Before we first-year nursing students were let loose on the hospital floor, we had to take a communication class, also known as "How to Talk to a Patient."  We learned useful techniques such as active listening and interpreting non-verbal cues.  The class, of course, didn't make us perfect communicators right off the bat.  I heard of one young nurse interviewing a patient on her first day of clinical training on the psychiatric ward.  As the patient finished describing all the heartbreaking events of his life, the stunned girl concluded, "Wow.  That's enough to drive a person crazy."

Mistakes aside, I found the classes very helpful.  One thing the instructor told us stood out to me, and I've never forgotten it: "Never, never tell a patient that you know how he feels.  Because you don't.  You can't possibly know how he feels."

I must confess that I've slipped up verbally a time or two and told a patient, "I know how you feel."  The patients' reactions were universally negative.  I can't blame them; it sounds so patronizing.  Worse still are those times I've witnessed a caregiver say to a crying patient during a procedure: "Oh, that doesn't hurt."  It would make me yearn for the opportunity to give the bigmouth a taste of his own medicine with the biggest IV catheter available.

The Republican establishment and media elite have obviously never taken a communications course, because if it's one sentiment conservatives have heard over and over again this primary season, it's "We know how you feel."  And just like my patients, my reaction is "No, you don't!"

The elites believe we'll never vote for Newt Gingrich because he's an old, fat guy.  They know that Americans always vote for the guy who looks "presidential."  The man who's tall, dark, and handsome.  Appearance is everything to the average shallow voter, they tell each other.  Lucky for the elites, their chosen candidate, Governor Romney, looks like a president straight out of central casting.  It's in the bag, they tell us.  After all, we know how you feel.

The elites believe that a candidate's moral failings are uppermost in the minds of conservatives, and those conservative minds are closed, bitter, unforgiving, and never forgetting.  After all, conservatives impeached Bill Clinton for immoral behavior, and he wasn't even divorced!  So a televised interview with an ex-wife is all it will take to knock the pins out from under Gingrich.  Women, especially, will never vote for the twice-divorced speaker.  Believe us, we know how you feel.

The elites believe that conservatives aren't serious about all that red white and blue, rah-rah, Founding Fathers stuff and will dump that rugged individualism nonsense the minute their own entitlements are threatened.  So the establishment Republican consultants instructed Romney to jump all over Perry's description of Social Security as a Ponzi scheme.  And as for that little problem of RomneyCare, just tell the conservatives that it wasn't a big-government takeover of health care -- it was a noble experiment in the tradition of the Tenth Amendment!  After all, conservatives are suckers when it comes to the Constitution.  Yes sir, we know how you feel.

The elites admit that Gingrich has performed masterfully in the debates so far, but if it's one thing they know, debates won't matter to voters in the general election.  The important thing, they tell us, is campaign organization and money.  Television ads -- that's the ticket!  Romney is the only candidate who can possibly compete with Obama in the money department.  Okay, maybe it didn't work in Iowa (a small, weird caucus state) or South Carolina (did you know they still have cockfights there?), but just wait till the big media state of Florida!  Romney's money and polished campaign will definitely triumph in the Sunshine State!  Trust us, we know how you feel.

Above all, the establishment believes that 2012 is an election year just like all the others.  (Forget about the Tea Party, they reassure each other -- that was a fluke. Hasn't Speaker Boehner done a great job keeping their asses in line?)  They knew that after Mitt Romney won Iowa and New Hampshire, the laws of inevitability dictated that he would win South Carolina.

But 2012 is not like all the other election years.  The elites heard many things coming out of South Carolina, but something they didn't hear was the Tea Party coming out of hibernation.  And if there's one thing the establishment should have learned by now, the Tea Party does not play by their rules.

Finally, the establishment believes they know how we feel about them.  I can speak only for myself, but if the results of the South Carolina primary are indicative, I don't think conservatives are too crazy about Washington, D.C. elites telling us they know how we feel. 

And as to how I really feel about them, well, as they say in South Carolina: Bless their hearts!

Carol Peracchio is a registered nurse.