A PUBLICATION PAPER THE EVALUATION OFHEALTHCARE PERSONNEL’S JOB SATISFACTION AT QUEEN LATIFA GENERAL HOSPITAL (A Case Study in Queen Latifa General Hospital ) by KURNIA CHANDRA DEWI 20121030088 HOSPITAL MANAGEMENT STUDY PROGRAM GRADUATE PROGRAM MUHAMMADIYAH UNIVERSITY YOGYAKARTA 2014 A PAPER PUBLICATION THE EVALUATION OF HEALTHCARE PERSONNEL’S JOB SATISFACTION AT QUEEN LATIFA GENERAL HOSPITAL (A Case Study at Queen Latifa General Hospital ) By KURNIA CHANDRA DEWI 20121030088 Acknowledged by the Advisor: 1st Advisor Dr. Susanto, MS June 7th, 2014 THE APROVAL STATEMENT OF FINAL ASSIGNMENT PUBLICATION FOR THE ACADEMIC PURPOSE As a civitas academica of Muhammadiyah University Yogyakarta, the undersigned: Name : KURNIA CANDRA DEWI Student Identification Number : 20121030088 Study Program : Hospital Management Type : Thesis Hereby I declare, in the purpose for science development I agree to give nonexclusive royalty-free rigtht to Muhammadiyah University Yogyakarta over my papers entitled: EVALUATION of HEALTH CARE PERSONNEL’S JOB SATISFACTION AT QUEEN LATIFA GENERAL HOSPITAL (case study in Queen Latifa General Hospital) together with an existing device (if needed). With this nonexclusive royalty-free rigtht, Muhammadiyah University Yogyakarta has the right to keep, to format, to manage in the form of a database), to keep and to publish my final assignment as long as it puts my name on it (with or without a thesis advisor's name) as the author/creator and the copyright owner. Stated in : Yogyakarta Statement Date : June 7th, 2014 (KURNIA CHANDRA DEWI) 20121030088 HEALTHCARE PROFESSIONAL JOB SATISFACTION EVALUATION AT QUEEN LATIFA GENERAL HOSPITAL ( A Case Study At Queen Latifa General Hospital) Kurnia Candra Dewi Hospital Management Study Program, Muhammadiyah University Yogyakarta Jl. Lingkar Selatan, Tamantirto, Kasihan, Bantul, Yogyakarta 55183 Email : dewi_dirwan@yahoo.co.id Susanto Hospital Management Study Program, Muhammadiyah University Yogyakarta Jl. Lingkar Selatan, Tamantirto, Kasihan, Bantul, Yogyakarta 55183 Email : paksanto1@yahoo.com Hasnah Rimiyati Hospital Management Study Program, Muhammadiyah University Yogyakarta Jl. Lingkar Selatan, Tamantirto, Kasihan, Bantul, Yogyakarta 55183 Email : hasnahrimiyati@yahoo.com ABSTRACT Backgorund : Queen Latifa General Hospital is a type D hospital which has 70% healthcare professional of the total employees. The turn over number of healtchcare professionals is fluctuative due to job satisfaction. The productive satisfaction will reduce operating budget and guarantee the satisfaction of internal customer, thus it will reduce the turn over number of the employees as well. Method: The method of the research is qualitative plan which was delivered in explorative description. The respondents in the research are medical professionals, nurses, another supporting healthcare professionals, and unit directors. The total respondents are 19 people. The research implementation technique was conducted by collecting the data by in-depth interview, triangulation, and observation. The content analisys was applied in the data analisys. Result and discussion: The content analisys applied in the data analisys, it resulted the healthcare professionals get satisfied toward their own work, but in the terms of salary they are not satisfied as it does not fit their work achievement, both education and training do not support their welfare, and healthcare professional promotion factor also conveys the dissatisfaction. Meanwhile, the factor of boss, co-workers and healthcare professional’s workplace convey the satisfaction. Conclusion and suggestion : from the result of work satisfaction evaluation, it is shown that the factors which contribute to healthcare professional satisfaction are the work itself, the boss, co-workers and workplace. The factors of salary and healthcare professional promotion show dissatisfaction. Keywords: Healthcare Proffesioanal Job Satisfaction INTRODUCTION Hospital service increasingly leads to a commodity item refers to the strength of the economy of the community. Hospital as an organization starts to change from an normative organization (social organization) towards socio-economic organization. The change of socioeconomic characteristic of hospitals into profitable business raises the demands from the parties concerned. The hospital's owner wants the hospital immediately to give a profit, meanwhile the hosital’s users demand higher quality of hospital services and stakeholders such as the personnels of the bureaucracy, including its main professional organizations of doctors and other health professionals working in the hospitals who require compensation as well, the comfort of the work environment work, work facillities, work performance recognition and and so on 1. The hospital has a number of resources including human resources. The personnles is the most important resource, because human beings as acting individuals who work together and direct a wide range of resources and useful funding source to achieve the objectives of the organization 2. The existence of personnels in carrying out their activities should be supported by the means, infrastructure and good management so that job satisfaction is achieved and can work well in accordance with the company's expectations. In the management of hospital organization, healthcare personners are the most dominant workforce in performing the duties. They have the task of providing basic health services to individuals, families, groups and communities in the quest for health, disease prevention, healing and recovery. The healthcare personnels, as the motor of activities in the hospitals, need to get motivation from the HR Department as responsibility for ensuring the satisfaction of healthcare personnels with their works3. Job satisfaction can be measured with a large gap between the expectations and the reality. It is influenced by several factors, such as the work, salaries, promotions, superiors, co-workers and work condition 4 . There is 2012 version of standard regulation of hospital accreditation, in the chapter of Improvement of quality and patient safety , which obliges hospitals to measure job satisfaction of health and non-health personnels 5. Employees’ satisfaction will drive the growth of employee loyalty to the organization. Their loyalty will lead to increased productivity. The employees’ productivity encourages the creation of external service value which then determines the external customers’ satisfaction, because customers’ it is one of the determinants of customer loyalty. The next impact of customers’ retention is increased revenue and profitability of the company. The productive satisfaction will lower operating costs and guarantee the satisfaction of internal customers, so it can lower employees’ turn over. Employees’ satisfaction can be achieved through the quality of internal service includes employees’ selection, design work, and payroll system 6. Queen Latifa general hospital is the legal private hospital in the form of limited company. it has attempted to provide job satisfaction on employees. Various attempts have been made seem to be unable to push the numbers turn over of thr employees, especially health workers. "The Evaluation of healthcare personnels’ job satisfaction at Queen Latifa general hospital (A Case study at Queen Latifa General Hospital)". The research results can give valid data and description of the job satisfaction of healthcare personnales to be the base of the chiefs of Queen Latifa general hospital to make decisions and also to get inputs and respond to the needs of the healthcare personnels due to the healthcare personnels’ job satisfaction, to minimize the turn over of the healthcare personnel so that the hospital can hire loyal healthcare personnels who are able to increase patients’ satisfactions of the hospital. DATA AND METHODOLOGY This research uses qualitative designs presented in a exploratory descriptive Based on the data above, there are fluctuations of the turn over number from 2010 to 2012. From the turn over data which shows the fluctuations in each year, the job satisfaction, probably, is one of the reason why so that needs to be done to evaluate the job satisfaction of the healthcare personnels at Queen Latifa General Hospital. This research uses primary data and secondary data to measure job satisfaction of the healthcare personnels which includes several factors such as the work itself, salaries, promotions, superiors, coworkers and working conditions. This research approach is crosssectional where data is loaded at a time using case study research through focus group discussion (FGD) In addition to the turn over factor, it is possible also because of the Queen Latifa general hospital as the new hospital does not have a system of evaluation of healthcare personnelss job satisfaction yet, so it needs to be made and work satisfaction of healthcare personnels need to be resized so that the hospital receives the inputs for the development of the healthcare personnels. FGD interview will be guided by the researchers, with the 17 (seventeen) participants consist of 3 (three) persons at the time of the first FGD and 14 persons at the time of the second FGD in unstructured form and everything possible is done naturally. Transcript of FGD is based on chronological discussions to facilitate the analysis. Based on the above background, the research will be done by taking the title The subjects in this research include healthcare personnels working in Queen Latifa general hospital and Directors of the department, whereas the object of the research is the Queen Latifa general hospital where guide and standard operating procedures are available on the unit as well as HR documents in the form of task descriptions, guidance of the employees appointment, and a list of employees’ salaries. The respondents in this study are the healthcare personnels at Queen Latifa general hospital which includes medical personnel (physicians, general practitioners, dentists), nursing personnel (nurses, midwives), the pharmacists (pharmacist, assistant of pharmacists), nutrisionist, physiotherapist, technical medical personnel (radiografer, health analysts, medical recorder) and The Board of Directors at Queen Latifa general hospital. The instruments used In the research on the evaluation of healthcare personnels’ job satisfaction at Queen Latifa general hospital are as follows: a) list of questions (guide) for in-depth interviews. b) list of questions (guide) is used for the FGD. The implementation technique of the research is by data collection obtained by in-depth interview as well as data of FGD regarding job satisfaction of the healthcare personnels at Queen Latifa general hospital. In-depth interviews were conducted to the Board of Directors of Queen Latifa general Hospital which consists of the Director of medical services department and Director of human resources and training department . Menwhile the FGD is conducted on healthcare personnels. Test of validity (validity) of this qualitative research uses a triangulation of the source (data) and methods. Triangulation of the sources is done through interviews with the directors of Queen Latifa general hospital, while triangulation of the methods is done through FGD with healthcare personnels. Test of reliability (reliability) is done by auditing the data. In this qualitative research, the phase of data collection and data analysis that is done is as follows; 1. Data Collection the researcher records all the data objectively and it is in accordance with the result of the observation, interview, check list of the evidence of implementation and comparisons in the field, they are: a) Field observation of the work, salaries, promotions, superiors, coworkers, working conditions at Queen Latifa general hospital. b) Document of the interview conducted to the Director of medical service department and Director of human resources and training department. c) Document of the FGD result is conducted on healthcare personnels at Queen Latifa general hospital. d) Secondary data in the form of operational procedure standard in the Human Resource Department which consists of task descriptions, guidance of employee appointment, and a list of employees’ salary. 2. Data Reduction In the data reduction, the writer conducted an analysis in order to classify and to delete the unused data. 3. Data Presentation The presentation of the data in this study is a description of the results of the research into information. 4. Decision making and verification are done after the data presentation and it is followed by drawing the conclusion. RESULT 1. Explanation of Work Factor a) The difficulty level and diversity of the work types can avoid the feeling of being saturated According to the Director of the departments the difficulty levels and the variety of work types generally make the employee to feel their workloads are increased and cannot avoid to be being saturated doing their jobs. This condition is contrary to the opinions of employees stating the level of difficulty and diversity the work types can avoid the feeling of beeing saturated. b) Knowledge and Implementation of the policy of the service In the in-depth interview and FGD, according to Directors of departments, service policy is already known by employees but the service implementation of policies have not been fullest because of less socialization from the the employee's supervisor or indifference towards the socialized information. c) Understanding towarrds service procedure An understanding of the procedures of the service according to the opinion of the Director of Departments and FGD results, procedures and services are not known entirely to employees and only few of them are carried out due to the lack of socialization. d) The suitability of work division with the capabilities of the employee The results of in-depth interviews and FGD show the tasks are proportioned according to the capabilities of employees. e) The base of work division at a work unit The result of in-depth interview about the base of work division in the work unit is a job description employees. f) Attitudes towards duty The attitude of Queen Latifa general hospital’s employees toward tasks/responsibilities is to accept the duty and do it with all responsibility. g) Compliance between the work and the expectation personnels state that their works are not in accordance with their expectations. h) The suitability of work in-depth interviews of job suitability it is obtained that they are all fit with their education and competencies. i) Satisfaction towards the results of the work The in-depth interviews results the work the employee is still average, it does not contribute to the hospital’s satisfaction. This result corresponds to the FGD results stating that the work is still not satisfactory. 2. The Description of Salary Factor a. The suitability of the salary and benefit with work result From in-depth interviews it is obtained that the salary and benefits have not been in accordance with the results of the work. A similar case is also delivered by a team of nursing and supporting in FGD, but in FGD the medical team is satisfied. b. The suitability of salary with formal education and training The result of in-depth interviews that the granting of salary does not comply with formal education and training of employees. A similar case also delivered health care personnel in the FGD. c. The granting of salary and benefits to meet the needs of life worthy The result of in-depth interviews and FGD, it is obtained the conclusion that the granting of salary and benefits to employees have not been able to meet a decent life. d. The salary differences based on objective evaluation and can be adjusted From the results of in-depth interviews and FGD it can be seen that the differences in salaries of employees of the Queen Latifa general hospital are based on subjective evaluations and it can be adjusted. 3. Promotion/career Factor a. Promotion/Career From in-depth interview about promotion/career it found out that is is still limited, it is also found out in FGD on healthcare personnels who state that the promotion/career of employees at Queen Latifa general hospital is not clear, subjective and the benchmark is still vague. b. Employees have equal opportunities in career enhancement From in-depth interviews it is obtained that the results for the enhancement of the career depends on the willingness and ability of employees, who are top achievers will definitely be promoted, while the result of FGD delivered that employees should have the same opportunities in career enhancement but it is not known by the medical team. 4. Superior factor a. The Superior’s support and encouragement In the in-depth interview respondents informed that the support and encouragement given by the superiors such as reminding, giving input, and helping the personnels if there are problems, they can be a friend to pass on complaints about the trouble they may find and provides a good example. In the FGD, it is also found out that the support and encouragement from the superior to the medical team are always available in the completion of tasks in field. b. Superior’s help and advice given to the employee's difficulty in employment The assistance and advice from superiors depend on the existing problem faced, while the results from FGD, it can be seen the help and advice given by the employer to the medical team is when the difficulties in the job already exist but they are insufficient. c. Communication between superior and employee The communication between superior and employee in the in-depth interview and FGD are smooth and no obstacles, the communication is done formally or non formally. d. The relationship between management and employees in the term of service The result of in-depth interviews and FGD on the relationship between management and employees in theterm of service is fine in general, but on the other hand in the level of implementing , there is misscommunication leads to negatively affect. 5. Co-workers Factor a) Colleagues Relation In depth interviews and FGD about relationships among colleagues, it is stated that employee relations associated individually is good but are less helpful / cooperation in terms of work completion. b) social relationships among employees In the in-depth interviews and FGD, the social relationship among colleague is fine overall. c) The hospital sense of belonging, trust and appreciate each other From the in-depth interviews and FGD, the sense of belonging of the employees towards hospital and the social awareness are still less. d) Colleagues suppport From in-depth interviews and FGD, it is found out that the colleagues’ suport are help and support. From the in-depth interview on the work environment in terms of safety, comfort, tranquility and cleanliness, according to the respondent is good, but the results of FGD from medical team, nursing team and supporting team, it is delivered that the working environment in terms of safety, comfort, tranquility and cleanliness is still lacking. c) The availability and functionality of supporting equipments In the in-depth interview i submitted that the availability and functionality of supporting equipment is available but not yet adequate, while the results of FGD it is obtained different results that the availability and functionality of supporting equipment is still limited and less. d) Desired working environment In the in-depth interview, respondents want a work environment with high level of employee awareness and sense of belonging of the employees toward the hospital. There is a balance between right and obligation. While the results of FGD, it is obtained that healthcare personnels want the desired working environment which is conducive, clean with maintained sterilization standard. 6. Working Condition Factor a) Work Situation In the terms of working situation, the results of in-depth interviews and FGD shows the same condition that working situaton is fairly conducive, it strongly supports the completion of the work even though there are still some limitations in the means and resources. b) Working environtment DISCUSSION 1. Description of the work Factor a. the level of difficulty and diversity of the job types can avoid the feeling of being saturated. There are different opinions that the degree of difficulty and diversity of the job types can avoid the feeling of being saturated. It is obtained from the the in-depth interviews and FGD. They occur due to the different point of views about the existing job, the director of the department who does not often check the field directly, then all the employees are observed totally. According to Eka, 2012, a number of variations in the work will create great work satisfaction, on the contrary little variation of the work shall cause the workers feel saturated and weariness, otherwise the work with too many variations and they go fast cause put the employees unde pressure psychologically8. From this condition, immediately it needs to make the same perceptions about work and evaluation towards the addition of employees’ work where it must be suitable with the individual's expertise in order to focus on more tasks and avoid the change in the short period in order to get maximum result. b. Knowledge adn implementation about the service policy Considering the two things above there are 2 possibilities occur in the implementation of policies at Queen Latifa general hospital. First, the transfer of information stucked in the middle management. Second, i.e., the information is carried from the middle leader but there are obstacles in communicating. Immediately, this condition needs to be concerned by enhancing the socialization of the service policy to all employees. c. Understanding of the service procedure Overall understanding and implementation the service procedure similar to the understanding and implementation of the service policy, so it needs to be done immediately by enhanceing the socialization tp all units at the hospital. d. The suitability between work distribution and the employees’ skill The suitability between the work distribution with the capabilities above would result well if it is by increading the capacity of employees through several activities which are in accordance with their basic tasks and functions both in house training or eks house training. e. The base of work distribution in the work unit The base of work distribution has been in accordance with the examination/review of the documents which are found in a job description guide of each unit in a hospital or in the file document of each employee in the Human Resource Department of the hospital. f. Attitude towards the work The positive attitude shown by the healthcare personels needs to be positively appreciated by the hospital management. According to Robbins (2003) in the thesis of Muslims (2010), a positive employees’ attitudes can be shown because they have work satisfaction, while employees who are not satisfied with their work will show a negative attitude towards their work 9. g. The suitability between work and expectation Most healcare personnels are still oriented to work full-time as clinicians than being a prt of management team as they do not understand about the work of management yet, this managerial things are not obtained in the College of healthcare personnel so they do not understand what they should do or what creativity they should create. Concerning the reason above it should be immediately followed up with increasing the the healthcare personnals’ understanding about it through formal or non-formal education. h. The work appropriateness According to Kaswan (2012), an appropriate work can increase productivity, responsiveness, quality, and service to the customers3. This condition is actually very good for increasing customer satisfaction, both internal and external. i. Satisfaction towards the result of the work The results of the work have not been appropriated since they are affected by the healtcare personnel who do not work optimallyit happens because the desired works do not suitable with their expectation. According to Luthans (2006) cited by Kaswan (2012), this is a duty for Human Resource Department to make the works enjoyable, adjusted to the employees’ interest, employees’ skills and work, and to motivate employees to make their works are interesting and fun to increase their own work productivity and satisfaction 3. 2. a. b. Salary Factor The suitability between salary and allowance According to Gilmer (1999), cited by Kaswan (2012), the employees who believe that the payroll systems is unfair tend to be dissatisfied with his work. This does not only applies on salaries, but also on allowances. Actually, when people are given the opportunity to choose the most allowance they want, their work satisfaction tends to be increased3. The suitability between salary with formal education and training c. According to Ivancevich (2001) quoted from Kaswan (2012), individual-based compensation approach about the knowledge-based salary, by giving rewards to employees for having additional knowledge either in the present job category or new job categories, it results better work quality significantly, absenteeism and accidents which is decreased significantly 3. If we consider the results of the in-depth interviews and FGD, then the Ivancevich’s theory is not yet implemented. the salary and allowance to meet the needs of proper life According to Sutrisno (2009), giving a proper salary and allowance does not only affect the financial condition of the employees, but it also can appease the employees to work more diligently and have initiative doing their work. On the contrary, by giving improper salary and allowances will trouble their work spirit, and their work perormance will be decreased 9. d. The salary Differences are based on objective evaluation and can be adjusted According to Sutrisno (2009), to achieve the level of fairness and a better level of eligibility, then giving different salary is only based on differences of managerial activities, responsibilities, skill, 10 knowledge, , and productivity . 3. Promotion/career Factor a. Promotion/career According to Eka (2012), promotion plays important role for every employee, even it becomes something they wish for in their work, the promotion means there is trust and recognition of employees ' skills and capability to occupy a higher. Therefore the promotion is one of the factors that affect the employee’s job satisfaction. In the implementation of the promotion there must be a set of requirements in advance and the requirements should be stated strictly and clearly 7. b. Employees have equal opportunities in career enhancement It is recommended immediately to make the provisions or terms about the promotion of employees at Queen Latifa general hospital and socialize it to all employees so that they all get the same opportunities for career enhancement/promotion. 4. Superior Factor a. The superior’s support and encouragement The support and encouragement from my superiors both stated or in the form encouragement to accomplish the work to achieve the business objectives b. The help and advice when the employees in trouble The nursing team and supporting teman state that help and advice are always given in the form of coaching or direct assistance on the spot. c. The Communicatio between supervisor and employees According to the Mangkunegara (2011), communication is influenced by two factors, i.e. the factor from the sender or called Communicator and the factor from the receiver or from comunikan. Both communicator and comunikan are affected by the skills, attitudes, knowledge and communication channel media 11. The communication between supervisor and employees is a management action to better guarantee that the actions, attitudes, and behavior of the employees in such a way so that the ability of the organization to achieve the objectives and goals , it also increases and makes the organization can meet its obligations towards the employees12. The communication is used to provide information to employees and to be the most effective tool for increasing motivation, satisfaction and productivity of the employees3. d. The relation between management and employees Good relations is a key to success in the workplace in order to work effectively, to have creative performance and qualified output within the organization. In addition, there is tremendous loyalty and a strong work ethic among the employees. The vision of the leader becomes the aspirations of employees. Consequently it is remarkable said Maxwell (2001) in Kaswan’s book 3. Managers and employees should pay attention and implement the factors that can strengthen the good relations, they are: trust, social intelligence, interest, equality, interaction skill, and open minded attitude 3 . 5. Co-workers Factor a. The relation among co-workers According to Ilma, Hamzah and Aminudin (2012), the relationships among coworkers in the workplace is the main thing in the work, especially for the healthcare personnels that would come into contact directly with the patients in their medical service 13. b. Social relationships among employees In an interview about the social relationships among co-workers, it is okay overall, as well as stated by healthcare personnel in the FGD, that us the social relationship among employees is good and solid enough despite the high level of selfishness (because most of the employees are still young). c. The hospital sense of belonging, trusting and appreciating each other According to Gooleman (2007) in Kaswan’s (2012), if there is a good relationship, it means person will feel more comfortable, engaging, understandable and there is mutual trust among them. They can be more creative together and more efficient in making the decision 3. d. The co-workers’ support According to Eka (2012), the achievement of a maximum results in work is supported by he co-workers’ support and also condition or social atmosphere. Each individual can not work by him/helself but he/she requires cooperation with other people, both in completing the work or in outside of the work communication 8. 6. a. b. Work condition factor Work Situation In this employment situation, the results of in-depth interviews and FGD was the same. The work situation is fairly conducive, strongly supporting the completion of the work even though there are still some limitations of the means and resources. The work environment From the in-depth interviews about the working environment in terms of safety, comfort, tranquility and cleanliness, the respondents state that it is good. It is different with the results of FGD where the medical team, the nursing team and the supporting team state that the working environment in terms of safety, comfort, tranquility and cleanliness is still lacking. c. The availability and function of supporting equipments In the in-depth interview, it is revealed that the availability and the function of supporting equipment is privided but it is not yet adequate, while the results of FGD obtained different results, it is stated that the availability and the function of supporting equipment is limited and less. d. Desirable working environment A good work environment will affect the sense of security for employees to work. It is related to the fulfillment of needs at the second and third level of the motivatio theory by Maslow, that is the need of the sense of security and safety and the need to be accepted in the social environment As in Hamsyah’s research (2004), the analysis tells that a conducive working atmosphere, where the facilities and infrastructure are available, comfortable environment, relations between employees, the harmonious relationship among superiors and employees will greatly affect the nurse’ job satisfaction 14. Conclusion From the analysis data above, it can be summed up: 1. Healthcare personnels are satisfied with the work factor 2. Healthcare personnels have not been satisfied with the salary factors Baru), Skripsi, Fakultas Ilmu Sosial dan Politik Universitas Riau. 3. Healthcare personnels have not been satisfied with the promotional/career factor 9. 4. Healthcare personnels are satisied with the superior factor 5. Healthcare personnels are satisfied with co-workers factor 6. 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