The Adventures of Library Heather

(Content warning: image of drug paraphernalia and mention of opioid overdose.)

In my research on how libraries promote health and wellness in their communities, I’ve encountered numerous stories about how libraries have become involved in combating the opioid crisis by offering training opportunities to staff in administering Narcan (a.k.a. naloxone), a drug that reverses the effects of opioid overdoses.

Yes, I’ve read a lot of stories on this topic. A lot.
Like this one from American Libraries.
And this one from the New York Times.
And this one from the Times Union in Albany.
And this one from Public Libraries Online.
And this one.
And this one.

In fact, the intersection of the opioid crisis and libraries has become so urgent that the Institute of Museum and Library Services (IMLS) has recently awarded a nearly $250,000 grant to OCLC, a global library cooperative based in Ohio, to help libraries and their partners respond to the opioid epidemic.

When I picture myself as a future librarian, I see myself answering reference questions, organizing community events, collaborating with other local organizations, and even doing more mundane tasks like preparing budgets or writing grants. I’m getting into the library profession because of my desire to serve the needs of the community, and I don’t think that everything is going to be sunshine and rainbows. I don’t imagine a sedate 9-5 job in hallowed hall of books. I am mentally prepared — ready and willing, in fact — to encounter issues relating to homelessness, poverty, and other difficult life circumstances that patrons may encounter.

But there’s something about the thought of dealing with opioid overdoses that kind-of terrifies me, and I’m not quite sure why. Maybe because it’s a life-or-death situation and “librarian” does not strike me as the sort of profession that deals in life-or-death situations. Maybe it’s because I’m inexperienced in dealing with drug-related issues. (I once helped someone locate a Narcotics Anonymous meeting and contact a rehab facility, but that’s the extend of my experience.) I’m usually pretty calm in a crisis, but I’ve never encountered a crisis involving an overdose before.

For whatever reason, the thought of future me having to administer naloxone (especially via injection) to an overdosing patron is nerve-wracking. This is not something you’re prepared for in library school. What if I do it wrong? What if I make a mistake and the person isn’t really overdosing, but something else is the matter? What if…?

After taking a deep breath, I managed to locate some reasons why I should be less worried:

• According to this article, “If Narcan is given to someone who is not experiencing overdose, nothing will happen; there is no potential for harm.” That’s reassuring, because I would never want to hurt someone while trying to help them.
• Naloxone is available as a nasal spray, not just as an injection. Nasal sprays seem safer and more manageable to me.
• Training is available to learn how to assess the signs of opioid overdose and to administer naloxone. No one would expect me to do it without training.
• In fact, the Central New York Library Resources Council (CLRC) offered a Narcan training workshop for librarians in December, and I expect they will do so again.

In spite of my apprehension, and perhaps as a way to combat it, I do intend to pursue training in this area since, according to all the articles and news stories I’ve read, it’s something I may very well encounter as a library professional. In fact, a pharmaceutical company recently announced it would supply two free doses of Narcan to every public library in the U.S. so the chances are good that I will someday work at a library where Narcan training will be essential. (It would probably also be a good idea for me to get certified in First Aid, CPR, and the use of an AED, too. Patron emergencies are by no means limited to opioid overdoses.)

I truly believe that libraries and librarians can change lives, and I hope, by the time I become a librarian, I will feel more confident and capable of dealing with this particular kind of challenge. I’d like to think I will be ready to help save a life if need be.

As I mentioned in a previous post, I have been researching how public libraries support health and wellness in their communities. Yes, I did find an example of libraries doing a bad job of providing credible health information to their patrons. (You can read about it here.) But October is Health Literacy Month, so now it’s time to focus on the myriad ways in which libraries do an excellent job of promoting health and wellness.

On July 12, 2018, two library staff members at Emily Fowler Central Library in Denton, Texas literally saved a man’s life. By performing CPR and using an automated external defibrillator (AED) on an unconscious patron, they kept the man alive while waiting for paramedics to arrive. Librarians across the country are also “saving lives in the stacks” by being trained to use the drug Narcan to counteract opioid overdoses in their workplaces. These are just two examples of public libraries supporting the health and wellness needs of their communities; there are numerous others. Although public librarians are not medical professionals, and public libraries are not medical buildings, they nevertheless have a long history of supporting the physical, mental, and social health of their patrons.

One way that public libraries are meeting community health and wellness needs is by providing health information to their patrons. This can be a challenge. After all, librarians are not there to provide medical advice, but they can and should provide access to accurate and authoritative information that will answer the patron’s questions.

So, how do librarians know what the best sources of information are? One resource is http://publiclibrary.health, a toolkit from by the Public Library Association to provide healthy community tools for public libraries. An increasing number of public librarians are also pursuing Consumer Health Information Specialization (CHIS) certification, which is offered through the Medical Library Association (MLA) and the National Network of Libraries of Medicine (NNLM). This training prepares a librarian to be a “confident, expert provider of health information to [their] community” by addressing topics like:

• getting to know the community and health consumers
• learning about both general and specialized health resources that can be used to aid patrons
• how to evaluate health information for quality
• effective communication techniques and training patrons to use health resources
• understanding health literacy and how to help patrons who may have low levels of health literacy
• technology and health
• ethical and legal issues surrounding the provision of health information

As stated earlier, public librarians are not healthcare workers and most know when they have reached the limits of their professional abilities to help patrons with health-related needs. So they have learned to call in reinforcement. In recent years, several public libraries have addressed the health and wellness needs of their patrons by hiring social workers, nurses, and other professionals as an official part of the staff to help address issues that librarians may not be qualified to tackle.

Social workers as library staff are not an entirely new idea. In 2009, the main branch of the San Francisco Public Library became the first library in the country to hire a psychiatric social worker as a full-time member of their staff. Since then, an estimated 30 more public libraries have followed suit to the point where public library social work is considered an emerging field. Library social workers may provide support to vulnerable populations — such as the homeless or low income individuals seeking help accessing social services like food stamps and Medicaid — and offer training to library staff in how to sensitively interact with patrons with a variety of needs. They may also work in a supervisory capacity, overseeing other social workers on staff, or even hiring patrons to assist their work. For example, at the Denver Public Library there is a peer navigator program which hires former homeless individuals and recovering addicts to help provide support to those currently affected by drugs and homelessness. (There is a great 10-minute video about this library program and one of the peer navigators. You can watch it here.)

Social workers are not the only health and wellness professionals to find their place on a public library staff. The Pima County Public Library in Tucson, Arizona has hired a registered nurse to assist patrons at the main library building. The Library Nurse service is the result of a partnership with the Pima County Department of Health to make the library and safe and welcoming place for all patrons. The nurse helps to achieve this goal by providing intervention when patrons become disruptive or need medical care, training other library staff in ways to help de-escalate problematic patron encounters, supplying confidential physical assessments, case management, and basic first aid services to patrons, as well as administering flu vaccines, helping patrons sign up for health insurance, and working with other community partners to institute an after-school snack program for approximately 300 children. And all of this is done at the public library.

I have lots more information to share about public libraries supporting health and wellness in their communities, but I think this is a good stopping place for now. Stay tuned for future installments, when I’ll talk about visiting health services, mental health, and the fun health-based library programs and activities that I learned about in my investigations.

In the meantime, let me know your thoughts. Did you know about social workers and nurses being hired full-time by libraries to help patrons? What do you think of the idea? Are libraries good partners in solving the pressing health needs of a community?