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Nursing Leadership and Management

You work in a public health agency. It is the agency’s policy that at least one public health nurse is available in the office every day. Today is your turn to remain in the office. From 1 PM to 5 PM, you will be the public health nurse at the scheduled immunization clinic; you hope to be able to spend some time finishing your end-of-month reports, which are due at 5 PM. The office stays open during lunch; you have a luncheon meeting with a Cancer Society group from noon to 1 PM today. The registered nurse in the office is to serve as a resource to the receptionist and handle patient phone calls and drop-ins. In addition to the receptionist, you may delegate appropriately to a clerical worker. However, the clerical worker also serves the other clinic nurses and is usually fairly busy. While you are in the office today trying to finish your reports, the following interruptions occur:

8:30 AM: Your supervisor, Anne, comes in and requests a count of the diabetic and hypertensive patients seen in the last month.

9:00 AM: An upset patient is waiting to see you about her daughter who just found out that she is pregnant.

9:00 AM: Three drop-in patients are waiting to be interviewed for possible referral to the chest clinic.

9:30 AM: The public health physician calls you and needs someone to contact a family about a child’s immunization.

9:30 AM: The dental department drops off 20 referrals and needs you to pull charts of these patients.

10:00 AM: A confused patient calls to find out what to do about the bills that he has received.

10:45 AM: Six families have been waiting since 8:30 AM to sign up for food vouchers.

11:45 AM: A patient calls about her drug use; she does not know what to do. She has heard about Narcotics Anonymous and wants more information now.

DQ: How would you handle each interruption? Justify your decisions. Do not forget lunch for yourself and the two office workers.

Sample Solution

1800s, however, the novel was not only reinforcing accepted morality but, with the birth of the Romantic era, challenging it. Novels such as William Godwin’s ‘The Adventures of Caleb Williams’ (1794) and Mary Shelley’s ‘Frankenstein’ (1818) took open opposition to the Industrial Revolution and upheld the plight of the oppressed peasant in line with Rousseau’s anti-capitalist philosophy, while Hawthorne’s ‘The Scarlet Letter’ (1850) challenged ideas about morality and legalism in a way that prompted The Church Review and Ecclesiastical Register to condemn it as ‘perpetrating bad morals’ (Wineapple, Brenda. Hawthorne: A Life. Random House: New York, 2003). Similarly, the beginning of the Victorian era in 1837 saw the conception of social problem novels like Dickens’ ‘Oliver Twist’ (1838) and Charlotte Brontë’s ‘Shirley’ (1849), which were more nuanced in their exploration of contemporary social issues. As a result, then, it is clear that the novel as a form has been socially ‘useful’ in addressing moral and societal issues in England since its popular conception. However, with the rise of other forms of media and a shift in public taste, as well as the growth of mass printing and changes in education, there is cause to explore whether, in the late 20th and 21st Century, the novel has ceased to serve this function and does not hold the same level of social influence as it did before. Similarly, there seems to be less emphasis on (and certainly less prevalence of) what can be loosely termed ‘literary fiction’, as opposed to ‘genre fiction’. The difference between these two is difficult to define objectively, but can be attributed to things like an emphasis on style and concepts rather than narrative and characters on the part of literary fiction. Literary fiction is written with an artistic emphasis, using literary techniques like metaphoric language and intertextuality to achieve an effect beyond furthering the narrative. This is not to say that genre fiction cannot have stylistic features, but that there is not an overall artistic emphasis: ‘The Girl on the Train’, a modern example of genre fiction (in this case, a crime thriller) employs some descriptive imagery. This imagery’s purpose, however, is characterisation, and beyond this the advancement of the character’s storyline. Ultimately what matters to the reader and author in a piece of genre fiction is the storyline.
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