Berdasarkan hasil kegiatan residensi didapatkan bahwa prioritas masalah dalam manajemen sumberdaya keperawatan di Instalasi Rawat inap RSUD Karawang adalah : " Karakteristik individu Perawat yang sangat bervariasi dengan tingkat pergantiannya yang tinggi (28 %) atau cenderung meningkat pada masa-masa yang akan datang ".Penelitian ini dilakukan terhadap seluruh Perawat yang bekerja di Instalasi Rawat inap RSUD Karawang . Tujuan penelitian ini adalah untuk mendapatkan gambaran mengenai faktor faktor yang menentukan niat untuk keluar dan untuk meramal pergantian Perawat tersebut , serta dapat menguranginya pada masa yang akan datang .Janis penelitian ini adalah deskriptif analitik yang dilakukan dengan pendekatan cross-sectional secara kuantitatif dan kualitatif . Metode kuantitatif digunakan untuk menguji hipotesis penelitian dan metode kualitatif digunakan untuk memperjelas analisa kuantitatif . Alat pengukur data kuantitatif adalah kuesioner terstruktur yang disusun merupakan madifikasi " Model Proses Pergantian Karyawan Mobley " , " Teori Kepuasan kerja Herzberg " dan " Minnesota Satisfaction Questionnaire " . Pengumpulan data kualitatif dilakukan dengan metode " Fokus Group Diskusi " . Variabel yang diukur adalah karakteristik individu Perawat , persepsi faktor internal Organisasi dan kepuasan kerja Perawat . Analisa data terdiri dari analisa data univariat , bivariat dan multivariat serta analisa data kualitatif .Hasil yang diperoleh adalah : karakteristik Perawat sebagian besar berumur muda dengan tingkat pendidikan SPK , berstatus kepegawaian Kontrak , mempunyai masa kerja singkat dan belummenikah . Tidak ada hubungan antara karakteristik individu Perawat yang sangat bervariasi dengan tingkat pergantiannya yang tinggi atau cenderung meningkat pada masa-masa yang akan datang .Faktor-faktor penentu yang menentukan niat keluar Perawat tersebut adalah faktor persepsi internal Organisasi yang kurang baik ( Odds Ratio 8.61 ) , khususnya hubungan dengan teman kelompok ( Odds Ratio 5.30) , serta rendahya tingkat kepuasan kerja dalam hal pencapaian , tanggung jawab dan peningkatan status .Langkah-langkah pengendaliannya adalah : perekrutan / penseleksian yang lebih realistik , mengefektifkan masa orientasi , program penanganan stres kerja , praktek kompensasi yang adil , gaya manajemen partisipatif , pemberdayaan sumberdaya manusia, pengembangan linier yang adil , ikatan kerja , kerja secara tim , desentralisasi dalam membuat keputusan dan intervensi berdasarkan masa kerja .Saran akademis, agar dilakukan penelitian lanjutan mengenai pergantian Perawat dari sudut pandang eksternal Organisasi , dan bagi RSUD Karawang agar mengadakan penelitian-penelitian semacam ini secara berkala untuk meramal pergantian Perawat , serta melaksanakan langkah-langkah pengendalian secara operasional tersebut diatas .

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Replacement of nurses from the point of view of Internal Organization and Job Satisfaction at the nursing unit of the C-class hospital in district of Karawang , West Java Province . Results based on the work carried out as a resident indicates that priority given in the human resources of nursing management at the nursing unit of the C-class hospital in district of Karawang is : " The high replacement rate (28 %) due to the severely different individual characteristics of nurses would tend to increase in future " .

This observation has been carried out to the nursing staff employed at the nursing unit of the C-class hospital in district of Karawang . The purpose of this observation is to find the image of the deciding factors which decide the nurse to quit and to predict replacement of nurses as mentioned above and could to decrease in future .This has been descriptive and an analytical observation , using a cross-sectional approximation applying both quantitative and qualitative methods . The quantitative method was applied to test the hypotheses relevant to the observation and the qualitative method was applied to clarify the quantitative analysis . The yardstick used for the quantitative data is in the form of structured questionnaires which were established using a modified " Model of Employee Turnover Process by Mobley " , " Theory of Job Satisfaction by Herzberg " and " The Minnesota Satisfaction Questionnaire " .

Collection of qualitative data was carried out using the method of "Focused Group Discussion " . The variable measured was the individual characteristics of the nurse , perception of the internal factor of organization and job satisfaction . Analysis consists of uni-variant , bi-variant and multi-variant as well as qualitative .

The result obtained are : that the characteristics of nurses are largely young and carry SPK education , enjoy the status of contract workers , have only short experience and are single. There is no relationship between the severely different individual characteristics of nurses and the high of replacement rate or would tend to increase in future . The deciding factors which decide the nurse to quit is the bad perception of the internal organization ( Odds Ratio 8.61 ) , especially with peer relationship ( Odds Ratio 5.30 ) and unsatisfied job for the goal setting , responsibility and higher status .

Controlling steps are : improved selection and recruiting , more effective orientation periods , controlling work related stress , fair and just compensation practice , participation in management , implementation of human resources , just and fair career prospect and promotion , work relations , team work , decentralized decision making , relating to intervention based on length of employment .

An academic suggestion would to continue the observation relating to replacements of nurses from an external organizational view point , and for the C-class hospital in district of Karawang to have regular and planned observations like this one to predict replacement of nurses, and to implement the steps necessary to execute operational control as mentioned above.