Diplomacy, Apologies and Boneheads

Bone Head watercolor and charcoal 2012 by jparadisi

Diplomacy is as necessary to successful nursing as IV skills, medication administration accuracy, and critical thinking. In fact, diplomacy is a subheading of critical thinking. Further, apology is a subcategory of diplomacy. During a recent shift at the infusion clinic, I had plenty of opportunity to practice both.

Nurses are well familiar with these shifts: They start looking like a doable workload. Then nothing goes as planned and you and your coworkers spend the entire shift chasing after it like a pack of grey hounds trailing behind a rabbit on a track. Unexpectedly, the rabbit jumps the track: Medications are not delivered on time from pharmacy. The patient needing a nurse inserted PICC is vein-less, requiring radiology placement and transport to their department; this delays the patient’s antibiotic treatment. The home infusion company is late delivering the continuous chemotherapy infusion for another patient left twiddling his thumbs waiting. IV pump alarms ring longer than anyone can bear, and nothing is on time per the electronic medical record. Meanwhile, the phones never stop ringing! 

These factors cost patients lengthy waits. During such shifts, I say, “I’m sorry” to patients all day long. For the sake of diplomacy, I can’t explain the bonehead roadblocks I’ve endured while trying to move their day forward as efficiently as possible. Diplomacy also prevents me from telling the bonehead roadblock he or she is a bonehead roadblock. I remind myself everyone, including me, makes mistakes, and to show a little love to the bonehead on the other end of the phone, because my turn will come.

My last patient of this shift doesn’t understand my explanation of why her care is delayed. Her sister eyes me suspiciously from a chair. I know she thinks I’m the bonehead. I stay the course, however, and it all works out. The patient eventually received safe treatment.

At the end of these shifts, it’s the outcome that matters. No one really cares who’s the bonehead.


  1. Ahhh, I so remember feeling like the bonehead, when in fact I was just a victim of circumstances and true boneheads. You know you are mature when you take the rap and smile… Thanks!


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