Improving Nurse Productivity Through Professionalism Self-Concept

I Gede Juanamasta

, Kusnanto

and Slamet Riyadi Yuwono

Faculty of Nursing Universitas Airlangga, Kampus C Mulyorejo, Surabaya, Indonesia

Poltekkes Kemenkes Surabaya, Surabaya,Indonesia

Keywords: Professional Self Concept, Productivity, Literature Review.

Abstract: Nurses are the biggest proportion of hospital staff. Nurses interact directly with patients in the services.

Therefore, it directly affects quality of patient care and satisfaction as well as productivity and improvement

of the hospital's image. Nurses believe that they have primary responsibility in the care and welfare of their

patients. Some problem of nurses in the self-concept is the lack of communication nurses with the public

and the invisible nurses in the media. The nurse's negative self-concept is partly due to the nurse himself.

The positive self-concept of professional nurses can improve nurse self-confidence in appropriate nursing

interventions to improve patient health status thereby increasing hospital productivity.

1 BACKGROUND

Hospitals are healthcare institutions that provide full

range of personal health services providing inpatient,

outpatient and emergency care (UU No.44 / 2009).

Hospitals in Indonesia have challenges in facing

with MEA and community demands related to

service quality. Increasing government bugdet

priority in health sector expected to improve the

productivity of the hospital and the quality of

service.

Data of several hospitals in Indonesia, related

efficiency of service quality still not meet the

standard of Indonesia Health Ministry (2007).

RSUD Raden Mattaher Jambi (2013) patient

satisfaction evaluation of nursing service obtained

results 72%. Dr. M. Djamil Padang (2013), the

incidence of patient fall 0.18% from Minimum

Standard Service (SPM) set 0%, patient satisfaction

rate 79.28% of SPM 90%. In addition, Fatas's (2017)

study at Hidayah Boyolali Hospital found that

patients were less satisfied with doctors and nurses

responsiveness and the attitude of doctors and nurses

in listening to patient complaints.

In complex care systems, the responsibility of

nurses and other professions to meet the demands of

quality healthcare services expectations of health

care consumers. Nurses are the biggest proportion of

hospital staff. Nurses interact directly with patients

in the services. Therefore, it directly affects quality

of patient care and satisfaction as well as

productivity and improvement of the hospital's

image. (KemenkesRI, 2017; Kim, 2011).

2 METHODS

The literature search conducted in some database

such as Gale, the Cochrane Library, EBSCO,

ProQuest and Plos ONE. There were 39 articles that

fulfil the inclusion criteria Strategies ways in search

journal are done by using the keywords nurse

professional self-concept and nurse productivity.

Time limitation was used in January 2001 to August

2017.

3 RESULTS

The concept of productivity defined as the

relationship between output and input (Krugman,

1997). In addition, the Asia Productivity

Organization (APO) define productivity is combined

between efficiency which means doing things right

with the effectiveness of doing the right thing

(Roghanian et al., 2012). The productivity of nurses

implicitly influences the productivity of current and

future nursing work. One's productivity may change

in the future because of education and training, the

intensity of physical capital and other factors. One's

productivity may decline in the future, for example

116

Juanamasta, I., Kusnanto, . and Yuwono, S.

Improving Nurse Productivity Through Professionalism Self-Concept.

DOI: 10.5220/0008321401160120

In Proceedings of the 9th International Nursing Conference (INC 2018), pages 116-120

ISBN: 978-989-758-336-0

if one's skills are not updated with the latest sciences

or work less because of ill health or become

unproductive if retired.

Letvak and Buck (2008) mentioned factors

related to decreasing work productivity are age,

number of years of work as RN, quality of care

given, work stress, work injuries, and health

problems. Conceptually, Kopelman (1986 in

Nursalam 2016) mentions the factors that affect the

productivity of nurses consists of organizational

factors, work factors and individual factors and work

environment.

Individual factors related to the knowledge, skills

and abilities and psychological nurses have a

positive correlation with nurse performance

(Mudallal et al., 2017; Yaghoubi et al., 2013). Brun

et al. (2003) revealed it is important to explore and

fully understand the potential psychological factors

of nurses. High demand for nursing services,

coupled with a lack of support from co-workers and

leaders, reduced autonomy, tense working

relationships between nurses and doctors, lack of

respect from their managers (Brun et al., 2003),

shifting organizational structure, and poor working

climate (Mrayyan and Al-Faouri, 2008).

Psychological nurses related self-concept

professional nurses reflect workers' emotions and

opinions about their own performance and feelings

towards themselves. Cowin et al. (2006) mentions

nurse self-concept is an important point nurses who

affect the career and it is very dependent on the

experience of nurses in their profession. In

particular, nurses with self-concept

Nurse with high professional self-concept give

influence to other nurses. This has the effect of

improving self-image, self-esteem, and other nurse

confidence. In contrast, low professional self-

concept reduce productivity (Chi and Yoo, 2001).

Research Arthur et al. (1999) discloses nurse

professional relationships with their patients build

on sincerity and reverence. Nurses around the world

have a lot in common in terms of caring. Nurses

believe that they have primary responsibility in the

care and welfare of their patients (Dahlborg-

Lyckhage and Pilhammar-Anderson, 2009;

Fagerberg and Kihlgren, 2001). ten Hoeve et al.

(2014) mentions the problem of nurses in the self-

concept is the lack of communication nurses in the

public and moreover they doesn’t appear to be

significant role at hospital in the media. Negative

self-concept is partly due to the himself (Donelan et

al., 2008; Takase et al., 2006). This is also in line

with the research Arumsari et al. (2016) mentions

the nurse's barrier in communicating.

Public does not pay attention to the position of

the nursing field and the lack of dignity of the

nursing field is mostly nurse experience, which leads

to a decrease in self-esteem resulting in low self-

concept (Valizadeh et al., 2016). This has a

stereotypical effect on nurses. Nurses need to

prevent the impact of stereotypes and improve

professional self-concept. An overview of

stereotypes affects the nurses use autonomy. Nurses

have need of inner strength for increasing self

concept (Takase et al., 2002; Tzeng, 2006).

According to Kemmer and Silva (2007), nursing

education create nurses' inability in public mediation

for themselves. They just think to still perform well

in health care and never fix this problem. The nurse's

inability will continue. Nurses need to increase the

range of roles and chances of basic and advanced

nursing practice offered to give more visibility to the

nursing role, so that the community can recognize

the role of the nurse (Kalisch et al., 2007; Kemmer

and Silva, 2007).

The self-concept of professional nurses can

improve the patient's health status through

appropriate interventions thus increasing the

productivity of the hospital. Nurses practitioner have

a significant role related to hospital productivity,

that important to improve nursing care with

sustainable transformation in their workplace (Nam

and Park, 2002). Good hospital productivity has an

effect on customer satisfaction, it also provides more

value in the public's view of the hospital. Research

conducted by Cowin et al. (2008) revealed that

professional status has a strong relationship with

nurse self concept. This is also supported by

research conducted by Randle (2001) suggesting that

organizational and cultural climate have a strong

influence on professional self-concept.

4 DISCUSSION

4.1 Theory of the Nurse Professional

Self Concept

Professional self-concept established by providing

good quality care to patients who are in the process

of efficient and energy resulting in patient

satisfaction (Lee and Yang, 2015).

The concept of a professional self, an attitude

that develops from a professional experience,

evolved from self-concept (Arthur, 1992).

Professional development from nursing students to

professional nurses has produced themes important

for the development of self-identity and self-concept

Improving Nurse Productivity Through Professionalism Self-Concept

117

(Evans, 2001; Godinez et al., 1999; Leathart, 1994;

Whitehead, 2001). Student nurses believe in

professionalism by three different themes

(belonging, knowledge, and affirmation). Other

research results show, answers to questions from

patients and family members, and what they add to

the meaning of nursing professionalism (Secrest et

al., 2003). In addition, general nursing students of

the nursing faculty, clinical preceptor, peers in the

clinical environment, and family influence in

professional development (Heath et al., 2001; Kelly,

1992).

O'Mara et al. (2006) study have found self-

concept capable of improving job satisfaction and

nurse retention plans. The results construction

analysis show self-concept shows strong relationship

to job retention global and job satisfaction, and this

is in construction in the retention analysis. This is a

strategy for improving the self-concept of nurses.

Kovner et al. (2006) note, salary justice is more

important than retention. In this study, nurse feel

better to stay in nursing with self-concept

improvements of general nurses and professional

status.

In the study of Cowin et al. (2008), this study

reveals the potential interrelationships between self-

concept and job satisfaction, in the hope of being

able to. Strong positive correlation between

professional status and general self-concept of nurse

(NSCQ). Changes that like to increase the

professional status of nurses have mutual effect on

nurse self-concept in general and happiness.

Approach to increase the professional status of

nurses in health care and communities with

exceptional plans in nurse retention plans (Takase et

al., 2006). In line of this study, finding by Takase et

al. (2006) relates to self-image and performance and

the retention to stay. Increasing capability and lore

in nursing and professional nurse self-concept may

be can keep experienced staff (Cowin, 2001).

Preparation in education to address gaps between

academia and services, so that the expectations of

health organizations can be met. A better

understanding of nursing experience after graduate

can enable staff of teaching staff and health workers

to improve professional self-concept and improve

nurse retention.

Over the years the media has been instrumental

in building the image of nurses. The nursing

organization needs to provide restrictions on media

and imaging in the media so as to maintain the

image of the nurse. In addition, an equivalent

education program with other health teams for

members of the nursing team may provide an

opportunity for equal professional status. (Williams,

2001).

4.2 Factors of Nurse Productivity

Nayeri points out that the productivity of nurses

depends on the "human resources" factor that acts as

the main variable. These parameters have a direct or

indirectly significant relationship with effectiveness

and efficiency. Management and organizational

factors play a role in shaping a culture of

productivity. Management and leadership styles

affect the productivity, effectiveness and quality of

staff services. In addition, employment status,

employment patterns, organizational methods, nurse

confidence level and a fair payment system based on

individual performance and effectiveness are also

factors affecting productivity. The need for training

to support staff is constantly changing and should

continue to be done in order to improve

organizational performance (Dehghan Nayeri et al.,

2006).

Human characteristics, such as education,

experience, skills, knowledge, and competence are

predictors of work productivity and are all

associated with improved clinical care among nurses

(Dehghan Nayeri et al., 2006). Factors in the nurse

such as fatigue and stress can have a negative impact

on productivity. Minimizing the time spent on non-

maintenance activities is needed to reduce fatigue

and save the required nursing resources (Dehghan

Nayeri et al., 2006). Work security and financial

wealth are other important factors found to be

associated with productivity.

Another aspect of nurse involvement is long

working hours. According to recent research, a

longer shift has been found to contribute to

accidents, illness, absenteeism and increased work-

related errors and ultimately lower productivity

(Dehghan Nayeri et al., 2006).

The balance between work and life has a positive

effect on productivity. This indicates that the

productivity of the nurses is equally related to the

nurse's dignity and respect. Dignity and respect for

work are indications of a respectful environment.

The nurse's experience of respect is linked to

cooperation, recognition, independence, support, and

justice (Dehghan Nayeri et al., 2006).

The performance of managers is a primary factor

that facilitates or inhibits the productivity of nurses.

Characteristics of managers that affect the

productivity of care is to direct the nurse by being

role models, using leadership styles appropriately,

motivating the team, supporting the team by

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providing recognition and rewards, maintaining

good relationships, and providing solutions to staff

problems. (Dehghan Nayeri et al., 2006).

5 CONCLUSION

All aspects of the individual, social and cultural

level for the organization, both in terms of subjective

and objective, should be explored more deeply

(Arthur and Randle, 2007). Therefore, there needs to

be a model from organizational level to individual.

Based on that, the researcher is concerned to conduct

research of self-concept modeling of professional

nurse to the work productivity of the nurse in the

inpatient ward of the hospital.

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