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"Ruang lingkup pelaksanaan program residensi adalah pencapaian kompetensi klinis dan penerapan peran ners spesialis dalam praktik keperawatan lanjut. Proses ini dilaksanakan dengan penerapan pendekatan teori Keperawatan Virginia Henderson pada sistem onkologi, penerapan Evidence Based Nursing terapi musik mengurangi nyeri kanker, dan penerapan inovasi protokol ERAS pada pasien mastektomi dan tiroidektomi di RSUP Cipto Mangunkusumo Jakarta. Pendekatan teori virginia Henderson sangat cocok diterapkan dalam memenuhi kebutuhan pasien dengan keganasan yang kompleks karena bersifat komprehensif dan holistik mencakup kebutuhan fisik, psikologis, sosial, dan spiritual. Penerapan evidence based nursing terapi musik menunjukan bahwa terjadi penurunan nyeri setelah diberikan terapi musik. Inovasi ERAS protokol menunjukan terjadi penurunan jumlah hari rawat dan berkurangnya komplikasi pasca bedah. Disarankan kepada perawat agar lebih mengembangkan penggunaan pendekatan teori Virginia Henderson dalam memenuhi kebutuhan pasien yang holistik dan menjadikan terapi musik sebagai alternatif pilihan dalam mengurangi nyeri kanker serta mengembangkan ERAS protokol pada pembedahan mastektomi dan tiroidektomi.

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The scope of the implementation of the residency program is the achievement of clinical competencies and the application of the role of specialist nurses in advanced nursing practice. This process was carried out with the application of Virginia Henderson's Nursing theory approach to the oncology system, the application of Evidence Based Nursing music therapy to reduce cancer pain, and the application of innovation to the ERAS protocol in mastectomy and thyroidectomy patients at Cipto Mangunkusumo General Hospital, Jakarta.

The Henderson virginian theory approach is very suitable to be applied in meeting the needs of patients with complex malignancies because it is comprehensive and holistic including physical, psychological, social, and spiritual needs. The application of evidence based nursing music therapy shows that there is a decrease in pain after being given music therapy. The ERAS innovation protocol shows a decrease in the number of care days and a reduction in postoperative complications.

It is suggested to nurses to further develop the use of Virginia Henderson's theoretical approach in meeting patients' holistic needs and making music therapy an alternative choice in reducing cancer pain and developing ERAS protocols for mastectomy and thyroidectomy surgery."

"Fokus perawatan kanker stadium akhir yaitu memenuhi kebutuhan fisik, psikologis, sosial, dan spiritual untuk megurangi penderitaan pasien menuju kematian yang bermartabat. Tujuan perawatan paliatif yaitu kenyamanan dan sesuai dengan prinsip asuhan keperawatan paliatif. Keberanian dan pengabdian perawat memenuhi kebutuhan yang kompleks ketika pasien sekarat dan menghadapi kematian menjadi pengalaman unik bagi perawat paliatif. Pengalaman yang unik ini di eksplorasi menggunakan pendekatan fenomenologi deskriptif. Delapan perawat paliatif terlibat sebagai partisipan. Hasil wawancara di analisis menggunakan metode Collaizi. Hasil analisis data penelitian diperoleh enam tema yaitu: asuhan perawatan paliatif di rumah dilakukan diluar pekerjaan utama di rumah sakit, keluarga menganggap peran perawat paliatif sama dengan caregiver, perawat paliatif lebih fokus menangani pemenuhan fisik dan psikologis pasien, Perawat paliatif lebih dominan melakukan kolaborasi untuk mengatasi nyeri dan tindakan edukasi dan motivasi untuk menangani masalah psikologis, Memberikan asuhan menjelang ajal dan kematian sesuai standar operasional prosedur keperawatan menjelang ajal, Tantangan dalam pengambilan keputusan tindakan perawatan paliatif. Direkomendasikan agar meningkatkan layanan menjadi keperawatan paliatif spesialis, meningkatkan pendidikan dan pelatihan perawatan paliatif serta pengaturan kebijakan layanan keperawatan paliatif dalam sistem pelayanan kesehatan nasional.

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The focus of end stage cancer care is to meet physical, psychological, social, and spiritual needs to reduce the suffering of the patient to a dignified death. The goal of palliative care is comfort and in accordance with the principles of palliative care nursing. The courage and dedication of nurses fulfills a complex need when the patient is dying and facing death becomes a unique experience for palliative nurses. This unique experience is explored using a descriptive phenomenology approach. Eight palliative nurses were involved as participants. The results of interviews in the analysis using Collaizi method. The results of the research data analysis obtained six themes, namely care palliative care at home conducted outside the main work in the hospital, the family considers the role of palliative nurse same with caregiver, palliative nurse more focus on handling physical and psychological fulfillment of patients, palliative nurse more dominant to collaborate to overcome pain and educational action and motivation to deal with psychological problems, Providing upturn and death care according to operational standards of dying nursing procedures, Challenges in decision making palliative care measures. It is recommended to improve services to palliative specialist nursing, improve palliative care education and training and palliative care policy setting in the national health care system."