The health services of emergency care unit is considered as one of the quality indicators of hospital services because this unit provides a specialized service to the emergency patients continuosly 24 hours a day, therefore the emergency care unit services should be facilitated optimally which is mainly determined by the qualified nursing personnel. In relation to the demand forhigh quality of nursing services, the material and nonmaterial reward system need to be taken into consideration in motivating a better working performance of nurses. Career development as one of important aspects in improving the quality of emergency care at D.Cipto Mangunkusumo National Hospital. The existing performance of nursing personnel is still not adequate and do not meet the standard of nursing care. Based on this sivation ; the research problems was to answer the need of a well established nursing functional career development either through a formal or non formal education as an effort to improve a professional, and high quality of services by providing a safe, quick, and appropriate interventions. This research study utilized a descriptive explorative design with a qualitative research mehtodology. The data was collected using a focus group discussion, interview and observation methods.The research study revealed that the existing training was not as an a part of career development system of nursing staffs, and even there was no career ladder for nurses, as a consequences, the tasks and responsibilities for all nurses were the same. In addition, there was lack of financial support for education and training of nurses. In order to improve the qualtiy of nursing services at the emergency care unit, it s expected and required that the career ladder should be formulated and proposed that all nurses should follow the stages of a standardized career development based on the fuctional levels, so that there will be a clear roles and fuctions for .each emergency care unit nursing persnonnel. Based on the result of this study, it is recommended: 1) to develop a training curriculum; 2) to formulate a training proposal; 3) to conduct a need assessment for education and traning/ and 4) to provide an adequate and appropriate reward, which will optimally facilitate the personal and professional growth for each nursing personnel.

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Pelayanan instalasi gawat darurat merupakan tolok ukur kwalitas pelayanan rumah sakit, karena merupakan ujung tombak pelayanan rumah sakit, yang memberikan pelayanan khusus kepada pasien gawat arurat secara terus menerus selama 24 jam setiap han. Karena itu pelayanan di IGD hams diupayakan seoptimal rnungkin. Untuk itu diperlukan kualitas SDM profesional termasuk tenaga keperawatannya. Sehubungan dengan tuntutan kualitas pelayanan tersebut aspek penghargaán baik material maupun non. material merupakan aspek penting untuk mendorong motivasi kerja perawat. Pengembangan karidr adalah salah satu aspek yang terpenting dalam upaya meningkatkan mutu pelayanan di IGD RSUPN Dr. Cipto Mangunkusumo. Kenyataan dilapangan menunjukkan bahwa sampai saat mi kemampuan SDM keperawatan yang ada belum themadai, bilum sesuai dengan standar yang telah ditentukan. Berdasarkan hal tersebut, permasalahan dalain penelitian mi adalah belum terlaksananya pengembangan karier fungsional keperawatan yang berkesinambungan baik melalui pendidikan formal maupun tidak formal dalam upaya meningkatkan pelayanan yang profesional, berkualitas, aman dan nyaman. Penelitian ini merupakan penelitian deskriptif dengan menggunakan pendekatan kualitatif. Pengumpulan data dilakukan melalui diskusi kelompok terarah, wawancara mendalam dan observasi.Dari hasil penelitian terlihat bahwa pelatihan yang dilakukan belum merupakan bagian dari pengembangan karier staf, sertajenjang karier perawat belum ada, sehingga tugas dan tanggung jawab untuk semua perawat sama. Demikian juga tentang penyediaan dana untuk pendidikan dan pelatihan terbatas. Untuk meningkatkan mutu pelayanan keperawatann di IGD, maka IGD diharapkan mampu merumuskan jenjang kanier keperawatan, dengan usulan semua perawat melewati fase-fase yang telah ditentukan sesuai peringkat fungsi, sehingga akan memberikan kejelasan peran dan fungsi untuk setiap tenaga keperawatan di IGD. Saran penelitian adalah pembentukan tim pengembangan keperawatan untuk 1) menyusun kurikulum; 2) menyusun proposal; 3) mengkaji kebutuhan pendidikan dan pelatihan; 4) pemberian penghargaan yang memadai, sehingga tenaga keperawatan dapat mengembangkan profesinya dengan optimal.