INFLUENCE OF HEAD OF ROOM LEADERSHIP STYLE ON THE

PERFORMANCE OF THE NURSE IN THE INPATIENT ROOM

CLASS III THE NEW BUILDING AND G3 THE HOSPITAL
REGIONAL GENERAL PROF. Dr. H ALOEI SABOE CITY
GORONTALO

Sri Meylani Bobihu 1) , Imelda Mohammad 2) , and Syarifuddin Mada 3)

1)
S1 Hospital Administration Study Program, Faculty of Health Science Technology
Science,
Bina Mandiri University of Gorontalo
2)
Boliyohuto Regional General Hospital
3)
Office of Community Empowerment and Village District. Gorontalo
E-Mail: srimeylanibobihu00@gmail.com

ABSTRACT

This study aims to find out how the influence of the leadership style of
the head of the room on the performance of nurses in the class III inpatient
room of the new upper building and G3 of the Prof. Regional General
Hospital. Dr. H Aloei Saboe City of Gorontalo.
This type of research uses a qualitative approach. This research
describes phenomena from the perspective of informants, reveals various
realities, and builds a comprehensive understanding of a phenomenon in a
particular context. Data collection uses observation, in-depth interviews and
documentation. Data processing using editing and coding .
The results showed that the leadership style of the head of the room
was democratic and participatory. The nurse's performance is good by
carrying out nursing care to the fullest and in accordance with Standard
Operating Procedures (SOP) and in accordance with the stages of nursing
care. The leadership style of the head of the room influences the
performance of nurses in the class III inpatient room in the new building and
G3 at the Prof. Regional General Hospital. Dr. H. Aloei Saboe City of
Gorontalo.

Keywords: Leadership Style , Nurse Performance

INTRODUCTION strategic role in efforts to accelerate the

Hospitals, which are health care
facilities for both individuals and
communities, are required to provide the
best service for these individuals and
communities. As the front line in
providing services to individuals and
society, nurses are needed to provide
nursing services in a professional and
accountable manner. The hospital as one
of the health service facilities has a very
improvement of the health status of the
Indonesian people. One of the professions
that has an important role in the hospital
is nursing [ 15 ].
To provide health services tailored to
the needs of the community, professional
nurses are tasked with working towards
creating a healthy health system. Likewise
with the health care system run by nurses
in hospitals. Nurses as the biggest health
workers play a role in providing constant,
continuous, coordinative nursing care to
meet the needs of clients [4].
The success of an organization in a
hospital depends on several factors, one
of which is the level of human resources
including a nurse, besides that the leader
is also a factor that greatly influences the
activities of his subordinates to carry out a
job with the intended achievement [2].
Head of room planning is very
influential on the excellence of nursing
services. The room chairperson's duties
include creating an organizational
structure and carrying out short and long
term planning. A head of room oversees
other implementing nurses and directs the
nursing process at the hospital, especially
in the inpatient unit. The head of the room
is responsible for the duties of the nurse
practitioner. The head of the room is
responsible for leaders and managers, to
achieve organizational goals and complete
the main duties of a nurse's profession
must exercise authority over his duties to
fulfill the unit's goals in providing nursing
care. If a nurse is able to provide quality
nursing services and care, her work is
considered successful
The leadership style used by the head
of the room to direct and coordinate
nursing care is one of the factors that
influence nurse performance. Effectively
leading others , both individually and
collectively, to achieve desired goals is
more profitable leadership. To achieve
ministry tasks and ministry goals, the
influencing process takes the form of
sharing power between the leader and
members rather than occurring in one
direction. The quality of nursing services
is determined by the function of the head
of the room. The role of the head of the
room is responsible for the results of
quality nursing services [4].
Leadership is the functioning of
leaders and subordinates in certain
situations. In leadership there must be an
element of influencing other people,
subordinate elements (members of the
organization) as people who are
influenced, elements of certain situations,
so that it functions in achieving
organizational goals [3].
Leadership style will influence in
directing each employee who is in a
different service unit, the leadership
function in this case has the role of
directing, guiding, and instilling the
meaning of the services provided to
patients so that employees work
professionally. Mistakes made by
employees can be caused by a lack of
direction and coordination given by the
leader. The briefing referred to, for
example, concerns job descriptions, roles,
and functions of each category both based
on the level or type of employee
education as well as from qualifications
[9].
There are 4 leadership styles based on
authority and power, namely:
1. Authoritarian
Task- or job-focused leadership
Take advantage of the authority and
leadership of your position. The leader
is the one who decides which goals to
achieve in making decisions. Only
information about tasks with rewards
and punishments that interest and
motivate people is provided.
2. Democratic
Respecting the personality and
expertise of each staff member is a
sign of good leadership. Information is
disseminated as freely and widely as
possible to the public using the
authority to stimulate staff ideas,
inspiring groups to define their own
goals, plans and implementation
controls.
3. Participatory
Is a combination of authoritarian
and democratic leadership styles ,
namely leaders who convey the results
of problem analysis and then propose
 these actions to subordinates. Staff
were asked for suggestions and
criticisms and considered the staff's
response to the proposals and the final
decision in the group.
4. Action-free
Staff determine their own activities
without direction, supervision and
coordination. Staff evaluate work
according to their own way, the leader
is only a source of information and
minimal control [15].
The art of leading others to
understand and agree on what needs to be
done, as well as supporting individual and
collective efforts to achieve goals, is
leadership. To achieve nursing goals,
nursing leadership must be able to
influence other nurses under them.
supervision to carry out their
responsibilities in providing services and
nursing care. Technical skills, or the
capacity to understand and perform
technical tasks , conceptual skills, or the
capacity to conceptualize and see the
business as a whole and analyze it, and
human relations skills, or the capacity to
work collaboratively with others as
members of a group, are one of the skills
required for this leadership. and
executive. The performance of other
people, in this case nurses, can produce
results through leadership which is a
means of leading.
In organizations and businesses
where the division of various tasks to be
completed forms the foundation of the
organization, leadership is an important
component. One factor in determining
leadership is if everyone in the
organization has various positions or
responsibilities. Because of the many
roles and responsibilities, the leader must
organize and coordinate everything.
Organizations and businesses that are
structured around the division of several
tasks to be completed place a high value
on leadership. One indicator of leadership
is whether each employee in the
organization has various positions or
responsibilities. Due to various positions
and responsibilities, the leader has to
organize and coordinate everything [8].
Nurses are human resources who play
an important role in the implementation of
health services in hospitals because they
are professions that consistently and
regularly provide services to patients . It
is the responsibility of nurses to determine
the quality of the hospital because they
are the staff members who interact with
patients and their families. In hospitals,
especially in inpatient units, nurses play
an important role. Nurses are the staff
members who spend the most time with
patients and play the most significant role
in the health care services in hospitals.
Nevertheless, patients and their loved
ones continue to express concern about
nurses. As shown by the many comments
made about hospital services by the
patient and his family a.
Nurses are human resources who play
an important role in the implementation of
health services in hospitals because they
are professions that consistently and
regularly provide services to patients
(Sari, 2016). It is the responsibility of
nurses to determine the quality of the
hospital because they are the staff
members who interact with patients and
their families. In hospitals, especially in
inpatient units, nurses play an important
role. Nurses are the staff members who
spend the most time with patients and
play the most significant role in the health
care services in hospitals. Nevertheless,
patients and their loved ones continue to
express concern about nurses. As shown
by the many comments made about
hospital services by patients and their
families [3].
Performance is the real result of the
work done by individuals or groups of
individuals to achieve more specific
organizational goals. Employee
performance usually includes the ability
to collaborate, quantity of results, quality
of those results, and timeliness. These
sections help employers or their
employees perform at the highest possible
level [6].
performance is influenced by two
factors, namely individual factors, both
internal and external to the organization.
a. Internal factors are factors related to
intelligence, skills, emotional
stability, a person's characteristics,
including attitudes, personality traits,
physical characteristics, desire or
motivation, age, gender, education,
work experience, cultural background
and other variables other personal
variables.
b. External factors are factors that affect
employee performance that come
from the environment, including
labor regulations, customer desires,
competitors, economic conditions,
organizational policies, leadership,
actions of colleagues, types of
training and supervision, wage
system and social environment [7].
Nurse performance is a form of
professional service which is an integral
part of health services. Caring for sick
people has existed since ancient times
based on instinct and experience. In the
nursing care system, performance can be
interpreted through nurse compliance
according to standards [12].
Performance measurement needs to
be done to find out whether during
performance implementation there are
deviations from predetermined plans, or
whether performance can be carried out
according to a predetermined time
schedule, or whether performance has
been achieved as expected [11].
Performance evaluation is a method
for evaluating the contribution of
employees to the organization. A
significant advantage of performance
evaluation is the ability to measure the
level of individual contribution or
performance of employees in carrying out
their responsibilities.
Nurse performance is defined as the
nurse's actions that contribute to the
achievement of the main tasks of the
profession and the goals and objectives of
the organizational unit. In reality, nurse
performance and workplace performance
are the same. Nurses want to be evaluated
using clear standards. , doable, and
objective. If nurses are treated well and
given greater rewards, they will be more
motivated to perform at a higher level [8].
Performance appraisal is based on
nursing care standards that have been
described by the Indonesian Ministry of
Health which refers to the stages of the
nursing process which include:
a. Nursing Assessment
b. Nursing diagnoses
c. Nursing Planning
d. Implementation
e. Nursing Evaluation [12].
Based on the description of the
problem, the researcher is interested in
examining more deeply the problem of
leadership style and nurse performance by
conducting a study on "The Influence of
Room Head Leadership Style on Nurse
Performance in Class III Inpatient
Rooms in the New Building and G3
Upper Prof. Regional General Hospital.
Dr. H. Aloei Saboe, City of Gorontalo .
RESEARCH METHODS
The method chosen for this research is
qualitative research. research methods
that describe phenomena from the
perspective of informants, reveal various
realities, and build a comprehensive
understanding of a phenomenon in a
particular context are referred to as
qualitative methods.
Qualitative research is a process of
inquiry about understanding based on
separate methodological traditions, clearly
an examination that explores a social or
human problem.
Research builds a complex, holistic
picture, examines words, reports detailing
the views of native speakers, and
conducts the study in a natural setting
[ 13].
Sources of data used in this study are
direct observation, in-depth interviews
and documentation. The respondents or
informants who will be interviewed are
the head of the room and several officers
or nurses in the class III inpatient room in
the upper new building and upper G3.
The data collection method in this
study was carried out through
observation, in-depth interviews and
documentation, which are explained
below:
1. Observation
Observation is a data collection
technique that is carried out through
direct observation, meaning that
researchers collect data through
observation, namely making
observations at research locations. So
that researchers can use a collection
method known as observation, they
must observe things related to field
research. Observation is a component
of data collection. Observation
collects data from the field.
Observation is a process that is
preceded by observation and then
systematic, logical, objective and
rational recording of various kinds of
phenomena in actual situations, as well
as artificial situations.
2. In-depth interviews (in- depth
interviews )
In-depth interviews are the process
of obtaining information for research
purposes and how to ask and answer
face-to-face between interviewers and
informants or interviewees, with or
without interview guidelines, where
interviewers and informants are
involved in social life for a relatively
long time.
In simple terms it can be said that
the interview (interview ) is an event or
a process of interaction between the
interviewer ( interviewer) and the
source of information or the person
being interviewed (interviewe )
through direct communication [14].
Technical interviews can be
carried out systematically or not
systematically. What is meant
systematically is that the interviews
were conducted by first preparing the
interview guideline instrument. Called
not systematic, the researcher
conducted interviews directly without
first compiling an interview guideline
instrument. Currently. With advances
in information technology, interviews
can be conducted without face-to-face,
namely through telecommunication
media. The interview must be
recorded, a recorded interview will
provide added value. Because,
recorded conversations will be
authentic evidence if there is a
misinterpretation. And after that the
recorded data is then written back and
summarized. And researchers provide
an interpretation of the data obtained
through interviews [10].
3. Documentation
Documentation comes from the
word document, which means written
goods, the documentation method
means procedures for collecting data
by recording existing data. The
documentation method is a data
collection method used to trace
historical data. Documents about
people or groups of people, events, or
occurrences in social situations that
are very useful in qualitative
research. The documentation method
means the procedure for collecting
data by recording existing data. The
documentation method is a data
collection method used to trace
historical data. Documents about
 people or groups of people, events, or
incidents in social situations that are
very useful in qualitative research
[14].
Data collection is a series of activities
that include data processing. In order for
research analysis to produce accurate
data, researchers must go through at least
the stages of data processing: editing,
coding, processing, and cleaning. In this
study, researchers used 2 stages of data
processing, namely as follows:
a. Editing
At this stage the researcher will re-
examine or examine the data that has
been obtained, then the researcher will
correct erroneous data or wrong data
and complete the missing data.
b. coding
At this stage the researcher will
mark each answer by providing a code
or value to make it easier for
researchers to process data [7].
In qualitative research, there are
three stages of data analysis, namely
coding, presentation, and drawing
conclusions or verification. At various
stages, the data analysis techniques
used are:
a. the data codification stage, which
began with the transcription of the
interview recordings, the field notes
taken during the in-depth interviews
were rewritten. Utilizing recorded
interviews and transcripts, separating
relevant information from irrelevant
information for display (codification)
b. Data presentation stage. The results
of this study will be presented
c. Interpretation of documents or
interview results is used to draw
conclusions from data findings in
the follow-up stage, which is also
known as the conclusion or
verification stage. The encoding and
presentation of the data is checked
again after conclusions are drawn to
ensure that there is no
misinterpretation [1].
Techniques for checking the
validity of data in qualitative research
include credibility tests, transferability
tests, dependability tests, and
confirmability tests:
1. Credibility Test ( Credibility )
In qualitative research, data
can be declared credible if there
are similarities between what the
researcher reported and what
actually happened to the object
under study. When in the field it is
found that there is a shortage of
health workers in the hospital
environment, then the problem of
this shortage of health workers
will be explored in more detail by
researchers, not those related to
the availability of health facilities
and infrastructure. Testing the
credibility of data or the
trustworthiness of qualitative
research data consists of extending
observations, increasing
persistence, triangulation,
analyzing negative cases, using
reference materials and member
checks.
2. Transferability Test (
Transferability)
In qualitative research, the
value of transferability depends on
the reader, to what extent the
results of the research can be
applied to other social contexts
and situations.
3. Dependability Test
The dependability test can be
carried out through auditing the entire
research process. The research results
cannot be said to be dependable if the
researcher cannot prove that a series
of research processes has actually
been carried out.
4. Confirmability Test
Confidability in qualitative
 research is more interpreted as a
concept of intersubjectivity (the
concept of transparency), which is a
form of the researcher's availability in
disclosing to the public about the
process and elements in his research,
then providing opportunities for other
parties to evaluate the results of his
research as well as obtaining
agreement between the parties . [5].
RESEARCH RESULT
In this study, there were 10 (ten)
informants consisting of nurses and room
heads. Based on the analysis of research
data, the results of the research and
discussion adjusted to the focus and
research sub-focus are described as
follows:
1. How is the Leadership Style of the
Head of the Room
The leadership style of the head of
the room in the class III inpatient
room of the new building and G3 for
the Regional General Hospital Prof.
Dr. H. Aloei Saboe the city of
Gorontalo has a democratic and
participatory leadership style. This is
in accordance with the results of
interviews with several informants.
2. How Nurse Performance
Based on the results of
interviews conducted by researchers
with several informants, it was found
that the performance of nurses in
class III inpatient rooms in the new
building and G3 at the Prof. Regional
General Hospital. Dr. H. Aloei Saboe
the city of Gorontalo is already good,
because it has carried out nursing
care to the fullest and is in
accordance with the Standard
Operating Procedures (SOP). This is
in line with what was conveyed by
several informants.
3. How does the leadership style of
the head of the room influence
nurse performance
Based on the results of
research conducted by researchers
through an interview, it can be
concluded that the leadership style
of the head of the room affects the
performance of nurses. This is as
stated by several informants who
were interviewed during the
research.
DISCUSSION
1 . How is the Leadership Style of the
Head of the Room
Leadership style will influence in
directing each employee who is in a
different service unit, the leadership
function in this case has the role of
directing, guiding, and instilling the
meaning of the services provided to
patients so that employees work
professionally. Based on the results of
research conducted by researchers
through interviews and documentation,
the following results were found:
The leadership style of the head of
the room in the class III inpatient room of
the new building and G3 for the Regional
General Hospital Prof. Dr. H. Aloei Saboe
the city of Gorontalo has a democratic
and participatory leadership style.
2. How is the performance of the nurse
Performance is the performance of
work achieved by a person or group of
people in carrying out their duties to
achieve more defined organizational
goals. Nurse performance is the nurse's
activity in properly implementing an
authority, duties and responsibilities in
the context of achieving the objectives
of the main duties of the profession
and realizing the goals and objectives
of the organizational unit.
Measurement of performance needs
to be done to find out whether during
the performance implementation there
are deviations from the predetermined
plan, or whether the performance can
be carried out according to the
 specified time schedule, or whether the
performance has been achieved as
expected.
Based on the results of interviews
conducted by researchers with several
informants, it was found that the
performance of nurses in class III
inpatient rooms in the new building and
G3 at the Prof. Regional General
Hospital. Dr. H. Aloei Saboe, city of
Gorontalo, for carrying out nursing care
to the fullest and in accordance with
Standard Operating Procedures (SOP).
This is in line with what was conveyed by
several informants. The stages of nursing
care that have been carried out by nurses
are as follows:
1. Nursing Assessment
Assessment is the initial stage to
collect data on the patient's health
status in a systematic, comprehensive,
accurate and sustainable manner. In
this case the nurse collects data
regarding the patient's health status
accurately and thoroughly. The data
collected is focused on identifying the
patient's past health status, the patient's
current health status, biological,
psychological and spiritual status,
response to therapy, expectations of
optimal health levels and high risk of
problems.
2. Nursing Diagnosis
In nursing diagnoses the nurse will
analyze the assessment data to
formulate a nursing diagnosis by
looking at the patient's complaints.
3. Nursing Planning
In nursing planning the nurse will
make a nursing plan to address the
problem and improve the patient's
health. This nursing plan includes
setting priority problems, goals and
action plans that will be given to
patients.
4. Implementation
In terms of implementation, the
nurse implements the actions
identified in the nursing care plan.
The process criteria in this
implementation include: working
with patients in carrying out nursing
care, collaborating with other health
teams, carrying out nursing actions to
address patient health problems,
providing understanding to patients
and families regarding skills in
nursing care.
5. Nursing Evaluation
In terms of nursing evaluation, the
nurse will evaluate the condition and
progress of the patient regarding the
nursing actions given in achieving
goals and revising the basic data and
planning. The process criteria in this
evaluation are compiling a plan to
evaluate the results of the
intervention in a comprehensive,
timely and continuous manner.
Based on the results of the research
conducted, it was found that the
leadership style of the head of the room
was democratic and participatory. As for
the nurse's performance, it is also good
and carries out nursing care to the fullest
and in accordance with the SOP. From the
data obtained from in-depth interviews
then processed with the editing and
coding stages, then the data was analyzed
using 3 stages namely codification, data
presentation and drawing conclusions, the
results of the study showed that there was
an influence of the leadership style of the
head of the room on nurse performance.
3. How does the leadership style of the
head of the room influence nurse
performance
The leadership style of the head of
the room will determine how to direct,
guide and instill positive values
regarding meaning in the health
services provided to patients. Some of
the problems committed by staff can
be caused by a lack of direction and
guidance from leaders. Based on the
results of research conducted by
 researchers through an interview, it can
be concluded that the leadership style
of the head of the room affects the
performance of nurses. This is as stated
by several informants who were
interviewed during the research.
Based on the research results
obtained from interviews with informants
regarding the influence of the leadership
style of the head of the room on, it can be
concluded that the leadership style of the
head of the room influences the
performance of nurses in class III
inpatient rooms at the Prof. Regional
General Hospital. Dr. H. Aloei Saboe.
This is in accordance with research
conducted by Nurjannah (2016) that the
leadership style of the head of the room
affects the performance of nurses.
Measurement of the leadership style of
the head of space in research.
The measurement of the leadership
style of the head of the chamber in this
study is based on the conceptual
framework of the research variable. The
leadership style has 4 (four) indicators,
namely democratic, participatory,
authoritarian and action-free. The results
of the interviews in the study showed that
of the four indicators above, there were
only 2 indicators of the leadership style
used by the head of the room in the class
III inpatient room at the Prof. Regional
General Hospital. Dr. H. Aloei Saboe
namely democratic and participative
leadership style. So that the discussion in
this study is focused on leadership style
variables with democratic and
participatory indicators.
The results of the study showed that
there was an influence of Democratic
leadership style on the performance of
nurses. This can be seen from the results
of interviews with several informants who
said that the head of the room always
motivated staff, discussed, received input
and suggestions for solving existing
problems.
In addition to the Democratic
leadership style, the participative
leadership style applied by the head of the
room also influences the performance of
nurses . This was conveyed by several
informants who said that the head of the
room always received input from staff,
asked for suggestions and criticism in
solving existing problems.
This research is reinforced by
research conducted by Nurjannah (2018)
which states that there is an influence of
the leadership style of the head of the
room on the performance of nurses in the
class 3 inpatient room of the new building
and G3 for the Prof. Regional General
Hospital. Dr. H. Aloei Saboe City of
Gorontalo
CONCLUSION
Based on the results of research and
discussion it can be concluded that:
1. The leadership style of the head of
the room in the class III inpatient
room in the new building and G3 at
the Regional General Hospital Prof.
Dr. H. Aloei Saboe the city of
Gorontalo has a democratic and
participatory leadership style .
2. The performance of nurses in class III
inpatient rooms in the new building
and G3 at the Prof. Regional General
Hospital. Dr. H. Aloei Saboe, the city
of Gorontalo has done well by
carrying out nursing care to the
fullest and in accordance with the
Standard Operating Procedures
(SOP) and in accordance with the
stages of nursing care.
3. The leadership style of a leader or
head of the room in the class III
inpatient room of the new building
and G3 over the Prof. Regional
General Hospital. Dr. H. Aloei
Saboe, city of Gorontalo, based on
the results of the interview, namely
the leadership style of the head of the
room influences the performance of
 nurses in the class III inpatient room
of the new building and G3 at the
Prof. Regional General Hospital. Dr.
H. Aloei Saboe city of gorontalo
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