How is CERC similar to therapeutic communication in nursing?
Generally , Crisis and Emergency Risk Communication(CERC) is similar to Therapeutic Communication in Nursing in almost all aspects in their principles.Similarities of both the communications are very much essential for a nurse to understand the emergencies faced by the clients . Given below the detailed of explanation of both communications.
1) CERC
Crisis and Emergency Risk Communication (CERC) draws from lessons learned during past public health emergencies and research in the fields of public health, psychology, and emergency risk communication. CERC program provides trainings, tools, and resources to help health communicators, emergency responders, and leaders of organizations communicate effectively during emergencies.CERC has been used in public health responses since 2001 to provide information that helps people make sound decisions to protect themselves and their families under narrow time constraints and with insufficient information.
It is built on six principles:
2) THERAPEUTIC COMMUNICATION IN NURSING
Therapeutic relationship – is a relationship that is established between a health care professional and a client for the purpose of assisting the client to solve his problems.
Components of a Therapeutic Relationship:
One of the most important skills of a nurse is developing the ability to establish a therapeutic relationship with clients. For interventions to be successful with clients in a psychiatric facility and in all nursing specialties it is crucial to build a therapeutic relationship. Crucial components are involved in establishing a therapeutic nurse-patient relationship and the communication within it which serves as the underpinning for treatment and success. It is essential for a nurse to know and understand these components as it explores the task that should be accomplish in a nurse-client relationship and the techniques that a nurse can utilize to do so.
a) TRUST
Without trust a nurse-client relationship would not be established and interventions won’t be successful. For a client to develop trust, the nurse should exhibit the following behaviors:
b) GENUINE INTEREST
Another essential factor to build a therapeutic nurse-client relationship is showing a genuine interest to the client. For the nurse to do this, he or she should be open, honest and display a congruent behavior. Congruence only occurs when the nurse’s words matches with her actions.
c) EMPATHY
For a nurse to be successful in dealing with clients it is very essential that she empathize with the client. Empathy is the nurse’s ability to perceive the meanings and feelings of the client and communicate that understanding to the client. It is simply being able to put oneself in the client’s shoes. However, it does not require that the nurse should have the same or exact experiences as of the patient. Empathy has been shown to positively influence client outcomes. When the nurse develops and utilizes this ability, clients tend to feel much better about themselves and more understood.
Some people confuse empathizing with sympathizing. To establish a good nurse-patient relationship, the nurse should use empathy not sympathy. Sympathy is defined as the feelings of concern or compassion one shows for another. By sympathizing, the nurse projects his or her own concerns to the client, thus, inhibiting the client’s expression of feelings. To better understand the difference between the two, let’s take a look at the given example.
Client’s statement:
“I am so sad today. I just got the news that my father died yesterday. I should have been there, I feel so helpless.”
Nurse’s Sympathetic Response:
“I know how depressing that situation is. My father also died a month ago and until now I feel so sad every time I remember that incident. I know how bad that makes you feel.”
Nurse’s Empathetic Response:
“I see you are sad. How can I help you?”
When the nurse expresses sympathy for the client, the nurse’s feelings of sadness or even pity could influence the relationship and hinders the nurse’s abilities to focus on the client’s needs. The emphasis is shifted from the client’s to the nurse’s feelings thereby hindering the nurse’s ability to approach the client’s needs in an objective manner.
In dealing with clients their interest should be the nurse’s greatest concern. Thus, empathizing with them is the best technique as it acknowledges the feelings of the client and at the same time it allows a client to talk and express his or her emotions. Here a bond can be established that serves as a foundation for the nurse-client relationship.
d) ACCEPTANCE
Clients are unpredictable. There are times that they outburst
with anger or act out their inappropriate desires. A nurse,
who does not judge the client or person no matter what his or her
behavior, is showing acceptance. Acceptance does not mean
accepting all the inappropriate behavior but rather acceptance of
the person as worthy. When the client displays an improper
behavior, the nurse can communicate with the client by being firm
and clear without anger or judgment. In this way, the
nurse allows the client to feel intact but at the same time aware
that his certain behavior is unacceptable. Let’s take a look at the
given example.
Situation:
A client tries to kiss the
nurse.
Inappropriate
response: What the hell are you
doing?! I’m leaving maybe I’ll see you tomorrow.
Appropriate
response: Adam, do not
kiss me. We are working on your relationship with your girlfriend
and that does not require you to kiss me. Now let us
continue.
e) POSITIVE REGARD
Positive regard is an unconditional and nonjudgmental attitude where the nurse appreciates the client as a unique worthwhile human being that shows respect for the client regardless of his or her behavior background and lifestyle. The following ways are example of how to promote respect and positive regard to a client:
f) SELF-AWARENESS
Self-awareness is the process of understanding one’s own values, beliefs, thoughts, feelings, attitudes, motivations, prejudices, strengths and limitations. Before a nurse can understand clients he or she should be able to understand him or herself. The first step in preparing oneself to build a therapeutic nurse-patient relationship is to understand oneself.
g) THERAPEUTIC USE OF SELF
A nurse can only use his or her personality, experiences, values, feelings, intelligence, needs, coping skills and perceptions to build a relationship with clients (therapeutic use of self) when he or she has developed self-awareness and self-understanding.
Therapeutic Techniques:
Offering Self
Active listening
Exploring
Giving broad openings
Silence
Stating the observed
Encouraging comparisons
Identifying themes
Summarizing
Placing the event in time or sequence
Voicing doubt
Encouraging descriptions of perceptions
Presenting reality or confronting
Seeking clarification
Verbalizing the implied
Reflecting
Restating
General leads
Asking question
Empathy
Focusing
Interpreting
Encouraging evaluation
Suggesting collaboration
Encouraging goal setting
Encouraging formulation of a plan of action
Encouraging decisions
Encouraging consideration of options
Giving information
Limit setting
Supportive confrontation
Role playing
Rehearsing
Feedback
Encouraging evaluation
Reinforcement
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