WHAT A BASE HOSPITAL LIBRARIAN SHOULD KNOW— OUTLINE OF A COURSE OF TRAINING* By Edith Kathleen Jones, Librarian , McLean Hospital, Waverley, Mass. Obviously, the first thing a hospital li- brarian should know is something of hos- pital organization. To all outsiders, the information that every large hospital, even in times of peace, is organized and admin- istered v er such strict rules and dis- cipline uid with such regard to rank of staff ai 1 employes as to be almost military in character, comes as an amazing discov- ery. Do you know that in the ordinary hos- pital — general, state or private — the Super- intendent is the apex of the cone, so to speak; that immediately surrounding him are the widening circles of the medical staff : first and second assistant physicians, junior assistants, internes, then the matron or superintendent of nurses, the heads of departments, as steward, dietitian, chief clerk, gymnasium instructor and librarian (if there is one) ; next the assistants, un- der clerks, stenographers, etc. ; then the training-school: supervisors, head nurses and pupil nurses ; last the other employes — engineers, firemen, electricians, carpenters, porters, cooks, laundry and ward maids — all the vast army needed to keep the ma- chinery running smoothly. Each depart- ment is under its own head, who, in turn, is responsible to the medical superintendent or the chief administrator, and every per- son has his fixed place and rank. Nurses must rise when a physician enters the ward or room and remain standing till he goes out. If there is a training school for men as well as women nurses the discipline is especially strict. Now translate all this into military terms and you have the commanding officer, who is a colonel, in place of the superintendent, surrounded by his majors, captains and lieutenants, who comprise the medical staff. The administrative staff is composed of the adjutant, the quartermaster, the chaplain and other officers; the non-commissioned officers, wardmasters, clerks, stenographers, * Read before the A. L. A. at the Saratoga conference, July 2, 1918. carpenters, etc., who are enlisted men; the nursing corps, consisting of women, headed by the chief nurse who is responsible for their work and behavior and must disci- pline them if they break rules. The nurses and the enlisted men are not allowed to speak to each other except to give and receive orders. The chaplain is in charge of the educa- tional and recreational as well as religious activities of the hospital, therefore the library nominally is under his command, tho in most cases he has so many other things to attend to that he is glad to let the librarian take the initiative and go to the commanding officer for orders and per- missions. Besides all this personnel, there are the patients, for whose benefit the hospital is organized and carried on. The library must take intb consideration the needs of all these persons — patients, officers, nurses and enlisted men — numbering anywhere from a few hundred to several thousand. Now there are several varieties of army hospitals, but the only ones which concern us are: the base hospitals connected with training camps, the general military (or naval) hospitals and the “reconstruction hospitals,” not connected with any camp. In the first, therefore, the library has the camp library to draw upon for help and for books; in the second and third she must rely upon the nearest large public library and dispatch office. The training-camp base hospital receives the men from that camp; cases of measles, scarlet fever, pneumonia, etc., which go into the medical wards; accident and operative cases, assigned to the surgical wards; men- tal cases, including epileptics and feeble- minded, who are put in the psychiatric wards. The general hospitals, unconnected with any camp, receive the chronic or severe cases from the camp hospitals, the troop ships or the various fronts; shell-shock, gassed, sick and wounded men from France. The reconstruction hospitals take the crippled soldiers and teach them trades and occupations, fit them with new arms and legs, and turn them out prepared to earn their own livings. In addition, there will be, of course, the hospitals for chronic cases who must be cared for all their lives by the government. All these hospitals will be more or less permanent institutions and the libraries in them should be placed at the outset on a permanent footing. Here, especially, the librarian should be enlisted for the duration of the war or longer; fre- quent changes will be disastrous. In these hospitals, then, we have a large community of men and women isolated from the rest of the world (for even in the training camps the base hospital is placed way off in one corner), away from camp activities or outside recreation. They must have recreation, so along comes the Red Cross and puts up a house for the use of the convalescent patients and makes it as homelike as possible. They must have books and magazines, for these armies of this world war are reading men, called from all walks of life, so the A. L. A. offers to provide books and certain periodicals and a librarian if the hospital will provide the room or building, the shelving and a few other things. Now arises the question of housing the library. Shall it be in the Red Cross build- ing, which generously offers its wall space and perhaps a room for its use, or shall we ask for a separate building — the chapel, perhaps — and set up housekeeping for our- selves? This is a nice question, for there is much to be said on both sides. The Red Cross house furnishes a pretty and very popular place, but it is noisy, for either the pianola or the piano is going from morning till night and sometimes there is a billiard room also; the nurses and en- listed men are not supposed to use these rooms till after hours (late in the evening) and, when all is said and done, the librarian is a guest in the Red Cross house and has not the same freedom which she would have in a home of her own. On the other hand, while the separate room or building will not prove so popular with the convalescent patients, it is a boon to the enlisted men, who can run in at noon mess and from supper till bedtime, read the papers, magazines and books and have a pretty, quiet and comfortable place to sit and a woman to talk to — things he cannot get at the Y. M. C. A., which is the enlisted man’s only recreation room. Moreover, in a separate house, the libra- rian can impress her own individuality upon it, making it pretty and attractive, with lots of color, yet keeping it masculine; can put up maps, pictures, and use bulle- tin boards for publicity purposes as she pleases, can have a quiet place in which to work and to make her plans for the different branch libraries in the Red Cross house, nurses’ quarters, officers’ quarters, etc., and plan her ward libraries for the next day. For the hospital librarian will spend her mornings on the wards, taking magazines, books and scrapbooks to the bed-patients, talking to them and cheering them up. Whichever plan is carried out, the libra- rian must work in close co-operation with the Red Cross people and the Y. M. C. A., for all are doing the same sort of work. And there is always at least one woman resident in the Red Cross house with whom the librarian will naturally associate. This brings us to the next thing a hos- pital librarian ought to know — her living conditions and social status. Both of these are rather unsatisfactory at present, for women are now for the first time in the history of the world being admitted into army life in other capacities than that of nurse, and, naturally, there is no place for them and they have no rank. The nurses’ quarters, where most of them are now housed, are crowded and not very comfort- able. In some hospitals, in or near a town, the commanding officer prefers to furnish transportation and have the librarian live outside. This is really the most comfortable for the librarian. It has just been arranged with the Red Cross Headquarters at Wash- ington to have the librarians room and eat in their houses, but this is possible only in the new type of house with several chambers, and then only when these cham- bers are not needed for families of very sick boys. There are, then, three possibil- ities of housing, all of them calling for meals in the hospital either in officers’ mess, nurses’ quarters or Red Cross House. Under the very best conditions living is not luxurious to say the least, and some- times it is disagreeable, but the librarian should thoroly understand all this before she undertakes the work and remember always that we women were not invited to enter this world of men and if we do in- trude we must bear ourselves as good sol- diers and not complain of hard beds, soiled table linen, lack of bathrooms, suffocating heat and dust in summer, freezing cold in winter, and tobacco smoke all the time. All this brings us to the librarian her- self — her qualifications for a position in- volving delicate readjustments of all her previous conceptions of living and work- ing. What is the first qualification de- manded? Library training? Now I expect a storm of protest from all you A. L. A. people, but I most em- phatically put that at the very end. Mind, I do not say she need not have any library training, for she should have the funda- mental principles, but first of all she must have certain traits of character which are indispensable if we wish to make these base hospital libraries a success — and we cannot afford to have a single one a failure ! First of all, she must be mature. A camp is no place for a young girl anyway, and in a base hospital, where the librarian comes into such close contact with so many men, she must be able to meet officers with dignity, chaperone the nurses, and mother the boys. The officers do not want a young girl — in fact, they will not have her ! She is only an embarrassing adjunct. The chief nurse does not want her — she already has the responsibility of from one to three hun- dred other girls. The enlisted men don’t want her — they are so keen on their job that girls (except the one girl back home that almost every one of them has, appar- ently) do not exist. The patients don’t want her — they want some one they can talk to as they would their mothers, for when these soldiers of ours are sick in hospital they are just homesick boys and they want to be mothered, and a young girl can’t do that. As one sailor affectionately told the librarian at his naval station, “You are mother and grandmother and aunt and sister and sweetheart all in one.” Ob- viously a young girl can’t be grandmother to a lot of boys! Accept this great, out- standing fact, then, that young girls are not wanted in camp and that for once mid- dle-aged women are at a premium — if they are the right kind. Second, the librarian must be dignified. In any institution where so many men and women are living in such cramped quar- ters and pursue the same routine day after day, there are bound to be petty jealousies, gossip, scandal and quarrels. The librarian must keep her dignity, take sides with none, be friends with all. She must bear herself so that neither officers nor men will dare to be familiar with her. She must be loyal to the hospital and her superior officers. No longer is the library the supremely important thing — the hospital and what it stands for is that — and only as the library is subordinated to and serves the needs of the hospital is it efficient or necessary. The librarian must be able not only to take orders and accept a reprimand in a soldierly spirit but she must be able to give orders tersely and explicitly. The common soldier is not supposed to think for him- self but he is trained to obey orders. She must know how to approach the command- ing officer or other officers with a well- formulated plan to be accepted or vetoed by them; she must not waste their time and patience by asking help in deciding which of two or three plans might better be car- ried out; she is liable to a curt dismissal if she does. She must not be sensitive and she must not be sentimental. Sympathy the boys want, but how they do hate to be wept over ! If in addition to all these admirable traits the librarian can sing, play, draw, paint, play games, get up impromptu enter- tainments on rainy days or dull evenings when the boys will not respond to ordinary methods of cheering up, or if she is skilled in any branch of handicrafts and can teach the boys to do things — then she is indeed a treasure and the possession of any of these 4 accomplishments might well balance a lack of library training. Still, we cannot overlook the undeniable fact that a librarian is supposed to deal with books, and it is very essential that she should know them well, have read them, enjoyed them and be able to inter- est the boys in them. The boys want detective and “wild west” stories, adven- ture, romance and poetry when they are sick; she must be able to select them off- hand. When they are convalescing they are restless, eager to get back into the game, and they fret for fear they will get behind in their classes and the other men will get to France before they do. Then they demand books on gas engines, turbines, radio and wireless, trigonometries, all sorts of things a woman knows little about. The librarian must know how to get these books and, what is more, must be thrilled when the eager boys show her pages of “beautiful” tables of logarithms, pictures of milling machines, and explain to her “how the wheels go round.” Em- phatically, she must know books as well as love boys. Don’t I advocate library training? Most assuredly I do ! I have been trying for seven years to get the large private hos- pitals to put in good libraries and trained librarians just because I know how much more efficient training makes a person. Yet it is a fact that in a hospital library you must forget all the rules you have learned except the fundamentals. The camp libra- ries have learned this too. They have found that it takes all their time to get books out fast enough for the men to read them — so eager are they — and that a book circulates just as well and isn’t lost any oftener if it isn’t in an accession book or a card catalog or even a shelf-list, and if it hasn’t an elaborate book and name card. These camps have taught us librarians many things and one is to forget rules and re- member only books and people. I have heard of a librarian who “is the sort of librarian to whom a book is something to be cataloged.” We do not want that sort in our base hospitals. Nevertheless, in order to forget things one must first have learned them, and even a hospital librarian must have some rudi- ments of librarianship, tho these can be learned while personality cannot. Given two applicants of equally charming per- sonality, knowledge of books and love of boys, one a trained librarian and the other not, I would give preference to the trained librarian. But , given a rather colorless, ineffectual sort of person who is an expert librarian and another applicant who has traveled extensively, speaks French, Italian and a few other languages, has a keen sense of humor and is interesting to meet, but has no library experience except a knowl- edge of books, certainly I would prefer the latter, tho I would suggest that she learn enough about classification, cataloging and a few other things to enable her to carry on the library. Even a trained librarian going from a public or a college library into a hospital must, I think, be bewildered at first by the utterly changed conditions and new prob- lems. It is no longer library first, every- thing done according to approved method, books all in order, readers coming to you, but hospital first, last and always, books suited to the patients to whom you must take them, previous methods often inade- quate, individuality and ingenuity needed. In the fifteen years since I left a college library to enter that of a hospital I had for- gotten all this till I found several of the base hospital librarians confronting these same problems and just as bewildered as I remember to have been. One such libra- rian said to me, “I see I must revise all my ideas of library work.” Realizing something of this and knowing the value of personality even without train- ing, it was suggested by Headquarters that a short course of supplementary training for base hospital work might be introduced into some of the schools for library science. Such a course is being worked out at Sim- mons College this summer. This library school was chosen because it is near sev- eral large general hospitals and near Mc- Lean Hospital, which is acknowledged to have the most beautiful library of any hos- pital in the country, near a training camp, a naval base hospital, a large public library which is the center of war activities, an 5 A. L. A. Dispatch Office and several schools for training teachers in occupational the- rapy and trades for reconstruction hospitals. Visits to such places give an idea of all kinds of hospital and war library service. This course, as it is organized, includes lectures on hospital and camp conditions; housing the libraries; qualifications and duties of librarians; care of the medical library; publicity methods; relations of base hospital libraries to A. L. A. Headquarters and to camp libraries. Also lectures on book selection and ways of getting books to patients, officers and nurses, with brief analysis of detective, mystery and secret service stories; wild west and adventure; romance and love stories and the little books for bed patients (including scrap- books); poetry, essays, drama and art; books in French and other languages and the opportunity to teach foreigners Eng- lish and our boys French; travel, history and war books ; outdoor books, games, occu- pations and handicrafts; books on mechan- ics, engines, etc.; some of the camp refer- ence books. These lectures are for all the students. In addition, those who are not trained librarians have lectures and prac- tice work in simple classification, catalog- ing, shelf-listing, charging, filing, alphabet- ing, care of periodicals and newspapers. The whole class should also have some practical experience in sorting gift books and discarding the problem novels and trash. In order to ascertain the amount of in- itiative of the students, examination might be given along these lines : Make out lists of forty or fifty books suited to bed patients, convalescents, officers and enlisted men. Plan a library housed in the Red Cross house (new type) and also in a sepa- rate building or room. Outline a plan of advertising the library thruout the hos- pital. Tell what special qualifications each applicant thinks she has for entertaining boys or being helpful to them. Such a course should enable the base hospital librarian to approach her peculiar problems with confidence instead of be- wilderment, and so prove of practical value. It also should provide an especially well- equipped personnel from which A. L. A. Headquarters may draw to provide satis- factory librarians for the rapidly increasing number of base hospitals thruout the country. i Digitized by the Internet Archive in 2017 with funding from University of Illinois Urbana-Champaign Alternates https://archive.org/details/whatbasehospitalOOjone