BUILDING INDONESIA S NURSE CHARAKTER THROUGH THE IMPLEMENTATION OF SOFT SKILL COMPETENCE

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1 BUILDING INDONESIA S NURSE CHARAKTER THROUGH THE IMPLEMENTATION OF SOFT SKILL COMPETENCE Rosita Saragih, SKM, M.Kes rositanet@ymail.com (Nursing Faculty of University of Darma Agung Medan) Abstract Character is a marker of who actually we are, how we think and behave. The character is largely determined by what we do, say and believe. Characters can be shown from our behavior. There are still many patient assume, if nurses in Indonesia still do not have a perfect character compared with nurses abroad. This is shown by the reality that most patients in Indonesia pursue the treatment abroad, with reason, Indonesia s nurse do not have soft skills in accordance with the patient s expectations. Nurses who have the character will be seen at their attributes of soft skills; intra personal skill and inter personal skill. Intra personal skill include : a) the ability to manage the time, b) the ability to cope with stress, c) the ability to change the strategy immediately if it is needed, d) the ability to change the beliefs that were previously assumed to be true after getting enlightenment e) the ability to change attitudes (either to self or others) f) the ability to carry out the process of creative thinking, g) the ability to determine the purpose of life and h) the ability to implement accelerated learning techniques. While the inter personal skills are : a) motivation skill, b) leaderships skill, c) negotiating skill, d) presenting skills (especially for listeners/audience in large amounts), e) communication skill, f) relationship building skills, g) delivering the opinion skill, h) the ability to show the potential of existing skills within themselves. Soft skill competencies should be developed by three institutions, namely 1) Family, 2) Society, 3) Educational institution. The formation of the character of a nation is influenced by these three institutions role. Informal and non formal education establish in family and community institutions, which are crucial for entering the world of formal education. In the formal education, lecturers are expected as a role model to the nurse s candidates, with the motto: tut wuri handayani (the lecturers should be able to give encouragement and direction), ing madya mangun karsa (in the middle or among the pupils, the lecturer must create the initiative and idea), ing ngarsa sung tulada (in the front, the educator must give the model or the example of the good deeds). Key words: Competence, soft skills, nurse 1

2 BUILDING INDONESIA S NURSE CHARACTER THROUGH THE IMPLEMENTATION OF SOFT SKILL COMPTENCE Rosita Saragih, SKM, M.Kes rositanet@ymail.com Nursing Faculty of University of Darma Agung Medan Excellent, Professional, independent, and having good manner, is one of the Vision of the Nursing Faculty, therefore, the institutional sides are always trying to carry out the Tri Darma Perguruan Tinggi (Three Higher Education s Obligations) in its commitment to held a high quality of nursing faculty s educational system to fulfill the seeking goal to produce graduates who excel, high moral standards, ethical, professional, competitive and able to solve the problems of nursing. The faculty carried out the research that was oriented to the problem of the public health and found the academic inventions which are locally, nationally and even globally related to the needs of people. Furthermore, the faculty implements the service to the community that in accordance with their requirements especially dealing with public health and nursing. What is character? A dictionary depicted a character as a complex mental and ethical nature marked someone. But, actually the character is who we really are and what we do. It is the accumulation of thoughts, values, words and actions. It becomes a habit that determines our destiny. A destiny can be summed up into the road of success or failure. People say that you can achieve success by having a good character. But what good character really is? A person of a good character will think upright with the truth and not thinking properly right in line with the core universal values. The aspects which determine the quality of a good man are trustworthy, respectful, responsibility, fairness, caring and good citizen. Well, whatever we call the character is, the institution s role is still as a developer of the character itself, by guiding people s thoughts, words, actions and habits to those right values, in which all people share, regardless of differences. Sources: Human characters are not only born, but developed. Character is developed through a process of life values and culture understanding through three main agencies, namely 1) Family 2) Educational institutions and 3) Community. These three institutions will be responsible for the formation of the nation s character. Character is a marker of who really we are, and how we think and behave. Character 2

3 is determined by what we do, say and believe. It is shown by the human s behavior when no one is looking (Boyatzis, et, al, 1995, in Nursalam 2008). Before discussing the development of character, in broad outline was inventoried by competence soft skill that covered 25 characters, they are : responsible and bore the jolt, empathy, critical thinking, discipline, leadership, creativity and innovative, initiative, communicative, the team work, enthusiastic, assertive, perceptive, dedicated person, having a high self confidence, behaved ethically, the problem solving, entrepreneurship, appreciated the work of the other person, altruistic, lifelong learning, decision making in nursing conscience, risk taking and honesty. Of the 25 types of characters above, including empathy, according to (Rosita, 2010) in her research entitled The Effects of Health Care Quality towards the Patient s Loyalty in Herna General Hospital Medan, based on the results of the analysis with cross sectional approach to hypothesis testing (F test and T test), statistic results test showed that there is significant influence between variable of concern (empathy) to the loyalty of patients with p = < This finding is consistent with the statement of Pasuraman (1990) in Tjiptono (2005) which says that attention is part of the service quality dimensions that affect customer s decision to use services. In the dimension of empathy, nurses are expected to give special attention to patients, with full attention and really put the interest of the patient in priority and understand the patient s needs. Empathy covered the ease of carrying out relationships, good communication, personal attention and the understanding of the patient s needs and entering into another s feelings. It is difficult to find nurses who have an equal hard skills and soft skills. Many nurses are good at academic lessons/theories but having less empathy for patients, they even do not understand patients characteristics which are ranging from the age, educational level, social culture, beliefs, customs and so forth (Notoatmodjo, 2007). Leininger, 1984 in (Sudiharto, 2007) said that the trans-cultural nursing services should be provided to clients based on their cultural background. It is the nurses who have the soft skill and really understand the ethnic and cultural background of the patients, as it is shown by the nurse s empathy towards the patients. Greeting the patients by name, using the patient s language are examples of empathy. Examples of interpersonal communication between the nurse and the patient which show a sense of nurse s empathy: Nurse : Good morning, Madam Ras!/ Good morning Nande (Nande : a call for mother in Karonese)/ Good morning, Namboru (Namboru is a call for a woman in Bataknese). 3

4 Patient : Well, good morning. Nurse : How do you feel, madam?/unggo pangakap ndu nande Uga (How do you feel Madam Uga?)/ Boha do nuaeng dihilala ho Namborungku? (How do you feel, aunty?) Patient : Ah. I think I m feeling better, because I ve got a good nurse. In trans cultural nursing, we can use any language that is used in accordance with the patient s daily conversations, such as conversation highlighted above, while the nurse is using the Indonesian language, Karonese language and Batak Toba language. The nurse can greet the patients by the name, so that patients will feel flattered, they will feel that the nurse is really care for them. Eventually, it affects the disease to be quickly recovered because of the stability of patient s emotions dealing with the services. A good communication skill is required in this dimension of empathy, in which a nurse should be able to understand the needs of patients, as expressed by (Mubarak and Chayatin, 2002). Patient s expectations after being treated in a hospital are vary, but we can simply generalize it of the need of being safe and secure, which are consists of 1) self protection, free from fear and anxiety and are not threatened by anything, 2) Patients also have the need of being loved, it means that even if they are sick, they are entitled to give and receive love, have a warmth respond, have friends and they are not shunned when they came home from the hospital. The nurse did not realize that this is the most important task in a holistic service toward patients. 3) patients still have the need of self esteem appreciation, even if they are being treated and again, only nurses who have soft skills can understand these needs; for example : the patients don t want to be embarrassed about the their lack of biopsycho-social. When the nurse put catheter to help the patient in removing urine, the nurse must not laughed or feel coy, because patients are really feel sensitive to their biological deficiency s issues. In addition, if the patients can t pay the hospital administration fee in a timely manner, the nurse should not embarrass them in public, because the patients also have their pride. 4) The patients also need self actualizations, meaning that they have their rights to meet their own needs and stay confident even though they were being treated or sick. Especially for the patients who have had medical treatment abroad, let s say in Penang for example, they will always compare the service they have obtained in a hospital overseas, no doubt they will carry on the treatment abroad. Baloglu (2002) said that in order to measure customer loyalty, there are two basic variables (behavior and attitudes) which is categorized into: 1. The Belief (trust) 2. Emotionally Attachments (Psychological/emotional commitment) 3. The Transitional Cost (switching cost) 4

5 4. Publicity from the mouth to the mouth (word of mouth) 5. The Co operation (Cooperation) It has been discussed previously that character can be shown of one s behavior while nobody was looking. Let s be focus on this conversation: Doctor : Nurse! How many intake and output does this patient have today? Nurse : it is 1500cc/1200 cc, doctor. Doctor : How is the blood pressure? Nurse : 150/100 mmhg, doctor. Doctor : How does she eat? Nurse : She eats the whole portion doctor, nothing left. This is really the picture of the soft skill is. This is the soft skills of nurses which are attached in their character. There are a group of nurses who always do their tasks when their bosses are supervised, while the meaning of characterized nurse is really showed in the way she does her responsibilities without anyone noticed. Some questions came up after three days I ve been hospitalized, why do the nurses don t care about my condition anymore? The critical period mighty be came to an end and their chief of nurses/doctor doesn t really pay their full attention in supervising them anymore, they might become the answers. It is unique while the nurse could answer the doctor s questions correctly without knowing that I was going to the toilet regularly and they don t even check my blood pressure, moreover I ve lost my appetite. The nurse might be estimate my condition and it probably wasn t the first for the nurse in giving an estimation report to the doctor. But, from the deep of my heart I do hope that this condition will never occur anymore as none of other nurses does the same mistake. The bad action showed by the nurse is no longer to be tolerated. Centuries ago, Aristotle state that in the progress of learning, making the child clever is not enough, we need to develop them to become a good person. Aristotle s famous phrase is It is not enough to make children smarter, but we need to develop them to be goo. Another than that specifically stated on 1999 UNESCO s convention stipulates that education should lead to a complete education which is form the intact human. Effort that has been taken in gaining the purpose to have proactive nurses is by implementing the soft skills in nursing education curriculum. Literally, soft skills can be defined as personal and interpersonal behavior (positive traits) that can improve and develop the nurse s performance (Initiative, decision making, teamwork). As we know, we can t gain a good character by only giving one day training. 5

6 The developed concept in the nurse s soft skill is in line with what is delivered by a character development expert. (Hoge, 2003, in Effendi 2008), he stated that character education is a conscious and planned effort to influence the development of desirable attitudes. Discussing the sorts of topic about character: A. Character Development by Family/Community (Informal/Non-formal Education) Informal education is the family and environmental education in the form of independent learning activities. The results of informal education are recognized as the formal and non formal education after students have passed the exam in accordance with national education standards. Pendidikan_informal Informal education has been less known by the society, but actually, this is the most classical education for children. Parents at earlier times when there was no school, only had once choice to educate their children, that was by educating their own children by themselves. It was a family centered education. If their children wanted to pursue their study in a higher formal education, they had to pass the test through PKBM or similar non formal organization that held the test. Religion, moral, ethics, politeness and social science are taught in this kind of education in this kind of education. Blum and Green in Notoatmodjo (2007) say One changes one s behavior is influenced by predisposing factors, in the predisposing factors the character of a person is reflected, whereas, what is gained from the family or the environment will carry over the readiness into the formal education. Non formal education is the path of education outside the formal education that can be implemented structurally and gradually. The results of this education equivalent to the result of formal education after going through the process of equalizing assessments by agencies designated by the Government or Local Government with reference to national education standards. Non formal education is provided for the citizens who need the service of education that serves as a substitute, supplement and/or complement of formal education in order to support life long learning. The non formal education s function is to develop the potential of non formal education learners with an emphasis on the mastery of knowledge, functional skills, professional attitude and personality development. Non formal education includes life skills education, early childhood education, youth education, women and empowerment education, literacy, skill s education and job training. Equalized education includes the education from the basic up to the high level, as well as other education aimed at developing the ability of learners such as Center for Community Learning Activities (PKMB), Courses agencies, training institutes, study groups, 6

7 talking assemblies, galleries and so forth, as well as other education s aims at developing skills of learners. Courses and trainings were organized for people who need sufficient knowledge, skills, life skills and attitudes to develop themselves, develop their professions, working, independent business, and/or continue their education to a higher level. B. Character Development by The Institute of Education (Formal Education) Formal education is a structured and tiered education which is consist of early childhood education, primary education, secondary education and higher education. Formal education is divided into two, state owned and private owned education. Soft skills education demands teachers role optimally. The character will not be well developed without a role model. The role model is the most important part in character building. The role model on campus is a lecturer. Therefore, a lecturer who has the soft skills is needed to develop the soft skills education. Apart from becoming the role model, lecturer should also be able to create a soft skills teachable moment as a conducive environment to develop the soft skill itself. There is a motto Tut wuri handayani, which is originally said : ing ngarsa sung tulada, Ing Madya Mangun Karsa, tut wuri handayani. The meaning of this motto is tut wuri handayani (the lecturers should be able to give encouragement and direction), ing madya mangan karsa (in the middle or among the pupils, the lecturers must create the Initiative and idea), ing ngarsa sung tulada (in the front, the educator must give the model or the example of the good deeds). So, that the sentence created by Ki Hajar Dewantara will be fulfilled as he says : In front, an educator must show a good example, in the middle or between the students, the educator must create a creation or idea and at the back he/she motivates and give instructions. Finally, of course, soft skills can t be successfully developed if it is only held by campus alone. A good cooperation is needed among the campus, family and community in developing the soft skills. If the soft skills education is only done on campus, but not reinforced or even weakened by the society rules and family, it will turn to doubts within the students. A unity of attitude, mindset and concepts among campus, family and society is really important in soft skills development. Some opinions regarding the soft skills education concepts are discussed as follow: 1. Establish the attitude of respect others as the vision of our educational institutions, it will be continued by discussing and getting the same perception of what the respecting others operational description is. 2. Socializing respect others attitudes and values to the entire academy units at campus, parents and stakeholders. 7

8 3. Implementing the vision of respecting others into the daily practice on campus, through a) the establishment of rules of sanctions related to the respecting others which is generally applied to each member of the campus. b) develop/hanging on/a poster, banner and other kinds of attributes that can remind the members of the campus dealing with the attitude of respecting others. c) Developing the campus activities that contain of respecting others values. d) Develop the role model of respecting others starting from the highest level leader and in accordance with the campus staff, lecturers and administrators. Role models of respecting others should be always practiced by anyone who meets the members of the campus. e) Design the learning process and the assignments that contain the respecting others values. f) Develop activities that involve students parents in the process of increasing respecting others values. The nurse s soft skill competencies are depend on informal/non formal, and formal education, as already described above. But, I think that informal education is really crucial for entering into the world of formal education. Predisposing factors in which the informal education are mostly there, will be shown at a new student s knowledge, attitude and practical life, who enters the world of higher education (formal education), especially in the knowledge of religion, morality, ethics, manners, morals and socialization. For example, if the applicants have been accustomed to worship their God, according to their beliefs, it will be continued to perform when they enter the higher education as it has been taught by their parents. Similarly, it will happen with the mind and characters, ethics, manners, moral and socialization with their new friends on campus. parents who had dispatched his son to be educated in the world of formal education must not easily and directly off the hand of both material and moral responsibility, we must remember that the environment will influence the behavior of the child too (HL Blum in Notoatmodjo, 2007). The difficult challenge experienced by a lecturer is not in preparing the accreditation forms, making SAP, or even in making money and so forth, but in facing the new students who come from a variety of characteristics who will follow a competency based curriculum. What are the competencies that must be achieved in one course? A maximum learning is really necessary in achieving the high student s competence. The institution also needs support and good communication with parents. Lecturer who is in charge of student affairs should manage extracurricular activities. In addition, the student organizations should avoid the stagnation of learning process in the classroom. But, according to (Sihombing, 2010), many students do not successfully manage their time, they are looking for excuses and blaming the student organizations as the cause of being a perpetual student. In the end, most if parents do not agree even angry with the students, when they found that 8

9 their children are being involved in the organization. The vice of the dean for the students affairs needs to discuss this matter with the parents. What are the attributes of soft skills for the intra personal skills and inter personal skills? Intra personal skills include: a) the ability to manage the time, b) the ability to cope with stress, c) the ability to instantly change the strategy if it is needed, d) the ability to change the beliefs that were previously thought to be true after getting enlightenment, e) they can change attitudes (either to self or others), f) the ability to carry out the process of creative thinking, g) the ability to determine the purpose of life and h) the ability to implement accelerated learning techniques. While the soft skills within the inter personal skills are: a) motivation skills, b) leadership skills, c) negotiating skills, d) presenting skills (especially for audiences in a large numbers), e) communication skills, f) relationship building skills, g) skill in expression, h) a skill of showing the potential skills within themselves (Sihombing, 2010). CONCLUSIONS Character is a dictionary which is describing the character as a complex mental and ethical nature of one s mark. But the character, actually, is who we really are. What we do. This is the accumulation of thoughts, values, words and actions. It becomes a habit that determines our destiny. Human characters are not only born, but developed. Character is developed through a process of understanding of life s value and culture through three main agencies, namely 1) Family, 2) Educational Institution, 3) Community. These three kinds of institutions are parts that are responsible for forming the nation s character. Character is a marker of who really we are and how we think and behave. Soft skills can t be successfully developed if only rely on the campus alone. It should be developed by a good cooperation among the campus, family and community. The soft skills education which is only done on campus, but not reinforces or even weakened by the rules of society and the family, will lead to students doubts. The integration of attitudes, concepts/mindset and principles of the campus, families and communities play the main role in the soft skills education/development. 9

10 References Baloglu, 2002, Dimension of Customer Loyalty, Cornell Hotel and Restaurant Administration Quarterly. Boyatzis, et al, 1995., dalam Efendi Ferry Nursalam, 2008, Pendidikan Dalam Keperawatan, Salemba Medika, Jakarta. Hoge, 2003., dalam Efendy Ferry Nursalam, 2008, Pendidikan Dalam Keperawatan, Salemba Medika, Jakarta. Leininger, 1984 dalam Sudiharto, 2007, Asuhan Keperawatan Keluarga Dengan Pendekatan Keperawatan Transkultural, Buku Kedokteran EGC, Jakarta. Mubarak dan Chayatin, 2002., Kebutuhan Dasar Manusia. EGC, Jakarta. Notoatmodjo, Soekidjo, 2007., Kesehatan Masyarakat Ilmu dan Seni, Rineka Cipta, Jakarta. Parasuraman, dkk., 1985., Delivering Quality Service, Balancing Custumer Perceptions and Expantations. Penerbit The FreePress.New York. Pengertian Karakter diunduh dari Desember 2011 Pengertian Pendidikan Informal diunduh dari Desember 2011 Pengertian Pendidikan Non Formal diunduh dari Desember 2011 Saragih, Rosita, 2010., dalam penelitiannya berjudul Pengaruh Mutu Pelayanan Kesehatan Terhadap Loyalitas Pasien Rumah Sakit Umum Herna Medan. Semboyan Tut Wuri Handayani diakses dari Desember

11 Sihombing, Lince, 2010., Soft Skills Mahasiswa dalam Kegiatan Ekstrakurikuler (Disajikan pada Pelatihan Pengetahuan Soft Skill Bagi Mahasiswa PTS di Lingkungan Kopertis Wilayah I Sumatera Utara tanggal 10 Juni 2010 di Medan) 11