Better nurses means better health care<\/p>\n
The meeting hall of the orphanage in the Yogyakarta district of
\nGunung Kidul -- one of the poorest districts of the country only
\na decade ago -- was full of men and women in brown uniforms.<\/p>\n
They were doctors and health officials, directors and heads of
\nthe local hospitals and public health centers (Puskesmas),
\ngathered to be informed by several experts that their nurses and
\nmidwives were woefully below professional par in their standard
\nof service.<\/p>\n
\"Remember the woman from Bogor who fell into a coma following
\na caesarean and whose husband is now asking that she be
\neuthanized?\" a district administration officer asked rhetorically
\nwhen opening the event, designed to endorse the concept of the
\nMinistry of Health and the World Health Organization (WHO) of
\nquality assurance for nurses and midwives.<\/p>\n
It was his teasing way of chiding the participants into
\nchanging.<\/p>\n
Dr. Arida, an official at the Yogyakarta provincial health
\noffice, who was attending the meeting in her capacity as guest
\nlecturer, told the audience: \"I would have taken offense had the
\nchiding been directed toward me.\"<\/p>\n
Stifled laughter and some sniggering met her remarks.<\/p>\n
\"Don't you want to be known for good quality service in your
\nclinics and hospitals?\"<\/p>\n
More uneasy laughter was heard.<\/p>\n
Arida and Dr. Tri Djoko Hadianto, another lecturer, recounted
\nhow campaigns to convince health officials to provide training
\nsessions for their nurses and midwives often meet with resistance
\nfrom among managers of clinics and hospitals.<\/p>\n
\"Change is difficult,\" Arida said. \"You want to upgrade the
\nnurses and midwives, but in order to do that you have to convince
\ntheir superiors first, and this is where resistance often
\nappears.\"<\/p>\n
The CPDMS training sessions for nurses and midwives have the
\nfull support of the health ministry and the WHO and donor
\nagencies because they have been proven to improve nursing
\nquality, but dissemination of the concept takes a lot of effort
\non the part of its consultant and trainers.<\/p>\n
\"We often meet nurses and midwives who are eager to learn and
\nparticipate in training, which means time away from work, but we
\nneed a commitment and managerial support before they can be
\ncarried out,\" Tri said.<\/p>\n
\"We need a special training in CPDMS for leaders (of health
\nclinics and hospitals) so they could, in turn, lead their
\nsubordinates to achieve in certain training programs.\"<\/p>\n
When CPDMS education and training for nurses and midwives has
\ntaken place, however, the progress more than makes up for the
\nhard work.<\/p>\n
\"Education can change the mindset and attitude of the nurses
\nand midwives, so the quality of health care in general can
\nimprove,\" said Dr. Sunartono, the head of Sleman district health
\noffice in Yogyakarta.<\/p>\n
One of the Yogyakarta village health clinics (Puskesmas)
\napplying CPDMS has just been awarded an ISO compliance
\ncertificate for quality service.<\/p>\n
Sleman is a good example of how attitude change means
\nimprovement in health service and economic returns.<\/p>\n
\"People used to think that you went to Puskesmas because you
\nhad to, because you did not have the money for better care,\" said
\nSunartono.<\/p>\n
\"We are slowly changing that perception. We are trying to
\nconvince the public that Puskesmas is an alternative health care
\nprovision to hospitals. Patients come to the cheaper Puskesmas
\ndespite having the means to pay for more expensive care.\"<\/p>\n
One of the ways to introduce the change, Sunartono said, is by
\nreturning 100 percent of a Puskesmas' income so it develops into
\na self-sufficient business unit which will suffer financially
\nunless it provides quality service. More funding and equipment is
\nallotted.<\/p>\n
Financial and human resource management is improved, including
\nthe participation of nurses and midwives in CPDMS training.<\/p>\n
\"Nurses and midwives are more focused on their work following
\nthe training and stick to operational standards, which even
\nincludes the simple but important routine of washing hands before
\nand after tending to a patient,\" he said.<\/p>\n
More residents of Sleman chose to seek the services of
\nPuskesmas, and it meant better income for staff members of the
\nbecause more money comes in.<\/p>\n
\"We time our service, from the moment a patient is received
\nup until they leave the clinic,\" said Markus Subadio, a nurse for
\n13 years. \"We try to remember that we should smile when tending
\nto the patients!<\/p>\n
\"We also have this weekly session where we discuss difficult
\ncases and how they are handled, where we fail and where we
\nsucceed. It gives us a sense of keeping up with health care
\ndevelopments.\"<\/p>\n
Tri Djoko is optimistic that training for the nursing
\nprofession such as CPDMS will in the longer term help introduce
\nimprovement in the overall health sector in Indonesia.<\/p>\n
\"I'd like to think that one day patients, even relatives of
\ndoctors, would feel safe and sure of a quality service wherever
\nthey go, Puskesmas or hospitals,\" he said.<\/p>\n
-- Santi W.E. Soekanto and Ratih Sayidun<\/p>", "url": "https:\/\/jawawa.id\/newsitem\/better-nurses-means-better-health-care-1447893297", "image": "" }, "sponsor": "Okusi Associates", "sponsor_url": "https:\/\/okusiassociates.com" }