Expanding Nursing Roles: A Phenomenological Study in Indonesian Primary Health Care

Abstract

Background: Providing nursing care is the primary responsibility of nurses working at Primary Health Centers (Puskesmas). However, in practice, they are often assigned additional roles such as treasurer, procurement officer, or quality assurance personnel positions that are not always aligned with their educational background in nursing. This mismatch of roles may lead to an increased workload, reduced focus on patient care, and elevated psychological stress. This study aims to understand the lived experiences of nurses in Puskesmas as they navigate the demands of both their core nursing roles and additional administrative responsibilities.

Methods: This study employed a qualitative descriptive approach with a phenomenological design. Data were collected through in-depth interviews, observation, documentation, and focus group discussions involving 12 participants from four Puskesmas. The data were analyzed through data reduction, presentation, and verification. 

Results: The study identified eight key themes: mismatch of additional tasks, dual workload, psychological pressure, limited training, work beyond official hours, minimal rewards, self-initiated strategies, maintained professionalism, and expectations for equal task distribution. Supportive management policies are needed to ensure fair task allocation and relevant training. 

Conclusion: While both main and additional task are perform adequately, overlapping duties have caused various impacts on nurses with non-nursing additional roles and the institutions involved.