WORK STRESS AMONG NURSES IN RURAL HOSPITAL

Introduction: Work stress is part of a work problem or negligence usually causes the safety of patients who experience fatigue to nurses in hospitals, stressed nurses usually cause injury to patients because nurses not focus on serving patients, are less friendly, often dizzy, and if the number of patients too much of it is one of the things that affect work stress. This study aims to determine the description of work stress on nurses at rural hospital in Lamongan. Methods : The study is a quantitative descriptive research design, using a questionnaire and distributed to 97 nurses who are on inclusion criteria. Results : The results of this study were divided into 3 codes which were low, moderate, and high and the results of the study showed that the indicators of psychological symptoms were 80 respondents with a percentage of 82.5% in the low category, while the moderate category was 17 respondents with a percentage of 17. .5%, for indicators of physical symptoms as many as 94 respondents with a percentage of 96.9% in the low category, while for the moderate category as many as 3 respondents with a percentage of 3.1% in the moderate category, for indicators of behavioral symptoms as many as 97 respondents with a percentage of 100, 0% is included in the low category. Conclusion : Most of the results of the research on nurses at RSUD Dr. Soegiri Lamongan low work stress with a percentage of 100.0% .


INTRODUCTION
Work stress is part of a problem or work omission that usually poses a threat to the safety of patients who experience fatigue to nurses in hospitals, stressed nurses usually cause injury to patients because nurses do not focus on serving patients, are less friendly, often dizzy, and if the number of Too many patients are one of the things that affect work stress, therefore nurses play an important role in a hospital. Referring to this, the hospital has patient safety standards that are designed to monitor and evaluate the performance of nurses, nursing services provided to patients are the main thing (Lindawati & Krisanti, 2009).
The phenomenon of work stress has become a problem in the world. This can be seen from stressful work in England, which counted 385,000 cases, in Wales 11,000 to 26,000 cases cases (Health & Safety Executive, 2013). The American National Association for Occupational Health said that out of forty cases of work stress, work stress on nurses was at the top and nurses could also have the opportunity to experience minor psychiatric disorders and depression (Posangi, 2017).
The incidence of falls in the inpatient ward often occurs in the health polyclinic at the M. Djamil Clinic, Padang, about 11 falls occurred out of 53 incidents of patient welfare in a few months. This is because the human asset factor is not ideal, for example the staff's job is to understand and prevent the patient's fall risk, there are 13 out of 22 medical workers who admit that they may lead the fall risk evaluation when the patient enters the emergency clinic and do not do it continuously. Medical clinics, and the increasing cost of care largely determines the administrative nature of the staff in the clinic. Carelessness of work pressure, patient welfare, injury to other exploratory patients indicate that medical officers at the Islamic Emergency Clinic Unisma Malang have not carried out fall risk assessments for patients and other fall risk management projects, for example, the introduction of markers in patients with patient risk of falls and teaching patients .
This research was conducted shows that of the 16 respondents there are 25.0% with this low presentation, 56.25% with moderate exhibition, and 18.75% with this great exhibition (Nur Kholifatul H, 2018). This also shows that turnover also affects the appearance of medical personnel in a room. In contrast to the examination directed by (Runtuwene, 2018) nursing calls are calls that require a significant level of ability and even require cooperation in different situations and conditions so that nursing calls in the work environment have very little (Budiyanto, 2019). L Lamongan is one of the districts which is in the category of rural areas, usually nurses in rural areas are far from stress levels because they are close to the nuclear family and the characteristics of patients in rural areas are more able to accept conditions. researchers want to know how the level of stress in rural areas.
Around 50.9% of nurses working in four provinces in Indonesia in 2006 experienced work stress. Nurses often experience dizziness and, fatigue, due to the high workload. This causes absenteeism to increase, productivity to decrease so that it has an impact on decreasing the quality of services in hospitals (Dyah Widodo E, 2016)

MATERIALS AND METHODS
In this study using research methods descriptive quantitative. In the form of an image. In this study, to find out the description of work stress on nurses at RSUD Dr. Soegiri Lamongan. The approach taken is an observation approach to nurses and then a questionnaire paper will be distributed. The research was conducted at Dr. Hospital. Soegiri Lamongan in March 2022.
The population in this study is a subject who knows the description of work stress that has been determined. The population consists of nurses who work at RSUD Dr. Soegiri Lamongan. The sample taken is mostly data or filling out a questionnaire for nurses in order to know the description of work stress in Dr. RSUD. Soegiri Lamongan from February to March 2022 totaled 97 questionnaires for nurses. The sampling used in this study is solvin sampling namely the selection of samples by determining the description of research work stress included in the study until a certain period of time, so that the number of respondents who needed to be fulfilled were 97 respondents. The measurement method used in this research is to know the description of work stress. The measuring instrument is by marking the checklist on the questionnaire sheet, and the measurement results are the description of work stress on nurses. The measuring scale used is the ordinal scale.
Collecting data in this study through questionnaires in the form of paper and then distributed to nurses at RSUD Dr. Soegiri Lamongan, who was in Dahlia 1, Dahlia 4, Bugenvil 1, Bugenvil 2 joined with Dahlia 2, Bugenvil 3 joined Dahlia 3, Bugenvil 4. This study was to find out or measure the picture of nurses' work stress. Data analysis was carried out in this study, after the data was collected and then tabulated, then in SPSS then the results were grouped and the percentage calculated. The data that has been in the percentage is then entered in the frequency distribution table and then analyzed descriptively. In this study, permission was obtained from the Hospital with ethical behavior No.445/0332.10/413.209/KEPK/2022.

RESULTS
The characteristics of these respondents are aimed at knowing or measuring the description of work stress on nurses at Dr. RSUD. Soegiri Lamongan. The characteristics of the nurse respondents in this study consisted of age, gender, religion, education, length of service, employee status, and marital status. Based on the data above, there is one group, most of which are respondents aged 19-40 years, as many as 75 people (77.3%) composition of respondents aged 40-60 years, namely as many as 22 people (22.7%) of the total respondents. Based on the gender table above, there are 38 people (39.2%) male respondents and the number of female respondents as many as 59 people (60.8%). This shows that female respondents were more involved in this study than male respondents.
Based on the religious table above, there are 97 people (100.0%) Muslim respondents and the number of non-Muslim respondents is 0 people (0%). This shows that the respondents are nurses in RSUD Dr. Soegiri Lamongan, the majority of Muslims and nonMuslims do not exist. Based on the education table above, there are 53 people (54.6%) as D-III and 44 people (45.4%) as S1. This shows that respondents whose education is more diploma nurses are involved in this study than those with bachelor of nurses.
Based on the table above, there are 91 people (93.8%) of respondents who have worked for 1-20 years and there are 6 people (6.2%) who have worked for 20-60 years. This shows that more respondents are 1-20 years old, than those who have worked 20-60 years. Based on the employee status table above, there are 73 people (75.3%) as a contract and there are 24 people (24.7%) as civil servants. This shows that most of the nurses in RSUD Dr. Soegiri Lamongan has a contract status and there are fewer civil servants compared to those with contracts. Based on the marital status table above, most of them are married and there are 86 people (88.7%) as married and as unmarried there are 11 people (11.3%) as unmarried. This shows that the majority of respondents are married.
After knowing the general data in this study, the following results will be shown related to the data on the level of work stress in nurses according to the general general data and 3 indicators which include: Based on table 2, it can be seen that most of the respondents who have mild work stress according to nurses are 97 people (100.0%). This shows that the majority of respondents have low work stress.

DISCUSSION
Most of the respondent are aged 19-40 years. This shows that the respondents have a mature age in thinking and working or productive age. According to (Aprilyanti, 2017) the more mature the level of maturity and strength of a person will be more mature and think.
Age is the age of an individual from the time of birth to the time of year. The more old enough, the maturity level of a person will be more mature in thinking and working. Then based on the results of the research on the characteristics of the respondents in the study, according to gender, respondents were dominated by female sex as much as 60.8%. This corresponds to the ratio of more women than men. According to (Anwar et.al, 2019) in managing human resources, especially female employees, it is necessary to pay attention to the psychological and biological aspects. Female employees tend to be more satisfied with their work than male employees. Women have maternal traits or instincts that are needed for a nurse, with these traits or instincts, it is hoped that female nurses can give more attention to patients.
Based on the results of the research on the characteristics of the respondents table above in religious research, the respondents in RSUD Dr. Soegiri Lamongan are all Muslim, which is as much as 100.0%. This shows that the majority of nurses in the hospital are all Muslim. Education is a process of preparing the younger generation to live and fulfill their life goals more effectively and efficiently (Hasanah, 2018). Education is more than teaching, the latter can be said to be a mere knowledge transfer process, not a transformation of values and the formation of personality with all the aspects it includes.
Based on the results of the research on the characteristics of the respondents table above in education research, the most respondents are D-III as many as 50.5%. This shows that nurses in hospitals are mostly D-III than S1. Education is one of the main instruments for the development of a nation (Wijayah et.al, 2018). Many countries in the world prove the progress they have experienced because of the education factor. John Dewey as an educational thinker calls education as a tool for achieving progress and social renewal.
Based on the results of the research on the characteristics of the respondents table above in the study of long working hours, respondents who worked longer hours were 88.7%. This shows that respondents have more years of work 1-20 years. According to Andra & Ismaniar (2018) length of work is a period of time or length of labor to work in a hospital, the period of time starts from someone working to become an employee in a place so that a certain period of time. Based on the results of the research from the table of respondent characteristics above, in this study there is one group of employee status that dominates, namely the status of contract employees as much as 71.1% of the total respondents. This shows that respondents have more contract employee status than civil servants. Employee status is employee status is a condition that distinguishes one employee from another in the company. In reality, the status of employees is divided into permanent employees/PNS and contract employees.
Based on the results of the research on the characteristics of the respondents table above, in this study there are two, namely married and unmarried and the most married status is married as many as 79.4% of the total respondents. This shows that respondents have the most married status and are superior to those who are not married. Early marriage is a phenomenon that we often encounter in Indonesian society (Manzahri, 2016). Factors related to early marriage are social status, especially problems of work and culture of the perpetrators of early marriage.
Based on the results of the work stress research on nurses, the overall data / general data of respondents at RSUD Dr. Soegiri Lamongan that is as much as 100.0% which shows that most of the respondents have mild work stress, these results indicate that the SPSS results with a percentage of 100.0% are mild. Based on the level of indicators of psychological symptoms, it shows that most of the respondents have a mild stress level of 82.5%. This shows that the work stress at Dr. Soegiri Lamongan/ Ruang dahlia 1, dahlia 4, bougainvillea 1, bougainvillea 2 combined with dahlia 2, bougainvillea 3 combined with dahlia 3 and bougainvillea 4. Researchers who do not get job satisfaction usually will not reach psychological maturity and nurses will feel frustrated. Nurses who have this attitude will usually daydream, have low morale, get tired and bored quickly, lack concentration in their work, are emotionally unstable, are often absent and do things that have nothing to do with the work they should this (Amir & Purnama, 2021).
Based on the level of indicators of physical symptoms, it shows that most of the respondents have a mild work stress level of 96.9% of the total. This shows that nurses in the hospital do not experience work stress in the physical work environment. Everything that is around the workers that can affect themselves in carrying out the tasks assigned, such as lighting, air temperature, space for movement, security, cleanliness, and others. The physical work environment is all physical conditions that exist in the workplace that can affect nurses either directly or indirectly (Hikari & Siti, 2017). From the above opinion, it can be concluded that the physical work environment is a physical condition around nurses that can affect their performance.
Based on the level of behavioral symptom indicators, it shows that most of the respondents have a behavioral stress level of 100.0% of the total. This indicates that the nurse does not experience behavioral symptoms. The importance of this nurse's work environment deserves attention, because tasks will be completed properly if high morale is achieved, which in turn will speed up the process of completing tasks that are the responsibility of workers so that humans will be able to carry out their duties properly, so that they can achieve a certain goal (Suprayitno &Kafil, 2020). Optimal results if supported by a pleasant and comfortable work environment so as to create a sense of satisfaction in nurses while working and then state that the physical work environment is appropriate for employees to carry out their activities. If the work environment is comfortable enough and the communication in it runs smoothly, the resulting performance will certainly be maximized. On the other hand, if the work environment is not comfortable, filled with chaos with poor physical conditions, it will create saturation of the nurses and result in job dissatisfaction of nurses in the company.

CONCLUSIONS
Nurses in rural areas mostly have low work stress and almost do not experience stress. Every nurse cannot be separated from work stress because every day they must carry out nursing care to patients. The most important thing is how to deal with the stress so that it does not become heavy and severe that it interferes with the quality of nursing care.