The Relationship between Perceptions of Management Rules with the

Tendency of Burnout in Nurses

Wasis Purwo Wibowo

, Adnani Budi Utami

, and Niken Titi Pratitis

Fakultas Psikologi, Universitas Airlangga

Fakultas Psikologi, Universitas 17 Agustus 1945

Keywords: Perception, Regulatory Management, Perception Management Regulations.

Abstract: Health care is a service that deals directly with the community (human service) as a result of collaboration

between nurses, doctors, and health care organization management teams. The unique characteristics of the

health organization that is the place of research is the alertness of all hospital staff who prioritize service to

patients with a motto of serving with love. This study aims to determine the relationship between

perceptions of management regulations and the tendency of burnout in nurses. Perception of management

regulations is the assessment or evaluation, interpretation and knowledge of nurses on the rules or

agreements of company managers with nurses regarding rules or management, commitments, company

policies, job demands, company support, and awards from management to nurses. Burnout is a condition of

saturation, prolonged stress, and psychological stress caused by physical, mental, and emotional fatigue

which is influenced by several factors, both internal and external factors. The number of subjects in this

study were 140 people taken from 215 nurse populations through simple random sampling technique. The

hypothesis proposed in this study is that there is a negative relationship between perceptions of management

regulations and the tendency of burnout to nurses. This research method uses a quantitative approach and

uses two measurement scales, namely the scale of perception of management regulations and the burnout

scale. The analysis used is the product moment correlation parametric statistics that are processed with

SPSS Windows 21 for IBM software. The results obtained show that burnout in high nurses followed by

perceptions of management regulations is also high. This happens probably due to the demands of the

family of patients who want to be able to get immediate service, so many insurance patients need the right

services. Other things include inadequate company facilities that hinder service and cause high burnout of

nurses.

1 INTRODUCTION

Health is a very important thing in human life, so

many health service organizations have emerged as a

form of government programs aimed at improving

public health. Health care providers are required to

be able to provide maximum service to the

community. This is important, because patients

expect services that are ready, fast, and thorough for

the healing of the disease they experience. Health

efforts need to be carried out with a maintenance

approach, health improvement (promotive), disease

prevention (preventive), curative healing, and health

care (rehabilitative), which are carried out in a

comprehensive, integrated and sustainable manner

(Khotimah, 2010).

Regarding health services, the role of doctors,

nurses and management teams are very important to

achieve maximum service. Services provided by

health care organizations are services that deal

directly with the community (human service) as a

result of the collaboration between nurses, doctors,

and health care organization management teams

where all are required to support each other in

providing health services continuously in accordance

with the standards has been regulated by health care

organizations. It was stated by Mariyanti and

Citrawati (2011) that inpatient services involving

patients, doctors, and nurses in sensitive

relationships concerning patient satisfaction, service

quality and hospital image. This is what the Husada

Utama Hospital of Surabaya then used as a foothold

in service and gave birth to a vision as a leading

Wibowo, W., Utami, A. and Pratitis, N.

The Relationship between Perceptions of Management Rules with the Tendency of Burnout in Nurses.

DOI: 10.5220/0008585100490054

In Proceedings of the 3rd International Conference on Psychology in Health, Educational, Social, and Organizational Settings (ICP-HESOS 2018) - Improving Mental Health and Harmony in

Global Community, pages 49-54

ISBN: 978-989-758-435-0

health care center for patients and families through

professional and quality services. Of course, the

consequence of this vision is the demand for nurses

and medical personnel to be able to achieve the

vision of the hospital.

The Demands to be able to provide services

according to standards so that the company can

always achieve excellence, both in terms of

production and services, including demands on

medical personnel at the Husada Utama Hospital

Surabaya. On the one hand, it is natural that the

hospital or company provides the best for patients

and other service users. On the other hand it is also

not uncommon to present its own pressures on

human resources in it. Robbins (2006) argues that

task demands are a factor that is related to one's

work and that it puts pressure on the individual if the

demands of speed assignments are felt to be

excessive and can increase anxiety and stress. These

pressures in psychological terms are known as

burnout.

Burnout is generally found in human service

professions, namely people who work in fields that

are directly related to many people and perform

services to the general public (Wulandari, 2013).

The study conducted by Rachmawati mentioned the

results of a survey conducted by the Indonesian

National Nurses Association (PPNI) in 2006,

showing that around 50.9 percent of nurses working

in four provinces in Indonesia experienced work

stress (Khotimah, 2010). Such conditions according

to Khotimah (2010) seem to be exacerbated by

demands from organizational management so that

nurses can always provide maximum service.

Based on observations of nurses in charge at the

Husada Utama Hospital Surabaya surgery room unit

conducted by the head of the surgery room unit, it

was shown that some nurses often arrived late, often

slept when guarding the service, were a bit

aggressive when communicating with fellow

employees, seemed less careful in working with

employees other. The same thing was also reflected

in a news article on www.harianhaluan.com on

November 5, 2015 which stated that there were

nurses who applied thugs. It happened in the South

Solok Hospital that there were nurses who yelled at

the families of patients with few words that tended

to be rude.

Some behaviors shown by nurses, both in South

Solok and in Surabaya according to Rahman (2007)

are indicators of burnout. Further explained that the

tendency to be cynical, often come late, and skip

work can be a benchmark for the occurrence of

burnout in nurses. Pines and Maslach (1978) said

that several studies of burnout were found in social

workers, nurses, psychiatrists, psychologists, prison

guards, child caregivers, teachers, and counselors

with almost the same conditions.

As a result of burnout in nurses, often raises

emotional reactions such as anger, anxiety, fear, and

aggression which are very influential on the care of

nurses in patients. Sulistyawati (2007) in her study

wrote that the effects arising from burnout are

decreased motivation for work, cynicism, the

emergence of negative attitudes, frustration, feelings

of being rejected by the environment, failure, and

low self esteem. Maslach (1982) also argued that

burnout has three dimensions, namely fatigue,

cynicism, and low self-esteem and also implicitly

recognizes the existence of supporting factors for the

creation of burnout conditions in the work

environment where the interaction between the giver

and recipient of the service occurs.

The discrepancy between what employees expect

and what the company gives to employees, such as

lack of support from superiors and unhealthy

competition among co-workers is a psychological

working environment that can affect the appearance

of burnout in employees (Sihotang, 2004). Rafii's

research, Oskouie and Nikravesh (2004) which

examined a number of nurses, showed that burnout

causes emotional avoidance, low quality work and

gives a negative impression on interpersonal,

intrapersonal and achievement of an organization.

Pines and Aronso (1989), burnout is defined as a

state of physical, emotional and mental exhaustion

caused by long-term involvement in emotionally

charged situations. Sihotang (2004) argues that

physical, mental, and emotional fatigue called

burnout can occur due to stress suffered by

individuals for a long time, in situations that require

high emotional involvement. Burnout can even

cause a low attitude of caring, rude attitude, lack of

self-respect, and an aggressive attitude. Weiten

(2010) added that burnout is often related to job

demands and regulations, which usually occur in

individuals who work in the field of social services.

Job demands as written forms in a company

regulation are explicit statements addressed to an

employee about things that must or should not be

done (Gammahendra, Hamid, and Riza, 2014). Not

infrequently a regulation and organizational policy,

is less clear so that sometimes the perception of

siding with an employee's working period without

seeing ability and lacking more opportunities for

employees in developing abilities or expertise. This

is what is then felt as a stressful demand for

employees which then raises the burnout on the

ICP-HESOS 2018 - International Conference on Psychology in Health, Educational, Social, and Organizational Settings

nurse. That is, the perception of nurses and

employees regarding the rules and policies of

hospital organization management is thought to be

the cause of the emergence of burnout.

Different perceptions of nurses regarding the

rules in the company become interesting knowledge,

because according to Notoatmodjo (2003)

knowledge is the basis for doing something or

acting, and related to experience and education.

Chaplin (1999) also argues, perception generally

depends on a number of stimulant factors, ways of

learning, state of mind or mood, and motivational

factors.

Perception of management regulations according

to Guntur (2010) is a perception of a regulation that

is made in writing that contains provisions regarding

the terms of work and company rules. Perceptions of

the management regulations need to be examined

further whether this is one of the things that affect

the occurrence of burnout in nurses so that by

knowing what is the right and obligation, the

services performed by nurses can run smoothly and

in line with expectations. According to , J.Bryan,

Tim Barnett, Kim Hester, & Clint Relya (2003)

employee trust in the organization's concern for its

welfare and the value of the contribution given is a

reciprocal relationship. High employee perceptions

of fair treatment of the organization will also

increase the level of work productivity. Conversely,

low employee perceptions of organizational injustice

will lead to decreased productivity and even lead to

emotional exhaustion in work, work stress and

intense burnout.

Based on the background that has been

described, then the formulation of the problem posed

in this study is "Is there a relationship between the

perception of management regulations with the

tendency of burnout on nurses?".

Benefits of research that will be conducted

include:

1. Theoretical benefits of adding a scientific study

in the organization's industrial psychology and

clinical psychology about burnout and

perceptions of management rules on nurses.

2. The practical benefits are

a. For hospitals that researchers hope this

research can be used as a reference and

information in making policy companies

and organizations in an effort to prevent the

occurrence of burnout so that the field of

service and production can be maximized.

b. For the nurse the researcher hopes this

research is used as knowledge and reference

to communicate things that cause burnout at

hospital management.

c. For other researchers that researchers hope

this research into a study of other research

development.

The hypothesis proposed in this study is that

there is a negative relationship between the

perception of management regulation and the

tendency of burnout in nurses. The assumption, if

the perception of positive management rules, the

tendency of burnout in nurses to be low, and vice

versa. If the perception of negative management

rules, then the tendency of burnout in nurses higher.

2 METHOD

2.1 Participants

Participants in this study were 140 nurses out of a

total population of 215 nurses at the Husada Utama

Hospital Surabaya, with a confidence level of 95%.

Sample criteria used are nurses of Husada Utama

Hospital Surabaya, aged between 23 to 35 years,

working period of more than 1 year. A total of 140

research samples were selected using simple random

sampling technique, namely by selecting each

individual who was randomly sampled (Latipun,

2011).

2.2 Measurement

Data collection techniques used in this study were

questionnaires in the form of a Likert scale with

scores moving from 1 to 4. The researcher only used

4 alternative answers because respondents would

tend to choose a safe and easy middle answer if

there was a choice of answers to abstention or

hesitation. Data collection in this study was obtained

by using two scales, namely the burnout scale and

the perception scale of the management regulations

made by the researcher. The measurement of this

variable uses a burnout scale that was prepared by

the researcher with indicators based on the

dimensions of physical fatigue (such as frequent

headaches, feeling nauseous, frequent colds,

insomnia, lack of appetite, and back pain),

dimensions of mental fatigue (such as less sympathy

with other people, being cynical, insensitive,

difficult to concentrate, and dissatisfaction with

work), as well as dimensions of emotional

exhaustion (such as irritability, irritability, anxiety,

sadness, and despair). The basis of this indicator is

derived from the opinion of Pines and Aronson

The Relationship between Perceptions of Management Rules with the Tendency of Burnout in Nurses

(1989) that there are three aspects of burnout,

namely a) physical fatigue, is fatigue associated with

the physical condition of the body, b) mental fatigue,

is fatigue which involves low self-esteem and

depersonalization, c) emotional fatigue, is fatigue

associated with personal feelings. Measurement of

perceptions of management regulations was obtained

from the perception scale of management

regulations based on the management aspects of the

Main Husada Hospital of Surabaya.

The results of the calculation of a reliable test

with Cronbach Alpha technique on the burnout scale

obtained a value of 0.984 while the scale of

perception of management regulations obtained a

value of 0.924. Reliability test results of both scales

obtained more values than the Cronbach Alpha value

so that on the scale of burnout and the perception

scale of management regulations have good

reliability.

2.3 Data Analysis

Data analysis used in this research is using statistical

analysis technique. The data technique used in

finding relationships and proving the relationship of

the proposed hypothesis is using product moment

correlation techniques processed with SPSS

Windows 21 for IBM software.

3 RESULT

Based on data that has been tabulated and analyzed

using product moment correlation from Pearson with

calculation using SPSS 21 for IBM obtained rxy =

0,461 with significant level p = 0,000 (p <0,05)

meaning there is significant positive correlation

between perception variable to regulation

management with variable tendency of burnout in

nurses so that research hypothesis that read there is

negative correlation between perception to

management regulation with tendency of burnout in

nurse not accepted or rejected.

4 DISCUSSION

The results showed that there was a significant

positive correlation between perceptions of

management regulations and the tendency of

burnout to nurses. This shows that the hypothesis of

this study was not accepted.

This happens because when the subject perceives

positively the management regulations by assuming

that the company's management regulations are

positive, they must be adhered to and implemented

properly. And as a consequence, the subject does not

reconsider the physical and mental consequences

that are possessed so that unconsciously the level of

fatigue and saturation of the subject increases and

results in experiencing burnout. This is contrary to

the opinion of Robbins (2006) that task demands are

a factor related to one's work and it puts pressure on

individuals if their demands for speed are perceived

as excessive and can increase anxiety and stress. In

fact, in this research subject when subject

perceptions were positive towards management

regulations, the subjects were increasingly burnout.

From the results of the mean hypothetical and

empirical mean obtained hypothetical mean (ц) on

the burnout scale of 52.5 and the empirical mean of

59.39 so that the hypothetical mean < mean

empirical which means burnout in nurses is high. On

the scale of perception of management rules

obtained the value of ц = 85 and the empirical mean

of 92.03 which means also the perception of high or

positive management regulations. This shows that

burnout in high nurses followed by perceptions of

management regulations is also high or positive,

thus supporting the rejection of the research

hypothesis. This may occur, among others, due to

the demands of the family of patients who want

immediate service, the number of insurance patients

so that they need the right services. Other

possibilities include inadequate company facilities

that hinder service and can cause high burnout to

nurses.

The results of this study also do not support the

results of the study presented by Noe (1994) that an

injustice perception of compensation received can

lead to negative employee behavior towards the

company and the impact of job involvement which

can be seen from low employee commitment and

ultimately will reduce their work performance.

Further explained about negative perception by

Nitisemito (1980) that psychological work

environment conditions that are not good, such as

poor communication between employees, co-

workers, or leaders, will support and maintain the

onset of psychological fatigue in the work, so there

is the possibility of employees being easily irritated,

anxious, and not concentrating on carrying out tasks.

Based on the results of this study, the perception

of management regulations only contributed 21.2%

to the appearance of burnout in nurses. There are

many other factors that may be related to burnout.

ICP-HESOS 2018 - International Conference on Psychology in Health, Educational, Social, and Organizational Settings

This factor illustrates that the hard work in

complying with all the regulations that are set is the

result of nurses who really feel fatigue, boredom,

and drained energy so that it is contrary to the

hypothesis of the researcher. The assumption is that

nurses or individuals who have good perceptions of

management regulations will feel their work or tasks

become normal.

Another opinion was also added as a reference to

the rejection of the hypothesis that the self-efficacy

of nurses in suppressing the occurrence of burnout.

Self-efficacy is a part of self-concept. Self-efficacy

is an individual's assessment of his ability to perform

tasks or actions needed to achieve certain

performance (Sulistyawati, 2007). Bandura revealed

that individuals who have high self-efficacy, when

facing a pressing situation will try harder and last

longer and will be more active in business than

people who have low self-efficacy, and will be more

daring to set targets or goals to be achieved

(Sulistyawati, 2007).

5 CONCLUSION

Based on the results of the study, it was concluded

that the hypothesis was not accepted or rejected, that

there was no negative relationship between

perceptions of management regulations and the

tendency of burnout to nurses. Other researchers

who wish to develop and continue this research are

expected to be able to pay attention to other factors

and examine in more detail the level of tendency of

burnout in nurses including gender, nursing or

employee work period, coping stress and self-

efficacy and self-esteem of nurses or employees and

so forth.

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