Reflection on Nursing Care in the Covid-19 Era

By humasfik On Tuesday, June 09 th, 2020 · no Comments · In

The COVID-19 INCIDENCE in Indonesia is increasing day by day and is now entering its fourth month. It is time to carry out a process of reflection that aims to get to know care and as material for efforts to improve care. One of the health workers who must improve and reflect on their model of care is the nurse. This does not exclude other health workers, but the emphasis on introduction and self-reflection on nursing staff is because in 24 hours, three shifts, namely morning, afternoon, evening, and in seven full days there is no hospital without a nurse.

It should be underlined that isolation is not a cure for Covid-19, but isolation is an effort to break the chain of spread, while the essence is care, treatment, recovery, and cooperation of patients, with nurses and all health workers in restoring health is a very important component. As the front line in the Covid 19 era, according to Liu, 2020 in The Lancet Global Health, 20, 1-9, nurses have a role in assessment, minimizing complications by carrying out close monitoring, carrying out airway management, changing positions, conducting education and collaboration in drug administration. Nurses will also assist patients in meeting their daily needs, including providing fluids and nutrition, meeting the needs of elimination and personal hygiene. Starting from screening, emergency action, isolation treatment, to handling critical cases which are carried out in collaboration by the health team are the duties of nurses.

Not only physical needs that must be assisted, also the need to fulfill psychological needs, spiritual needs and the need to be heard and understood are the essence of patient care. On the other hand, there has been a major phenomenon change in this Covid era, where generally in Indonesia the family empowerment model when the family is cared for is very thick as a culture in Indonesia, but in the Covid-19 era this culture changed 100% or it can be said that the culture of family involvement in care The hospital cannot be carried out because of restrictions to prevent transmission and the patient must be isolated so that the family cannot wait. The impact of this isolation treatment causes a very big change and encourages all nurses to carry out more comprehensive care from all bio, psycho, social, spiritual, and cultural components.

Maybe you’ve heard testimonials circulating on social media, where a professor from a well-known university in Jogja was greatly helped by the presence of nurses, doctors, and other professions. On the other hand, there are also complaints that convey the presence of patients who feel they are not given caring care by nurses. This condition can be a self-reflection that must be improved and become evidence that nursing care is highly anticipated.

Citing news where the presence of care from nurses is highly anticipated, there needs to be positive improvements from the aspect of care. Positive views are given to nurses regarding how nurses encourage patients to be able to carry out healthy activities, such as sports, relaxation therapy by singing or doing spiritual activities. It should not be a song or a Tiktok toy that is blow-up, in fact it is an upbringing and there is a basis for knowledge so that it is not misinterpreted. Tiktok is one of the social media that can be used as a tool for relaxation, reducing loneliness in isolation rooms. The selection of this media begins with an assessment of patient needs which is indeed in line with the development of the digitalization era and the millennial era, establishing a diagnosis, then implementing interventions.

Whereas in Nursing Law No. 38/2014 it is stated that nursing care is a series of nurse interactions with clients (patients and families) and their environment to fulfill the needs and independence of clients in caring for themselves. Meeting the needs and independence herein lies the main role of nurses. The fulfillment of needs is valued, this loneliness in isolation is what nurses fulfill when together with activities and relaxation playing Tiktok. There is an essence of care here, not just playing games, so whatever the care should be, it should start from the process of assessment and determination of diagnosis, targets, and planning, implementation and evaluation. The selection of media such as TikTok can be chosen according to the culture and character of the patient, and there are limitations where it does not go beyond infection prevention and control standards such as sitting on the floor or even carrying around cleaning tools like those circulating on social media.

Indeed, care is always based on concepts and theories, one approach to care delivered by Henderson is known for fulfilling basic human needs, namely the fulfillment of the need for normal breathing, eating and drinking, elimination (BAK/BAB), movement, and rest and sleep, hygiene. self, dressing and thermoregulator/temperature stability. If analyzed from the eight patient needs from Henderson, then this is very relevant to the needs of Covid-19 patients. Where the nurse must meet the patient’s breathing needs, according to the level of need, starting from respiratory assessment, giving oxygen to the need for collaboration to get intensive care using a ventilator. Likewise, how to maintain a stable patient’s temperature, the need to eat and drink, help meet the needs of defecation, urination, personal and environmental hygiene, movements such as exercise and rest and sleep comfortably.

The next six needs consist of the need for safety, namely avoiding the risk of falling and injury in the hospital, the need for communication and if it is expanded to include social relationships and psychological needs, worship, the need for productive activities, recreation, and the need for learning. These six needs are also very relevant to care in the Covid-19 era where unstable patient conditions have a risk of falling, fall risk assessment, nurse assistance when going to the bathroom, and monitoring of bed dividers and environmental protection are risk management that must be carried out for all patients. patient. Productive activities, communication, psychological, recreational, and educational needs are also very important care because it will increase motivation and learn to adapt and be ready to take care of themselves when the patient comes home from the hospital.

Then how is the care that has been carried out in the ministry? There needs to be self-reflection that must be done by nurses and nursing leaders so that management is better. That actually caring and fulfilling the patient’s needs is a noble task that must be carried out by nurses. Nursing managers must direct and monitor whether aspects of nursing care have been carried out and how to continue to encourage the achievement of improving the quality of care.

The second reflection that must be done is a reflection by all people so that they know and understand that nurses are not actually doctors’ assistants whose work is only to distribute drugs, measure temperatures, so they can be replaced with robot nurses. Robots are not nurses because robots are just tools, like Tiktok, which might be able to help distribute drugs or food that is used to help reduce infection transmission in the Covid-19 era. The robot cannot respond to complaints from patients whose catheters have leaked due to shifting positions, or the needs of a patient with Covid-19 who is sad and misses his family. Not to mention the activities that require critical thinking related to critical and emergency care based on the response to the needs of patients whose time is very fast and requires knowledge, and high skills. Robots are assistive technology for health workers to carry out structured tasks while the essence of caring and how nurses interact in meeting needs and preparing patient independence will not be replaced. Let’s do a reflection of care in order to provide the best service.


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