Studi Fenomenologi: Pengalaman Perawat IGD Dalam Menangani Pasien COVID-19 Di RSUB Malang

Lompoliu, Angelia Yoan and Dr. Dra. Indah Winarni,, M.A and Ns. Tony Suharsono,, S. Kep., M.Kep (2021) Studi Fenomenologi: Pengalaman Perawat IGD Dalam Menangani Pasien COVID-19 Di RSUB Malang. Magister thesis, Universitas Brawijaya.

Abstract

Coronavirus 19 (COVID-19) merupakan penyakit menular yang pertama kali terdeteksi pada akhir tahun 2019. Namun dalam kurun waktu 2 bulan penyakit ini telah menyebar ke beberapa negara. Penularan yang begitu cepat membuat penyakit COVID-19 ditetapkan sebagai peristiwa pandemi diseluruh dunia oleh WHO. Perawat IGD merupakan garda terdepan dari sistem pelayanan kesehatan dalam menghadapi wabah. Pada saat terjadi pandemi COVID-19, banyak terjadi perubahan dalam sistem pelayanan di IGD, membuat beban kerja di IGD menjadi bertambah. Peran penting perawat IGD adalah meminimalkan risiko penularan. Namun masalah yang dihadapi perawat IGD adalah meningkatnya risiko infeksi yang tidak dapat diprediksi. Hal tersebut menempatkan perawat IGD menjadi populasi yang rentan terinfeksi. Di Indonesia terdapat 5.682 perawat yang terinfeksi COVID-19. Berdasarkan penelitian, para penyintas COVID-19 mengalami gejala penyakit jangka panjang. Hal tersebut dapat menimbulkan masalah bagi perawat IGD penyintas COVID-19 yang harus kembali bekerja di IGD dengan beban kerja yang berat. Tujuan dari penelitian ini untuk mengeksplorasi makna pengalaman perawat IGD penyintas COVID-19 selama bekerja di IGD RSUB Malang. Metode yang digunakan dalam penelitian ini adalah desain penelitian kualitatif dengan pendekatan fenomenologi interpretatif. Menggunakan pendekatan fenomenologi interpretarif adalah untuk mengekpor pengalaman perawat IGD penyintas COVID-19 saat bekerja pada situasi pandemi. Lokasi penelitian di IGD Rumah Sakit Universiat Brawijaya. Jumlah partisipan ada 6 orang perawat IGD yang merupakan penyintas COVID-19. Teknik pengambilan data melalui wawancara mendalam selama 30-60 menit. Analisis data mengunakan IPA dengan pendekatakan teori Biggerstaff & Thompson (2008) dengan 4 tahap: First encounter with the text, Preliminary themes identified, Grouping themes together as clusters, Tabulating themes in a summary table. Hasil dari analisis diperoleh 11 tema: 1. Mengalami kesulitan pada saat melakukan screening dan hambatan psikis serta fisik dalam menggunakan APD; 2. Mendapat tambahan pengetahuan dan pengalaman; 3. Tidak mengkhawatirkan diri sendiri tetapi lebih mengkhawatirkan orang lain; 4. Berusaha melindungi diri dari stigma; 5. Memutuskan isolasi di safe house rumah sakit karena takut keluarga terpapar COVID-19; 6. Memutuskan isolasi di rumah karena tidak nyaman isolasi tanpa kehadiran teman akrab; 7. Memutuskan isolasi di safe house rumah sakit karena tidak dikehendaki isolasi di rumah oleh petugas puskesmas; 8. Membutuhkan dukungan saat isolasi mandiri di rumah; 9. Mendapat berbagai dukungan saat isolasi di safe house rumah sakit; 10. Melakukan introspeksi diri setelah terpapar COVID-19; 11. Menjadi lebih berpengalaman dan lebih menyadari pentingnya menjalankan protokol kesehatan pada level maksimal. Bekerja di IGD saat pandemi merupakan situasi yang sulit yang harus dihadapi perawat IGD. Kebaruan penyakit membuat perawat IGD mengalami keterbatasan dalam pengetahuan dan kurang pengalaman untuk mengenal sifat dari penyakit serta ancaman yang ditimbulkan, sehingga perawat IGD kesulitan untuk melindungi dirinya sendiri. Mendapat tambahan pengetahuan dari pelatihan dan pengalaman selama menangani pasien COVID-19, membuat perawat IGD menjadi lebih siap untuk berkerja di IGD selama pandemi serta mampu untuk melindungi dirinya sendiri. Saat terkonfirmasi COVID-19, perawat IGD tidak mengkhawatirkan dirinya sendiri karena mereka telah menyadari risiko menjadi perawat IGD saat bekerja pada masa pandemi. Mengetahui adanya stigma yang beredar di masyarakat terkait pasien COVID-19, menimbulkan kekhawatiran pada partisipan, sehingga partisipan berusaha untuk melindungi diriviii dari stigma dengan tidak menginformasikan kepada tetangga ketika terkonfirmasi COVID-19. Kekhawatiran lain yang di rasakan partisipan adalah menularkan penyakit kepada keluarga. Lansia, anak, maupun orang yang memiliki riwayat penyakit penyerta akan mengalami gejala yang berat ketika terkonfirmasi COVID-19. Hal tersebut membuat partisipan tidak rela jika mereka akan menularkan penyakit kepada keluarganya. Partisipan berusaha melindungi keluarga mereka dengan memisahkan diri dari keluarga dengan menjalankan isolasi di rumah sakit. Perawat IGD yang terkonfirmasi COVID-19 harus menjalani isolasi mandiri dan minum obat (vitamin) untuk meningkatkan daya tahan tubuh. Tidak semua partisipan menjalankan isolasi di rumah sakit. Ada juga partisipan yang memilih untuk isolasi di rumah. Alasan partisipan yang memilih isolasi di rumah karena mereka merasa tidak ada orang yang di kenal akrab yang berada di ruang isolasi di rumah sakit. Partisipan yang memilih isolasi mandiri di rumah merasa kesulitan harus melakukan aktivitas sendiri tanpa bisa berinteraksi dengan orang lain. Minum obat menjadi kendala lain yang harus dilalui partisipan saat menjalani isolasi. Walaupun obat yang diminum berupa vitamin, namun cukup banyak vitamin yang harus diminum partisipan. Hal tersebut menjadi semakin sulit dilakukan partisipan yang tidak terbiasa dengan minum obat. Sulitnya menjalani isolasi membuat partisipan mambutuhkan dukungan. Partisipan yang menjalankan isolasi di rumah sakit merasa senang ketika mendapat dukungan dari keluarga dan teman kerja, terutama dari teman yang ada bersama di ruang isolasi. Pernah terkonfirmasi COVID-19 membuat perawat IGD melakukan introspeksi diri dan menyadari kelalaian yang pernah dilakukan, sehingga partisipan melakukan perubahan perilaku saat kembali bekerja ke IGD. Mendapat pengalaman menjadi penyintas COVID-19, mendapat berbagai dukungan saat menjalani isolasi, dan melakukan intriospeksi diri dalam memperbaiki prilaku, membuat perawat IGD perasa percaya diri untuk kembali bekerja menangani pasien COVID-19 di IGD

English Abstract

Coronavirus 19 (COVID-19) is an infectious disease which was firstly detected at the end of 2019. But, within only two months, this disease has been transmitted to many countries. The transmission was really rapid which turned COVID-19 disease was established as a pandemic phenomenon all over the world by World Health Organization (WHO). The emergency room nurses were the first line of health service system who would overcome this disease epidemic. During the pandemic of COVID-19, a lot of changes occurred in the service system of emergency room, which affected the higher workload in emergency room. The important role of emergency room nurse was to minimize the transmission risk. However, the emergency room nurses were demanded to face a problem of unpredictable increase of infection risk. This situation has positioned the nurses of emergency room to be the most susceptible population. In Indonesia, as many as 5682 nurses have been infected with COVID-19 disease. Based on the preliminary studies, the COVID-19 survivors suffered a long term of disease symptoms. This condition could cause problems on nurses who were COVID-19 survivors that they must back to work in the emergency room with a heavy workload. The aim of this research was to explore the significance of experience of emergency room nurses who were previously the COVID-19 survivors during their work at emergency room of Brawijaya University Hospital, Malang. This research used qualitative design and interpretative phenomenological approach. The interpretative phenomenology was aimed to explore the emergency room nurses’ experiences who have been COVID-19 survivors while they were working in a pandemic situation. The research location was taken at emergency room of Brawijaya University Hospital. The total participants of this research were about 6 emergency room nurses who have been the survivors of COVID-19. The technique of data collection was done through in-depth interview for about 30-60 minutes. The data analysis used IPA and approach of Biggerstaff & Thompson’s theory (2008) in these four stages: first encounter with the text, preliminary themes identified, grouping themes together as clusters, and tabulating themes in a summary table. Based on the analysis result, the researcher collected about 10 themes: 1. Experiencing difficulties during screening and psychological and physical barriers in using PPE; 2. Gain additional knowledge and experience; 3. Not worrying about yourself but more worried about others; 4. Try to protect yourself from stigma; 5. Deciding on isolation in a hospital safe house for fear of the family being exposed to COVID-19; 6. Deciding on isolation at home because it is uncomfortable to isolate without the presence of close friends; 7. Deciding on isolation in the hospital safe house because the health center staff does not want isolation at home; 8. Needs support while self-isolating at home; 9. Get various supports during isolation in hospital safe houses; 10. Doing self-introspection after being exposed to COVID-19; 11. Become more experienced and more aware of the importance of implementing health protocols at the maximum level.. Working at emergency room during pandemic was a hard situation which must be encountered by emergency room nurses. The disease progression made emergency room nurses to find limitation of knowledge and lack of experience in order to identify characteristics of disease and threats that might appear, thus, the emergency room nurses found difficulties to protect themselves. The training on additional knowledge and experience while treating COVID-19 patients would make the nurses to be better prepared at emergency room during the pandemic and be able to protect themselves. When the emergency room nurses were confirmed as having COVID-19x disease, they did not worry themselves, since they have already known the risks of their profession as emergency room nurses. The stigma that has been spread in the society relating to COVID-19 patient would cause worry and fear on the participants, so they attempted to protect themselves from that stigma by not informing their situation to the neighbors when confirmed with COVID-19. Moreover, the other fear felt by the participants that they might transmit the disease to the family. Elderly people, child, and people with comorbid would have severe symptoms when they were confirmed with COVID-19. This factor affected participants to avoid the disease transmission possibility on their family. All participants have attempted to protect their family by separating themselves and having selfisolation at the hospital. The emergency room nurses who have been confirmed with COVID-19 should have selfisolation and medicine (vitamin) in order to increase their body immunity. Further, the participants felt uncomfortable that they should have isolation with unfamiliar people, so a few of participants decided to have isolation at home. But, the participants who decided to have self-isolation at home, they felt difficult to do activities by their own without any interaction with other people. The recommendation to take medicine became another problem that they must overcome during their self-isolation at home. Although the medicine was only vitamin, but a lot of them must be taken by the participants alone. This condition turned harder for the participants who were not used to take medicine. The difficulty of having isolation made the participants need some supports. The participants who have isolation at the hospital felt happy when they received family and co-worker supports, especially from the mates who were together in an isolation room. The experience of COVID-19 confirmation made the emergency room nurses to have self-introspection and realize for their negligence, so they could change to the better behavior when they were back to work at emergency room. By having a lot of supports and self-introspection, the emergency room nurses felt more confident to be back at work and handle COVID-19 patients

Item Type:	Thesis (Magister)
Identification Number:	042107
Subjects:	600 Technology (Applied sciences) > 610 Medicine and health > 610.7 Education, research, nursing, services of allied health personnel > 610.73 Nursing and services of allied health personnel
Divisions:	S2/S3 > Magister Keperawatan, Fakultas Kedokteran
Depositing User:	soegeng sugeng
Date Deposited:	03 Jan 2022 04:08
Last Modified:	24 Feb 2022 08:45
URI:	http://repository.ub.ac.id/id/eprint/187742

Text (DALAM MASA EMBARGO) Angelia Yoan Lompoliu.pdf Restricted to Registered users only until 31 December 2023. Download (3MB)

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