TINJAUAN YURIDIS PELAKSANAAN TINDAKAN MEDIS OLEH PERAWAT DALAM PELAYANAN KESEHATAN DI RSUD PROF. DR. W. Z. JOHANNES KUPANG PADA TAHUN 2012

RICKY RONALDY JUSUF THERIK, Prof. Dr. Siti Ismijati Jenie, SH, CN

2012 | Tesis | S2 Magister Hukum Kesehatan

Pelaksanaan tindakan medis merupakan wewenang dokter sebagaimana tercantum dalam Pasal 35 UU RI No. 29/2004, sedangkan lingkup wewenang perawat dalam PERMENKES RI No.148/2010 antara lain pelaksanaan asuhan keperawatan dalam upaya promotif, preventif, rehabilitasi dan pemberdayaan masyarakat. Realitanya, ternyata sejumlah tindakan medis dilakukan oleh perawat di rumah sakit. Tujuan pokok penelitian ini adalah mengetahui dan memahami aspek yuridis pelaksanaan tindakan medis oleh perawat di RSUD Prof. DR. W. Z. Johannes Kupang, dengan tujuan khususnya yaitu mengetahui dan memahami perlindungan hukum bagi perawat yang melaksanakan tindakan medis; mengetahui dan memahami pedoman pelaksanaan pelimpahan wewenang serta mengetahui dan memahami tanggung jawab dokter, perawat dan rumah sakit dalam hal pelimpahan wewenang pelaksanaan tindakan medis dari dokter kepada perawat. Jenis penelitian ini adalah penelitian hukum sosiologis dengan pendeketan empiris, dilakukan di RSUD Prof. DR. W. Z. Johannes Kupang. Subyek penelitian meliputi narasumer dari pihak manajemen serta dokter dan perawat pada beberapa unit pelayanan yang memungkinkan terjadinya proses pendelegasian. Penentuan besar sampel menggunakan teknik non random purposive sampling. Pengumpulan data dilakukan dengan cara wawancara, penyebaran kuisioner dan studi dokumen. Hasil penelitiannya adalah perlindungan hukum bagi perawat yang melaksanakan tindakan medis muncul dalam bentuk SK Direktur tentang Pelimpahan Wewenang Pelaksanaan Tindakan Medis Tertentu Dari Dokter Kepada Perawat, Standar Operasional Prosedur ( SOP ) Melapor Pasien Lewat Telepon dan SOP Persiapan Dan Pelayanan Visite Dokter Di Ruangan, namun kebijakan ini belum disosialisasikan oleh manajemen. Pedoman Tata Cara Pelaksanaan Pelimpahan Wewenang yang digunakan adalah SOP Melapor Pasien Lewat Telepon dan SOP Persiapan Dan Pelayanan Visite Dokter Di Ruangan. Hasil kajian terhadap kedua SOP ini ternyata tidak terdapat item yang mengatur adanya suatu proses pendelegasian. Tanggung jawab dokter adalah bertanggung jawab atas semua instruksi dan akibatnya yang dilimpahkan kepada perawat ( vicarious liability ); perawat bertanggung jawab jika melakukan tindakan medis di luar instruksi yang didelegasikan ( personal liability ) dan tanggung jawab rumah sakit adalah menanggung kerugian karena kelalaian tenaga kerja ( corporate liability ).

Implementation of medical act is physicians’ authority as set in Article 35 of UU RI No. 29/ 2004, while nursing authority scope is in PERMENKES RI No. 148/2010 including implementation of nursing care within promotion, prevention, rehabilitation and community empowerment. In reality, some of medical acts and procedures performed by nurses at hospital. The main objective of this research is to know and understand the legal aspect on implementation of medical action by nurses in Public Hospital of Prof. DR. W. Z. Johannes Kupang, and the specific objectives are to know and understand the legal protection for nurses who doing medical action; to know and understand the guidelines of authority delegation on implementation of medical acts; and to know and understand responsibility of physicians, nurses and hospital in term of authority delegation on implementation of medical acts from physicians to nurses. This research is a sociolegal research with empirical approach which performed in Public Hospital of Prof. DR. W. Z. Johannes Kupang. Research subjects included speaker of management and physicians and nurses in several units that allow the delegation process. This research use non random purposive sampling technique to determine number of sample. The data was collected by interview, questionnaire dissemination and study of documents. The result of this research are legal protection for nurses who performed medical act appeared in form of Director’s decision about Authority Delegation for Implementation of Specific Medical Action from Physician to Nurses, Standard Operasional Procedure ( SOP ) of Reporting Patient Through Phone Line and SOP of Preparation and Visiting Service by Doctor in Patient’s Room, but these policies have never been socialized by the management. The existed guidelines of authority delegation on implementation of medical acts are SOP of Reporting Patient Through Phone Line and SOP of Preparation and Visiting Service by Doctor in Patient’s Room. In review of both SOPs is no one item explained existence delegation procedure. Physician’ responsibility is responsible for instruction and its impact that delegated to nurses ( vicarious liability ); nurses responsibility in law appeared if nurses do medical act outside delegated instruction ( personal liablility ) and hospital responsibility is bear all losses due to staff negligence( corporate liability ).

Kata Kunci : tindakan medis, perlindungan hukum, tanggung jawab