>> Nancy Groce: Welcome everybody. My name's Nancy Groce. I'm a folklorist at the American Folklife Center at The Library of Congress. Thank you so much for joining us. This is one of our Botkin lectures. The Botkin lectures are an ongoing lecture series that highlight the work of ethnomusicologists, folklorists, oral historians, the cultural heritage workers throughout, really throughout the world. And we record all our Botkin lectures. And they eventually become part of the archive at The American Folklife Center. So, welcome to this - this is a second of a two part series on field work in the post pandemic world. It will be recorded, and it will be available in about three weeks after it's processed. So, just bear that in mind. Today I'm delighted to welcome two - actually three speakers, talking about two projects both of which were part of the centers ongoing American Folklife Center's Archie Green Fellowships which are documenting occupational folklife throughout The United States. And the goal of the Archie Green Fellowships is to document contemporary workers. Now the two projects you'll hear about. One of them was started before the pandemic and then the field workers had to change course in the middle of the pandemic or - had - would seriously affected by the pandemic. The second project Alana Glaser will be talking about nursing American veterans. And she too had to rethink some of her outreach and field work and recording techniques because of the pandemic. So, we'll first hear from Alana Glaser and then we're going to hear from Josephine McRobbie and Joseph O'Connell who did a project on midwives - I'm sorry. Midwives, doulas, and birth workers in North Carolina. But we're going to start with Alana Glaser who is an assistant professor in the department of sociology, anthropology St. John's University in Queens New York. And she does a lot with medical anthropology and she's going to talk about her current Archie Green Fellowship on nursing American veterans. So, Alana, thank you so much for joining us and would you start by telling about your project. >> Alana Glaser: Absolutely. Thanks, Nans so much. I'll just show my PowerPoint as well. Okay. SO, again my name is Dr. Alana Glaser. I'm a medical anthropologist and an assistant professor at St. John's University. And this year I have been conducting remote oral histories among nurses working for the Veterans Administration which is the largest healthcare provider in The United States and the second largest federal department in The United States. I wanted to briefly remind everyone about the content that shaped this past year for nurses in The United States, especially nurses, but actually healthcare worker's more broadly as well. The COVID-19 pandemic as of course everyone remembers had a devastating effect on healthcare workers nearly 4,000 healthcare worker's died in the 12 months of the pandemic. Direct care workers who handle everyday patient care most prominently nurses were more likely die than physicians were from COVID-19. And unlike the general population among healthcare workers more than half of those who died were under the age of 60. As a result of that toll as well as other compounding factors, between 20% and 40% of nurses are considering leaving the profession. And almost 50% of intensive care nurses are considering leaving that role. One particular cause of the turnover and the sort of potential departure from the nursing field has been the prevalence of moral injury among nurses who through a combination of their individual facility you know individual hospitals or - and or federal mismanagement of the circumstances, felt unsupported and unprepared to protect themselves or their patients during the worst of the COVID-19 pandemic spread. This image that you see sort of as the background is from a July 2020 demonstration where National Nurses United activists laid 160 pairs of white nursing sneakers on the capital lawn each representing a nurse who at that point had passed away from COVID-19. All of this is to say that the timing of my Archie Green Fellowship which was scheduled to begin in July of 2020 early on presented what appeared to me as insurmountable logistical and in fact ethical challenges, in terms of how to proceed with recruiting and interviewing nurses. My initial plan, my proposal, included in person oral collection and ethnographic observation among Veterans Administration nurses in three US states; Florida - for US surgeries. Florida, Washington, D.C. and California. I'd planned to begin traveling and conducting interviews in July 2020 drawing on contacts that I have from previously working at National Nurses United. And to build a social network sample out from those friendships and colleagues that I knew from that period. Well, July came and went, and I continued to hold out hope that August might prove a little safer, a little more open. When all of our courses at St. John's University for fall 2020 went remote, I realized that the in person aspect of my research agenda would not be feasible in 2020. I still retained hope that I could do some in person interviewing in 2021. But I essentially crapped it for the fall. And at the time I had another more formidable issue to content with as well, which was that my recruitment efforts were really stymied. I still to this day have reached out to about half a dozen people who I never heard back from, from this time last summer. It was really difficult to get phone calls back. Sometimes I'll get phone calls back hearing that the person I reached out to had left nursing due to circumstances at their hospital diminishing significantly. Others gotten back in touch with me to tell me that they had gotten sick with COVID or had lost loved ones to COVID. And still others said that I'll be in touch once things slow down. Nancy was very gracious and fielded a number of emails and calls for me early on expressing my fear that I might have to change or in fact scrap the oral history project as I planned it because it looked early on like it wasn't going to be feasible to complete it within the year. Luckily, there were some changes that provided a great deal of reassurance to me in November and December of 2020. The first was that I realized I wasn't going to even make it down to Washington, D.C. to conduct in person interviews. So, I contacted Dr. Carmen Von Hewitt who is a VA nurse at the Washington, D.C. Medical Center. And also [inaudible] certificates in Health Inequity and Care and Women's Global Health Leadership which are two online programs offer through National Nurses United that I taught in. So, Carmen and I had a relationship through the course work that she completed with me. I'd planned to be in touch upon reaching D.C. and you know had hoped to talk to her and to interview her as part of the project at that time. But when it became clear that I was going to have to do remote interviews even for D.C. and I'm in New York, that's relatively nearby, I reached out to Carmen who was a godsend. She not only agreed to participate and do the first oral history with me in in I think it was either December or January. She also extended her cultural capital and her savvy to recruit about almost two dozen additional nurses through her professional and social service network. So, it finally got the ball rolling on remote oral history collection to tap into Dr. Hewitt's links and to her social network, which I am forever grateful for. And in fact, Dr. Hewitt is a fellow as I was last year for this coming year 21 to 22. The second piece that also came together around the same time was that I contacted my previous colleague at American University in the Health Inequity and Care program, Dr. Adrienne Pine thinking that perhaps she and her students might be able to conduct in person interviews with Baltimore and D.C. and perhaps even Virginia based VA nurses on my behalf sort of as part of a class project. I could provide some training and some guidance and maybe they could carry out the leg work in person. I was still being a bit optimistic and perhaps naive about everyone's comfort level with in person interactions even as early or as late [inaudible] as January and February. So, that didn't transpire. But I did end up collaborating with Dr. Pine's graduate and undergraduate students with the Health Inequity and Care course to conduct interviews. So, in many cases about five or so students who have joined me for remote oral history collection and they helped draft questions that - which Dr. Hewitt also weighed in on. But in particular three students Hanna Shows [phonetic], Bee Paxton and Lisa Krajecki [phonetic] went an incredible step further and reached out to nurses on my behalf to get them to join our project. So, Hanna posed on Facebook and LinkedIn. Bee made contacts through the Michigan VA where she and her family knew people. Lisa reached out to nurses in her life to ask if any of them might know people working at the VA. And lo and behold about six additional interviews came through this kind of novel partnership with undergraduate and graduate students at American University and with my former colleague Dr. Pines work there. So, as things started to taking shape it became clear to me that my early on panicking wasn't exactly warranted. That by March we'd really the team that I've assembled with you know for which I am incredibly grateful, started to make some headway. And so this sort of time and patience bore itself out in delivering some recruitment successes. And then finally the other kind of important piece of this before I move on to some of the content, was that it requires ongoing efforts. So, the majority of the interviews I conducted between March and June and I'm still conducting interviews, collecting more interviews and oral history data for the project. I'm still waiting on transcriptions, my transcriptionist who I work with are located in Uganda and India so they're contending with a second wave of COVID lockdowns and quarantine delaying that process sort of. So, this sort of time and patience piece remains a salient lesson as does the ongoing effort at this particular moment and this particular contacts requires. But I also found that despite these limitations and particularly the difficulty I encountered with recruitment, there are some interesting and for me unexpected benefits to remote field work, some strengths. So, conducting oral history using remote audio recording software certainly has significant limitations. Like telehealth and remote learning technologies, it rife with glitches, it's limited by both having a working device on both ends of the connection as well as having a reliable internet connection on both ends of the connection. So, there are a number of small everyday issues that arise in a remote interview setting that we don't have to contend with in contend with in person. There are also these ongoing difficulties with scheduling and with returning phone calls and emails and overall sort of just you know the harried nature of online mediated communication. [inaudible] remote oral history collection which this is the first time I've undertaken remote oral history collection. My previous fieldwork was all in person. It did facilitate inclusion of VA nurses from around the US which I'd not earlier anticipated. And that turned out to be a great benefit, not only because I could include nurses from for example, the Houston VA where I previously hadn't had any contacts and hadn't imagined conducting interviews in person. But is the largest VA in The United States and has a variety of positions housed within it for nursing staff and other healthcare providers. And I similarly could include very rural more New England nurses who I wouldn't have had the opportunity to include in a study that was based on my in person interviews in three states. But it also provided the opportunity to talk with nurses representing a range of applications of the nursing profession. So, from nurse administrators and managers to nursing instructors to psychiatric nurse practitioners in in-patient homeless facilities, to Dr. Hewitt who is a primary care home based nurse who does home visits with patients who are unable to come to the primary care clinic. To nurses whose primary role in the hospital is referring patients out to private sector services when they're not available through the VA. The sheer breadth and dynamism of the nursing roles inside the VA is one of the strengths of this collection, I think. Sort of getting that on record and available to everyone. And certainly would have been limited if I'd only had three states to work with. Finally, the actual interface worked quite well for this population in my experience. I used a podcasting software suggested to me by the staff at The Library Congress called Spotcast. And Spotcast permits you to see the other person as so you're in the Zoom or Skype or WebX meeting. And you can mute your microphone just as you would in Zoom. And what I found was that the [inaudible] and passionate nurses were incredibly accommodating. If I asked one question and hit mute, they would just sort of go on and on about myriads, circumstances and stories connecting themes and connecting points in their lives to lessons that they wanted to impart. They were so easy to talk to and to encourage to essentially monologue that the mute button ended up being incredibly effective. And really demonstrated for me someone who is also really talkative and has much more of a conversational interview style, particularly in the in person setting, it demonstrated to me the value of being quiet. And really allowing the person I'm interested in learning more about to speak at length and to give them some silence to collect their thoughts and to you know answer at length. It also permitted me to provide you know intensive and enthusiastic visual cues indicating that I wanted that to keep going, which I think also helped with the kind of [inaudible]. But as you'll see in the transcripts, there are pages and pages and pages of interrupted nurses histories from their own perspective with only really me nodding and smiling at them as a form of prodding. So, I want to get to quickly touch on some themes and connections and then give a couple portraits including that of Dr. Hewitt before concluding. There was - this is another picture from that demonstration that National Nurses United had in July of 2020. There were a number of themes that arose in the interviews. So far, I have 25. But I'll have another 5 to 10 more before the end of this month. And so I feel fairly confident in making some assessments about the connections between them and the themes that I saw. The first is this quote that came up in multiple interviews. In a handful of interviews. So, a nurse told me this quote verbatim. But the theme was prevalent in all of the interviews that I conducted. Veterans have written a check to The United States Government payable up to and including my life. And this sentiment that nurses feel working for the Veterans Administration that they are caring for a population who willingly put their lives on the line to protect you know the nurses freedom, the nurses lifestyle, the way of life that you know they associate with The United States and America was incredibly palpable and very, very powerful for almost every single nurse I interviewed. Another benefit of the online platform was that many, many of our interviews became incredibly poignant and emotional in part because I think the you know comfort of their own home, the sense that they were sort of just reflecting privately, really encouraged nurses to tap into what really seems to me to be a reservoir of pain and difficulty that they have experienced over this past year given the difficulties with COVID. But also of the significance that this particular work has and holds for many of the nurses I spoke with. The significance of [inaudible] that they are treating the patient population. Second, this is more of a summation that I came up with is that VA nurses are part of our national history acting as repositories for generations of experiences and struggles. This again was reflected in almost every single interview I've conducted thus far where nurses really identified their opportunities to speak at length with veterans family members about their backgrounds, about their military deployments as well as their day to day issues and their healthcare and their health conditions as being the most rewarding aspect of their job. This sort of sense of you know being a listening ear and being an individual who can hold the history of US you know essentially combat [inaudible] in their bodies and in their hearts was capital reoccurring throughout every interview that I conducted. The other quote that I wanted to share with you was, from just a couple weeks ago, I would think early July, one of the nurses I was interviewing when asked how the VA handled or when - how the COVID-19 pandemic effected the VA systematically. She said that "The pandemic pulled the VA together," which was another thread that I heard time and time again. That despite the difficulty of the COVID-19 pandemic, for Veterans Administration nurses, they really saw it as an opportunity for the VA to demonstrate what it does well. What the sort of centralized, largest private healthcare or sorry. Not private. Largest healthcare provider in the country can do with proper funding and adequate resources. And so, in almost all instances there was a real sense of pride at the way that the VA as opposed to private healthcare systems addressed the pandemic to protect their patients as well as their nursing staff and other healthcare staff. The nurses also express that COVID demonstrated the value of nursing to the public and to physicians because of the spotlight on nursing that public you know sort of had a renewed or an increased sense of their capacity and their expertise on the job. But moreover I heard many times that nurses really led the way in handling the pandemic inside the facilities. That nurses sort of expertise at the level of hands on patient care was what was needed to navigate this highly unprecedented circumstance in the context of the VA. COVID also hastened long anticipated transitions to telehealth medicine for elderly veteran patients. Just like many of us in our roles most of the nurses I spoke with worked at some point over the past year in a remote capacity often providing telehealth visits for veteran patients. And in the case of the VA, veterans were provided with a device, like an iPad or a tablet to use for these appointments. And again, this is one of the ways that the VA sort of is hoping to as far as I understand, push the adoption of telemedicine more robustly even post pandemic quarantine. And finally, for many of the nurses particularly those who have themselves an interest in sociology or societal level inequity they reported the ways that they saw COVID-19 exposing flaws in th US healthcare system that nurses have long known about and [inaudible] about. So, as I said, as I'm finishing here and forgive me, I'm going to go I think just a little bit over, I wanted to make sure that I could include just a couple portraits of the nurses that are included in the collection. This is Dr. Carmen Von Hewitt my key interlocketer [phonetic] as we say in anthropology and friend, as well as Archie Green Fellow. And she has been a nurse for 33 years. As I mentioned she works at the Washington, D.C. Medical Center where she spent 23 years working as an agency nurse or contact nurse initially before coming on staff in the surgical units and then the medical ICU unit. Then working in the medical advice center, the call in center. Before about five years ago, moving to the home based primary care unit, which is where she visits veterans in their homes to do case management and assessments. This sort of intimacy working with veterans in their homes provides Carmen the opportunity to bond with the veterans and their families. And as she told me to give the veterans an opportunity to participate in the wellness model of healthcare where they set goals for their own health and talk with her about their plans to meet them. Carmen's also an ordained minister and elder in her church. She has a MA in biblical studies as well as a Doctor of Ministry and two certificates in Health Inequity and Care as well as Global Women's Health Leadership. This is Fran Hodgskins [phonetic]. She worked as a VA nurse for 34 years. She's a mental health nurse specialist living in Houston, Texas. She considers herself a nurse historian as well because in addition to her day job, she collects nursing memorabilia; diplomas and nursing uniforms, caps and gowns. Anything she can find second hand that allows her to preserve the history of nursing in the US. She's worked in multiple VA hospitals around the country. Now she's working in the geriatric psychiatric in-patient unit in Houston's VA department. And she talks quite a bit about how her artistic endeavors as a musician and an artist provide a point of rapport and community with the veterans regardless of where they live in the country. This is Robert O'Keefe. I just interviewed Robert last week. This also gives you a sense of the Spotcast setup that I was using for these interviews. He lives in Pennsylvania. And he works at the Willington Delaware Veterans Hospital. Bobby is a Marine. And he's still in the Marine Reserves today. He spent 15 years working at a community based hospital there in Delaware. But after 2016 deployments to Iraq and Afghanistan where he saw several soldiers injured including one who's foot was essentially amputated in the field, he returned to the US and decided he wanted to work for the VA. He felt obligated to care for his fellow soldiers in that capacity. So, he told his wife I'm leaving my you know good stable job at the community hospital and I'm going to get a job at the Delaware Veterans Administration instead. Since that time, he joined the DEMPS team which is the Disaster Emergency Medical Personnel System that the Veterans Health Administration provides to areas around the country, where they deploy clinical and nonclinical staff to disaster areas. This was the team that deployed throughout COVID. So, Bobby deployed three times throughout COVID. First to New Jersey to a long-term assisted living home for veterans. Second time was also to New Jersey to a medical surgical veterans facility. And the third time was to Oklahoma City to their ICU. Oklahoma City - this was in December of 2020 when Oklahoma City had an acute outbreak of COVID and all of the nurses I've spoken to who were there at that moment, in December through January report intense trauma from the number of deaths, the inadequacy of the hospitals morgue to handle the corpses as well as exhaustion and overwhelmed from the intensity of the deployments there and the ICU units sort of need at that point. Bobby and I as I said just spoke last week. And this was the first time he had talked with anyone really about his experiences deploying during COVID and he was rightly and justifiably quite emotional. And still holding on to a lot of grief and trauma form the past year. Finally, this is Dr. Elle Cook. She's a San Diego psychiatric clinical nurse specialist. And she also has a doctorate in nursing. Her dissertation research was a qualitative study as African American women's perceptions of beauty in a Eurocentric esthetic sort of comparing the psychological impact of standards of beauty and internalization of those norms. She now works at the Aspire Center which is a forty bed rehabilitation center for veterans who have post-traumatic stress disorder and who have substance abuse. This is according to Dr. Cook, the best position that's she's held at the VA. It allows her to practice at the top of her license as a clinical nurse specialist meaning that she can conduct individual therapy treatments, can prescribe medication, do family therapy as well as oversee clinical rotations from other nurses there. As I said, I wanted to just be sure to [inaudible] a couple of portraits before I conclude. I know I'm a little bit over. I apologize for that. And I want to thank you all again for allowing me to participate in the Botkin lecture series. I'd like to thank Nancy and all of The Library of Congress staff for all of the help over this past year. It's been such a pleasure and an honor to talk with the nurses particularly at this moment. Thank you. >> Nancy Groce: Alana, thank you so much. That was a wonderful presentation. And we really look forward to getting your interviews in and processed and make available then to the public. They're going to greatly enrich the Occupational Folklife Project and just holding to The Library of Congress. So, we will rather than taking questions right now, what I'd like is for everybody to hold their questions until after our second presentation. And then will have a chance for the audience to ask you and the other presenters any questions they might have. But that was a fabulous presentation. Thank you so much. Our next presentation will be from Josephine McRobbie and Joseph O'Connell who were - who jointly did a project in the last cycle the 2020 - no I'm sorry. 2019 cycle of Archie Green Fellowships on midwives, doulas and birth workers in really throughout North Carolina. And your materials have come in. We're processing them now. So, they're not quite ready for prime time but they will be soon. They're available to researchers who come into our reading room. And they will eventually like all the other Occupational Folklife Project interviews be available online. But you started working on this project before the pandemic struck and then suddenly, you're in the midst of a pandemic. So, could you just give us an overview of the project and how - and the impact of the pandemic on your project. >> Josephine McRobbie: Yeah. Thanks, thank everyone for having us today. It's great to be able to talk about this work. We haven't had too many outlets yet to share this research. So, it's very exciting. So, our Archie Green Fellowship looked at an occupational cluster of workers. So, these were nurse midwives, certified professional midwives as well birth doulas and other people providing birth support, practicing all around North Carolina. And so there's a lot we could say about the kind of subtleties of this group of workers and how they, how they work with each other and how they're different. But in the most basic of terms midwives provide the medical care around pregnancy, around birth, and the postpartum period. And this includes delivering or catching babies. While doulas provide a role that's alongside but independent of the medical team. So, they provide companionship, advocacy, and other forms of support to people who are expecting children. So, both of these professions practice at hospitals, at clinics, and free standing birth centers as well as in a few kind of limited cases in North Carolina which is quite restrictive in the clients home. Next slide please. So, the women we spoke to referred to their work as more than an occupation. It's also a passion. It's a politically critical endeavor. It's a privilege. And here's Tina Braimah's description of what she does as a nurse midwife. "We hold space from that transition from inside to outside from one world to the next." Tina is a former mechanical engineer whose current career sees her focus on working with pregnant women of color and women of a number of different faith traditions. And so she is one of the people whose work initially inspired us to do a project on these occupational groups. Our aim was to do audio interviews that captured a mix of biographical and cultural information. So, we wanted to hear how someone came into their work and their professional and community sourced way of participating it in. And it's could include everything from a doula who used herbs from Puerto Rican heritage when working with clients to the home birth tradition of decorating and signing birthing tubs to moments of negotiating with complex medical systems to serve a clients needs. And we wanted this project to reflect a diversity, a geography, race, and ethnicity in occupational experience. It was really important for us to continue educating ourselves about the workers out there as we went along. To make sure we gave space to more than just one network of practitioners. Next slide please. In addition to the audio interviews we took portrait photos of the participants. And here are a selection of those photos. These are pre-pandemic. And before COVID-19 we'd interviewed 16 people. We'd established a pretty good rhythm. We met and we'd make contact with a really broad and diverse group of people in these professions. We'd usually have a phone call with them to discuss the project and answer their questions. And then we'd let interviewees choose a place to meet. This mean that - this meant that we took our reporting from an -- everywhere from people's dining rooms to their medical offices. We set up with myself or Joe playing as the lead interviewer and the other person running tech and monitoring our audio levels. And this was really great to have the resources to be able to have a two person team at interviews and get really good audio quality. It's something that I think neither of us had really had the opportunity to do at that level before. So, we were grateful for that. We also made a simple access website that we can have John put in the chat, so that people could hear and download their interviews basically, about a week or two after they were done before it became part of the official American Folklife Collection, American Folklife Center Collection. And this was really wonderful because these occupations are subjected to a lot of cultural misconceptions. And so this gave our interviewees the opportunity to listen to a couple of interviews, see who else was participating. And determine if we were, they were the kinds of people that they would want to open up to and share their stories with. But in general this group of workers was incredibly welcoming, and we got really comfortable with them. We spent hours at workplaces. We met people's kids and their pets. And we even hosted some people here in our living room if that was a more convenient location, often because of kids and pets and other people's homes. So, it's easy to see - next slide please. It's easy to see how we benefited from doing this work in person. The material culture in peoples spaces was very rich. We generally didn't do kind of documentary style photographs. But these are a couple of snapshots that we took of things we wanted to remember. So, on the left is a DVD lending library for clients and colleagues belonging to a midwife in Garner. And she told me that the film on the right, it's a 1979 film called Birth in the Squatting Position is soft of legendary among birth workers. And something that's used as kind of a classic instructional tool even now. On the right is a bookshelf that's in the office of a certified nurse midwife. And on the shelf, you can see, on the middle shelf there's a model of a baby, a pelvic girdle, and a placenta. And she uses those to show her clients th anatomy of vaginal birth. On the bottom left you can see that circular model and that shows how the cervix dilates during labor. And on the top shelf you can see a photograph of the interviewee and her nursing school classmates. So, as I mentioned in addition to being around this stuff of peoples lives, we also got to meet their colleagues, their families, and their friends. And these are all sources of information that really guided our recorded sessions. Next slide please. So, as COVID became a concern in mid-March of 2020 we had to hit pause on our interview planning. And as we communicated with people we'd already spoken to or planning to speak to we heard a lot of about their lives were in the moment. So, for healthcare workers and people working in healthcare spaces, things were especially challenging. They needed to figure out how to continue to serve their clients while also keeping themselves safe and everyone else safe. And beyond that there're are a number of concerns specific to this occupational group or groups. So, a couple of examples of this. Hospital based midwives found themselves in much more stressful work environments with the change and guidance on safety procedures. Lots of client anxiety. Lots of anxiety themselves. It's health disparities that were already a focus for many people that we spoke to working in these professions were becoming even more pronounced. Home birth midwives found themselves suddenly to be in incredibly high demand. Because many expecting families were weary of visiting hospitals. And they were looking for a different way to have their children. Birth workers were in some cases having to figure out their own protocols for masking, temperature checks, and COVID screenings. Like Alana said, nurses were really leading the way in a lot of these spaces. For several months doulas were not granted access to some hospitals in their support roles. And they effectively in some cases had to facetime into their clients labors and deliveries, which was like you know telemedicine and like everything else, is a very limited way to be able to do your work especially with something as fought and difficult and sensitive, sometimes as birth. And finally clients who had likely chosen to work with midwifery model of care or to work with a doula because they valued empowerment during labor and pregnancy suddenly found themselves with a lot let - a lot less choices in hospitals. And the next slide please. So, intuitively we knew we needed to wait for you know kind of an unforeseen amount of time to resume our interviews. And we weren't sure if we should be planning to use remote methods or if we would be able to get back to distanced in person interviews, seeing as we were fairly close you know within you know - within probably five hours to anyone we were going to interview. So, we - for the next month or two we kept an eye on The Oral History Association, The Association for Independence in Radio, Publore, and other professional discussion forums to kind of see what other people were doing. We also consulted regularly with Nancy and the AFC staff about what might make the most sense for our research. And they were incredibly gracious and generous in talking through this with us. And in the meantime, we started practicing with some online recording software. Joe actually enlisted his dad as a faux interviewee as somebody who would be able to give us some good feedback about how things were working in another household. And as we did this we were thinking basically what do we need to do in this imperfect moment to make sure that we can create an atmosphere that the participant feels positively about their experience, where it isn't adding a burden to them and it can feel like something that is so meaningful, and a good use of their time during a very, very busy period. And it was a time when so many occupations and life work were becoming unmoored. So, we were cognizant of not wanting to impose our need for reflective conversations at a time where everything felt difficult, unclear, and even traumatic. So, with that I'll pass along to Joe. He'll talk a little bit about how we proceeded. >> Joseph O'Connell: And John, we can advance to the next slide now. So, as Josephine said that was a period of about two months when we were still discerning how and whether to move forward with the remaining interviews that we had planned to do. That was about a third of the project that we - that remained to be completed. And at that point we sort of began to see new norms emerging just in society in general. A lot of people were moving their work online. We were starting to have a lot of Zoom meetings. It felt like the time was right to make the decision to so our interviews online. To not delay the project any further but to accept the imperfections and all the good and the bad that came with interviewing people by video conferencing. The same way that so many of us were adapting our work to that format. So, we began to dip our toe in the water of recording online and interviewing online which neither of us had ever done before. And we did that slowly at first sine we weren't really sure how it would go. We'd experimented with it. We tested some platforms. And we knew that there would be some technical challenges. We knew that there would be some challenges just in the comfort of communicating remotely and communicating in a mediated - internet mediated way that's subject to pauses and glitches and imperfections. And that doesn't include all the information that you can gather in a face to face setting. But we thought that those were surmountable challenges and we'd be able to collect something that was worth collecting even if it was different than what we planned to collect. So, initially our - an important thing too to us was we really wanted to make these sound better than a Zoom call. You know it was already - the Zoom experience was already something that we were not excited about in our lives. It was already becoming ubiquitous and we posted on the AFC blog about some other platforms and techniques that we tried. If anybody wants to read that post, there's a little bit more information. But the ending of that story is that we wound up coming back to Zoom for exactly for the reason that it was ubiquitous, and it was - it had become normal. It'd become very easy for people to use and a standard. And what we got out of the accessibility that came with using the platform that everybody was using was worth a lot more than whatever we could get out of trying to use something that would be a superior technical tool. So, once we, once we settle into this pattern of asking people to meet with us on Zoom, it really did - we didn't have too much difficulty finding, finding people that wanted to speak with us, that wanted to participate. It was fairly easy for people to incorporate into the remote work that they were already doing. A lot of the midwives and doulas that we were speaking with were doing telemedicine or meeting with clients on Zoom. So, we found that the time was right for people to begin participating in this project again. And we're glad that we went forward when we did. And we can, we can move to the next slide now. So, just a few of the observations that we came away with. One is that we think that it was a good idea to continue the project when we did rather than delaying any further. Because we started to recognize that even with two months passing some of the familiarity that had built up with the communities that we were communicating with and even with the subject matter, some of that was starting to fade and become a bit duller. It seems like there was an arc to the project where when we were in a habit of doing the interviews, of listening back to the interviews, there was something that we gained a kind of sharpness that we gained in our, in our, in our grasp of the topic in our ability to kind of be in the culture of this occupation. And if we had waited longer or tried to restart the project after the pandemic, I think we would have lost a lot. I think it would have been very difficult to get back to the point that we were at when COVID hit. Another, another lesson I think is that it doesn't really make sense to try to recreate an in person interview with your remote interviews. So, we got used to the idea that were accepting a different kind of experience. One of the things that was missing was a sense of ceremony that gave the in person interviews their tone al lot of the time. There's something about setting up microphones in a space with someone that - it made it feel official and sort of made it feel important. And you know people interacted with that and commented on that in a variety of ways. They sometimes took selfies as we were setting you. Or they would do Instagram live stories about the fact that were about to be interviewed. And sort of interview us about interviewing them for their Instagram feed. And so, those were moments when we can kind of mark the significance of what was happening. And one of the interviewees compared it to actually to a therapy session. She said she'd never spoken as much about herself except for when she was paying for therapy. And so there're all these aspects of heightened experience that came with the in person interviews that we had to acknowledge that. We weren't really able to offer that on Zoom. That is was going to be something else. And it might be, as Alana mentioned, it might be more of a question answer format. It might be more of a monologue. It might be simply more like hitting record and asking someone to tell their story without as much interaction, without as much ceremony. There were some positives and some forms of collaboration that emerged in our remote interviewing that we thought were valuable. For example, when we asked people to do a remote interview with us, we're sort of asking them to step into a kind of technician role. They're doing their own sound. They're deciding where to place their equipment. And deciding how they want to present themselves in a different way then if it would have been in person. And that was especially true with photographs. Since we weren't taking photographs in person anymore, we were asking people to submit a selection of photos that they would like to live alongside the interviews in the archives. And so we got a really - a wider variety then we would have gotten otherwise. And we think there's some value in the range of images that people sent us. And also in the fact that they were self chosen. That they were sort of curated by the participants. And a third point here that was I think an advantage of doing the interviews in this moment. Initially it was a little bit jarring to try to figure out are we talking to people about their work routines, their normal business as usual lives or are we talking about what had changed during - in their work lives as a result of the pandemic. And in a certain way it seemed like one could actually feed off the other is what I realized. And a good example of that was in an interview with a midwife named Nancy Harmon. She was talking to us about how she had to change what she wears to a birth during the pandemic. And that - she and her staff had had to buy scrubs and PPE. And that it was entirely out of step with what their normal work culture was, which was to wear street clothes and to make things seem as normal and comfortable as possible for the people involved in a birth. So, just briefly to quote in the interview she told me. "We like to look like the people that we are. But for right now wearing scrubs makes us look like people who are aware that we don't want to spread a virus from one family to the next." So, in that case, the change in her norms and her habits at work actually I thought led to a really illuminating reflection on why those were her practices to begin with. And she sounded almost pained to be wearing hospital attire. And it was I think very indicative of how important it was for her to wear street clothes as a signal that birth could be approached as a normal and natural process. And we can move to the next slide. So here are a couple examples of photos that participants sent to us. And I want to share a little bit more about what was interesting to us about actually having them curate their own photos. There were a couple times when we met in person pracademic with people we were interviewing. And despite our best efforts to make them feel comfortable having their picture taking, they would comment on being underdressed or under prepared for a photo. And so that element was kind of removed when we asked people to submit their own photos. They - it was a good feeling for us to be able to put them entirely in control of how they wanted to present their appearance and. So, here are a couple examples where midwives or doulas sent us in what looked like studio portraits or professional photography where clearly - this was the image that they felt comfortable presenting. And we can go to the next slide which is in some ways on a different end of the spectrum. These are photos from Carrington Pertalian [phonetic] in western North Carolina who is a hospital based nurse midwife. And she was one of a couple people who went above and beyond and actually sent us what amounts to basically a photo essay or photo diary of her life. And so, a couple examples of Carrington's we really like. There's one photo of her early in the pandemic wearing a mask. But you can see she's smiling. And it's a Wonder Woman mask which is a nice reflection of both the pandemic era lionizing of healthcare workers and the feminist orientation of the profession. And also, she actually sent us a few photos of her - directly after a birth. And then others that are just markers of her way of life. Here's her on a scenic, scenic drive in - somewhere in the Blueridge mountains with her dogs. We can move to the next slide now. So, to wrap up, here is a map of the locations of the doulas and midwives who we managed to interview for the project. And the blue markers are people we spoke to in person, pre-pandemic. And the purple are people that we interviewed post pandemic, or during the pandemic rather, remotely. And one final quote from one our interviewees here. We'll include that at the bottom just as a final reflection on some of the meaning of the work that's done by midwives and doulas in the state. And [inaudible] further slide. Okay. >> Josephine McRobbie: Thank you all. >> Joseph O'Connell: Thank you so much to The Library of Congress and American Folklife Center for the opportunity to share out work in this context. And for the opportunity to do the work. It's been such a privilege to have the time and resources to get to know this occupational group. And it was really gratifying also to see their excitement at having some of their experiences documented and shared. So, please feel free to reach to out either Josephine or I or both of us if you have any questions or comments. And if you'd like to hear any of the interviews that we did before, they're up on The Library of Congress website. You can check out our access page which John linked in the chat earlier. So, thanks once again for having us. >> Nancy Groce: Thank - and thank you Joseph and Josephine, that was a great presentation. We have - actually we have quite some time for questions for the - for people who are attendees. But maybe I'll start by asking the two - the three speakers whether they have question for each other. Alana? Joseph? Josephine? >> Josephine McRobbie: Yeah. I had a question for you Alana. I'm wondering and I'm thinking about this myself. Do you think that you'll choose to do remote interviewing for future projects? Do you see a space where that would be useful or are you ready to move on? >> Alana Glaser: That's such a good question. You know I don't know. I really, as I said, I really benefited from having the opportunity to be quiet. I was happy to have the experience of being a little more of an attentive listener than an active conversational partner. But [inaudible] important of the field work I've done in the past has been, for just an observation where you know it's not an interview directed setting but it's more casual. And in my experience, those have been really useful for like aha moments and having some of those like illuminating conversations. So, I think I wouldn't want to sacrifice that aspect. So, that's of course difficult like with the medical setting anyway. I don't [inaudible] getting access to like hospitals so that I can assist on the floor. But I think that maybe there's like some complimentary methods to employees. Have you all thought about whether you'll continue doing remote or return to in person oral history collection? >> Josephine McRobbie: It's given me a lot of - like a lot more appreciation even for the ability to go into people's spaces or to - yeah, just all of the gestures and nonverbal cues that were easier in person. Even things like we can't see peoples hands on Zoom you know. We can't see the way their shifting their bodies. So, I do have some projects you know that my - that might be far, far fetched geographically that you know that would be something that would now be more feasible. Yeah, what about you? >> Joseph O'Connell: I think you made a good point that the online setting really moves things into the column of interviewing rather than field work sort of by necessity. Unless somebody's will to just have their phone on and you know show you around while they go about their life. But I would say that in some ways its made me want to kind of blur those lines a little bit and think about maybe just being more flexible with what counts as documentation or kind of challenging some of my expectations of what the pattern of how I think documentation is done. So, that there's something about that kind of the freeing aspect of it not meaning to look one way, that I think I would try to apply. I don't know if that would - hopefully that won't only look like Zoom - doing Zoom interviews. But the principle of it I think could be useful. >> Alana Glaser: Right. That makes a great deal of sense. And it reminds me of your - the points you both made about inviting the you know interview subject into the process because of the move to remote interviewing. And that was so interesting and something I hadn't quite identified. But I think I also vibed as I was doing interviews. And you put it so well. And I was wonder as well, because the other thing that you said that stuck me as being so insightful the opportunity to reflect on previous patterns once, they've changed because of COVID was useful in like illuminating the significance of our you know our routines, our work patterns. Were there other insights that came to mind because of the way that your interview subjects responded to COVID along those lines? Or was that the predominant one? I thought that was so brilliant. I'm so curious if there's anything more along those lines? [ Inaudible ] >> Josephine McRobbie: I mean I think one takeaway for me that have to do with COVID, and the topics of the interviews was just how invested this group of workers are in their profession. That it really is more, more than a job that they clock into and clock out of which is - makes me feel very gratified in why we chose this topic. Because it felt, it felt like the level of investment was palpable in the people we spoke with even when things were at their most difficult. Even when like we said, doulas had to facetime into labors, which is just you know kind of unfathomable for this kind of work. >> Nancy Groce: Well, interesting. If we can turn over my colleague John Fenn. Hi John. >> John Fenn: Hey. >> Nancy Groce: Is on the line and he's monitoring questions that are coming in from the audience. Are there any that have - that you'd like to share with us? >> John Fenn: Yeah there, there are a few. So, I'll take them in order. The first one has a long lead up to it. But it starts with a compliment. First of all, really wonderful work. So, I just want echo that for all the presenters. And this question exists at the intersection of some of the technical stuff and some of the emotional stuff you both drew on. And so may - we'll take this order. Maybe we'll start with Josephine and Joseph. Did you find that interviewers were - interviewees were able to be more vulnerable, possibly even more intimate in their responses due to the online format, maybe thinking they're in the comfort of their own homes, being a safe space? So, we'll start with you all and then we'll go to Alana on that one. >> Josephine McRobbie: It felt like it really depended. I feel like for some people, the ceremony that joe spoke of with setting up for an interview can also inhibit people. And so there are times where it felt like that was you know might - people might clam up a bit more at the beginning. And doing Zoom call they were doing you know a few Zoom calls a day. So, that maybe felt like a space where they could be more open. >> Joseph O'Connell: I agree that it's hard to generalize. I think for me, I think that my interview style - I'm more capable of making people feel a bit more comfortable in person. And So, I felt like it was harder to create intimate conversations in that setting. So, it was interesting to hear when Alana said that in some cases, that you had the opposite of people felt very open. >> John Fenn: Yeah, Alana do you have anything to add to that? >> Alana Glaser. Right. In my case, I can't quite determine if the interviews would have shaped up in a similar way if we were in person. But they were across the board very poignant and often very emotional. I think it is mostly a testament to the strong feelings that the nurses I spoke with have for that are in population and the patients and the importance of their role. And then the essentially the burnout. And that moral injury left over from this year. But I do think there's something about the fact that you know they were in the privacy of their own homes. That they - at multiple times a nurse would say something and would start to cry. And usually I am [inaudible] or [inaudible] on with me, we'd start to cry as well. And it was often very shocking for all of us, that we were crying. That we found ourselves crying. And the nurse included. Bobby for example, who just spoke last week, as I said he hadn't had anyone I think ask him you know to talk about Oklahoma City in particular since he's been back. And you know his house was empty. His wife was out. His kids were out. And so I think he felt authorized to break down essentially in that context. Whereas had we done it in - I'm trying to think of the other settings I've conducted interviews. Had we done it in his home, in person it might have felt more guarded. Or if we'd done it a library setting you know a setting, I used to conduct interviews in the Bronx Public Library. And it was a little more stilted. So, I do attribute some of the strength of the emotional content of the interviews to the interface. But I don't think that's solely it. Though I don't a control group to compare you know since I just did them all, all remotely. >> John Fenn: That, that's a great point about the control group. All right. This next question is again for across the presentations. Did you experience any participants who wanted to be involved, but felt resistant to making their interviews accessible to the public or to researchers? You know all this stull will go on loc.gov eventually. If so, how did you handle those situations? And we can go in the reverse order. So, Alana we can start with you if you have something to. >> Alana Glaser: I did. I had two nurses who were participant - communicating with me about scheduling an interview and interested in participating until I asked them to sing the release. And then they mentioned they didn't feel comfortable signing the release. So, I just respected that decision. And I had a number of nurses, probably not quite a dozen, but 10 or so who because they work for The Library of Congress felt uneasy about going on record, speaking about their careers. In some cases they asked their supervisors directly for permission and were denied permission. In other cases, their local VA culture you know just imparted a sense of paranoia about their ability to speak about their own experiences. And have it not be construed as speaking on behalf of the VA, which nurses who work there are prohibited from doing. I don't think there's actually any worry in that regard since they're all speaking about you know their growing up, and their long-term experiences. But there were a number of nurses who I think ultimately would have participated if their employer had been a little more flexible or if they had - yeah, just didn't have so much worry about the impact of being publicly associated there. >> Nancy Groce: You changed the title of your study [inaudible] because of that, right? >> Alana Glaser: That's right. The study was initially called something like nurses experiences caring at the Veterans Administration. And we titled the - we included the Veterans Administration formal - formally in the title. But a couple of the nurses expressed concern about that. So, we switched it so that it was a slightly more vague at the outset. And wouldn't have this issue of are they speaking on behalf of the VA as an entity and are they legally prohibited from doing so? That's right. I forgot. That's right, Nancy. >> Nancy Groce: And so it's now called Nursing American's Veterans. >> Alana Glaser: Right. Yeah. So, it has a little less. >> Nancy Groce: A little bit of a work around. >> Alana Glaser: Yeah, a little ambiguity I suppose. >> Nancy Groce: Yeah. We have to - when we get to the library's point of view, we have to have titles that people can - when they search 40 or 50 years from now, can come up with your topics. So, we give a lot of thought to making titles succinct enough but also focused enough and comfortable enough that it will work in various ways. So, Alana gave that a lot of thought. Josephine, Joseph do you want to respond to that question? >> Joseph O'Connell: Yes. We did meet people who hesitated to have their interview made public. And we found ways to work with them. The biggest hesitation really had to do with understanding what our project - what our project was, what the outlet was. And that is evidently people told us later, that was because of a history of antagonistic reporting on midwifery. And so, we needed to establish some trust and show that we were not, not doing anything secretive to try to shine a negative light on the profession. And once we were able to do that, once I think we were sort of - once our project was maybe a bit better known in the community, then people felt comfortable - more comfortable participating and making their words public. And the access page that we made helped with that because the people who we reached out to could see who we talked to already. And they could listen to those interviews and they could check out the kinds of questions we were asking. And see evidence that we really were doing what we told them we were doing. >> John Fenn: Great. >> Nancy Groce: John, do we have more questions: >> John Fenn: There is, there is one more question. It's - and it's specifically for Alana. And the asker is wondering if you could speak a little bit more about some of the advocacy that you mentioned participants in your project were involved in? Just some brief overview. >> Alana Glaser: Sure, I would be happy to. So a few of the nurses who I interviewed I knew through my previous [inaudible] with National Nurses united, which is the largest union reprising registered nurses in The United States. And they represent a number of VA facilities. In D.C. where Dr. Hewitt is. Here in New York where I am. Florida. Texas. So they're, they're are sort of spread out. And so some of the nurses that I spoke with who participate in Nation Nurses United activities were really active around COVID-19 sort of trying to push both private facilities and The Center for Disease Control to adopt the precautionary principle in managing PPE. The protective gear. As well as sort of you're making sure that the proper equipment was available to nurses and that they weren't being essentially sacrificed for the bottom line of private healthcare facilities. But this particular union is sort of what you might think of as a social justice union. So they also have been involved and Dr. Hewitt could talk to us more about this, with environmental justice campaigns. They have a campaign at St. - at Hopkins for equity on the job. They also have a number of projects that they do locally to ensure that there are equitable conditions for nurses, but also for patients in the hospitals where they work. One of the nurses I interviewed who is a longstanding member of National Nurses United deployed with them in a way that's kind of analogous to Bobby's deploying with the DEMPS team. But what National Nurses United does, is it sends nurses to disaster stricken areas internationally to provide medical - emergency medical care. So, she went to Puerto Rico following hurricane Maria. She went to the Houston are following - I'm forgetting the name that hurricane. And then she also deployed to the US southern border to provide healthcare and advocacy for detained migrants of the past like three or four years. So she - and actually she also I think went down to Honduras at one point too and set up a clinic. So, she's been all over with this National Nurses United brigade. And then Dr. Cook is also a member of the union and has a kind of analysis around that. But she's sort of independently through her church and through other San Diego based entities, works on issues of racial discrimination, racial discrimination in healthcare. And unequal distribution of sort of resources on which people rely to maximize or optimize their health. So, she does that both through the union but also as I said, through church that she is active - part of. And I just got an email blast from her recently about an event that they have coming up. There were a number of examples like that where both through the union, which is the formal channel through which I know many of the nurses. But also through a variety of social service entities. Dr. Hewitt similarly raises funds for St. Jude's Children's Hospital through her nursing sorority which is the first African American nursing sorority in The United States. And they have really in-depth social service and fund raising activities that they do. And most of the nurses I spoke with had some [inaudible] outside of their official job that had an activist or social service commitment in their community. It was very illuminating to speak with them about that. >> John Fenn: Great. That's all the questions Nancy. >> Nancy Groce: Okay. Well, I think maybe - I don't want to go too much over time because I know people are busy with schedules. But I wanted to thank you all for participating in this. We're, we're working on processing Alana's collection and Josephine and Joseph's collection. And they will be online and available probably not immediately but as soon we possibly can. In the meantime, there online - they will be made available at our reading room once the - when we have - now reopening the reading room. But this has been a really interesting discussion. I want to thank you all so much for taking part in this. And as I mentioned at the beginning, this has been recorded and we'll process it, do captioning and put it - make it available online probably in a couple of weeks. We'll put out a notice when it's available. But I want to thank Joseph and Josephine and Alana for joining us this afternoon. I want to thank the crew here at the library, Thea Austin, and Greg Kittleson [phonetic] and Elizabeth and John to - for being online and helping us make this a successful online event. And to everybody in the audience who took time out of their days to come and be involved with this discussion. So, thank you all and we'll look forward to seeing you in the future.