Nurse PerformanceThrough Motivation and Work Discipline on Productivity (Case at a Hospital in DKI Jakarta)

This study examines the influence of factors related to the performance of hospital nurses in DKI Jakarta. These factors include motivation, work discipline which then in this study functioned as an independent variable and productivity as an intervening variable that affects the performance of nurses who functioned as a dependent variable. This research was conducted by quantitative research methods. This research was conducted by hospitals in DKI Jakarta in August – December 2022. The population in this study was hospital nurses in DKI Jakarta as many as 400 respondents. The instrument in this study is a questionnaire consisting of 40 questions. Based on the results of research from 400 respondents there is a direct and significant influence between motivation and work productivity which is 3,847%, there is a direct and significant influence relationship between work discipline and productivity which is 8,936%, there is a direct and significant influence between motivation and nurse performance which is 4,599%, there is a direct and significant relationship between work discipline and nurse performance which is 8,936%, There is a significant relationship between productivity and nurse performance which is 13.834%, there is a direct and significant influence between motivation and productivity through nurse performance which is 2.340%, %, there is a direct and significant influence between discipline and productivity through nurse performance which is 2.641%.


I. INTRODUCTION
The development of hospitals initially only provided certified healing (curative) services to patients through inpatient care.Furthermore, hospitals due to advances in science, especially medical technology, increased income and public education.Health services in hospitals today are not only curative but also rehabilitative.Both services are integrated through health promotion efforts (promotive) and prevention (preventive).

Nurse PerformanceThrough Motivation and Work Discipline on Productivity (Case at a Hospital in DKI Jakarta)
The hospital is a unique and complex organization because it is a labor-intensive institution, has special properties and characteristics and functions in the process of producing medical services and has various professional groups and patient services.In addition to carrying out the functions of public health services, hospitals also carry out educational and research functions, hospitals today are no longer only in charge and function only limited to medicine (curative) as well as prevention (preventive) of disease but has increased to promotive and rehabilitative functions.Performance is a real effort given by each individual or group in accordance with their role to the hospital.Good nurse performance is the expectation of all patients.Mention that performance is the result of work in quality and quantity achieved by a nurse in carrying out her duties in accordance with the responsibilities given.This happens as a consequence of community demands on the need for excellent service or high-quality service.The performance of nurses is measured by the services provided to patients, so that patients feel satisfied or dissatisfied.(Tungga Dewi et al., 2018) (Gutterman, 2022) The performance of nurses is an important aspect in hospitals, because this is what will determine the progress or retreat of the hospital.Nurses become an inseparable part of the hospital, if the nurses perform poorly then what happens is decreased.The quality of services provided by nurses given to the image of the hospital becomes poor, and the performance of nurses becomes a benchmark for the success of health services that shows the accountability of service institutions within the framework of good hospital service governance.
Nurse performance appraisal is a form of guarantor of the quality of nurse services, .A good nurse performance appraisal is not only seen from the results she does, but also seen from the nurse's process in completing her work.Nurse performance appraisal is carried out once a year by their superiors to see the quality of nurses in order to improve the image of the Hospital.(Salminen et al., 2021) The following is presented a table of performance assessment of Hospital nurses in 2022 based on the results of an initial survey, hospital researchers in DKI Jakarta found that there are still many complaints from patients and families of internal and external patients about the performance of hospital nurses, where the standard for performance appraisal is 90% (good).1. Above, it can be concluded that in 2022 elements of performance assessment of hospital nurses in DKI Jakarta are still in the sufficient and good category for elements of discipline, responsibility, cooperation, self-direction, emotional control are in the good category with the number of percentages above 50% each while the empathy element is in the good category assessment with a percentage of 46.77%.Thus, it needs some efforts that must be made by management in improving the performance of hospital nurses for the better, especially for empathy.Based on the above, the formulation of the problem to be expressed is: How is it affected immediately and indirect motivation and work discipline on nurse productivity that has an impact on the performance of hospitals in DKI Jakarta

II. LITERATURE REVIEW
Motivation is the drive to act on a series of processes of human behavior taking into account the direction, intensity, and perseverance on the achievement of goals.Motivation is needed so that nurses have enthusiasm in doing an assigned job.If the employee's needs are not met, the employee will show disappointed behavior.Conversely, if his needs are met, the employee will show happy behavior as a manifestation of his satisfaction.The main benefit of motivation is to create work passion, so that work productivity increases, while the benefits for employees themselves are that those completed must be in accordance with the standard rules that apply within a specified period of time.In addition to motivation, this study also used work discipline variables.Good work discipline reflects the magnitude of a person's sense of responsibility towards the tasks assigned to him.Work discipline problems are very important in all activities carried out by every employee, especially in an effort to improve work improvement and the quality of work results.Saying discipline is a rule that is done firmly and strictly.Work discipline is a tool used by managers to communicate with employees so that they are willing to change a behavior and as an effort to increase awareness and willingness to obey all company rules and social norms.(Rahmah et al., 2021) ; (Ichlapio, 2020) Nurse as a highly disciplined hospital employee means that the nurse must obey all the rules in the hospital, both written and unwritten and does not avoid sanctions if she violates the duties and authorities given to her, so as to increase the productivity of nurses' work.
The existence of work delays outside the norm can be used as a factor of the decline in nurse work discipline which is generally caused by a lack of responsibility for their work, such as laziness or leaving the place.While work productivity is not solely aimed at getting as much work as possible, but the quality for work is also important to note, as it is determined that individual productivity can be assessed and what the individual does in his work.In other words, employee work productivity is how someone carries out their work or performance.Work productivity is a comparison of the effectiveness of output (achievement of maximum performance) with the efficiency of one of the inputs (labor) which includes quantity, quality in a certain time (You et al., 2021) By What was said above, then work productivity basically includes a mental attitude that always has a view of life today must be better than yesterday and tomorrow must be better than today.Such an attitude will encourage a person not to be satisfied quickly, but to develop himself and improve work skills in a way that always seeks improvements and improvements in work.The relationship between employees and organizational leaders is reflected in the joint efforts between organizational leaders and employees to increase productivity through quality control circles and evaluation results on superior work.This includes the skill level, which is determined by education, and the skills in supporting his work.
Performance is the ability of an organization to maintain its objectives by using resources effectively and efficiently.This ability is an achievement that has been achieved by these employees accumulated into a work achievement.Performance can be used as a criterion for an authorized employee selection and development program.While appraisals can identify performance and assess how high employee participation is in meeting their performance appraisals.The quality of work indicates friendliness, thoroughness, interrelation of the results of work by not neglecting the volume of work.Good quality work can avoid the level of errors in the completion of a job that can be beneficial for the progress of the organization.To encourage performance, there needs to be motivation which is a factor that encourages someone to do a certain activity, therefore motivation is often interpreted as a driving factor for one's behavior.Every activity carried out by a person must have a factor that drives the activity, therefore, the motivating factor of a person to do a certain activity is generally the needs and Nurse productivity Discipline Performance Motivation desires of a person, motivation is closely related to the performance of an individual.(Naibaho, 2021) ; (Hartiti et al., 2020) ; (Tungga Dewi et al., 2018) ( Urus et al., 2019) shows that there is a significant positive relationship between discipline and nurse work productivity.The results of research conducted by that work discipline has a positive and significant effect on nurse performance.In the study) said stated, nurse productivity has a significant effect on the performance of the company received.If there are units or individuals of organizational employees who do not have high productivity, then the task of the leader is to provide motivation, (Suwaldiyana, 2021) (Jeffrey & Dinata, 2017) Training, and so on to the officer.
The frame of mind in this study is to know or test whether there is an influence of motivation and work discipline on work productivity and its impact on the performance of hospital nurses in DKI Jakarta.The framework is a synthesis of theoretical reviews that reflect the relationship between the variables studied and is a guide for solving research problems and formulating hypotheses.).

III. METHODS
The population in this study are hospital nurses in DKI Jakarta.The research conducted is research that explains the causal relationship between independent variables (discipline and motivation) and dependent variables (productivity) and (performance).This study focused on the relationship between research variables and examined the certainty of the influence of discipline and motivation on nurse performance productivity.
In research methodology based on, the dependent (endogenous) variable is often referred to as the output variable, criterion, and is often referred to as the dependent variable.The dependent variable is a variable that is influenced or which is the result of the independent variable, the dependent variable used in this study is performance (Y).While the intervening variable, that is, the variable theoretically affects the relationship between the dependent variable and the independent becomes an indirect relationship.Independent variables are variables that are often created as stimulus, predictor, antecedent variables, also referred to as independent variables.An independent variable is a variable that affects or causes changes or arises dependent variables.The independent variables in this study were discipline (X1), motivation (X2).(Sugiyono, 2016) (Gujarati & Porter, 2009) Model path analysis used to analyze the pattern of relationships between variables with the aim of determining the direct or indirect influence of a set of independent variables (exogenous) on the dependent variable (endogenous).Path analysis is used to analyze the pattern of relationships between variables with the aim of determining the direct or indirect influence of a set of exogenous variables on endogenous.Using 2 (two) structural models, namely: (Liu et al., 2019;Streiner, 2005) Structure of other variables that were not studied or mismeasurement of variables.

IV. RESULTS
In accordance with the formulation of problems aimed at proving the correlation of motivation, discipline to nurse performance through productivity.The following is an explanation of the stages of statistical testing processed using SPSS 25, obtained results to calculate the direct influence of numbers in the Beta column.Here's how to calculate direct influence, is as follows: a) Effect of motivation variable on performance X1 to Y = 0.410 b) The effect of discipline variables on performance X2 to Y = 0.638 c) Effect of motivation variable on productivity X1 to Z = 0.314 d) The effect of discipline variables on productivity X2 to Z = 0.610 e) Effect of performance variables on productivity Y to Z = 0.776 To calculate indirect influence by means, it is as follows: The effect of motivational variables on performance through productivity: PXZ x PZY = (0.314 x 0.776) = 0.243 The influence of discipline variables on performance through productivity: PXZ x PZY = (0.610 x 0.776) = 0.473 To calculate the total influence by the way, it is as follows: 1) The effect of motivational variables on performance through productivity: PXZ + PZY = (0.314 + 0.776) = 1.09 2) The effect of discipline variables on performance through productivity: PXZ + PZY = (0.610 + 0.776) = 1.386 The calculations for all influence paths are complete, therefore a path diagram will be created for the Path Analysis model as shown below: Based on the results of the analysis and discussion that has been carried out, the researcher made the following discussion: The results of the t test show that the calculated t value of 3.847 (motivation X1) is greater than t table 1.984 and the significant value of 0.000 (motivation X1) is smaller than 0.05.So that the motivation variable has a direct and significant effect on employee productivity.Motivation is seen as a positive effort in mobilizing, mobilizing, and directing the power and potential of the workforce, in order to productively succeed in achieving and realizing the goals set earlier.Thus, it can be concluded that motivation affects productivity.Motivation appears as a positive effort in moving, mobilizing, and direct the power and potential of the workforce, in order to productively successfully achieve and realize the previously set goals.Results of research conducted by (Sureka et al., 2020).Thus in accordance with previous researchers that motivation affects productivity.Discipline is a growing force in the employee body and causes employees to adjust voluntarily to regulatory decisions and high values of work and behavior.Discipline is a management activity to carry out organizational standards.(Mihalca et al., 2021) (Suwaldiyana, 2021) (Jeffrey & Dinata, 2017) The main goal of labor discipline is to increase efficiency as much as possible by preventing waste of time and energy.Work discipline tries to prevent damage or loss of property, machinery, tools and work equipment caused by carelessness, joking or theft.shows that there is a significant positive relationship between discipline and nurse work productivity.Based on the results of statistical tests showing that using the Pearson Product Moment the relationship between discipline and nurse work productivity is known that the probability value (p = 0.000) < sig_a = 0.05.Productivity is the relationship between the outputs or results of the organization of required inputs.Productivity can be quantified by dividing output by input, increasing productivity can be done by improving productivity ratios, by producing more output or better output by a certain level of resource input.(Sureka et al., 2020) (Sui et al., 2019) Nurse productivity has a direct effect on performance of 0.77.This is acceptable according to the research.Work productivity in nurses is a variable that can improve the performance of nurses in hospitals in DKI Jakarta.(Ojo et al., 2018)

V. CONCLUSION AND SUGGESTION
Based on the results of the analysis and discussion that has been carried out, researchers can draw the following conclusions:

Table 1 .
Hospital Nurse Performance Assessment in 2022