The role of the head of room in supervising the icu room of Sembiring Delitua general hospital

Nursing services are a sub-system in health services in hospitals, of course they have an interest in maintaining service quality, moreover, nursing services are often used as a benchmark for the image of a hospital so that it demands the professionalism of implementing nurses and managing nurses. Optimal contribution in realizing quality health services is carried out through the leadership style of the head of the room. The leadership style carried out by the head of the room will have a close impact on the nurse's performance. The formulation of the problem in this research is how is the role of the head of the room in supervising the ICU room at the Sembiring Delitua General Hospital?. The data obtained through interviews with the results of the analysis using the Triangulation method can be concluded: Input (HR), Process (knowledge, skills and leadership), Output (democratic leadership style) carried out on informants. The results in this study that the leadership in the ICU room is good because the head of the room applies democratic leadership.


INTRODUCTION
Good health services in hospitals are health services that guarantee patient safety. Patient safety is a variable to measure and evaluate the quality of nursing services that have an impact on health services. The patient safety program is an attempt to reduce the number of Unexpected Events (KTD) that often occur in patients while being treated in a hospital so that it is very detrimental to both the patient himself and other parties (Carryer, Gardner, Dunn & Gardner, 2007;Robert Hwachter, nd).
The image of the hospital is influenced by the services provided by nurses, where nurses are the largest staff in the hospital and the spearhead of service providers who interact directly with patients. Gillies (1994) said that one third of all activities in the hospital are the activities of nurses. Therefore, a third of the quality of service in hospitals is influenced by nurses, and one of the factors that affect nurse performance is nurse job satisfaction. Nurses who work in hospitals are an inseparable part of the management system that applies in the workplace. There are many factors related to the management function of the head of the room that can cause nurse satisfaction or dissatisfaction at work.
The head of the room plays an important role in supervision and is a manager who is responsible for implementing nurses, so that they can improve the quality of nursing care provided and ultimately improve the performance of implementing nurses. Research by Izzah (2002) in the inpatient room of the Batang regional general hospital, Central Java, said that the supervision of the head of the room had a positive impact on job satisfaction.
Supervision is an activity that is carried out based on skill and intentional in the implementation of supervision so that the goals and quality of reflection and learning occur (Davys, 2010). Effective supervision is built on three pillars, namely supervision, inspection, and education. Each pillar depends on and contributes to the others synergistically, either to improve or reduce the supervision process (Falender, 2004). Supervision is carried out by people who have the ability in the field being supervised. The nursing manager or head of the ward has responsibility for the effective and safe delivery of nursing care to patients and for the physical, emotional and positional well-being of nurses.
The managerial function that handles nursing services in the treatment room is coordinated by the head of the room. The head of the room is the spearhead of achieving the quality of hospital services and is responsible for overseeing the implementing nurses in carrying out nursing care. For this reason, a head of space is required to have more competence in carrying out his managerial duties. Managerial abilities that must be possessed by the head of space are planning, organizing, movement and implementation, supervision and control and evaluation (Arwani & Supriyatno, 2006).
Of the several managerial functions of the head of the room, one that must be carried out by the head of the room is the supervisory function through nursing supervision to improve the quality of nursing services. Supervision is planning, directing, guiding, teaching, observing, encouraging, improving, trusting, continuously evaluating every nurse fairly and wisely. The main purpose of supervision is to further improve the performance of subordinates, not to find fault. Supervision is carried out by direct and periodic observation by superiors on the work carried out by subordinates and if problems are found they are immediately given instructions or assistance to overcome them (Suarli & Bachtiar, 2009).
Nurse competence in patient care as a whole and holistically is defined as the concept of nursing practice which includes knowledge, skills, performance. Attitudes and values that are claimed can be in accordance with holistic concepts and can be accepted by society and can be developed into a competency standard (Scott Tilley, 2008;Yanhua & Watson, 2011). Nurse competency-based professional practice is actually integrated between competency elements, both knowledge, skills and responsibility and accountability. To ensure that nurses are truly competent in providing nursing care, an effort is needed to ensure and prevent unexpected events that can threaten patient safety. To realize optimal service, professional nurses are needed. The professionalism of nurses in their work can be seen from the nursing care provided to the clients they care for. Nurses need to document all forms of nursing care provided through recording or documentation. Therefore the implementation of nursing care is one of the benchmarks for the quality of service from a hospital (Hastuti, A, 2014).
Problems that have existed for a long time are attached to nursing services, where nurses perceive their daily tasks as a routine and are purely intuitive. Therefore nurses who can carry out nursing care according to standards of care have a very important meaning in efforts to improve service quality. The quality of work of nurses determines the quality of hospital services while documentation is an indicator of the quality of hospital services (Triyanto et al, 2008).
Nursing services are a sub-system in health services in hospitals that definitely have an interest in maintaining service quality, moreover nursing services are often used as a benchmark for the image of a hospital in the eyes of society, thus demanding the professionalism of implementing nurses and managing nurses. Optimal contribution in realizing quality health services is carried out through the leadership style of the head of the room. The leadership style carried out by the head of the room will have a close impact on the performance of nurses This is reinforced by research conducted by Burns (2004) on 124 nurses who found support from good supervisors would reduce nurse stress so that it would indirectly increase job satisfaction, which had an impact on nurse performance. This is also in line with research conducted by Mena (2000) researching in the state of India against 51 supervisors and 80 nurses found that the quality of supervision is related to job satisfaction, supervision from superiors will affect job satisfaction and burnout levels. Manavanicharoen and Vidhaya's 2000 study in Thailand found that there was a relationship between the involvement of nurses and supervisors on job satisfaction. This study shows that participatory management has tremendous potential in increasing nurse job satisfaction.
Based on the description above and the phenomena that occur in the field, researchers are interested in analyzing the role of the head of the room in carrying out supervision in the ICU room at Sembiring Delitua General Hospital. In the interview the researcher will provide a number of questions related to the knowledge, skills and leadership performance of the head nurse. The characteristics of the informants are in Sembiring Delitua Hospital.

METHODS
The implementation will be carried out in the ICU room of Sembiring Delitua Hospital in 2021, consisting of 5 informants. 4 of them are nurses and 1 is an implementing midwife. In-depth interviews were conducted from 21 March 2022 to 30 May 2022.
The interviews went well and smoothly, the main informants provided important answers for researchers which could be the main material in seeing the leadership style of the head of the room. Furthermore, the researcher conducted additional interviews with 2 people Inputs Input (input) is everything needed to carry out management work. Resources that are critical to implementing the program include adequate staff and good skills to carry out their tasks.
The main leadership resource in the room for supervising the Sembiring Delitua hospital in 2021 is the staff. Availability of personnel in Sembiring Hospital is one of the elements in program implementation. In terms of quality, the number of staff in the ICU room at Sembiring Delihusada Hospital is still insufficient, this can be seen from the employees who have multiple tasks. On the one hand, they serve as temporary executors, especially during the night service.
Regarding the quality of employee staff, they have attended related special training that has been carried out. The number and competence of employee staff is one of the prerequisites that must be met in implementing the program, especially in bad moods. Management of human resources in a hospital requires the right leadership style so that it can form synergy between superiors and subordinates in this study, namely the head of the room and the implementing nurse.
By applying the right leadership style, it is hoped that there will be a harmonious communication relationship between the head of the room and the implementing nurse in improving the performance of nursing care services to patients.

Process a. Room Head Leadership Has Knowledge
The image of the hospital is influenced by the services provided by nurses, where nurses are the largest staff in the hospital and the spearhead of service providers who interact directly with patients. Gillies (1994). The head of the room plays an important role in supervision and is a manager who is responsible for implementing nurses, so that they can improve the quality of nursing care provided and ultimately improve the performance of implementing nurses. Research by Izzah (2002) in the inpatient room of the Batang regional general hospital, Central Java, said that the supervision of the head of the room had a positive impact on job satisfaction.
Nurse competency-based professional practice is actually integrated between competency elements, both knowledge, skills and responsibility and accountability. To ensure that nurses are truly competent in providing nursing care, an effort is needed to ensure and prevent unexpected events that can threaten patient safety. To achieve optimal service, professional nurses are needed.
Based on the results of the interviews conducted by the researchers, it illustrates that the head of the ICU room at Sembiring Delitua Hospital has good knowledge and experience so that the head of the room can provide guidance or evaluate each patient operation. Supervision is carried out by planning, directing, guiding, teaching, observing, encouraging, improving, trusting, continuously evaluating each nurse fairly and wisely. The main purpose of supervision is to further improve the performance of subordinates, not to find fault. Supervision is carried out by direct and periodic observation by superiors on the work carried out by subordinates and if problems are found they are immediately given instructions or assistance to overcome them (Suarli & Bachtiar, 2009).

b. Room Head Leadership Has Skills
Based on the results of the interviews conducted by the researchers, the researchers found that the 5 informants said that the head of the room has a strong influence that must be possessed by a leader, this influence is skill.
The aim of the training is to improve quality and productivity, create more profitable attitudes, loyalty and partnerships, and meet the needs of human resource planning. Training programs do not cure all problems in advancing organizational goals Siagian (2009), training can be beneficial both for organizations and for employees. The benefits for the organization are: increasing work productivity, creating a harmonious relationship between superiors and subordinates, making decision-making processes faster and more precise, increasing the morale of the entire workforce, encouraging openness in management, facilitating effective communication, and resolving conflicts effectively. functional.

c. Room leadership has Performance
Based on the results of the research above, it can be concluded that karu leadership has performance that must be owned by a leader, this influence is more humble. This is in line with research conducted by Daniel Suranta Ginting in 2020, which said that at one time supervisors would need assistance in making decisions through practice in assignments to find better methods for carrying out delegation of tasks in work groups, of course requiring support from members group. Even though the supervisor pays attention to the conditions and results of work, the main concern is the people, for that they must know each individual and be able to stimulate each executor to want to improve himself. One of the main goals of supervision is orientation, training and individual guidance, based on individual needs and leading to the utilization of abilities and the development of new skills.

Output
Based on the results of research with in-depth interviews, namely the leadership of the head of the room in supervising at Sembiring Hospital can be seen from the knowledge, skills and performance of the head of the room as a leader in the ICU Room of Sembiring Delitua Hospital through questions given by students to the implementing nurse.
Based on the in-depth interviews above, it can be seen that a comfortable work environment is the reason for the good performance of employees in the ICU room, always doing work according to the SOP with the existing conditions and mutual respect between members and the head of the room. This research is supported by research which says that the work environment includes material and stimulation inside and outside the individual, both physiological, psychological and social as measured by indicators one of which is communication and cooperation. From this situation it can be said that room comfort is the main cause that causes good or poor employee performance in the ICU room of Sembiring Delitua Hospital.
CONCLUSIONS AND SUGGESTIONS 1. Good leadership, because the readiness of input related to Human Resources (HR) head of the room has done one of the three duties of the head of the room fairly and can manage its members well. 2. Good leadership, because the head of the room has good knowledge, experience, skills that can be a strong influence that a leader has, and has good performance, which can be seen from the democratic attitude shown by the head of the room who has a humble nature and always has a democratic attitude. 3. Good leadership, because the head of the room who has a democratic leadership style can make his members open to each other about Robert Hwachter's work. (n.d.). patient safety.

Funding Statement
This research did not receive funding assistance from certain institutions. The author reports no conflict of interest in the content of this article.

Conflict of Interest Statement
No potential conflicts of interest have been reported regarding the submitted articles