What kind of nurse are you?

1 I'm not asking the obvious. My question does not deal with specialty or area of nursing. It's more an insight into who you are. I've been on here a couple of years, and have absorbed opinions about some of you by the words you post. I admire some of you enormously. Others..not so much.
In that vein, what kind of nurse are you?
Pessimist/Realist
Optimist/Dreamer.
Do you view situations the way they are? Or the way you wish they were?
Do you gloss over the ugly, or present it in as gentle and yes, compassionate, way as possible?
I'll start.
I had a pt who would not leave their O2 on. His sats dropped in the 70s. He was SOB.
Not confused, just angry and obstinate.
All day the nurse "fussed" over him. Explaining ad nauseum why he needed the O2
When I came on, I looked him directly in the eye, and told him if he didn't wear the O2 he was going to die. Plainly, bluntly. I was not mean. My intention was not to hurt him. I wanted to make sure he understood the ramifications of his choice.
I don't approach pts like that every single time, as situations warrant different approaches. But as a whole, I prefer the direct, plain and simple approach.
What about you? Are you a fusser, or a plain speaker.
Used to be a fusser, pleader, "oh please if you just don't mind it's kind of important to keep your oxygen on". Now I find the simple and direct route works wonders!

I am linear nurse. I am a pragmatic realist and almost always have an algorithm running in my head related to "what is wrong with this patient, and what do I do about it?" I am plain-spoken and matter-of-fact.

linearity here, too. problem-solving, applying data and research, standards of practice, get 'er done nursing. with a soupcon of creativity, oppositional disorder, and wild-woman thrown in for fun.

I am ridiculously realistic but not pessimistic. As to approach, it depends on the pt and the situation. I tend more towards direct but can ameliorate that if necessary.

Quote from imintroubleIn that vein, what kind of nurse are you?Pessimist/RealistOptimist/Dreamer.What about you? Are you a fusser, or a plain speaker.

I'm a pragmatist. The glass is not half-full, nor is it half-empty. Clearly, the glass was larger than it needed to be.okay, so I guess I'm a smart-alecknow leave that o2 on!

Here's an example. I've been dealing with a patient with severe uncontrolled hypertension. His diastolic is routinely >120. He will only take his medication on and off. I said to him one day, "You are not going to be able to get it up if this goes on." That got his attention when all else failed.Part of my job is doing diabetic education classes. Some of my patient population lacks concern for their condition. And so again comes the talk of maybe not being able to get it up.I also have several appointments per week where I inform my patients they have tested positive for hep C. They have (mostly) acquired hep C through their IV drug use and dirty tattooing. I get very blunt about their prospects if they get another strain or genotype of hep C or continue to abuse their livers. I can tell you those diplomatic and boring CDC brochures do not help my patients.Once I was with a patient who was very critical. He asked me, "Am I about to die?" I said quietly and kindly, "I don't know, but I am staying with you." Every moment is unique and calls for its own approach.

Once I was with a patient who was very critical. He asked me, "Am I about to die?" I said quietly and kindly, "I don't know, but I am staying with you." Every moment is unique and calls for its own approach.[/QUOTE]I can be direct and honest with my pts about everything but death and dying. It's so hard for me to admit to a pt that they're dying, because I'm scared too.

Ahh I made a post and AN froze. Anyway, im a realist, and I may exagerate in the right situation to get my point across. I will say in some situations if the patient is not being compliant with the worst case scenario could be. Such as "if you do no use the IS you could end of with very bad PNA and on a vent in a life threatening situation". Or in your example with the man taking off his oxygen, I would have said the same as you but gone on to explain what happens when he dies. "Your sats will drop, your heart will stop, the code team will come, we will do chest compressions and crack your ribs, put a breathing tube in, and you will be in the intensive care and you might die". Probably extreme but it usually gets the job done. Works well when family is around, then they get scared. Yes its scare tactics but sometimes its all that works. Im not like that all the time, just when I need to be. I can also be caring when the time calls for it.

Quote from imintroubleOnce I was with a patient who was very critical. He asked me, "Am I about to die?" I said quietly and kindly, "I don't know, but I am staying with you." Every moment is unique and calls for its own approach.I can be direct and honest with my pts about everything but death and dying. It's so hard for me to admit to a pt that they're dying, because I'm scared too.

I'm not going to worry about every little thing, or plead with my residents to do anything. My role is to educate and explain, or find out why or why not. If after a brief discussion, the refusal is still present, oh well. People have the right to refuse. You learn to go with the flow....or go insane.

Every person I encounter dictates my course of action. I have the people that need me to be the bad guy and set their ass straight, I have people that just want someone to talk to and need to get something off their chest. I deal with every kind of person with the floor I am on now and found that no way works the same between two people.