Expert medical help and a listening ear‐at the library

In her first week working at the Pima County Public Library, Registered Nurse Emily Pogue helped a newly-homeless woman find safe shelter and access to the medications she needed. She listened to the stories of military veterans, helped them organize a buddy system, and she helped library staff deal sensitively with a child's case of head lice. In just a month, library staff noticed a drop in calls to 911 and experienced far fewer behavioral incidents.

Where people gather in large numbers, public health is always a consideration. But a trained health responder has been missing from the library—until recently.

In January, Pima County Public Library, in partnership with the Pima County Health Department, became the first library in the nation to employ a public health nurse on site. Pogue spends most of her work week circulating through the Joel D. Valdez Main Library and five library branches, a stethoscope around her neck. She listens to the worries of the elderly, the unemployed and the homeless who turn to libraries for help and safety, and directs them to social services when appropriate.

How did this come about? Managing Librarian Karyn Prechtel began thinking about the possibility of a library public health nurse more than two years ago and was encouraged when the San Francisco Public Library hired an on-site social worker.

Pogue says she is blessed to have this chance to provide health care in a non-threatening location like the library. “It takes a nurse to put a gentle hand on theirs and say, "I'm here for you."

Pima County Public Library hires public health nurse [Pima Public Library]

"‐ Posted by Lisa Bunker, Pima County Public Library

LibraryLab posts come courtesy of the American Library Association member interest group Library Boing Boing.


  1. i’m not suggesting that there isn’t a place for public health nurses — there is.  it’s at the local public health department.

    my feelings were similar for this idea:

    there’s a place for those things, too.  it’s called a machine shop.

    as a “library assistant” (meaning that i do all the jobs of a full librarian, but cannot have the title and pay because i’ve not yet finished my mls) who has seen my library’s own budget cut again and again, seen coworkers laid off and not replaced, and knowing that this is typical in libraries these days…  i just think that this is foolish.

    libraries are having enough difficulties with funding as it is; how much does it cost to employ a qualified, full-time (as i assume based on the fact that she works at six different locations) nurse?  what i’d like to know is what further budgetary cuts were made for actual library spending and employment in order to hire her.

    1.  The nurse works for the public health dept., not the library. Two different funding sources.

    2. Octolover, I think your question about how this has affected other spending in the Pima County library system is a good one.  I’d also be really interested in seeing that.  This info included in a detailed report after 6-12 months of the program will be useful info for other libraries considering such a service.

      But I have a real problem with your Not In My Stacks attitude about non-traditional ways for libraries to reach individuals in a community.  This attitude is dangerous to the profession, both internally and externally.

      In my opinion, the best way to determine the value of any library is by looking at its public services, where you can see the impact of information resources on a community.  There are clear trends out there, like having coffee shops in college libraries, having videogame setups in Young Adult collection areas in public libraries, or having as many public Internet-accessible computers as you can afford — these are all ways to respond to the needs of your service population and are what keeps a library relevant and useful in its community.  Or one can respond by saying “There’s a place for that and it isn’t the library.” The core functions of a library and of librarians are always shifting — it’s both exciting and scary.

      I’m assuming that most of your comment probably stems from your own dispiriting frustration in the library world.  Librarians are dependent on funding from municipal governments, boards, and administrators who too often simply do not *get* libraries in any way (“It’s just a bunch of books, right?”).  I’ve had at least one job where the only other library employee was laid off and it sucks in the extreme.  But I assume you’re not saying that there’s *no* place in libraries for these sorts of programs, right?  If an institution does have the budgetary wherewithal to afford certain public services, then they should do so to support the public’s needs and interests.  And every institution is different.

      I personally like visiting public libraries when I go to a large city {nerd!} — it is crystal clear from walking around some of these buildings that a number of patrons could use the services of a health professional or social worker.  If you read the mission-vision-values statements of the Pima County Libraries , it is easy to see why they funded this public health program, especially considering the size and urban nature of the system, comprising 20 branches in the metro Tucson area alone.  And from a reference librarian point of view, you know that relevance and convenience are valued by patrons (to say nothing of having a ref librarian who happens to be a subject specialist); I’d rather talk to a on-site nurse than have a librarian tell me a good website related to my issue.

      Just so you know, I am a librarian and archivist.  I’ve never worked in a public library.  I am an avid user of public libraries.

      (strangefriend: I’m not sure that what you say is correct…a PCPL Director’s Report from earlier in February says “In partnership with the Pima County Health Department, PCPL has hired a full-time Public Health Nurse.”)

      1. In my opinion, the best way to determine the value of any library is by looking at its public services…

        Then it’s not a library; it’s a community center.  My local library can’t even keep books on the shelves.  They haven’t done an inventory in over 20 years.  Nobody curates the collections.  But they have art exhibits.  They have a big computer room.  They have special events galore that are completely unrelated to reading.

        If you want to work at a community center, go work at a community center, but for God’s sakes, stop calling yourself a librarian.  It’s not an evolving business plan to meet the needs (which means whims) of a barely educated public.  It’s a library.

        I don’t care about your profession or whether you have a job or whether you feel good about what you’re doing if that means that you sell out the basic meaning of a library being a place for books and reading.

        1. I think hacker spaces and art exhibits are a different argument, because lonely military vets, homeless refugees, and lice (not to equate the three) show up at the public library no matter what your philosophy. Clearly they don’t care whether the sign says “Community Center” or “Public Health Department.”

          So to me it sounds like providing support for what one can reasonably say is a core function of the library anyway — providing expert  reference about available resources — could really help with balancing out the other core functions mentioned here. Surely librarians WOULD rather clean up collections than skin infestations.

        2. Antinous, congratulations on your passion for books and reading.  Seriously…that’s the main way I use my own public library system.  It’s not a pretty way you put it, but yes, a library should “meet the whims” of the public.  A library should always strive to meet the informational needs of its public — both what it hears from its service population and what it identifies as yet-to-be vocalized needs.  Since at least the 19th century, these needs have been met primarily through printed books (which I personally still think is the best non-human resource for learning all sorts of good stuff).  But things are changing and not everyone thinks about paper books that way, and the proportion of people who do is in a natural decline.

          I know you’re only a lowly Boing Boing Lead Moderator, so you may not be aware that information sources like the Internet ( ) and ebooks ( ) are rapidly changing how people connect with the information they need…and changing how libraries help people make those connections.  A library — especially what goes on in the physical library building — obviously has to change with the way people use information.  Or they run the risk of evolving like Borders, Waldenbooks, or Tower Records have “evolved.”  (And yes, it is easy to carry this argument to its endpoint, that there is no need for public libraries.  Hmmm, if only they would work to stay relevant…)

          Public librarians need public input to do a good job.  Antinous, have you and like-minded library patrons voiced your feelings about the direction that your library is going, to try to make the whims *your* whims?  Do you think they should offer more ESL classes?  Encourage more active involvement from their Friends of the Library group?  Support more book clubs?  Do a better job helping job-seekers?  Make it easier for users to request intra-system book loans?  Hold more author lectures?  Carry more ebook titles and run e-reader workshops?  All of theses public services and programs have been around for decades (except the last one).  Or are you mostly pissed that they they never buy the new Lessig or Godin books, the last 16 pages were ripped out of the Diary of Anne Frank Cliffs Notes you checked out, and every last Lovecraft, PK Dick, and Pirsig title in the card catalog has been reported missing and hasn’t been replaced?  If it’s this last issue, have you asked the library director why collections development and management seem to have fallen apart?  Speak up, brother library lover!

          1. I don’t have much of a problem with libraries meeting the informational needs of the public. I have a real problem with them being used as free Netflix. One of the reasons that the librarians never have any time to do any librarying is that they’re checkout-scanning Eddie Murphy movies all day.

            And I’ve spoken to the head librarian about the fact that nobody has any idea what is and isn’t on the shelves, and she just gives a mealy-mouthed excuse about the economic downturn. Except, they never did any of this stuff when the economy was roaring. I have on multiple occasions checked the online catalog for a book, seen that it’s on the shelf, and then, when I can’t find it, had the librarian look in their computer to discover that it’s been missing since 1990. Literally 1990. And nobody has done anything about it.

            If you try to be everything to everybody, you will be truly useful to nobody.

        3. THANK YOU.  between this and your post below — my thoughts, exactly.  this “trend” in librarianship and in libraries is why i’m currently taking a break from pursuing my degree.  i want to be a librarian and work in a library — if i wanted to go into social work, i’d go into that field, but that’s not what i signed on for.  i don’t want to be an employment counselor, a babysitter, a public health aide, a coffeeshop barista, or a computer skills tutor — and i worked at blockbuster video once already in my lifetime, so i don’t want to go back there, either.

          i want to be a librarian.  in a proper library.  but the push for increased/varied public services isn’t my only worry; other changes being made or discussed are dumbing down our jobs (ditching library of congress-style cataloguing in favor of bookstore-style arrangement, or centralizing cataloguing online and making it user-modifiable so that instead of being controlled by librarians, it’s littered with patron tags, commentary, obscenities, et cetera).  all this means that a career that now requires a master’s degree will eventually become less specialized and eventually lower-paying and more entry-level.  dumbed-down libraries don’t need real librarians, don’t you know?

          finally, in defense of your local head librarian, she may unfortunately have her hands tied.

          1. finally, in defense of your local head librarian, she may unfortunately have her hands tied.

            No, she’s just one of those people who got promoted due to incompetence. If you can’t do a real job and they can’t get rid of you, they make you a manager.

  2. Awesome.  Someone in another thread was lambasting the “public health industry” or some such.  LOL.   THIS is the public health industry… ummm, errrrrh… yeah, HELPING people.

  3. In 2002, I was amazed to find out that medical doctors can be found almost anywhere in German cities. They usually have a small office in apartment and office buildings. I was so afraid to go visit a large hospital, how to get there, and who to talk to. My friend looked at me like I was a Crazy Foreigner and told me to “Just go downstairs”.

    Yep, a tiny little sign on the first apartment door. It was a doctor’s office/clinic. She ran it by herself. She tried apologizing for her parsed english.  I told her I didn’t care and that my illness wasn’t in german. 

    German pharmacies were a beauty to behold. Just think ultra fancy cigar shops. 

    (I had strep) 

  4. This is an awesome idea and it needs to be implemented wherever possible. THIS is how you do government. As to octolover, well strangefriend had the best and most succinct reply. And as to Palomino’s eye-opener, makes me despair that we Americans can be so willfully butt stupid.

  5. Libraries aren’t just for books any more. Given the number of homeless people who make the library their main point of contact with the government, I think this is a swell idea. A library is SO much more pleasant than the local welfare office or poor-folks’ hospital.

    [Disclaimer: I personally know two of the people mentioned in this article.]

  6. Hi, I wrote the article and would like to clarify a few things about our funding, etc. Public libraries nationwide are not all funded the same way. We are very lucky in Pima County to get our support from a relatively stable tax generated from county property taxes. Yes, we have been hit by the downturn, but not to the extent that other communities and other libraries have been hit. We’re still hiring and moving forward. Even better, our leadership is very supportive of experimentation in the ways the library can serve our communities. This just isn’t a time to play it safe.

    One of our strong local allies is the Pima County Health Department. We recognize health literacy along with financial literacy and technology literacy as entirely appropriate areas for the library to tackle. In addition to our public health nurse we have yoga, bollywood dance, and fitness classes at the library, and a very popular health fair for the area’s large refugee population. @herbison:disqus, you’re correct that she is an employee of the library, though she was hired with the assistance and support of the Health Department (loved your commentary, BTW).

    The bottom line for us is that with one hire we’ve made the library safer for visitors and staff, and helped some of the “lost” people who come in for our other services. If not for Nurse Emily it would not have been possible to effectively help the domestic abuse victim who arrived at the library with all of her belongings and was at the end of her rope. I’m so glad our nurse was there for her.

    1. Ultimately the services for all of these people come out of the taxpayers pocket. If they get served early things don’t get out of control and require long-term, expensive interventions by hospitals or law enforcement. The U.S. used to have an extensive system of public health nurses for a very good reason: it was cheaper than epidemics. 

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