Pengalaman Kelelahan Perawat dalam Memberikan Asuhan Keperawatan Medikal Bedah di Ruang Pelayanan Multidisiplin (Neurologi, Bedah,  dan Jantung)

Muhammad Erza Fratama; Bahrul Ilmi; Muthmainnah

doi:10.62027/praba.v4i3.990

Authors

Muhammad Erza Fratama Program Studi Magister Ilmu Keperawatan, Universitas Muhammadiyah Banjarmasin
Bahrul Ilmi Dosen Poltekkes Kemenkes Banjarmasin
Muthmainnah Dosen Universitas Muhammadiyah Banjarmasin

DOI:

https://doi.org/10.62027/praba.v4i3.990

Keywords:

Descriptive Qualitative, Medical-Surgical Nursing, Multidisciplinary Service Unit, Nurse Fatigue, Workload

Abstract

Nurses working in multidisciplinary units providing neurological, surgical, and cardiac care experience complex demands related to diverse patient characteristics, nursing needs, and care coordination, which may contribute to fatigue. This study aimed to describe nurses’ experiences of fatigue while providing medical-surgical nursing care in a multidisciplinary service unit. A descriptive qualitative design was conducted through in-depth interviews with 10 nurses selected using purposive sampling in the Rambutan Ward of Sultan Suriansyah Regional Hospital, Banjarmasin, in May 2026. Data were also collected through non-participant observations and document reviews from May to June 2026. Analysis used the Miles and Huberman interactive model, including data reduction, data display, and conclusion verification. Trustworthiness was maintained through triangulation, member checking, peer debriefing, and audit trails. Five themes were identified: complexity of multidisciplinary patient management, factors influencing fatigue, fatigue experiences, impacts of fatigue, and strategies with future expectations. Nurses reported physical, cognitive, emotional, psychological, and overwhelmed fatigue, along with empathic experiences resembling compassion fatigue. Fatigue was associated with organizational factors, patient characteristics, personal factors, and work-environment conditions. Organizational support, effective work-system management, adequate resources, and adaptive strategies are essential to support nurses in managing multidisciplinary care demands.

References

Alshammari, B., Alsaleh, G. S., Alrasheeday, A., Baghdadi, N., Almalki, N., Alshammari, F., Assiry, A., & Almalki, M. (2025). Association between missed nursing care and nurse fatigue: A cross-sectional correlational study. Nursing Reports, 15(8), Article 298. https://doi.org/10.3390/nursrep15080298

Asgari, E., Kaur, J., Nuredini, G., Balloch, J., Taylor, A. M., Sebire, N., Robinson, R., Peters, C., Sridharan, S., & Pimenta, D. (2024). Impact of electronic health record use on cognitive load and burnout among clinicians: Narrative review. JMIR Medical Informatics, 12, Article e55499. https://doi.org/10.2196/55499

Bakker, A. B., Demerouti, E., & Sanz-Vergel, A. (2023). Job demands-resources theory: Ten years later. Annual Review of Organizational Psychology and Organizational Behavior, 10, 25–53. https://doi.org/10.1146/annurev-orgpsych-120920-053933

Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). SAGE Publications.

Gillies, D. A. (1994). Nursing management: A systems approach (3rd ed.). Saunders.

Gou, J., Zhang, X., He, Y., He, K., & Xu, J. (2024). Effects of job demands, job resources, personal resources on night-shift alertness of ICU shift nurses: A cross-sectional survey study based on the Job Demands-Resources model. BMC Nursing, 23, Article 648. https://doi.org/10.1186/s12912-024-02313-0

Guest, G., Namey, E., & Chen, M. (2020). A simple method to assess and report thematic saturation in qualitative research. PLOS ONE, 15(5), Article e0232076. https://doi.org/10.1371/journal.pone.0232076

Hiestand, S., Waage, S., Forthun, I., Pallesen, S., & Bjorvatn, B. (2024). Factors leading to excessive fatigue in nurses: A three-year follow-up study. BMC Nursing, 23, Article 446. https://doi.org/10.1186/s12912-024-02066-w

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. SAGE Publications.

Malterud, K., Siersma, V. D., & Guassora, A. D. (2016). Sample size in qualitative interview studies: Guided by information power. Qualitative Health Research, 26(13), 1753–1760. https://doi.org/10.1177/1049732315617444

Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook (2nd ed.). SAGE Publications.

O'Brien, B. C., Harris, I. B., Beckman, T. J., Reed, D. A., & Cook, D. A. (2014). Standards for reporting qualitative research: A synthesis of recommendations. Academic Medicine, 89(9), 1245–1251. https://doi.org/10.1097/ACM.0000000000000388

O'Connor, T., Gibson, J., Lewis, J., Strickland, K., & Paterson, C. (2023). Decision-making in nursing research and practice-Application of the Cognitive Continuum Theory: A meta-aggregative systematic review. Journal of Clinical Nursing, 32(23–24), 7979–7995. https://doi.org/10.1111/jocn.16893

Pi, R., Liu, Y., Yan, R., De, Z., Wan, Y., Chen, Y., He, Z., Liu, F., Wang, Y., & Li, S. (2025). Nurses' occupational fatigue level and risk factors: A systematic review and meta-analysis. PLOS ONE, 20(7), Article e0326519. https://doi.org/10.1371/journal.pone.0326519

Riedl, E. M., Perzl, J., Wimmer, K., Surzykiewicz, J., & Thomas, J. (2024). Short mindfulness meditations during breaks and after work in everyday nursing care: A simple strategy for promoting daily recovery, mood, and attention. Workplace Health & Safety, 72(11), 491–502. https://doi.org/10.1177/21650799241262814

Roy, C. (2009). The Roy adaptation model (3rd ed.). Pearson Education.

Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health, 23(4), 334–340. https://doi.org/10.1002/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G

Surendran, A., Beccaria, L., Rees, S., & McIlveen, P. (2024). Cognitive mental workload of emergency nursing: A scoping review. Nursing Open, 11(2), Article e2111. https://doi.org/10.1002/nop2.2111

Tarwaka, Bakri, S. M., & Sudiajeng, L. (2004). Ergonomi untuk keselamatan, kesehatan kerja dan produktivitas. UNIBA Press.

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042

Vreugdenhil, J., Somra, S., Ket, H., Custers, E. J. F. M., Reinders, M. E., Dobber, J., & Kusurkar, R. A. (2023). Reasoning like a doctor or like a nurse? A systematic integrative review. Frontiers in Medicine, 10, Article 1017783. https://doi.org/10.3389/fmed.2023.1017783