Penerapan Aspek Bioetika Pengalaman Perawat Paliatif Dengan Keluarga yang Berduka di Ruang Isolasi Selama Pandemi COVID-19

Astarina Wisnu Adi Nugraheni, Dr. Chistantie Effendy, S.Kp.,M.Kes ; Dr.Dra. Retna Siwi Padmawati, MA

2023 | Tesis | MAGISTER BIOETIKA

Pendahuluan: COVID-19 membawa perubahan yang cukup signifikan dalam proses asuhan keperawatan akhir hayat. Pasien yang terkonfirmasi COVID-19 derajat berat dapat dikatergorikan sebagai perawatan paliatif dan mendapat perawatan di ruang Isolasi. Proses pendampingan akhir hayat di ruang isolasi memiliki pengalaman dan tantangan tersendiri bagi perawat. Penelitian ini membahas tentang pengalaman perawat dalam melakukan proses asuhan keperawatan di ruang isolasi menggunakan pendekatan prinsip dasar bioetika dan aspek pemecahan masalah Bioetika klinis.

Metode: Penelitian ini merupakan jenis penelitian kualitatif fenomenologi. Jumlah partisipan sebanyak 13 orang yang terdiri dari 9 orang perawat ruang isolasi dan 4 partisipan keluarga pasien yang meninggal di ruang isolasi. Proses pengambilan data dilakukan melalui wawancara mendalam menggunakan snowball sampling. Analisis data diolah menggunakan proses koding yang diinterpretasikan dan disajikan secara menggunakan panduan CoReQ.

Hasil: menyajikan pengalaman perawat dalam melakukan asuhan keperawatan akhir hayat, terdapat 3 tema yang muncul yaitu Perasaan Perawat, Penggunaan sarana dan prasarana rumah sakit, Pengelolaan Sumber Daya Manusia (SDM) dan Penguatan Mutu Layanan dalam proses penanganan pasien. Ditinjau dari segi bioetika perawat tergambar memiliki sikap mengutamakan pasien dan menerapkan prinsip etika dalam menciptakan kematian yang bermartabat selama pandemi COVID-19.

Kesimpulan : Dalam melakukan asuhan keperawatan akhir hayat perawat patuh terhadap seluruh prosedur yang telah ditetapkan oleh Instansi. Perawat menggunakan pendekatan prinsip bioetika klinis dan Aliran Berfikir Deontologi. Dalam melakukan asuhan keperawatan akhir hayat perawat memperhatikan Autonomi, Beneficence, Non Maleficence dan Justice dengan pertimbangan kebaikan satu sama lain.

Introduction : COVID-19 brought significant changes in the end-of-life nursing care process. Patients with confirmed severe COVID-19 can be categorized as palliative care and receive care in the isolation room. The process of assisting the end of life in the isolation room has its own experiences and challenges for nurses. This study discusses how the experience of nurses in carrying out nursing care in an isolation room uses the basic principles of bioethics and aspects of clinical bioethics problem-solving that are processed from the basis of ethical thinking.

Method : The study uses the phenomenological method. The number of participants was 13 people consisting of 9 Nurses and 4 participants from families of patients who died in the isolation room. The data collection process was carried out through in-depth interviews using snowball sampling. Data analysis was processed using a coding process which was interpreted and presented using the COREQ guide.

Result : The research reveals the experience of nurses in carrying out nursing care at the end of life, There are 3 themes, namely Nurse Feelings, Nurse Responsibility or Motivation and HR/Managerial apply. In terms of Bioethical principles, nurses are shown to have a caring and empathetic attitude, upholding ethical principles to create a dignified death during COVID-19 by paying attention to the prima facie of patients and their families.

Conclusion : Carrying out end-of-life nursing care, nurses comply with all procedures set by the Agency. Nurses use the approach of clinical bioethics principles (Autonomy, Non-Maleficence, and Justice) and deontological thinking while still paying attention to the Bonume Comune Principle.

Kata Kunci : Ethical, End of Life Care, Isolation, phenomenology, Covid-19