic with new research programs, particularly designing advanced data systems to make sure we learn as much from this experience to prepare for the next. While literature cannot provide the comfort of a hug, it can provide ideas that can aid in supporting someone through the process of grief.

My thoughts turn to my nurse colleagues who have witnessed so much death this year—among your patients, co-workers, and communities at large. I extend my wishes for resilience and comfort. I can offer little, but the acknowledgement that your experience of COVID-19 was so different from mine, and the assurance that NLM’s programs of research and offerings of significant literature resources will continue to make available the information needed for practice, and the learning that comes from practice.

In April 2020, as the pandemic was emerging, our colleagues from the United Kingdom offered some helpful hints in this Journal of Clinical Nursing article, one of the freely accessible articles made available through NLM’s Public Health Emergency COVID-19 Initiative. The authors encouraged nurses to address their own psychological and safety needs through peer and team support. This includes looking after each other’s well-being and encouraging temporary and long-standing teams to check-in on each other—particularly at the beginning of a shift, where such contact can activate a sense of social support. The authors also exhort that the stress response to staffing shortages, a sense of futility, and unrelenting grief is normal and will resolve – and yet each person responds differently, so make sure you check in with yourself!

For every one of you who greets each workday with the worry of exposing your family to COVID-19 or putting yourself in harm’s way, I thank you for persisting, and for what you are doing for patients. I trust that the next few months will be a time for resetting your practice to something that is manageable and less fraught with risks.

As we celebrate Nurses Day, we do so with sadness arising from the strains experienced by our profession over the past year, the loss from too many deaths, and the exuberance of the enduring strength of nursing! My hope for Nurses Day 2022 is that our common paths lead to a healthier, safer world. 

Please let me know how NLM can join you on this journey.

Learning from my Irish Heritage

Today is the Christian Feast of Saint Patrick, one of Ireland’s patron saints who lived during the fifth century. Celebrated today around the world as St. Patrick’s Day, this observance has evolved into a celebration of Irish culture and is a day of fun and family for those who are Irish or wish they were! As one of the 70 to 80 million people around the world who claim Irish roots, this celebration offers a chance for me to reflect on my own Irish heritage and what I have learned from it. And as those who have read this blog before know, family is of preeminent importance to me as a source of joy, strength, and comfort — all of which I have drawn on throughout my life.

Ireland is best known for its music and mythology, sports, scholars, and, most relevant to me, deep allegiance to kin groups. I can’t claim any skill on the feadan (tin whistle) or the cláirseach (the 30 string harp), although I enjoy a céilí (a celebration), and I do have some familiarity with the mythology, particularly the Morrígan, the Celtic triple war goddess of old, Queen Maeve, the strong-willed, ambitious, and fearless legend, and the warrior queens of the North. In terms of sports, I’ve learned enough to enjoy a hurling match and can follow Gaelic football. Ireland is known as ‘the land of saints and scholars,’ and my Irish heritage has provided me with a genuine and deep-seated love of learning that has been integral in my life.

Valuing my Irish heritage means also looking clearly at what makes Ireland what it is today.

The response to oppression gave rise to nationalism and a drive to be an independent sovereign state, leading to independence in 1921 (only 100 years ago!) and militance with sometimes tragic results advanced in the name of freedom. The Good Friday Agreement of 1998 brought about the end to one kind of violence. The Good Friday Agreement brought a measure of quietude to the challenges of expressing different views, yet more than twenty years later, differences still persist. And the recent investigations into mother and baby homes engendered an awareness of the need for the apologies to survivors of this awful period in Irish history.

Some believe the “Irish temperament” is a mixture of stubbornness, personal warmth, and a wit that shines through adversity. I certainly hope I have all three of these, perhaps a bit more of the latter two than the first. However, having a bit of stubbornness is important, particularly as the director of NLM, which serves as NIH’s center for biomedical informatics research and the world’s largest biomedical library. Being stubborn, coupled with warmth and wit, has helped me guide the NLM as it approaches its 3rd century in existence. It has helped me serve as an advocate for the technical infrastructure necessary to secure our resources and to make them permanently available around the world. It has provided me with the tenacity needed to hold firm to the values of what libraries mean to society – institutions rooted in collecting and disseminating the literature of the world with integrity and without censorship.

What this means to NLM is that we must continue to hold to our enabling legislation of 1956, to acquire, preserve … materials pertinent to medicine and … make available… materials in the library. As Joyce Backus, our former Associate Director of Library Operations, was fond of saying, “science is self-correcting,” meaning that we don’t need to exclude materials that are no longer aligned with our global perspectives, but we do need to continue to gather and make available the full range of information.  

So, I hope you join in the celebration of all that is Irish on this St Patrick’s Day and remember that history is complex — and the purpose of libraries, including the National Library of Medicine, is to reflect the progress and perspectives across time, rather than a snapshot of a particular point in time.

How can we help you in this celebration?

Dismantling Structural Racism

NLM stands with NIH Director Francis Collins in establishing new ways to support diversity, equity, and inclusion, and identifying and dismantling any policies and practices that may harm our workforce and our science. This work is just getting started and I encourage you to respond to a Request for Information that NIH issued seeking input on the approaches NIH can take to advance this goal. Comments can be submitted through the submission website and must be received by April 9, 2021.

The NIH has long supported programs to improve the diversity of the scientific workforce. Yet those efforts have not been sufficient to achieve racial equity across the biomedical research enterprise. This month, NIH launched an effort to end structural racism in biomedical research through a new initiative called UNITE. UNITE is an acronym that reflects the multidimensional approach that NIH is taking to address this complex problem.

UNITE:

  • Understanding stakeholder experiences through listening and learning
  • New research on health disparities, minority health, and health equity
  • Improving the NIH culture and structure for equity, inclusion and excellence
  • Transparency, communication, and accountability with our internal and external stakeholders
  • Extramural research ecosystem: changing policy, culture and structure to promote workforce diversity

NLM is committed to improve diversity, equity, and inclusion with regard to structural racism and all aspects that make us who we are and take into account from where we came. We are grounded in the belief that advancing diversity, equity, and inclusion improves the quality of science and engenders more robust knowledge representations and more culturally-competent means of supporting investigations and delivering health information.

Through our intramural research and extramural programs, we are supporting research to identify and mitigate bias in data sets and analytic tools, and enhancing the diversity of young scholars preparing to enter the fields of biomedical informatics, computational health, and data science.

In addition to actively participating in NIH-wide diversity, equity, and inclusion efforts, we are turning to the NLM staff to garner ideas about how NLM should specifically create an environment that promotes diversity and inclusion within our Institute. Last week, more than 150 people attended a special conversation between NLM staff and leadership where we learned many things and shared ideas ranging from improving recruitment to understanding implicit bias.

The NLM leadership has taken up the challenge and will work with our creative staff to set a path forward to promote inclusive excellence, and create a workplace that is diverse, inclusive, equitable, and respectful of the talents of everyone.

NLM is committed to supporting NIH in identifying and dismantling any policies and practices that may harm our workforce, our science, and society at large. This is just the beginning of our journey to improve the NIH and everyone’s health by ending structural racism in biomedical research. 

I invite you to join us in this journey too.

Vaccines, Vaccinations, and NLM

As I write this message, I am one of the more than 25 million people in the U.S. who have received both doses of the coronavirus vaccine. I received my first dose of the Pfizer vaccine on February 4, and my second dose on February 25. NIH is distributing vaccines to employees based on priority group following general guidance from the CDC, but I became eligible first through my health plan. I’m sharing my story with you today and highlighting how the NLM has and still plays a role in vaccines and vaccinations during this time of the COVID pandemic.

Getting a spot in the COVID vaccine line will become one of the shared stories of this pandemic. As story tellers, we will likely exchange tales of how each of us got that prized place, particularly for those of us who received the vaccine in the first few weeks of distribution.

Here’s my story: As a resident of Washington, DC, and someone who is over 65 years of age, I became eligible pretty early – January 11. At the time, DC released appointment slots through its public web site. What if you don’t have a computer, typing skills, or access to the internet? Can the public library help here? Of course! In addition to providing internet access and coaching support from library staff, some public libraries are becoming sites for the distribution of the COVID vaccine. Each Monday and every other Thursday, as more appointment slots were released, I dutifully logged into the DC vaccination registration website, entering details and hitting refresh. Unfortunately, the available slots ran out quickly with each attempt. It was indeed frustrating. Through my health plan, I was entered into a vaccine registration list. As an NIH employee, I got my name on a list too. I was probably number 15,543 at NIH since I am healthy and able to work remotely, but I became eligible through my health plan in late January and was spared the déjà vu of type, refresh, repeat!

NLM played a big role in helping get this vaccine to me and people around the world.

We played a key role in making sure the genomic basis for vaccines and therapeutics were freely available to the public. In January 2020, NLM released the first fully annotated SARS-CoV-2 gene sequence to the public through our GenBank database, the world’s largest database of publicly available genetic sequences. Because NLM maintains extensive data repositories of nucleic acid sequences – the building blocks of genes – researchers were able to search NLM’s entire Sequence Read Archive (SRA) to better understand and characterize the biological properties of SARS-CoV-2 in record time. 

NLM created a dedicated website, the Severe acute respiratory syndrome coronavirus 2 data hub, for researchers to search, retrieve, and analyze data for more than 150,000 digital genomic sequences of the virus. In addition, we partnered with publishers around the world to make available for computerized data mining the full text of over 100,000 articles related to the coronavirus, helping scientist to identify key biological targets. Our ClinicalTrials.gov repository includes over 400 studies designed to develop, evaluate, and determine the effects of various COVID-19 vaccines.

Screen shot of MedlinePlus COVID-19 webpage

Our MedlinePlus consumer health information site contains specialized information about COVID-19 vaccines, clinical studies, and the vaccine distribution process. MedlinePlus helps people find information (in English and Spanish) about the COVID-19 vaccination program in the United States, and is a resource where people can find reliable, up-to-date information about how to protect themselves and their loved ones against infection while awaiting the vaccine. Linking to health information from the NIH and other federal government agencies such as the FDA and CDC, MedlinePlus provides access to fact sheets, statistics and research, journal articles, and even videos to help people learn more about COVID-19 vaccines.

What makes NLM unique is not just that it contributed to the process that helped make vaccines available, it’s that NLM has been helping scientists, clinicians and the public understand, prevent, manage, and cope with infectious diseases and health problems for nearly 200 years.

To Prevent Influenza!, 1918
National Library of Medicine #101580385

NLM identifies, selects, and archives a remarkable volume of content documenting these pandemics, from the scientific journals to the public health announcements. We were here 100 years ago, preserving information about the 1918 influenza pandemic, and we’re on track to be here in 100 years when future scholars and members of the public want to peruse the records of the COVID-19 pandemic and other health challenges faced by society.

The NLM serves scientists and society by providing trusted health information to understand, prevent and treat illness in support of public health. How can we help you?

Nursing and Libraries – Powerful Forces in Motion

This month, NLM joins the Nation in celebrating Black History Month. Libraries play an important role in ensuring equity of access to information. From my career as a nurse, I know that libraries are important vehicles for delivering trusted information. To celebrate my dual allegiances to nursing and libraries, in this post, I am tuning into the voices of Black nurses to learn what libraries mean to them.

Black nurses have made huge contributions to the health and well-being of people and are foundational to the health care system as we know it today. Rhetaugh Dumas, PhD, RN, a psychiatric nurse and academic leader, once served as the deputy director of the NIH’s National Institutes of Mental health (1979-1981). Another psychiatric nurse, Chester A. Woffard, III, MSN, RN was a leading thinker in suicidology, particularly addressing the needs of nurses coping with suicide among colleagues. May L. Wykle, PhD, RN, devised critical intervention strategies for caregivers, with particular attention to self-care needs among minority elders. Loretta Sweet Jemmott, PhD, MSN, RN, is an expert in health promotion and created much of the evidence base for HIV risk-reduction interventions. I’ll bet every one of these nurses used (and still uses) the library often!

I asked some nurse colleagues to reflect on the role libraries have played in their professional and personal lives – and look what I learned!

Linda Burnes Bolton, DrPH, RN, FAAN | Senior Vice President and Chief Health Equity Officer | Cedars-Sinai Health System

Libraries have been my constant go-to place for knowledge and skills to support any task I took on. It was important to me to join a profession that would enable me to read, learn, and be of use to other humans — nursing was the answer to my prayers. Reading in the library and collecting journals from around the world was a way to learn about life, humans, and nurture my sense of purpose to be of use to others. Libraries are full of stories about human caring; they are a safe place to gain knowledge and to explore and imagine life’s possibilities. I treasure my memories of being in the aisles of public and private libraries in schools, after school, and now accessing the wise words and secrets held by libraries electronically.

Sheldon D. Fields, PhD, RN, CRNP, FNP-BC, AACRN, FAANP, FNAP, FAAN | Associate Dean for Equity and Inclusion Research Professor | The Pennsylvania State University College of Nursing

As a healthcare professional who is also a researcher, educator, and health policy specialist, I have leveraged the resources of the NLM many times. As an HIV prevention research scientist, I rely heavily on the biomedical literature databases such as PubMed to keep up to date on the research literature and for dissemination of my own work. As a nursing educator, the NLM training resources and courses on how to use various databases, as well as resources such as MedlinePlus and DailyMed for drug information have been most beneficial in my work with nursing students. The NLM supported National Information Center on Health Services Research and Health Care Technology is also a reliable source for all things health policy related. Having such reliable, up to date, and accessible resources from the NLM is critically important to all facets of my career. 

Paule V. Joseph, PhD, MS, FNP-BC, CTN-B, FAAN | Lasker Clinical Research Scholar Tenure Track Investigator | NIH Distinguished Scholar | Acting Chief, Section on Sensory Science and Metabolism Unit (SenSMet) | Division of Intramural Clinical and Biological Research (DICBR), National Institute on Alcohol Abuse and Alcoholism (NIAAA) | Biobehavioral Branch, National Institute of Nursing Research (NINR)

During my PhD program, I realized how critical the library and librarians were in my scientific journey. The librarian at the UPenn Biomedical Library — who was also a nurse — played a crucial role in my PhD trajectory. It was the first time I had met a nurse who was also a librarian, and her intimate knowledge of nursing and the scientific literature helped me a lot. In my role as Principal Investigator, the librarians at NIH have been integral to the development of my lab as I have developed my clinical protocols and conducted literature searches for systematic reviews and meta-analysis. I have even co-authored papers with them. In addition, they are always available to train and share new tools to streamline the research process. The librarians have been very helpful in teaching the fellows and students in my lab about databases and guidelines to conducting reviews. When COVID-19 started and reports about COVID’s toll on taste and smell began to emerge, the NIH librarian (who knew what my lab studied) reached out and helped us tremendously by curating the literature on that topic. I am still using those resources as I develop a COVID-19 taste and smell long-hauler study.

Beverly Malone, PhD, RN, FAAN | President and CEO | National League for Nursing

As a nurse working on my doctorate, I had the opportunity to spend a summer in Washington, DC working with a Senator on many health-related issues. During that time, the Library of Congress became my refuge as I worked on my dissertation section on leadership and mentoring. Resources from the Congressional Library helped me understand the power of mentoring and recognize that nurses were sometimes left behind in terms of the mentoring process. Throughout my career, I’ve been inspired by the graciousness and generosity of spirit in people saying, “I see something in you that perhaps you can’t see in yourself.” But I know that I have been able to recognize this through what I learned at that beautiful, wonderful place called the Congressional Library. The library is where the literature revealed secrets to say, “Look at how fortunate you are to have been mentored all of your life.”

Monique Powell, MSN, RN | Nurse Manager, Cardiac Intensive Care Unit | Children’s National Medical Center

I think back on my freshman year at Howard University and one of the most memorable moments occurred in the Founders Library. I remember the first time I walked through the doors I felt this incredible sense of belonging and history. The library was named Founders in honor of the 17 men that help to found Howard University. This building holds an incredible collection of history for African Americans, and I felt privileged to be able to sit down at the tables and walk through the stacks of books. I had an assignment to research how the African American community has interacted with the medical community. As I researched this topic and used the microfiche machine to view documents, papers, and letters, I remember feeling that I had access to history in a way that I never had before. I remember coming across a personal check signed by Ruby Dee and Ozzy Davis sent to the Howard University School of Medicine to support the students — a piece of history that still moves me so many years later. My experience that day has stayed with me and encourages me to continue the work I am doing in health care and for my community. I am a proud graduate of an Historically Black College and University and feel honored to be able to serve my community as a nurse.

Asia L. Reed MSN, RN, CPN | Professional Development Specialist | Nursing Education and Professional Development | Children’s National Medical Center

The library has helped shape my educational destiny in so many ways. I have appreciated the academic library both online and in-person throughout my undergraduate and graduate nursing programs. The library offers free educational resources, caters to specific research needs, provides space for meeting with others, and supports personal and professional growth. Having recently graduated with my master’s degree in nursing education, the library contributed to my success by providing access to a variety of education resources and online databases that supported my needs. The articles I chose were directed toward my learning styles, which had a positive impact on my academic achievements. As a novice nurse educator, the library continues to play an important resource in my career path and for my pediatric nurse residents.

Reneè Roberts-Turner, DHA, MSN, RN, NE-BC, CPHQ | Director, The Department of Nursing Science, Professional Practice, and Quality Magnet® Program Director | Children’s National Hospital | Assistant Professor of Pediatrics | The George Washington University School of Medicine and Health Sciences

What I always loved most about being in the library is the quiet and calm I felt as soon as I walked through the doors. During my senior year of college, my mentor (who was an employee within the University of Virginia Wise Library) heavily influenced my decision to use my bachelor’s degree in Biology to pursue Nursing instead of medicine. I spent many hours reading about healthcare careers, in various books and journals, reading articles using the microfiche machine, and concluded Nursing was the profession for me. I also spent a significant amount of my time at Marymount University’s Emerson G. Reinsch Library, where I was introduced to the Washington Research Library Consortium and benefitted from the ability to borrow materials from other academic libraries in the Washington, DC area. As I pursued my doctoral degree via online classes, I felt the same satisfaction with the electronic library format. Although I’m not physically in the library, whenever I log on to the electronic library, I still feel a sense of quiet calmness.

Linda D. Scott, PhD, RN, NEA-BC, FNAP, FAAN | Dean and Professor | University of Wisconsin-Madison School of Nursing

Those who knew me as a child can attest that I always wanted to be a nurse. My earliest professional inspiration was Florence Nightingale, whom I mimicked as I provided nursing care to my dolls and even tried to replicate her uniform by wearing a blanket that served as a cape. My information came from books through my neighborhood Bookmobile. An astute Bookmobile librarian noted my hunger for learning and encouraged me to explore more about nursing at the public library. That’s where I learned a more complete history about the nursing profession and discovered a wider representation of nurses, including some who looked like me. Learning about Mary Eliza Mahoney and Mary Elizabeth Carnegie, and later Hattie Bessent and Rhetaugh Dumas—along with other nurses of color whose footprints are evident in the profession—turned my emulation of the nurses I admired into a belief in the possibility for myself. Library resources have not only been invaluable to me throughout my education and career, but they helped me see myself on the “path we tread.”

Ora Strickland, PhD, RN, FAAN | Dean and Professor | Nicole Wertheim College of Nursing & Health Sciences | Florida International University

I remember my parent’s library. It had encyclopedias, short stories, poems, and even medical books. Whenever any of us got sick, my mother would run to her medical books, and I took notice. All those books piqued my interest in becoming a nurse. Throughout my career, I’ve found that university libraries serve nurses very well because the librarians are good. I’ve been fortunate to frequent university libraries where librarians collaborate with the schools of nursing to set up library committees to review the library holdings in health care and related fields to make sure that their holdings are adequate and address the needs of nursing students. One library I have visited often throughout my career is NLM. I’d spend hours and hours at NLM; it’s a wonderful place. I also met some real scholars when I was at NLM. That’s what I miss most with the rise of the internet – because a library is also a community meeting place. It’s a place to meet other wonderful scholars and some of those scholars can end up being collaborators.

Retired Rear Admiral Sylvia Trent-Adams, PhD, RN, FAAN | Senior Vice President and Chief Strategy Officer | University of North Texas Health Science Center at Fort Worth

During my graduate education, particularly my doctoral program, libraries became my lifeline and my “go-to” place to help me problem solve and find resources that I couldn’t identify myself. Librarians gave me ideas that I hadn’t thought of and became my alternate support system outside of my department – and outside of my profession. Libraries have been very integrated into all the work I’ve done and the positions I’ve held throughout my career. Librarians deserve a lot of credit for my academic and professional success.

Mia Waldron, PhD, MSN-Ed, NPD-BC | Nurse Scientist, Nursing Science, Professional Practice & Quality | Children’s National Hospital | Assistant Professor of Pediatrics | George Washington University School of Medicine and Health Sciences

Libraries were a steady feature in my life. I spent childhood summers in the Brooklyn Public Library reading fiction; I worked as a clerk in the Cardozo Law Library as a teen; and decided on the sorority to join based on histories read at the Schomburg Library. The decision to change my college major from pre-medicine to nursing was made after poring over career data found in the health sciences library over 30 years ago. The importance of knowledge, as a nurse, has proven invaluable throughout my career. In most instances, my first instinct is to turn to a library.


What a journey! Libraries are shaping the future of nursing and health care, and these nurses give us a glimpse into how all libraries, including the NLM, resonate with the dreams of nurses and provide support and skills to move forward in practice.

I am grateful to my colleagues for sharing their perspectives, and so proud of what the merging of these two forces — nursing and libraries — bring to the health of the world!

How have libraries influenced you and your career?