The Implementation Discipline and Work Productivity of Non

Military Nurses

Setiadi and Muh. Zul Azhri Rustam

Institute of Health Science Hang Tuah, Surabaya, East Java, Indonesia

Keywords: Discipline Work, Work Productivity.

Abstract: The contribution of nursing service to the quality of health service depended upon nursing management, and

one of the indicator of excellence in nursing is how much the productivity of the staff nurse in providing a

good care to client and family. To achieve the optimal productivity growth needs some supporting factor

includes conducive work, climate work, good work ethos and high discipline. This research aims at identifying

the relationship between discipline with work productivity of non military nurses at dr. Ramelan Surabaya

hospital. The design was a descriptive correlation. The number of sample was 170 of 302 total population,

obtained through a systematic random sampling technique. Using the level of significance (α=0,05). The

result shows a relationship between work productivity and discipline (p=0,028), compliance to the schedule

(p=0,014), local policy (p=0,00), standard (p=0,024) and direct superior (p=0,014). The multivariate analysis

showed that age (0,000) represents most related to work productivity. The conclusion is directed to the

director and nursing manager that performance of nursing care, work discipline standards and team building

development, fair reward system for high work performance and penalty for low work performance need to

be developed further.

1 BACKGROUND

Health care in the last decade is facing changes in

various aspects of order and service resources as the

impact of globalization that generates changes in all

aspects of life. Where the positive impact has made

the patient as someone who is educated because of the

amount of information obtained about various things

including health. The Condition then grow the

patient's awareness of the right to choose quality

services because they have high purchasing power.

professions are required to adapt to improve the

quality based on the needs of the community,

including nursing services in the hospital. The

nursing profession is the spearhead of health services

in hospitals that have a great influence on improving

the quality of health services as a whole, since nurses

as health workers for 24 hours interact with clients.

Nurses are also the most human resources in the

hospital which is about 40-60%.

The contribution of nursing service to the quality

of health services depends on the management of

nursing, and one measure of the success of good

nursing service is how much the productivity of the

nurses in providing good nursing care to clients and

their family (Gibson J.L, 1997). Productivity in the

organization of nursing is realized through the

provision of nursing care that guaranteed quality and

quantity based on predetermined standards and its

effectiveness and efficiency (Swansburg, 1999).

Productivity is the goal of every type of

organization, including nursing services, with high

work productivity of nurses, the service in hospitals

will be better and the quality of health services can be

improved. The improvement of work productivity is

aimed to increase profits in the nursing organization

including to improve the nurse's progress as well as

to improve client's satisfaction as the recipient of

nursing services.

Several factors known to affect work productivity

include work climate, work ethic and work discipline.

Discipline is the most important operative function of

human resource management because the better the

job discipline will be the higher the achievement of

work that can be achieved (Hasibuan, 1999). The

nurse's work discipline in a unit or nursing ward is

different. There are nurses who are diligent and

diligent in working so it is very productive and have

a high ability in completing the duties and

responsibilities in providing nursing care.

590

Setiadi, . and Rustam, M.

The Implementation Discipline and Work Productivity of Non Military Nurses.

DOI: 10.5220/0008329205900595

In Proceedings of the 9th International Nursing Conference (INC 2018), pages 590-595

ISBN: 978-989-758-336-0

Conversely there are also nurses who are lazy and

lack a good work ethic that productivity is low.

The Results study in the field showed that the

level of discipline of nursing staff in implementing

nursing care in the hospital has been not optimal, also

found the work discipline of nurses in Rumah Sakit

Islam Samarinda have a high discipline of 49.5% and

low of 50.5% work discipline is still not good. This is

reinforced by research of (Sukamto E, 2005), also

found the discipline of nurses working in Rumah

Sakit Islam Samarinda have a high discipline of

49.5% and low 50.5%.

According to some head of room information, the

behavior of non military nurses in complying with the

rules and regulations of the room is also lacking. It is

seen there are still some non military nurses who

arrived late to the room after morning ceremonial. On

the otherside, there are found some non-military

nurses who should be replaced by others. The work

discipline shown by some non-military nurses has no

organizational expectations and should be alerted by

the special management of the care sector in order not

to spread to other nurses.

2 METHODS

The method used in this research is descriptive

correlative method, where will be studied the

influence or relationship between variables

(Arikunto, 2002). To find an analysis of the

relationship between work discipline with work

productivity of nurse implementer, researcher use

cross sectional approach that is collecting data from

four variables collected in one time. To find the

analysis of the relationship between work discipline

with work productivity of nurse implementer,

researcher use cross sectional approach that is

collecting data from variable collected in one time.

The population in this study were all non-military

implementing nurses at 25 inpatient wards,

amounting to 302 people in dr. Ramelan Surabaya

hospital. The sample in this study was 170 people,

taken by probability sampling with systematic

random sampling technique. The variables in this

study are work discipline and work productivity of

nurses. Variable Discipline work in divided into 4 sub

variables that is time discipline nurse service,

discipline to nurse discipline, discipline against nurse

work standard and discipline to boss. The data

collection instrument uses a structured questionnaire

developed based on the lattice of variable components

of work productivity and work discipline. To know

the relationship or degree of closeness between the

variables studied, work discipline with work

productivity bivariate analysis used with Chi Square

test correlation test (Dahlan S.M, 2008).

3 RESULT

Respondents with good work discipline are more

likely to have a good work productivity with a

proportion of 65% compared to respondents who did

not work discipline. The result of chi square test

shows p value = 0,028 (p value <0,05), mean there is

statistically significant relation between work

discipline with work productivity. Odds Ratio (OR) =

2,129 (95% CI 1,129-4,014), which means that

respondents who have good working discipline have

the opportunity to work productively 2,129 times

compared with respondents whose work discipline is

not good.

Table 1: Relationship between work discipline with work productivity.

Work discipline

Work productivity

Total

(95 % CI)

p value Less Goo

n % n % n %

Less 34 54 29 46 63 100

2,129

(1,129-4,014)

0,028

38 36 69 65 107 100

Total 72 42 98 58 170 100

Table 2: Relation of time-related compliance to work productivity.

Obedient to the boss

Work productivity

Total

(95 % CI)

p value

Less Goo

n % n % n %

Less 13 72 5 28 18 100

4,098

(1,389 – 12,089)

0,014

Goo

59 39 93 61 152 100

Total 72 42 98 58 170 100

The Implementation Discipline and Work Productivity of Non Military Nurses

591

Compliance of respondents to working time is

likely to be greater to have a good work productivity

with a proportion of 61% compared to respondents

who adherence to work time is not good. The result

of chi square test shows that p = 0,014 (p value

<0,05), meaning there is a statistically significant

correlation between respondent's compliance with

working time and work productivity. The Odds Ratio

(OR) = 4,098 (95% CI 1.389-12.89), which means

that respondents who have a good working time

compliance will have an opportunity to work

productively 4,098 times compared to respondents

who have poor working time compliance.

Compliance of respondents to the discipline is

more likely to have a good working productivity

with a proportion of 73% compared to respondents

who obedience to the order is not good. Based on

result of chi square test turn out show value p = 0,00

(p value <0,05), mean there is statistically significant

correlation between obedience of employee to

discipline with work productivity. The Odds Ratio

(OR) = 6.778 (95% CI 3,331-13,791), which means

that respondents who have compliance with good

orderliness will have the opportunity to work

productively 6,778 times compared with the

respondents whose compliance with poor order.

Compliance of respondents to the standard of

possibility to have a good work productivity with a

proportion of 51% and respondents who adherence

to the standards are not good have good productivity

with the proportion of 68%. The result of chi square

test shows that p = 0,046 (p value <0,05), meaning

there is statistically significant correlation between

employee compliance to standard with work

productivity.

The respondent's compliance to the boss is likely

to have a better working productivity in proportion

(63%), compared to the respondents who adhered to

the underachievers (36%). Based on the result of chi

square test, it shows that p = 0.010 (p value <0,05),

which means there is a statistically significant

relationship between employee compliance to

superiors with work productivity. Odds Ratio (OR)

= 3.042 (95% CI 1.351-6,852), which means that

respondents who have good compliance to their boss

will have a chance to work productively 3,042 times

compared to respondents whose compliance with

their supervisor is less good.

4 DISCUSSION

4.1 Work Discipline

The discipline of work in this study is the nurse's

perception of the form of obedience of one's

behavior in complying with certain rules relating to

Table 3: Compliance relationship to the rules of work productivity.

Comply with

order

Work productivity

Total

(95 % CI)

p value

less goo

n % n % n %

Less 41 72 16 28 57 100

6,778

(3,331-13,791)

0,000

Good

31 27 82 73 113 100

Total

72 42 98 58 170 100

Table 4: The relationship of compliance to standards with work productivity.

Obey the

standards

Work productivity

Total

(95 % CI)

p value

Less Good

n % n % n %

Less 22 32 46 68 68 100

0,497

(0,262-0,943)

0,046

Good 50 49 52 51 102 100

Total 72 42 98 58 170 100

Table 5: Compliance relationship to superiors with work productivity.

Be obedient to your

boss

Work productivity

Total

(95 % CI)

p value

less Good

n % n % n %

Less 20 65 11 6 31 100

3,042

(1,351-6,852)

0.010

Good 52 37 87 63 139 100

Total 72 42 98 58 170 100

INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research

592

his work with the indicator of service time

compliance, compliance with the rules, adherence

to nursing standards, and obedience to superiors.

the problem of work discipline, is a matter to note,

because with the discipline can affect the effectiveness

and efficiency of achieving organizational goals. With

frequent unskilled employees, the target completion of

work is never achieved which in turn affects the

productivity of the organization's work. This agrees

with (Nitisemito, 1991) who says that a job will be done

as effectively as possible, when discipline is well

executed.

Discipline of work at dr. Ramelan Surabaya

hospital structurally will be influenced by the rules of

the navy that has a very high work discipline focus.

High work discipline at dr. Ramelan Surabaya

hospital does not appear just like that but it is a

continuous learning process that is developed in a

military way with leadership center as role model or

role model for subordinates so that it can generate

motivation and motivation for their subordinates.

Implementation of discipline in dr. Ramelan Surabaya

hospital applies the existence of rules and regulations

as guidelines of employees in working with

progressive approach, using a number of steps in

shaping employee behavior.

4.2 Nurses Work Productivity

Result of research about work productivity in hospital

dr. Ramelan Surabaya more than half of it is classified

as good (58%). Nursing is one form of professional

health services aimed at clients both in good health

and illness through nursing tips using nursing process

approach. Nursing services provided by a nurse

greatly affects the quality of nursing care that will be

accepted by the client. Therefore, to be able to provide

quality nursing care so nurses need to be oriented to a

better client outcome. These conditions can be

achieved if the work environment created a qualified

nurse. To realize professional nursing services in

hospitals, productivity is very important for hospitals

to be well managed.

The nursing manager must be able to determine the

strategic steps in the management of existing

resources. One of the strategic steps that can be

applied is with existing input and output management

systems. Inputs include human resources, facilities,

regulatory policies, and capital that must be developed

optimally, the outcome is the result of activities of the

organization including productivity as the end result

of the production process, which is inseparable with

the effectiveness and efficiency of the company. In

order to improve work productivity, spirit and good

performance in dr. Ramelan Surabaya actually has

tried to do the arrangement in various fields one of

them is the arrangement in the field of nursing

resources.

Various efforts have been made by the head of the

Department of Nursing, among others, by doing daily

supervision to provide guidance, direction and

motivate nurse implementers to work passion

according to professional demands. Another policy is

the provision of opportunities to improve higher

education gap.

4.3 Compliance Relation to Working

Hours with Work Productivity

Compliance to working hours in this study is the

perception of nurses implementing in obeying the

attendance of the time agency that has been

established by the institution. Based on the results of

the study found that there is a significant relationship

between employee compliance with the work time

that has been determined with the productivity of

work. This finding concurs with the statement of

(Stamps P.L, 1997) which says that one component

of job satisfaction relevant to the health sector is the

existence of organizational policies in the form of

rules or limits established and enforced by the

management of the hospital.

These policies include employee supervision,

arrangement of work schedules, holidays and

opportunities for growth and prosperity. setting job

schedules according to the percentage of time spent,

for example when a person should start and stop

working, when to start working again and when will

end and so on, will likely prevent waste and work will

be effective and efficient.

If the employee enters work in accordance with

the specified working hours then the job completion

targets will be achieved in accordance with the target

set. Regulation of discipline working time in hospital

dr. Ramelan Surabaya with the implementation of

morning apple around 07.00 am and apple lunch at

2:45 pm which is required to all employees in the

hospital. Implementation of time discipline in

hospital dr. Ramelan Surabaya is also supported by

the shuttle for employees who live in Surabaya and

surrounding areas.

4.4 Compliance Relationship to the

Code with Work Productivity

Compliance with the discipline in this study is the

perception of nurse implementers in obeying the

order set by the institution. Based on the result of the

research, it shows that there is a significant

correlation between the respondent's compliance to

the order and the productivity of the kerjan. The

results of this study concurred with (Siagian S.P,

The Implementation Discipline and Work Productivity of Non Military Nurses

593

2002) which states that other factors that determine

work productivity is the discipline of work which

means willingness to comply with regulations

applicable within the work organization environment

respectively, so it is expected to increase work

productivity (Nitisemito, 1991) argued that the

willingness to comply with the rules or regulations

applicable within the work organization environment

respectively, it is expected to increase work

productivity.

The purpose of an institution or organization can

be achieved if management manages, mobilizes and

uses its human resources effectively and efficiently.

One of the indicators of work discipline here is the

discipline in complying with the rules established in

the company.

With a high awareness in implementing

organizational rules embodied in high work

discipline, then a work productivity will also be

achieved. According (Hasibuan, 1999) that there are

several indicators that affect the level of discipline of

employees in the organization such as role models

and assertiveness, remuneration, justice, and

punishment sanctions.

4.5 Compliance Relation to Standards

with Work Productivity

Adherence to the standards in this study is the

perception of nurses implementing in compliance

with work standards established by the hospital in the

room. Based on the results of the study indicates that

there is a significant relationship between employee

compliance to the standard with work productivity.

The results of this study agree with what (Gillies,

1996) has said, that the use of nursing standards is

necessary to know the quality of services provided

and to reduce costs and is expected to limit the

likelihood of negligence. The existence of standard

work that the standard work certainty will be clear,

each will know the limits of authority and

responsibility, so that facilitate the daily work well

that will eventually increase productivity. If

employees do not know the standard of work and their

authority, they will tend to be misdirected, which will

result in a decrease in their performance.

Many employees are productive but have not been

able to do a good job because it is unclear about the

authority to be done. To protect nurses in the

workplace, hospitals should establish policies that

regulate the employment relationships and authority

components of each member so that the nurse feels

secure in doing every job because there is a protective

legal umbrella. Policies compiled by hospitals should

be tailored to the availability of facilities, equipment

and technology. States that professional nursing

practice must be realized in a real practice that is

direct care to patients, families, groups or

communities. Nursing services will be accepted and

trusted by the consumer if the quality of the service is

guaranteed through standard standards and always

upgraded from time to time.

4.6 Compliance Relation to Bosses with

Work Productivity

Compliance with superiors in this study is the

perception of nurse implementers in obeying

superiors in accordance with the rules set by the

hospital. Based on the results of research, indicate

that employee compliance to superiors related to

work productivity. The findings of this study

concurred with (Hasibuan, 1999) which states that

with exemplary leadership of a disciplined high

discipline subordinates became high. Many

employees show good work productivity because of

their reluctance and attachment to their superiors.

Employees feel bad if they do not work according

to the target given his boss. This will have an impact

on employee productivity in work. Respect and

reward of employees to leaders can be due to good

personality qualities or have high professional quality

in their field. So employee compliance is based on the

identification of a feeling of admiration or

appreciation to the boss. Respect and reward of

employees to leaders can be due to good personality

qualities or have high professional quality in their

field. If the center of this identification does not exist

then the discipline of work will decrease, the violation

will increase in frequency.

5 CONCLUSIONS

Productivity of non-military nurse in dr. Ramelan

Surabaya showed good work productivity (58%) and

poor productivity (42%). With the proportion of

respondents in completing the tasks in accordance

with academic ability, the skills and experience are

mostly good (76%), which works effectively for the

most good (59%) and the most efficient (59%) .

Work discipline relates to the productivity of non-

military nurse worker at Dr Ramelan Hospital

Surabaya

 Compliance with non military military nurse

practitioners in Dr Ramelan Hospital Surabaya is

related to work productivity.

 Compliance with non-military nurse working

standards in Dr Ramelan Hospital Surabaya is

related to work productivity.

INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research

594

 Compliance with non-military nurses' superiors

at Dr Ramelan Hospital Surabaya is related to

work productivity.

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