Praktik profesi keperawatan di RSUD dr. TC Hillers Maumere Kabupaten Sikka Nusa Tenggara Timur

SADIPUNG, Dafrosa, dr. Tjahjono Kuntjoro, MPH, DrPH

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Keperawatan diakui sebagai suatu profesi sejak Januari 1983, tepatnya pada seminar Nasional Keperawatan di Jakarta. Namun hingga kini keperawatan di Indonesia belum diakui sepenuhnya sebagai pelayanan dan keperawatan yang profesional yang mandiri. Kenyataan dilapangan masih ditemukan kendala-kendala baik yang bersifat internal seperti pelayanan keperawatan profesional belum terbentuk sepenuhnya, pelayanan keperawatan masih diberikan oleh tenaga keperawatan yang bervariasi seperti SPK, AKPER, dan hambatan yang bersifat eksternal seperti tekanan kebutuhan masyarakat akan pelayanan keperawatan yang professional. Hal ini juga terjadi di RSUD dr. TC. Hillers Maumere dimana praktik profesi keperawatan belum berjalan sesuai standar Departemen Kesehatan RI, para perawat lebih banyak bergelut dengan tugas non keperawatan, dan bila memberikan pelayanan masih berorientasi pada kegiatan prosedural, rutinitas dan lebih dari itu sekedar perpanjangan tangan dokter. Tujuan penelitian: Penelitian ini bertujuan untuk mengetahui gambaran praktik profesi keperawatan di RSUD dr. TC. Hillers Maumere Metode penelitian: Penelitian ini merupakan penelitian deskriptif dengan rancangan studi kasus, mengunakan data kuantitatif didukung oleh data kualitatif untuk mengetahui gambaran secara umum praktik profesi keperawatan. Subyek penelitian adalah direktur RS, Kepala bidang keperawatan, dan 79 orang perawat pelaksana. Pengumpulan data melalui wawancara, observasi dan penelusuran dokumen serta analisa data secara kualitatif. Hasil penelitian: Praktik profesi keperawatan di RSUD dr. TC. Hillers Maumere tidak berjalan sesuai dengan standar Depkes RI, hal ini disebabkan karena belum adanya kebijakan rumah sakit tentang legitimasi standar asuhan keperawatan, standar operasional prosedural dan juknis pelaksanaan praktik profesi keperawatan, serta tidak ada penghargaan khusus terhadap profesi keperawatan, sehingga dalam praktiknya perawat pelaksana tidak merasa memiliki hak dan kewajiban untuk menerapkannya. Perawat sudah terpola dengan kegiatan rutinitas, dan berdasarkan keyakinan dari masing-masing perawat tanpa menggunakan SAK dan SOP kegiatannya tetap berjalan. Kesimpulan: Penerapan asuhan keperawatan merupakan kegiatan inti untuk mewujudkan profesionalisasi keperawatan, maka kedepan diharapkan manajemen rumah sakit perlu membuat kebijakan tertulis dan disyahkan oleh pihak yang berwewenang tentang standar asuhan keperawatan dan standar operasional prosedural serta petunjuk teknis pelaksanaan dengan mengacu pada standar DepKes RI.

Background: Nursing is considered as a profession since January 1983 in the Nursing National seminar in Jakarta. However, it is not yet acknowledged as an independent professional service and nursing in Indonesia up to this time. In fact, there were still some internal obstacles such as professional nursing care was not yet fully formed, nursing care was still given by varied nursing care such as nurses graduated from SPK, Nursing Academy, and external obstacles such as community demands for professional nursing care. These were also occurred in RSUD dr. TC. Hillers Maumere where nursing care practice was not yet suitable with the standard and the service was still oriented to procedural and routine activity and doing the doctor orders. Objective: This research was aimed to find out the description of nursing professional practice in RSUD dr. TC. Hillers Maumere. Method: This was a descriptive research using a case study design. Quantitative data were taken, and were supported by qualitative data in order to find out the general description of nursing profession practice in the hospitals. The research subject was hospital director, head of nursing and 79 nurses. The data were collected by interview, observation, and study documents. Result: Nursing profession practice in RSUD dr. TC. Hillers Maumere was not suitable with the standard of Department of Health Republic of Indonesia and this was caused by limitation of supporting policy from the hospital director, standard operational procedure, and technical guidance on the implementation of nursing profession practice as well as no specific appreciation toward nursing profession so that nurse felt that they did not have right and obligation to implement it. The nurse was already used to with routine activity and based on their respective belief that without using SAK and SOP the activity is still running. Conclusion: The application of nursing care was still considered as main activity to realize nursing profession. It is expected, therefore, that hospital management need to make a written policy regarding nursing care standard, standard operational procedure as well as guidance on the implementation technique by referring to the standard of Department of Health Republic of Indonesia.

Kata Kunci : Praktik profesi keperawatan, Asuhan Keperawatan, Proses keperawatan, Practice of nursing profession, Nursing Care, Nursing Process