Get to know: Mabel A. Trafford

Get to know: Mabel A. Trafford

Manager, Medical Library
Tripler Army Medical Center, Hawaii
“When the US goes to war…there are injured people to take care of.”

Whether a doctor or nurse is practicing in the US or abroad, the responsibility of their health science librarian is the same. Ensure they can get the medical information they need. STAT.

No one knows this better than Mabel A. Trafford, Medical Library Manager at Tripler Army Medical Center in Hawaii. During her tenure at Tripler, Mabel has developed an in-depth understanding and appreciation for supporting military doctors and nurses.

Get a peek inside the ‘pink’ military complex and read how Tripler Medical Library:
• Uses physical space to drive library loyalty
• Quickly establishes trust with new residents
• Participates in medical casualty exercises


How long have you worked at Tripler Army Medical Center library? What unique interactions or activities do you experience as a librarian for a military center?
I have worked at Tripler for several decades. The support of the leadership for the Medical Library has been for the most part a gratifying experience. We have seen an increase in the number of staff, in promotions for us, in the budget; alas, our space was increased and then later was decreased, but the number of users continues to increase. I find that military doctors and nurses may have a more encompassing view of their role as health professionals because they always have to be ready to be there if and when the US goes to war and there are injured to take care of. During Afghanistan and Iraq, we had information kits ready for people who were deploying to those places; also, we would receive phone calls and emails from doctors and nurses who needed information stat for patient care.

At more than 10K square feet in size, the Medical Library at Tripler is impressive. Do staff and students rely on it as a place for both congregating and as a refuge?
They have given some of our space to Surgery Residents and Internal Medicine Residents. This has actually been a benefit, because these people are close to us, they come more frequently to ask for help with literature searches or journal articles, so it’s more like, we haven’t lost space, we have gained 35 or so dedicated library users. Others come 24/7 to have a quiet space to read or use a computer without being interrupted, or just chill.

Similar to its size, the Medical Library supports an impressive number of patrons, including the clinical and administrative staff of Tripler; Dept. of Defense medical facilities at Hickam, Pearl Harbor, Japan and Korea; and 260K+ local active and retired military personnel, veterans and their families. How does your library work to ensure that all needs are met?
We serve the medical personnel at all these places. We don’t do consumer health or patient education; there are other Tripler staff who provide information for patients and their families. If we had patients coming to the Medical Library, it would not provide the refuge that the doctors and nurses sometimes seek. We also serve the facility on Hickam called the Joint POW/MIA Accounting Command (JPAC). When remains of US military who have been war casualties are found, they are sent to JPAC to be identified. The remains of the 55 US military personnel recently returned by North Korea were sent to JPAC for identification.

Medical librarians are becoming more active in clinical education, supporting faculty in various ways. Assisting in the development of evidence-based courses, starting journal clubs and rounding with residents are just a few examples. Are the librarians at Tripler involved in this sort of activity? If so, can you please describe a few of the current activities and share your thoughts on how this has been received?
Tripler has 12 residency programs; each year in June when the new residents arrive, we schedule orientations with each program and we focus on the resources we have in their specialty area. Once we have their names, we stay in touch with the residents and the program directors and faculty so they get to know us; they learn that we do know what we are talking about, and we are responsive to their needs. We work to make sure we give them access to the resources they need. We have established a few Clinical Librarianship programs and attend Morning Reports regularly. We have also built into our budget the funds to pay processing fees for some of the residents when they publish their research reports or case reports.

How does Tripler support the Army’s efforts to treat civilian and military patients?
The Army and Army Air National Guard on Oahu and the Big Island have provided MEDEVAC services for civilian and military patients when called upon. I think Hawaii is the only state where the military provides this service for civilians when needed. Every two years, Hawaii is the host for the Rim of the Pacific (RIMPAC) military exercises; a number of countries send military people and equipment here for a month of war games. Tripler participates by staging a MASCAL (medical casualty exercise). This July in the scenario, a series of large simulated earthquakes caused significant infrastructural damage across the Hawaiian Islands. Patient actors with simulated injuries were found at staging areas throughout the islands and transported by medical evacuation (MEDEVAC) to Ford Island. There they were redistributed to nearly every acute care hospital throughout the state. That caused an influx of casualties to Tripler.

window_rainbow.jpgWhat is the most rewarding aspect of your career?
I really love my job; the people are great and the support and respect we get is impressive and inspiring. When we find a new product that we know the providers will love, we buy it and have a great time promoting it and sharing it with them.

What is the most challenging aspect of your career?
Making sure I am looking ahead for the next big thing. Not being complacent about what we have. Not taking anything for granted. Appreciating the view out my office window every day [see the picture].

What do you think will be the biggest changes/challenges to your field in the next five years? Ten years?
We need to keep focusing on the value we provide to our institutions. When we sink into that out of date view that, because we do not actually bring income into the institution, we do not provide value, we will lose our jobs and the people we actually work for, health care providers and their patients, are the big losers. We must always think in terms of the value we provide, the return on investment (ROI) value and the intangible value that is the library as place and the librarians as resources.

What sparked your interest in a library science career?
The biologists at Marine Lab where I worked originally were doing interesting field work on larval fish populations, the movements of adult migratory fish species and occurrence of non-migratory fish up and down the Atlantic coast of the US. There was a lot of collaboration with Woods Hole people, Rutgers faculty and researchers in Maryland. There also was the growing awareness and horror of what pollution was doing to the marine life in the New York Bight. By working in the Library, I could stay in touch with all these researchers and sometimes even be invited to participate in field research.

I have been a Medical Librarian for many years. My first Medical Library position in Hawaii was at St Francis Hospital. Sister Maureen was the CEO of the hospital; she was friends with a lot of local entertainers and musicians. She was one of my main reference customers and would frequently ask me to call the public library and get the words for various Hawaiian songs.

My next job was at the Hawaii Medical Library. HML had a larger staff and was more academically oriented, because it was the Medical Library for the University of Hawaii School of Medicine. I really learned a lot from the more experienced Medical Librarians there.

Three years later, I came to work at Tripler Army Medical Center. The Medical Library is on the top floor of the hospital. We can see all the way from Diamondhead to Pearl Harbor and the Waianae Mountains. Tripler is a big pink building up on a hill; it’s not exactly your image of a military complex. [see picture]

Why did I take this position and why do I still love my job? Before I moved to Hawaii I worked for the US Dept of Commerce in the Library of a fisheries research laboratory. I worked with great people and got good support from the administration. They paid my way through Rutgers Library and Information Science Program and gave me time off to attend.

Tripler, as an Army Medical Center, is a US Dept of Defense installation. There are rules and regulations but they can work in your favor too. I have justified many things I do by saying “It says so in AR (Army Regulation) xxx.” We decided several years ago that we were going to focus on the value we provide in our services to all the staff at Tripler. One of the services we provide is document delivery. We say just ask us and we will send you the article. We also do literature searches for anyone who needs more information about something. We started a Clinical Librarianship program. We installed a people counter by the door and obtained more computers for our customers. We were able to increase our staff by 50% and more than 250 people come into the Medical Library every day now.