Rogerian Letter

Madison Lovette
Louisiana State University

Author Note:
The following Rogerian Letter was writer for English 2001, taught by Jean Coco, and addresses
issues raised in the case study Staying Out of the Line of Fire: A Medical Study Learns About
Bad News Delivery, published in Health Communication in Practice: A Case Study Approach.
12435 Bonne Bell
Denham Springs, La 70726
Phone: (225) 368-2465

April 20, 2017

Trinity Bell
Hospital Administration
4657 Airline Hwy
Baton Rouge, La 70818

Dear Trinity Bell Hospital Administration,

My name is Madison Lovette and I am a nurse here at Trinity Bell. I work here five days
a week in the Labor and Delivery department. I have recently become increasingly interested in
the training of medical students in addressing patients. My interest comes from a conversation I
recently had with a current medical student named Christie, while she was doing her rounds on
the Labor and Delivery floor. We had a conversation about the way she was trained in medical
school about how to think about and talk to patients. Her description of the way that she was
taught to view her patients was especially interesting to me. As a nurse, we watch the doctors in
the hospital work with their assigned medical students daily and we ourselves interact and help
teach these students. In my experience, I have observed these medical students talking to patients
as if they are in a rush. This is due to the fact that they are very focused on time management due
to being taught that this aspect of being a doctor is of utmost importance.
As the Hospital Administration, you are in charge of the time management, budget, and
overall quality of Trinity Hospital. As a nurse, I am in charge of making sure I see every patient
in a timely manner, conduct no unneeded tests that would cost the hospital and patient money,
and that the patient is satisfied with their care when they leave Trinity Hospital. As you can see,
we have these three things in common. Your rules pertaining to the doctors and nurses of this
hospital are very clear and all exist for a reason; to ensure quality and safety.
Working with the medical students myself, I see the way that the students interact with
patients. I myself see that they are not very personable and seem to be very detached. In the
article Beyond breaking bad news: how to help patients who suffer by Micheal W. Rabow and
Stephen J. McPhee, doctors are to build a therapeutic relationship with patients (Rabow, 1999).
The medical students I work with do not seem to truly talk to the patients, instead they seem to
talk at them. Christie told me during our discussion that they are taught from the beginning to
look at patients as if they are cadavers (Thompson, 2005). Sally Warmington in her article
Practicing engagement: Infusing communication with empathy and compassion in medical
students clinical encounters, comments that some patients feel as if the physician does not care
about their wellbeing (Warmington, 2011).
 Medical schools and hospital administrations do need to teach medical students to have
time management skills and develop appropriate relationships with patients. The students and
doctors who work in busy hospitals and areas of intense work such as trauma centers especially
have to have their doctors working at a steady pace or patients would not be taken care of
properly. Doctors also have to have a certain degree of detachment from patients to prevent any
unprofessional relationships. If a doctor or nurse is too attached to their patient, they may make
the wrong decisions on patient care based on emotions which may harm the patient. These
reasons alone justify and suffice the teachings of medical schools and hospital administration.
There are situations and areas where having detached doctors and nurses are needed to ensure the
safety and care of patients.
In my research, I have found that many patients feel as if detached nurses and doctors are
not what they want. Christie told me that she remembers a time where her brother was given bad
news and due to the detached quality of the medical assistances news delivery, her brother was
very disturbed and did not actually know what was going on (Thompson, 2005). In Rabows
article he stresses that physicians need to communicate well with their patients and encourage
emotions (Rabow, 1999). Warmington also highlights that physicians need to show empathy and
compassion (Warmington, 2011). Warmington says in her article it is common to hear people
express disappointment about the way in which doctors relate to them (Warmington, 2011).
There is benefit in having doctors know the appropriate balance of emotions when it comes to
their patients. There could be a rise in patient satisfaction and hearing negative comments may
become a not so common thing if doctors were taught to be more empathetic with their patients.
After having time to further investigate why medical schools and hospital administrations
teach such detachment to the doctors, I do have a deeper understanding and appreciation. I see
why students are taught to be this way and the benefits of doing this. Perhaps though, you the
Hospital Administration of Trinity Bell could take on the task of helping better the relationships
our doctors have with their patients. We could work together to put together seminars for the
doctors who are currently teaching the medical students to aid them in their teaching tactics.
These seminars could help the doctors learn an appropriate balance of emotions and
professionalism to then reflect onto the medical students. I as a nurse and you as the hospital
administration want to do everything in our power to ensure quality care and patient satisfaction.
The seminars may not be the best solution, but I am hopeful that we can come together to come
up with a solution to the detached teachings of the incoming medical students in hopes to not
have patients so commonly think of their doctors in a negative light.
Sincerely,
Madison Lovette
Madison Lovette, RN-BC.
Labor and Delivery Nurse
madisonlovette@yahoo.com

References
Thompson, T.L. (2005). Staying out of the line of fire: a medical student learns about bad news

delivery. In Ray, E.B. Editor, Health communication in practice: A case study approach.

(pp. 11-25). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

Rabow, M.W., & McPhee, S.J. (1999). Beyond breaking bad news: How to help patients who

suffer. In Western Journal of Medicine. (pp. 260-263).

Warmington, Sally (2011). Practicing engagement: infusing communication with empathy and

compassion in medical students clinical encounters. In Professor Micheal Traynor Editor,

Health: an interdisciplinary journal for the social study of health, illness & medicine.

(pp. 327-342). UK: SAGE Journals.