I do understand what it's like not to have administrativ
Dalia & all: 

I do understand what it's like not to have administrative support; I left my last hospital position in 1990 for very similar reasons.  At the time, I gave myself a a year to find something else in this rural area, after doing everything I could via the chain of command and library patrons to change the intolerable conditions.  Things changed for the better when the administrator in question left, but the hospital is now part of a system where five hospitals are served by one professional librarian position and solo library associates at three of the five libraries.  When the associate I hired & trained retires, I don't know how they'll function.

I'd like to add a short story & some comments to Dalia's post, and encourage more of you to continue to do your best in whatever setting you're in.  As I found out in 1990, the the grass is not always greener, especially in general academia where librarians seemed more bogged down with structure and rules than what we see in the "special library" setting.  Hospital librarians have the advantage of working closely with their patrons (using old-fashioned term on purpose), and the psychosocial rewards are many.

Sometime before 1990, an administrator at a sister hospital forced the librarian to start charging everyone for ILLS.  So she developed and implemented the policy.  When the first bills were sent, a physician stormed into the administrator's office and demanded that they return to free ILLs.  And it happened....   The sad part of the story is that she left the profession not long after - I recall that she didn't need a job and decided it wasn't worth this type of stress and lack of respect.

There are sources for ILL/document delivery beyond those noted so far.  One not mentioned is the CINAHL Express document delivery service, where costs include payment of publisher royalty fees.  I've suggested off list for those having problems locating resources found via CINAHL.  The CINAHL Managing Director tries not to index new titles that don't offer a reasonable way to access content, but that isn't easy.  Their goal is comprehensive coverage of nursing and allied health, which requires publisher cooperation.  Remember that a journal will not be indexed in MEDLINE without allowing MEDLINE to include author abstracts.  No commercial or non-profit database has the power to require this that MEDLINE has.   Publishers may expect the database to pay for the copy permission.

As I near retirement, I find the current situation very distressing.  While heartened by what I see happening to support evidence based practice in the UK and some other countries, I just don't see it happening here.  For those who don't know, I'm currently on a "short leash," pretty much homebound due to ankle fracture Dec 26 with surgical repair January 11 (we thought a sprain).  My recent hospital stay and subsequent home care has provided insight into the best and worst of care, including roommate who died 4 days after surgery for a broken shoulder.  I can't say whether her complications were related to the surgery, but I have plenty of other observations that don't belong here.  

Enough said - I think I'm not weaning off pain meds fast enough :-)

Thanks for listening - Peg
 
Peg Allen, Library Consultant
P.O. Box 2, Stratford, WI, 54484
715-687-4976
www.pegallen.net   pegallen67 @ yahoo.com
Coordinator, Hmong Health Education Network, www.hmonghealth.org