The Relationship Between Job Weight and Work Situation with Nurses' Work Discipline

The successful implementation of the work of the health center when carrying out its role is indicated by the best quality of service. Excellent service, friendliness and timeliness of treatment provided to patients are closely related to nurses' work discipline. The instability of work weight is another manifestation of the beginning of fatigue, boredom and stress due to work, to the point that it affects the work discipline of nurses. Work discipline is a component that affects the work situation among several other components. This research has a direction In 2021, The goal was to evaluate how the workload and work environment relate to the level of work discipline among nurses at the Haurpanggung Health Center Garut. This study employs a descriptive correlation design, with a sample of 42 nurses. The findings of this research indicate that the majority of nurses view their workload as substantial or burdensome, most of them find the work environment unfavorable, and a significant number of nurses at the Health Center lack discipline. The inference made is that there exists a relationship between the workload and the discipline of nurses, as well as a connection between the work environment and nurse discipline specifically within the Haurpanggung Garut.


INTRODUCTION
Puskesmas is a technical unit that implements health services and is under the control of the District / City Health Office.The main role of the center is to deliver preventive, promotive, curative, and rehabilitative services, both in the field of individual and community health (Masniadi & Rizqi, 2022).
Puskesmas acts as a basic element in the health organization structure, where various health workers work together to achieve health development goals.In accordance with the Provisions of the Minister of Health No. 857/2009, Puskesmas are placed as the frontline in the provision of primary health services.As the main technical institution, Puskesmas has a great responsibility when fostering the quality of primary healing services by developing the ability of its employees (Aningsih & Kusumastuti, 2022).
The success of Puskesmas in carrying out its role is characterized by the quality of primary care services they provide.Key elements in providing good health services include speed of service, friendliness, effectiveness of actions, and comfort for patients and other visitors (Perceka, 2018a).The support and commitment of Puskesmas staff is a crucial factor that is very influential in the stages towards the progress of Puskesmas (Hakman et al., 2021).
Excellent service, friendliness and timeliness of treatment provided to patients are closely related to nurse work discipline.Work discipline is a form of compliance with one's attitude by seriously obeying the rules and regulations related to work and implemented in Copyright @ Taufik Huda, Andhika Lungguh Perceka, Nurani Ai Erlinawati, Herlin Rusyani an organization.Discipline at work is very important for each individual so that smoothness and order in the work environment can be maintained (ANANTA, 2021).The level of discipline of a person can be a determining factor in the progress or decline of an institution.
A company that has responsible and highly disciplined employees tends to operate effectively and produce high-quality services.This is due to the fact that each employee who participates in the work mechanism will carry out the job with full responsibility (Risna, n.d.).
Work discipline is a management activity to motivate employees to answer the goals of various rules.Work discipline is behavior, deeds and actions that are in harmony with the rules of the institution orally or in writing.Work discipline is the most important element in employee capacity building.Instead of that, in order to avoid mistakes, negligence, mistakes that cause inefficiency, work discipline is needed (Siahaya, 2023).Likewise, nurses will be perceived by patients to work optimally if they work according to their abilities and expertise and are on time in providing services (Hapijah, 2023).Working beyond their abilities will cause fatigue and boredom which have an impact on mental disorders, so that people become lazy to work and absent from work.The condition of high work weight will get heavier if the working conditions also do not maximally support efforts to complete their work properly, such as an uncomfortable work environment, heat, sultry, incomplete medical equipment, uncomfortable and noisy workplace (Khomaryah et al., 2020).Fatigue in nurses occurs when they work beyond 80% work duration.That is, when the effective work duration exceeds 80% work duration, it shows that the workload of nurses is very large or not comparable.Therefore, it needs to be negotiated to increase the quantity of nurses in the recovery room (Hasibuan & Munasib, 2020).
Health workers are a key element when carrying out the functions of a health center.
If the quality of health workers is lacking, the quality of health center governance and services will definitely decline (B.Hartono, 2018).In an effort to grow the quality of Puskesmas services, support is needed from employees, especially nurses, who have the ability to carry out their duties and are ready to adapt to change.Nurses, who act as the front guard in providing health services, are not only expected to demonstrate expertise and professionalism when carrying out nursing activities, but are expected to have emotional sensitivity in responding to patients who are in a variety of moods and psychological backgrounds (Raharjanto, 2020).
High workloads, followed by pressure from health services and relatives of patients, result in nurses being able to work quickly and in rushed situations.Some parts related to obtaining the total score of all items, the proportion of the work weight system, working conditions and work discipline can be known as the percentage of the overall score (Hikhmat & Melinda, 2019).
(2) Bi Variate In order to determine the relationship between two variables, the chi-square test was conducted.Table 3 shows that the majority of nurses' working conditions, 28 nurses (66.67%) stated that they were not good and 14 (33.33%)nurses said they were good.

c. Distribution of Work Discipline
The results of research data processing regarding work discipline can be observed below: Copyright @ Taufik Huda, Andhika Lungguh Perceka, Nurani Ai Erlinawati, Herlin Rusyani Table 5 shows that the proportion of undisciplined nurses is higher among nurses with heavy workload (80%).The calculation of bivariate experiment obtained p value = 0.008.
With p less than 0.05, it shows that H0 cannot be accepted, and Ha is accepted, so the conclusion is that there is a relationship between work weight and nurses' work discipline.

b. Assessment of the Relationship between Work Situation and Work Discipline
The results of bi variate assessment in table 6 regarding working conditions with nurses' work discipline can be observed as follows: So it becomes risky for the level of service delivered by nurses because when the weight of work is high, the level of accuracy and comfort of work decreases (Anwar & Yusuf, 2023).Likewise, various factors such as the number of patients a nurse must care for, whether their work capacity is in line with the level of education obtained, the duration of work used to carry out responsibilities consistent with daily work time marks, and the availability of facilities that assist in completing their tasks, all greatly affect the weight of the nurse's work (Rusniati et al., 2023).The more additional tasks given will increase the weight of the nurse's work (Parashakti, 2020).In line with research (Martini et al., 2022), the weight of work that is too heavy will cause a decrease in work motivation (FAUZAN, 2022).
The amount of extra work that must be handled by a nurse can hinder their performance.Fluctuations in workload are another cause of decreased performance.
Sometimes the weight of work can be very light for a period of time, but then it can become very heavy at other times.When the workload increases and there is no recruitment of new personnel, this can lead to psychological pressure, fear that the work will not be completed, and anxiety, which can ultimately reduce the performance of nurses (Sofiantika & Susilo, 2020).
Copyright @ Taufik Huda, Andhika Lungguh Perceka, Nurani Ai Erlinawati, Herlin Rusyani As the weight of work is considered heavy by nurses when viewed from the age of nurses, in general, most nurses (58.5%) are ≤ 35.A relatively young age considers the work that has been done is still considered heavy because it has not been working for a long time and is not experienced, especially coupled with additional and changing work weights (Awaludin & Perceka, 2019).
Giving extra work to nurses is still possible, as long as they do not neglect their main duties.Management needs to regularly evaluate both the basic and additional tasks assigned to nurses (Sumanta, 2022).Communication between the leader who delivers the work and the recipient of the work must be maintained in an orderly manner so that the work can be completed according to the ability of the person or worker, while still achieving the set targets.This is important so that nurses can complete their work according to the set targets, while paying attention to the abilities of the individuals out the work (Kansil et al., 2022).

Working Conditions
Based on the results of data processing according to Table 4.3, it shows that the working conditions of nurses at the Haurpanggung Garut Health Center in 2021, most nurses (64.3%) stated that they were not good.Working conditions are all objects around workers that can cause workers when carrying out the work given.
In line with research (Ede, 2022), which says there is a relationship between the work environment and work productivity and discipline.The work environment situation can have effective or bad consequences, that effective working conditions will lead to the growth of work values, discipline, and increased motivation.
Working conditions are a condition that is closely related to the identity of the workplace for the attitudes and behavior of workers, which is closely related to the incidence of psychological development that is felt when working or when certain conditions must be continuously monitored by institutions which include work saturation, the same job and fatigue.Even when observed from the age of the majority, who are less than 35 years old entering young adulthood, comfort at work, the work situation is considered less effective (WISNADEWI, 2022).
The non-physical work situation covers all elements related to work relationships, whether between leaders, between partners, or subordinates.This aspect of the work environment has a significant role and should not be ignored.It is important for companies to create conditions that support cooperation among various levels in the organization, including superiors, subordinates, and peers.Such efforts include creating a warm and Copyright @ Taufik Huda, Andhika Lungguh Perceka, Nurani Ai Erlinawati, Herlin Rusyani family-like work atmosphere, promoting effective communication, and fostering self-control among all team members (Andi, 2021).
The researcher's analysis shows that work situation is one of the elements that affect ability and satisfaction at work.When the work environment is uncomfortable, productivity tends to decrease and employees tend to be less to work, and conversely, when the work environment is comfortable, productivity tends to increase and employee discipline also increases.However, other factors can also affect work productivity, so in situations where the work environment is uncomfortable but productivity remains high, it may be due to other elements that are increasingly influential in the environment.

Work Discipline
Based on data analysis from Table 4, the results show that the majority of nurses at the Haurpanggung Garut Health Center in 2021 (57.1%) did not maintain discipline.
According to Handoko (2011), discipline is a managerial action that aims to encourage the implementation of organizational standards.It involves training with the direction of correcting and improving nurses' insights, actions, and personalities until they have the motivation to cooperate and achieve better performance (MUSIYANTO, 2023).
In the context of health care institutions, work discipline is a key element when deciding on the level of service provided.Studies in non-health institutions have shown that work discipline is a significant predictor.Research conducted (Hendry, 2021), states that most of the variability in service quality can be explained by work discipline (by 75%), while other factors explain the remaining part.Managers can adopt certain approaches to ensure a high level of discipline among nurses, such as monitoring whether they follow established procedures and comply with hospital rules.In addition, managers must also address common discipline-related issues, such as attendance, workplace behavior, honesty, and off-hours activities.All of this is done to maintain and improve the image of discipline in the institution (Leuhery, 2018).
Especially when viewed from the length of service, employees should set a good example in terms of work discipline because most nurses (73.2%) have a work period of more than 10 years.Nurses with a relatively long period of work discipline is something that should have been accustomed to being done and obeyed.But in reality, discipline is still lacking.Efforts by Puskesmas leaders to conduct routine evaluation and coordination improve work discipline (Sopali et al., 2023).

Relationship between Work Weight and Discipline Work
Based on Table 5, the comparison of nurses who are not disciplined is greater for nurses who have heavy work weights (80%).The bivariate experiment obtained p-value=0.008.The p-value of 0.008 is less than 0.05, showing that H0 is not accepted and Ha is accepted, so the conclusion obtained is that there is a relationship between work weight and nurse work discipline.
The weight of work must be adjusted to the ability of individuals who carry out tasks, such as nurses, so that performance remains optimal.Poorly planned management can result in subjective complaints, uncontrolled increase in work weight, and ineffectiveness and imperfection which in turn can result in job dissatisfaction and decreased performance as well as decreased service quality (Putriana, 2023).In order to foster employee effectiveness and control, care leaders should consider the regularity between the quantity of personnel and the workload of nurses.Excessive workload can provide a psychological burden that can reduce nurse performance.Based on the table analysis, out of 36 questions answered, 23 questions (63.9%) regarding nurses' capacity were rated as good (Martini et al., 2022).This is when viewed from the age of most nurses (58.5%) who are relatively young employees, so that the work to be done is felt heavy and not in accordance with the experience he has gained so far, especially coupled with additional work.
The weight of work can be divided into two: the weight of physical work and the weight of psychological work.The weight of physical work can take the form of busy work such as carrying, managing, moving objects.On the other hand, the weight of psychological work can take the form of the level of skill and performance that workers have (Haddad et al., 2023).
Actual achievement and performance is the performance or real work results obtained by employees when carrying out obligations in line with the work given.However, if the work weight is excessive, it will have an impact on performance.Heavy or excessive work weight can reduce performance.The weight of work is the situation of workers when directed at responsibilities that must be completed within a specified period.
The elements that affect performance are: First, the organization includes job weight, resources, leadership, rewards and organizational governance.Second, personal elements, including: skills and capacities, knowledge, age, length of work, education and gender.The weight of work is a situation where workers are met with responsibilities that must be completed within a specified period.The weight of work has an impact on employee Copyright @ Taufik Huda, Andhika Lungguh Perceka, Nurani Ai Erlinawati, Herlin Rusyani The high weight of work can cause a decrease in performance, because workers who have a heavy work weight tend to produce low quality work and experience time inefficiencies due to fatigue.To achieve maximum performance, it is important for nurses to be in good physical condition so that they can complete their tasks more efficiently.High fatigue due to the weight of work can significantly affect performance levels, in accordance with research on the relationship between work fatigue and nurse performance in the inpatient ward of RSI Fatimah Cilacap, which shows a correlation between fatigue due to high work weight and performance in the inpatient ward (Agustiningsih et al., n.d.).
The low performance of a worker must also be seen from various factors.In general, individual performance can be reflected in three main elements, namely determination, expertise when carrying out tasks, and the workplace.This performance can be seen through personal actions and different assessments of actual gains in carrying out tasks.Performance appraisal, which is a formal measurement of an individual's performance, is a way to measure how well the individual performs tasks in accordance with established standards (A.Hartono & Sutopo, 2018).
Performance evaluation is important to determine whether the work has been carried out according to a predetermined schedule and whether the results have reached the expected standards.If the execution of the work matches or exceeds expectations, it can be considered that the work was successfully executed well.However, if the results are below the expected standard, it can be considered that the actualization of obligations is not ideal.
So it is necessary to evaluate the work and maintain the balance of the weight of the work of nurses in each room to improve performance by hospital leaders (Purnomo & Shalahuddin, n.d.).
Research at Sartika Asih Bandung Hospital in 2021 shows that there has been no evaluation of nurses' job weights.This is evidenced by the increasing workload, including Copyright @ Taufik Huda, Andhika Lungguh Perceka, Nurani Ai Erlinawati, Herlin Rusyani additional tasks such as handling accidents or robbery victims, which are quite high, while the current number of nurses still does not reach the ideal standard.Ideally, the ratio between the number of patients and nurses is 1 to 3.6 patients, so that Bhayangkara Level II Sartika Asih Bandung Hospital is in the middle of 21 nurses.Evaluation of the balance between the number of patients and nurses needs to be done so that the perceived heavy workload can be overcome.Excessive work will definitely have a negative impact on nurse performance (Helena & Alvianda, 2019).

Relationship between Working Conditions and Discipline Work
Based on table 6, the proportion of nurses who are not disciplined is found in most nurses (70.4%) by saying that working conditions are not good.The bivariate experiment obtained a p value of 0.02 less than 0.05 indicates that HO is not accepted Ha is accepted, so the conclusion is that there is a relationship between the work situation and the work discipline of nurses at the Haurpanggung Garut Health Center in 2021.
Working conditions are a situation related to the peculiarities in the work area on the actions and actions of workers related to the occurrence of psychological transitions due to causes felt while working or during situations that require immediate attention by the institution which include job saturation, equal obligations and fatigue.The state of working conditions or the work environment has an impact on work comfort and work discipline (Hakman et al., 2021).
In line with the research findings (Hulwani et al., 2021), said there was a gap between discipline and nurse performance.Nurses are not disciplined, so service will be hampered and have an impact on nurses' productivity decreasing.Working conditions or work environment refer to conditions that affect employee behavior and attitudes in the workplace, which can trigger psychological changes due to work experiences or certain situations.This is an aspect that needs to be continuously considered by the organization, including in overcoming problems such as boredom, monotony, and fatigue.Discipline plays an important role in organizational growth and is used as a tool to stimulate workers to maintain discipline when carrying out obligations (ANANTA, 2021).
Motivation is a psychological mechanism that arouses, guides behavior towards the acquisition of goal-adapted personality direction (Perceka, 2016).Nurses, as a strategic part when trying to reach the direction of health development, have a significant role when delivering valuable nursing care for patients.A good level of discipline reflects the value of workers' commitment to the work delivered, which can drive work enthusiasm and help achieve the direction of the institution (Ilani, 2021).
performance when carrying out their work.Employees with extra work weight will reduce the level of work gain and strengthen the existence of time inefficiency (Kaamilia'Aini & Paskarini, 2022).The research being carried out by researchers is in line with(Elviyana, 2022), about the relationship between job weight and nurse performance in the inpatient room of the UGM Prf SoedomoGM Hospital, it is concluded that there is a relationship between job weight and nurse performance.The results of this research strengthen the researcher's research, namely the weight of work has a relationship with performance, meaning that the heavier the work weight, the performance will decrease (Kaamilia'Aini & Paskarini, 2022).

Table 1 .
Distribution of Age and Length of Service of Nurses

Table 3 .
Frequency Distribution of Working Conditions

Table 4 .
Distribution of Work Discipline of Nurses Analysis of the Relationship between Work Weight and Work DisciplineThe results of bivariate analysis regarding the weight of work with nurses' work discipline can be observed as follows:

Table 5 .
Results of Analysis of the Relationship between Work Weight and Nurses' Work

Table 6 .
Acquisition of Assessment of the Relationship between Working Conditions With Copyright @ Taufik Huda, Andhika Lungguh Perceka, Nurani Ai Erlinawati, Herlin Rusyani weight refers to the number of activities must be worked on by an individual or team at a certain duration during a normal situation.A common problem that arises in health services is the imbalance of nurses' job weights.Although managers often find it difficult to assess the extent of this job weight because it is based increasingly on subjective complaints.This condition starts at the level of designing nursing labor needs that are not aligned with the work capacity of the service institution (Okfasyah, 2020).