Librarians at Nemours Children’s Health, a multi-state pediatric health system, have noticed increased stress, compassion fatigue and a lack of fulfillment among healthcare associates, including physicians, nurses, allied health and non-clinical staff. We sought to develop a program to help mitigate these stressors and reduce the alienation caused by COVID-19. Our program is grounded in the principles of narrative medicine, and we chose Microsoft Teams as our meeting platform to make our program available to associates across three states. Participants who attend this session will be able to:
- Use close reading and writing to process difficult events and mitigate compassion fatigue.
- Discuss works of art, prose, poems and graphic novels and reflect on their assumptions and biases.
- Develop relationships with their teammates based on shared discussions and participation in activities.
We met with stakeholders, including our chief wellness officer; the office of health equity and inclusion; and marketing and communications to discuss our “Healthcare & the Humanities” (H&H) program. We also met with continuing medical education to obtain approval to issue CME credit to participants. We decided to hold the program monthly and limit participation to a maximum of 15 attendees per session. Collectively, we chose the focus pieces and flow for the first three sessions — these included excerpts from graphic novels and works of poetry, followed by discussion. Pieces would be encountered as a group during the sessions; no advance reading required. We chose pieces coinciding with heritage months and identity recognitions (e.g., Black History Month and Latinx Heritage Month). We developed announcements to market H&H via organizational newsletters; we also added a dedicated program page to our library portal. Announcements included a link to register for the program via SignUpGenius. A week prior to the program, we sent a Teams meeting invitation to all registrants. We held our first program on Jan. 19, 2022, for 10 attendees. Approximately 5–10 attendees have consistently attended subsequent sessions. We are evaluating our program by conducting surveys and assessing informal feedback.
We began distributing online surveys to participants using Qualtrics software in June 2023 and have received 20 completed surveys so far. A few highlights include:
- 75% of the respondents replied “Strongly Agree” to the question: “Did this program help you connect with/relate to patients and families?”
- 75% of the respondents replied “Strongly Agree” to the question: “Did this program help you connect with colleagues and reduce isolation?”
- Comments include: “I thought it was super meaningful”; “Wonderful program, fantastically supportive group”; and “I really love these sessions! They are great stress reducers and offer new knowledge for me.”
We partner with associate resource groups (ARGs), groups bringing together associates with similar demographics and interests, such as the African Heritage Group, Pride Group and Asian-Pacific Heritage ARG, to enrich discussions, obtain suggestions for additional focus pieces and assess informal feedback. These sessions have been very well attended: We had 18 attendees in June for Pride Month and 11 attendees in May for Asian American and Pacific Islander Heritage Month.
The following are summaries of four different sessions we have developed and facilitated; they demonstrate the range of topics and media we use for our discussions, including visual art, graphic novels, music and mindfulness meditation with therapy ponies. We have included links to the specific works and focus pieces we used during each session.
Places That No Longer Exist: A Discussion of the Paintings of Ellen Harvey
For our discussion in October 2022, we focused on a unique website called The Disappointed Tourist that features the artwork of Ellen Harvey. She initiated the project to create paintings of places that people would like to visit that no longer exist. Based on photographs and old postcards that people have sent to her, she has created works that reflect the longing and nostalgia for bygone days. We focused on selected paintings from her website on the theme of childhood memories, including amusement parks, a carousel, an automat and a shoe store for children in the shape of a giant shoe. Our group found the paintings very poignant, and it generated a conversation on our own childhood experiences of places that no longer exist.
Website for The Disappointed Tourist: https://www.disappointedtourist.org/
An Exploration of Groundbreaking Women in Primate Research: A Discussion of the Graphic Novel ‘Primates: The Fearless Science of Jane Goodall, Dian Fossey and Birute Galdikas’ (written by Jim Ottaviani and illustrated by Maris Wicks).
We decided to choose a graphic novel for our March 2023 discussion in honor of Women’s History Month. The novel offers a look at three groundbreaking women who were mentored by archeologist Louis Leakey and did field work on primates. We focused our discussion on the work of Jane Goodall and her experience with studying chimpanzees in Tanzania. The group read selected pages aloud from the graphic novel and watched a short video about Jane Goodall. The attendees discussed the amount of courage it took for her to work in the field in isolation, the importance of her mother in encouraging her interest, and Jane’s work in animal conservation.
Ottaviani, Jim, and Maris Wicks. Primates: The Fearless Science of Jane Goodall, Dian Fossey, and Birute Galdikas. First edition, First Second, 2013.
88 Keys and 4 Strings: A Look at the Music of Amy Yang and Yo-Yo Ma
In honor of Asian American and Pacific Islander Heritage Month, our session in May 2023 featured the work of pianist Amy Yang and cellist Yo-Yo Ma. We watched an interview on the music of Amy Yang that was featured in the television series “Articulate” with Jim Cotter. She discussed the importance of her parents’ support and their challenging journey to move to the United States to escape the Cultural Revolution in China. We also watched an interview with Yo-Yo Ma in which he discussed his childhood love of music and the influence of his parents in guiding his talent toward the cello. The group remarked on the power of their stories and the importance of their parents in helping them both to achieve.
Episode on Amy Yang featured on “Articulate” with Jim Cotter:
https://articulateshow.org/videos/a-vision-of-music
Interview with Yo-Yo Ma on PBS News Hour:
https://www.pbs.org/video/what-yo-yo-ma-is-learning-about-life-and-music-at-60-1452554474/
The Human-Animal Bond in Healthcare: Mindfulness With Miniature Horses
The Assisted Dog and Pony Therapy (ADAPT) program was featured in our January 2023 session. The ADAPT program at Nemours pairs a licensed mental health counselor with animal assisted therapy. Animal therapy is beneficial for children who may be experiencing chronic health conditions, behavioral and communication difficulties, and grief. Participants may experience physical benefits such as lowering of blood pressure and release of oxytocin; mental health benefits such as decreased feelings of depression and anxiety; and comfort.
Our program featured mini horses Gypsy and Taco, who, with members of the ADAPT team, led participants in a mindfulness exercise. We learned the importance of mindfulness in our daily lives and the bond between humans and animals.
Resources:
What Animals Teach Us About Mindfulness
Mindfulness and Meditation With Horses Grazing
Learn How to Do Controlled Breathing With Your Pet — Nemours ADAPT Team
Olivia DiLeonardo, MLS, is a medical librarian and narrative medicine instructor at Nemours Children’s Hospital and the UCF College of Medicine in Orlando, Florida. She earned her MLS at Emporia State University in 2003 and her CPA in narrative medicine at Columbia University in 2018. Olivia has been facilitating narrative medicine sessions for medical students and faculty at Nemours and UCF since 2014. She believes that everyone is creative and enjoys helping people discover that part of themselves. Olivia lives with her husband Ernest, son Max and African Grey Parrot, Rowan, in downtown Orlando.
Ann Ferrari, MLS, MA Ed, is a medical librarian at Nemours Childrens Hospital in Delaware. She has an MLS degree from the University of Pittsburgh and an MA degree in education from American University in Washington, D.C. Her previous experience includes serving as a hospital librarian and community college reference librarian in Pittsburgh. Her roles at Nemours include research assistance, teaching and serving as nursing liaison. She enjoys exploring creativity in narrative medicine by facilitating sessions for the Healthcare and the Humanities program. Her other creative endeavors include serving as a member of the Delaware Art Museum book club that focuses on art-related themes. Ann lives with her husband Pete and their pets (a Collie and ginger cat) in Wilmington, Delaware.
Susan Harnett is a medical librarian at Nemours Children’s Health, Jacksonville, Florida. She received her MLS from Rutgers University in New Brunswick, New Jersey. Her previous positions include the University of Florida, where she taught in the Honors College’s Uncommon Reads course and is co-author of an article describing medical librarians’ engagement with the program and health humanities. She is the author of several articles on health literacy and co-editor/author of a book for librarians who work with institutional regulatory committees. Susan lives in Ponte Vedra, Florida, with her husband and too many cats.