Analysis of Job Satisfaction of Implementing Nurses on Work Productivity

Job satisfaction is a problem that is often faced by nurses working in health services. The causes of job satisfaction include rewards, competence, and work stress which will have an impact on work productivity. Analyzing the job satisfaction of implementing nurses on work productivity. Analytical descriptive research with a cross sectional approach. The sample of implementing nurses in the Inpatient Installation and Intensive Care Installation is 317 implementing nurses. There is a correlation between competence (r=0.260 p=0.001) work stress (r=0.394 p=0.001) job satisfaction (r=0.322 p=0.001) to work productivity in the Inpatient Installation room. There is a correlation between competency (r=0.573 p=0.001), work stress (r=0.522 p=0.00) job satisfaction (r=0.242 p=0.010) and marital status (r=-0.204 p=0.031) in the treatment room intensive. There is no relationship between reward, age, gender, education level, years of service, employment status on work productivity (p=>0.005). There is a relationship between competence, work stress, job satisfaction and marital status on work productivity. There is no relationship between rewards, age, gender, education level, years of service, employment status and work productivity.


Introduction
The hospital provides individual health services by providing emergency, inpatient and outpatient services. Human Resources directly provide maximum service to patients. To maintain quality work productivity, quality human resources are needed. Nurses account for 40.85% of the number of other health workers (RI Ministry of Health, 2021). Work productivity is influenced by various factors such as man factors, materials, machines and methods (Martono, 2019).
Various data on the work productivity of nurses have been reported in Egypt where two-thirds of nurses have low productivity levels (Ali et al., 2019). The work productivity of nurses at Zainal Abidin Pagar Alam Hospital is in the good category 56.7%, in the bad category 46.3% (Riyanti & Yulianto, 2020). RSU GMIM Bethesda Tomohon work production in the good category 43.4%, not good 56.6% ( Andini, 2019). Hospital Dr.M.Djamil Padang good category 71% (Arif et al., 2020).
Various studies state that nurse job satisfaction is heavily influenced by several factors including salary, leave, working hours, and co-workers (Liton & Dawlat, 2020). The emotional state of an employee regarding his work, what is done with what is expected at work (Kadir Rahman et al, 2017). Work environment, structural empowerment, organizational commitment, professionalism, job stress, patient satisfaction, ratio between patient and caregiver, social

Methods
Analytical descriptive with cross sectional. Using non-probability sampling with purposive sampling technique Inclusion criteria for implementing nurses who work in Inpatient and Intensive Care Installation rooms, at least 1 year. Exclusion criteria for nurses who refused to participate. The characteristics of implementing nurses in the IRNA and IPI rooms show an average productive age between 33-34 years, the most female gender, the majority of DIII Nursing, service period between 9-10 years. PK 2 career path The results showed that most of the respondents answered that the reward was in the unfavorable category at IRNA at 56.6% and at IPI at 50.9%. Variable competence in the less category in the IRNA space was 76.6% and 67.9% in IPI. The high category of work stress in the IRNA was 54.1% and the IPI was 65.2%. Job satisfaction in the poor category at IRNA was 52.7% and 51.8% in the IPI room. Work productivity in the poor category was 56.6% in the IRNA room and 51.8% in the IPI room.  The statistical test results for the relationship between the characteristics of the nurse practitioner and the work productivity of the nurse practitioner showed that in the IRNA room there was no relationship between age, gender, education level, years of service, career path, marital status, employment status and productivity with a value of p> 0.005. In the IPI room, there is a relationship between marital status and work productivity with a correlation coefficient of r=-0.120 p=0.031 with a negative relationship and very weak relationship strength.

The Relationship between the Characteristics of the Implementing Nurse and Work Productivity
Age indicates productive age in both IRNA and IPI. This age is very profitable for organizations how to empower nursing human resources professionally to produce benefits for the organization. Gender shows no significant relationship to work productivity. There is no difference in the type of work a nurse does in a hospital for the work done between men and women and the skills possessed are the same. The level of education is an organizational reference for accepting someone to work. One of the determining factors for work productivity is education (Sulistiyani, 2018). The education level of the majority is D III Nursing so that the skills possessed are more or less the same both in the IRNA room and in the IPI room.
Tenure is the length of time a person works in an organization. Based on research results both at IRNA and at IPI the working period is 9-10 years. Conditions for a long working period if not supported by comfortable working situations and conditions only work to carry out obligations without innovating. Competence is something that is owned by someone who can influence his behavior at work (Siska & Hendri, 2018). The majority are at PK level 2 who are able to perform holistic nursing care for patients independently, but complex cases need guidance. Marital status is the most married status in both IRNA and IPI. Those who are married have greater responsibilities and view work as the future. The employment status of the majority is temporary workers. There is no relationship between employment status and work productivity. There is no effect of employment status on Quality of Work (Kaluku, et al 2019). The test results show that age, gender, education level, years of service are not related to work productivity. Age has no relation to work productivity (Prasetya et al., 2020). Years of service, education level and work productivity have no significant relationship (Riyani & Farikha, 2016).
Marital status is related to work productivity. For those who are married have greater responsibility towards the family so they see work as the future. However, this is different from previous research, there is no relationship between marital status and work productivity (Riyani & Farikha, 2016).

The Relationship Between Rewards and Work Productivity
Reward is an appreciation given to someone for the achievements achieved, usually in the form of a bonus in return for the performance achieved. Reward also functions as a promotion and a form of appreciation for nurses for their achievements and performance. The results showed that there was no relationship between rewards and work productivity in both the IRNA and IPI rooms. However, the results of the reward test on job satisfaction have a positive effect. This means that even though the nurse's reward is high, job satisfaction has not been fulfilled will affect work productivity. If job satisfaction is fulfilled it will have a positive impact on work productivity. Previous research stated that rewards have an effect on nurse job satisfaction (Susanto et al., 2020, Waltz et al., 2020. There is an influence between rewards and nurse job satisfaction (Isnainy & Nugraha, 2019, Jimmy Fitria, 2017. There is an influence between rewards and job satisfaction (Isnainy & Nugraha, 2019). Based on the results of interviews with the implementing nurse, he said "the welfare of nurses, especially salaries, is still low, services and action services are not in accordance with the number of our patients, the remuneration system needs to be implemented so that there are not too many differences in services between rooms,".

The Relationship Between Competence and Work Productivity
Competence is something that is owned by someone who can influence his behavior at work (Siska & Hendri, 2018). The better the competence possessed by the nurse, the more confident the nurse will be in their ability to provide professional nursing care. Statistical test results show that there is a relationship between competence and work productivity. The results of interviews with implementing nurses said "the placement of nurses is not entirely based on competence," it is better if the training is adjusted to the competence of nurses and the room where they work," Competence has a positive effect on work productivity (Abubakar, 2018, Juliadi, et al, 2022. Competent nurses will feel confident in providing nursing care to patients. Competence is an important factor in maintaining work productivity (Prasetya et al., 2020).

The Relationship of Work Stress to Work Productivity
Work stress has an unfavorable impact on individual health and work productivity. Nurses experience higher stress compared to other staff in hospitals (Kuo et al., 2020). Work stress stimulates the body to react to the body's ability. In this situation the body will try to do the task better and faster. However, if left in a long condition will reduce work productivity. The results of interviews with executive nurses, even though we are under stress and lack of staff, we continue to work professionally," "if there is an increase in service, at least it can reduce the work stress we experience. Several previous studies have stated that work stress is related to the work productivity of nurses (Umboh et al., 2020, Andini et al, 2019, Radito & Germana, 2020.

The Relationship Between Job Satisfaction and Work Productivity
Nurses who are satisfied with their work will survive in their work environment and will try to provide the best for the organization, doing their work with a sincere feeling. Job satisfaction is not only from wages, competence and work stress but is caused by many factors. Nurses who have positive beliefs about their work abilities have an impact on job satisfaction (De Simone et al., 2018).
Statistical test results show that there is a relationship between job satisfaction and work productivity both in the IRNA and IPI rooms. The results of the interview with the implementing nurse said "We are sincere and intend to work because of worship", I feel satisfied and proud to work in the biggest hospital. "the situation and conditions of work and a comfortable work space, co-workers who support each other make us comfortable working".
Previous research said there is a relationship between job satisfaction and work productivity. Job satisfaction is a determinant of work productivity (Istiqomah et al., 2021, Radito & Germa 2020. Work productivity is not only influenced by job dissatisfaction. but influenced by various factors including knowledge, skills, abilities, attitudes, and behavior (Sulistiyani & Rosidah, 2018).

Conclusion
The conclusion; (1) there is no relationship between demographic characteristics (age, gender, education, years of service, work space, career path, and employment status) with the work productivity of executive nurses at Abdoel Wahab Sjahranie Hospital Samarinda. There is a relationship between marital status and work productivity; (2) Reward has a significant relationship to work productivity through the job satisfaction of the implementing nurses at Abdoel Wahab Sjahranie Hospital; (3) there is a relationship between competence and the work productivity of implementing nurses at Abdoel Wahab Sjahranie Hospital; (4) There is a relationship between work stress and the work productivity of implementing nurses at the Abdoel Wahab Sjahranie Hospital in Samarinda; (5) There is no relationship between job satisfaction and work productivity of implementing nurses at Abdoel Wahab Sjahranie Hospital Samarinda.

Suggestion
The suggestion; (1) Organizational support is needed, in this case the management in minimizing work stress and increasing dimensions that can affect nurse job satisfaction such as rewards and competence; (2) There needs to be a technical skills development program as well as continuing education to support the competencies needed by nurses in accordance with the area of care; (3) Strategies and efforts are needed to minimize the impact of work stress experienced by nurses through activities or training and management of work stress management.