Kesenjangan pengembangan karir perawat klinik dalam jenjang jabatan struktural di RS Mohamad Ridwan Meuraksa, merupakan sesuatu yang kurang sesuai dengan konsep pembinaan karir. Kesempatan pengembangan karir perawat klinik PNS terbatas bila dibandingkan dengan perawat klinik militer. Disisi Iain pengembangan karir melalui jalur karir fungsional belum jelas, yang diperlukan dalam pengembangan karir terutama perawat klinik PNS, karena dengan adanya jalur karir fungsional akan menempatkan perawat klinik sesuai dengan peran dan fungsinya di rumah sakit, dengan harapan akan meningkatkan kinerja dan mute pelayanan.Penelitian dilaksanakan di Rumah Sakit Mohamad Ridwan Meuraksa Jakarta dengan metode penelitian kualitatif. Data sekunder diperoleh dan telaah dokumen serta data primer diperoleh melalui wawancara mendalam terhadap pimpinan Rumah Sakit dan suprasistem sampai dengan perawat pelaksana dilapangan. Adapun tujuan penelitian adalah untuk mengetahui gambaran pola karir yang efektif untuk pengembangan karir perawat klinik di Rumah Sakit Mohamad Ridwan Meuraksa.Rumah Sakit Mohamad Ridwan Meuraksa memiliki tenaga keperawatan berjumlah 189, yang berstatus perawat klinik berjumlah 178 orang yang terdiri dan perawat klinik militer 50 orang, perawat klinik PNS 84 orang dan perawat klinik sukarelawan 44 orang. Karakteristik dari masing-masing personil tersebut adalah Perawat Klinik militer mempunyai umur sebagian besar antara 31 - 40 tahun berjumlah 39 orang (78%), pendidikan sebagian besar SPK/bidan/SPRG berjumlah 39 orang (78%), masa kerja sebagian besar antara 6 - 10 tahun berjumlah 22 orang (44%), dan sebagian besar berpangkat Bintara berjumlah 39 orang (78%). Perawat klinik PNS mempunyai umur sebagian besar antara 31 - 40 tahun berjurnlah 29 orang ( 33,3%), pendidikan sebagian besar SPK/bidan/SPRG berjumlah 70 orang (80,5%), masa kerja sebagian besar antara 16 - 20 tahun berjumlah 29 orang (33,3%), pangkat sebagian besar golongan II berjumlah 72 orang (82,8%). Perawat klinik Sukarelawan mempunyai umur sebagian besar antara 20 - 30 tahun berjurnlah 39 orang (88,6%), pendidikan sebagian besar D3 keperawatan berjumlah 29 orang (65,9%).Pengembangan tenaga keperawatan di Rumah Sakit Mohamad Ridwan Meuraksa melalui pendidikan dan pelatihan, hampir seluruh program berasal Bari supra sistem. Rumah sakit sendiri hanya mempunyai program pelatihan, tetapi belum menjadi program yang tersistem dengan baik. Pengalaman kerja yang diperoleh oleh tenaga perawat dalam pengembangan karirnya adalah melalui riwayat jabatan dan kepangkatan, program mutasi dan promosi, pendidikan dan pelatihan yang mereka peroleh, bimbingan para perawat senior dan pimpinan, dan khusus perawat milker penugasan lapangan dari supra sistem. Kebijakan dan peraturan tentang pengembangan karir perawat klinik di Rumah Sakit Mohamad Ridwan Meuraksa tergantung dari supra sistem terutama dari Kesdam Jaya, karena rumah sakit merupakan badan pelaksana dari Kesdam Jaya. Disamping itu Ditkesad sebagai pembina teknis dari kecabangan kesehatan secara tidak Iangsung juga ikut mempengaruhi keputusan rumah sakit. Pala karir yang berlaku saat ini hanya pola karir struktural sesuai dengan struktur organisasi dan tugas Rumah Sakit Moh. Ridwan Meuraksa. Berdasarkan wawancara mendalam sebagian besar informan menyatakan bahwa, pola karir fungsional sudah seharusnya dibuat agar pengembangan karir perawat klinik sesuai dengan pola karir profesional yang sesuai dengan konsep teori tentang pola karir perawat yaitu perawat klinik I, Perawat klinik II, Perawat klinik III, perawat klinik IV, dan perawat klinik V.Pada akhir penelitian ini dapat diambil suatu kesimpulan bahwa untuk peningkatan kualitas pelayanan, maka perawat klinik hares ditempatkan sesuai dengan peran dan fungsinya.

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Regarding to the concept of career development, there is a disparity on career development of structural function level of clinic's nurses at MRM hospital, which is considered inequitable. Because, clinic's nurses that having the status of civil government officer (PNS) has more limited opportunity in developing their career, comparing to their colleagues at military clinic. Moreover, the developing career through functional career route is still unclear. Suppose that career route is very important to PNS clinic's nurses, as they can develop and improve their career in suitable roles and functions. Therefore, they can implement their tasks and duties at the hospital in proper way, and it is expected that their performance and their quality services will be increased. Based on the thought above, this study has an aim on describing an effective career pattern on career development of clinic's nurses at MRM hospital.

The study is carried out at the MRM Hospital in Jakarta, using qualitative research method. Two types data will be perform, i.e. the primary data attained from in-depth interview of hospital top director until program implemented nurses in the field, and the secondary data that obtained from documents review.

The MRM hospital has 189 nurses, which 178 of them are clinic's nurses. Of 178 clinic's nurses, 50 of them are military clinic's nurses, 84 are PNS clinic's nurses, and 44 are voluntary clinic's nurses. To describe each personnel characteristics: there are 39 (78%) of military clinic's nurses are mostly on the range of age 31 to 40 years old; 39 (78%) are graduated from SPKJBidanISPRG; 22 (44%) of them have working period on the range of 6 to 10 years; and most of them 39 person (78%) are in lowest grades of military rank, called Bintara. From 84 PNS clinic's nurses, there arc 29 (33.3%) in the range of age 31 to 40 years old; 70 (80.5%) are graduated from SPK/Bidan/SPRG; 29 (33.3%) of them have working period from 16 to 20 years; and 72 (82.8%) of them are in the rank of grade II PNS. Of the 44 voluntary clinic's nurses, mostly or 39 (88.6%) of them are in the range of age 20 to 30 years old; 29 (65%) person have graduate from nurses diploma (D3). At MRM hospital, the development of nurse personnel is trough education and trainings. Almost all of training programs at the hospital are part of the supra system program, as the hospital only have a limited training program and have not yet arrange as a systematically usefulness program. Working experience as part of career development is mostly achieved due to experience on function and rank of their employment grade, mutation and promotion program, education and training, guidance from their seniors, and particular from military nurses are supra system of field duty. The policy and regulation on clinic's nurses career development at MRM hospital is depend on its supra system of Kesdam Jaya, as because the hospital is part of implementation unit (badan pelaksana) of Kesdam Jaya. Moreover, the Ditkesad, as the technical assistant from health subdivision, is also indirectly influence the decision making on the hospital management. The pattern of career development that legitimately valid up to now is a structural career pattern appropriate with the organizational structure and the duty on the MRM hospital. As the in-depth interview, almost all informants stated that a functional career development is should be determined in order to support the career development of clinic's nurses. Therefore, it will be suitable to its professional career development and it's also concurred with the theory of career pattern concept of the nurse, i.e. clinic's nurse I, clinic's nurse II, clinic's nurse III, clinic's nurse IV, and clinic's nurse V.

To increasing the quality on hospital services, it is needed to arrange the clinic's nurses on regards to their roles and function with considerable on their education, working experiences, and competency.