Implementing Caring in Nursing Practice

Setiawan, Ph.D

Dekan

Fakultas Keperawatan USU

Caring Nursing

Caring is the essence, moral ideal,

and foundation for nursing practice (Boykin& Schoenhofer, 2001; Leininger & McFarland, 2006; Watson, 2005)

Caring nursing formalizes the conception

of professional nursing practice and

validates nursing as a discipline of

specialized knowledge in the action of

caring for and about the patient and

family (Nelson & Watson, 2012)

Caring Science

What is Caring Science??

Developed by Jane Watson in 1979

Human trait with moral attitude in

science and art

What is Caring Science??

Support the nurses to reflect upon what it

means to be whole, to be healed, and to

be caring (Hills & Watson, 2011)

An evolving ethical-epistemic field of study that

is grounded in the discipline of nursing and

informed by related fields (Watson & Smith, 2002)

caring sbg sifat manusia

caring sbg ideal moral

caring sbg afek

caring sbg interaksi interpersonal

caring sbg intervensi

Caring Behavior

Actions characteristic of concern for the well-

being of a patient

(Mosby's Medical Dictionary, 9th ed. 2009)

A wide variety of features and actions and these may be

words, thoughts, feelings, looks, actions, movement, gestures,

body language, touch, acts, procedures and/or information

(Udomluck , Tonmukayakul , & Tiansawad, 2010)

Instrumental and expressive behaviors

that, when used in the context of shared professional

interactions, facilitate understanding,

learning, comfort, human dignity,

security, self-confidence, hope, and

encouragement (Duffy, 2013)

Caring Skills

Seperangkat perilaku yang mencerminkan caring

seorang perawat dalam berinteraksi dengan

pasien atau klien dalam upaya menumbuhkan

hubungan saling percaya yang terapeutik

(therapeutic-trust relationship) (Setiawan, 2019)

Instrumental caring behaviors

1. Technical behaviors,

2. Physical behaviors

The expressive caring behaviors

1. Psychosocial behaviors

2. Emotional behaviors

• Patient’s diagnosis

• The type of institution

• Nurse’s age and experience

• Self-respect

• Beliefs

• Workplace circumstances

1. understand patients’ conditions and appreciate

their uniqueness as people

2. allowing them to provide care centered on the

patient

3. reinforcing their desire to enhance their ability to

provide patient care commitment to the nursing

profession and organization

How to Implement Caring Behaviors

1. Dimulai dari diri perawat sendiri

We need to love, respect, care for

ourselves, and treat ourselves with

dignity, before we can respect, love,

and care for others and treat them with

dignity.

2. Menerapkan Caring Behavior Dalam

Praktek Keperawatan

Model caring (menggunakan teori caring) sangat

membantu dalam menuntun perawat

menerapkan caring dalam merawat pasien.

Caring behavior akan konsisten ditampilkan

sementara non-caring behavior perlahan-lahan

ditinggalkan.

Perawat harus menjalin hubungan caring dengan

pasien.

Mutualitas harus terbentuk antara perawat dan pasien

mengenai situasi dan kebutuhan pasien

Perawat harus memperlakukan pasien sebagai

makhluk holistik (body, mind & spirit) dengan sikap yg

positif

Perawat harus mempromosikan kesehatan pasien

dengan melakukan penyuluhan & intervensi dan

memperlihatkan penerimaan atas pasien apa adanya.

Caring occasions/moments harus diciptakan oleh

perawat

Memahami diri sendiri seutuhnya

Membaurkan energi kehidupan perawat & pasien

Mempraktekan caring secara sadar

Menyadari bagaimana caring memberi keuntungan

bagi pasien

Berperilaku caring yang akan memperkaya kehidupan

perawat, pasien, kolega dan menciptakan lingkungan

yg positif

Caring Behaviors in Deli Hospital

• Dilaksanakan sejak tahun 2014

• Dalam bentuk Protap Interaksi Staf RS

berbasis Caring (5 tahap)

• Di evaluasi tiap bulan

• Pelaksanaan Momen 3 menit

• Pelaksanaan Momen 3 menit plus

• Monev oleh Karu tiap bulan dan

dilaporkan dalam briefing bulanan

Caring Behaviors in USU Hospital

Training on application of caring science in

hospital

Implementation the SCIP at 11 wards.

Monitoring and evaluation of the SCIP

Measurement impact of implementation of the

SCIP

Application of Caring Science at USU

Hospital

HOSPITAL POLICY

SURAT EDARAN No: 2399/UN5.4.1.1.5/KPM/2018

on Implementation of SCIP in delivering

Nursing Care for improving quality of

Medical and Nursing Service

Date on 31 July 2018

dari Diryanmed atas nama Direktur Utama

untuk seluruh Ka.Instalasi dan UnitPelayaan Medik & Keperawatan, juga selu

ruh KaRu Rajal & Ranap

Application of Caring Science at USU Hospital

SCIP

SETIAWAN’S CARING INTERACTION PROTOCOL

Application of Caring Science at USU Hospital

Thank You

@Lake Toba, Medan, Indonesia