Fishbone Analysis sebagai Metode dalam Optimalisasi Penerapan Sistem Jenjang Karir Perawat
Keywords:
Nursing career ladder, Fishbone analysis, Nursing management, Nurse professionalism, Quality of careAbstract
The nursing career ladder system is an essential component of hospital human resource management aimed at enhancing nurses’ motivation, performance, and professionalism. However, its implementation remains suboptimal due to structural and managerial constraints. This study aimed to analyse factors influencing the optimisation of the nursing career ladder system using fishbone analysis. A qualitative descriptive-analytical design was employed. Participants included nurse managers and staff nurses working in inpatient units, selected through purposive sampling. Data were collected through in-depth interviews, observations, and surveys, and analysed using fishbone analysis to identify root causes across the dimensions of man, method, material and machine, and money. The findings revealed that low motivation for career development, weak evaluation and promotion mechanisms, limited training facilities and technological support, and insufficient budget allocation and incentive systems were the main barriers to optimal implementation. These interrelated factors contributed to uneven clinical career distribution and reduced job satisfaction among nurses. This study concludes that optimising the nursing career ladder system requires a comprehensive and integrated approach, including strengthening nursing governance, enhancing professional development, utilising information technology for competency mapping, and ensuring sustainable financial and incentive support to improve nursing professionalism and quality of care.
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