Observasi lapangan

1. FIELD OBSERVATION
PANEL
Tabaringan Health Center
By : Group 14

2. GROUP
14
Muh. Asy Shidiq 110 2015 0003
A. Muh. Yasser Mukti 110 2015 0022
Andira Ratu Nurrasyid 110 2015 0030
Andi Aisya Zealand 110 2015 0051
Nur Zamzam Azizah 110 2015 0059
Amaliah Hakim 110 2015 0070
Rifqy Aditya 110 2015 0078
Rindang Cahyani Abas 110 2015 0101
Elsa Shafira Prasetyati 110 2015 0117
Cindy Purnamasari 110 2015 0136
Atika Rahmah Mustapa 110 2015 0147

3. LOCATION
Located in JL.Tinumbu Lrg.154
No. 2 District Ujung Tanah
Kelurahan Tabaringan.
Located in the middle of Cidu’s
Market. The health center start to
give service at 8.00 am

4. FACILITIES
There are some facilities
provided by the health center
which are:
• Bin
• Satisfaction box
• Benches
• Toilets and wastafel
• Parking lot

5. ■ Location : difficult access
■ The waiting room : shaky chairs
■ Late service
■ The parking lot
■ Insufficiency of facilities : the tools to clean the tartar
■ Information about disease
Some the negative sides of the health center:

6. Patient
Come
locket
BPJS
(Jamkesmas,Jamkesda, dan askes)
Service
Dental
Clinic
KIA/KB
Clinic
Prescription
pharmacy
Done
General
clinic
Further
Examination
Laboratory
Result

7. Counter. The first place that
the patient attend when
Come to the health center
Before the patient choose what
Treatment do they want to get.
Firstly they have to do an
general check up

8. Dental clinic
Action Room

9. Immunization
(P2 Programme)

10. Patients can choose based on what they feel about
the service of Tabaringan health center

11. Doctor-Patient Interaction
■ Doctor and patient interact closely. The doctors treat patients kindly. The
doctors are very friendly.
■ For every actions that done by doctor towards patient, doctors always ask for
permission and also whether they are comfortable (hurt or not) during
examination, (informed consent)
■ Based on the interview we did on a patient, he said that the doctor is very
friendly. The doctors treat patient really well. As a result, the patients are
comfortable and satisfied with the service.
■ E.g. dr. Ella said that there was a patient who wanted to pay due to high
satisfaction.

12. ■ Based on our observation, there were some nurse who sometimes did not help
the doctor. The doctor seemed to work alone possibly due to there were so many
patients coming that day. As a result, these nurse did not accompany the doctor
in the room.
■ Based on an interview we did towards a nurse, she told us that the doctors were
sometimes very discipline but it is only for the development of the health care.
The doctors always give motivations to them so that they keep their good work
and to minimalize mistake to the patient.
Doctor-Nurse Interaction

13. Cont..
■ The doctor treats the nurse not as a sub-ordinate rather treats all
staff equally as the one who serve the citizens.
■ However, generally, there is a good communication between
doctor-nurse. The doctor is open-minded towards the nurse about
the health care. Mutual relation between doctor-patient seems
good and they look quite close.
Cont..

14. ■ The relationship between doctors is close.
■ The doctor educates all young doctors(coass) very well.
■ E.g. the head of the health center act as a good leader. She treats
all the doctor as a friend/collages not as a sub-ordinate.
Doctor-Doctor Interaction

15. General Clinic
■ Beneficence : the doctor has to do its job is to give the best service to the
patient.
■ Autonomy : the doctor have fulfilled to the patient autonomy, which has given
information to patient, although according to our observation the information
that is given is still lacking.
■ Nonmaleficence : doctor have fulfilled this priciple, namely to provide what is
best for the patient and notgive adverse effect to the patient
■ Justice : doctors also fullfilled this principle, that does not discriminate against
patients based on social, racial, cultural, and economic, except old or disabled
people who are prioritized so not required to queue

16. ■ Autonomy :
Based on the observation that we have done, the doctor in the dental clinic has
fulfilled the right of the patient that is to know about the information about the
patient’s disease. Because that is one of the patient’s right to have all of the
information of his/her disease.
Futhermore the final decision is in the patient it self, to do the suggestion from the
doctor or not.
■ Justice
The doctor to her/his patient don’t dicriminate the patients based on the social,
racial, etc. The doctor gave the same service to all of her patient.
Dental Clinic

17. cont..
■ Nonmaleficence
In our observation we can’t see an emergency situation. So we can’t tell you that
there is a priciple of nonmaleficence in the dental clinic.
■ Beneficence
The doctor in dental clinic do all of her best to give the treatment for the patient.
She try to give more benefit to the patient than the bad one. She give the
reference to the patient if she can’t to hadle the patient’s disease.

18. ■ Beneficence
1) Midwives have always tried to provide the best service, by trying to maintain a
state of vaccine
2) Trying to contact the family of a baby who does not come a time when the
baby is immunized
■ Autonomy
By explaining to patients about the KB’s tools that exist and also allow the patient
to make the decision to chose his/her own tool that he/she wants and is best for
him without intervening
■ Justice
Still provide the same service to all patients without discriminating patients
KIA/KB

19. CLINICAL ETHICS OF JONSEN,
SIEGLER DAN WINSLADE “FOUR
BOX”
■ Medical indication : Tabaringan Health enter had been fulfilled this aspect, because the doctor
had given the information about patient’s disease like indication, diagnosis, and prognosis
■ Quality of life : The quality of life is strongly related to the present and future conditions or
treatments of the patients. Like all health centers, Tabaringan Health Center is only a small
medical provider, only capable of treating minor injuries and providing consultation and
medication. Even so, nearly all the patients that we encountered were satisfied with the services
and treatments. Depending on the type of treatment they required, the patient’s quality of life
can vary greatly. Some needs medical attention while some don’t. The overall treatment was
also good. People who do get treated here are satisfied with treatments given by the doctors.
However, some patients sometimes needed further medical attention, but the health center only
have limited facilitiy to treat their diseases. Realizing this, they send these patients to counsel on
hospitals where the facilities are more advanced and complete.

20. Cont..
■ Patient preferrences : health officials have met this rule, because it has been fully devolved
health elections that will be taken by the patients themselves, but health officials suggest
only selecting the best treatment that should be taken by patients
■ Contextual features: during our observations, the decision to entrust the family medicine
doctor. later we also did not find any problems in the data source clinicians and nurses

21. Based on the observation we can conclude that the services provided
by the health centeris good enough. However, the behaviour of the
nurses needed improvement because they were lacking in discipline.
Besides informed consent given by the doctor is still lacking. The
employee who was in charge of the counter also needed disciplinary
because they were once late. Interms of amenities, it still must add
support facilities for patients. Because according to our observation,
the seating that is provided by the health center is still not enough to
accommodate the patients who come for treatment.
CONCLUSION

22. Thank You…