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Abstrak :
Skripsi ini membahas tentang tanggung jawab dan perlindungan hukum bagi perawat anestesi yang melakukan tindakan pembedahan tanpa didampingi oleh dokter spesialis anestesi. Anestesi merupakan tindakan yang sangat beresiko dan hanya dapat dilakukan oleh dokter spesialis anestesi. Namun terdapat pengecualian apabila tidak ada dokter spesialis anestesi atau berhalangan hadir, kewenangan tersebut dapat dilimpahkan dengan tetap berkoordinasi dan pemberian dosis sesuai dengan perintah dokter spesialis anestesi. Peraturan Menteri Kesehatan Nomor 18 Tahun 2016 tentang Izin Dan Penyelenggaraan Praktik Penata Anestesi mengatur bahwa pelimpahan wewenang tersebut dilakukan dengan cara mandat, karena tanggung jawabnya tetap berada pada pemberi mandat yaitu dokter spesialis anestesi. Sebagaimana kasus dalam Putusan Nomor 109/Pid.sus/2015/PN. Trt, seorang perawat melakukan tindakan anestesi dengan memberi dosis sesuai perkiraannya sendiri dan menghubungi dokter spesialis anestesi setelah tindakan anestesi dilakukan. Dengan menggunakan metode yuridis-normatif, penelitian ini bertujuan untuk menganalisis perbandingan kewenangan antara dokter spesialis anestesi dengan perawat anestesi serta tanggung jawab rumah sakit terhadap tindakan anestesi yang dilakukan tanpa didampingi dokter spesialis anestesi. Sedangkan deskriptif analisis adalah pelimpahan kewenangan yang dilakukan secara mandat dan tanggung jawab serta perlindungan hukum bagi perawat anestesi. Hasil penelitian yang diperoleh ialah segala tindakan perawat anestesi harus di bawah pengawasan dokter spesialis anestesi sebab pelimpahan wewenangnya secara mandat, mengakibatkan tidak berpindahnya tanggung jawab atas tindakan tersebut dan rumah sakit pun berkewajiban untuk mengawasi serta bertanggung jawab atas segala tindakan yang dilakukan oleh pekerja di rumah sakit tersebut.

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This thesis discusses the responsibility and legal protection of anesthetist nurses who perform surgery without being accompanied by an anesthetist.  Anesthesia is a very risky action and can only be done by anesthetists.  However, there are exceptions if there is no anesthetist or unable to attend, the authority can be delegated by continuing to coordinate and administer doses according to the anesthetist's orders.  Minister of Health Regulation No. 18 of 2016 concerning Licensing and Implementation of Anesthesia Management Practices stipulates that the delegation of authority is carried out by means of a mandate, because the responsibility remains with the mandate giver, namely the anesthetist.  As is the case in Decision Number 109 / Pid.sus / 2015 / PN.  Trt, a nurse performs anesthetic action by giving the dose according to his own estimation and contact an anesthetist after the anesthesia is performed.  By using the juridical-normative method, this study aims to determine the comparison of authority between anesthetist and anesthetist nurses and hospital responsibilities for anesthetic actions carried out without the anesthetist's specialist.  Whereas descriptive analysis is the delegation of authority which is carried out by mandate and responsibility as well as legal protection for anesthetist nurses.  The results obtained all the actions of anesthetist nurses must be under the supervision of anesthetist specialist because the delegation of authority in a mandate, resulting in no transfer of responsibility for these actions and the hospital is obliged to supervise and be responsible for all actions carried out by workers in the hospital.

Abstrak :
ABSTRACT
Tindakan anestesi merupakan tindakan yang berisiko tinggi, yang diberikan kepada pasien pada saat pasien akan menjalankan tindakan pembedahan. Dokter yang berwenang memberikan anestesi ialah dokter spesialis anestesiologi. Dalam memberikan pelayanan anestesi kepada pasien, dokter spesialis anestesiologi dibantu oleh perawat anestesi, dan berdasarkan Peraturan Menteri Kesehatan No. 31 Tahun 2013 apabila dokter spesialis anestesiologi berhalangan hadir, kewenangan dapat dilimpahkan kepada perawat anestesi secara delegasi. Namun dalam putusan nomor 109/Pid.Sus/2015/PN.Trt, perawat anestesi yang memberikan pelayanan anestesi kepada pasien tanpa adanya izin atau perintah dari dokter spesialis anestesiologi maka perawat anestesi tidak berhak melakukan tindakan anestesi. Dengan menggunakan metode yuridis-normatif, penelitian ini bertujuan mengetahui pengaturan kewenangan dan tanggung jawab hukum perawat anestesi dan dokter spesialis anestesiologi dalam tindakan pembedahan, serta deskriptif analisis pelimpahan kewenangan secara delegasi dari dokter kepada perawat dan  tanggung jawabnya di dalam putusan nomor 109/Pid.Sus/2015/PN.Trt. Hasil penelitian yang diperoleh ialah dokter spesialis anestesiologi berwenang untuk mengawasi dan mengatasi pelaksanaan pelayanan anestesi, perawat anestesi berwenang untuk melakukan pelayanan anestesi dengan berkolaborasi dengan dokter spesialis anestesiologi. Dalam pelimpahan kewenangan perawat bertanggung jawab langsung kepada dokter anestesi sebagai pelaksana. Dan dapat bertanggung jawab secara mandiri apabila bertindak diluar dari kewenangan yang dilimpahkan.

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ABSTRACT
Anesthesia is a high risk action which has delivered to patient while surgical procedure. A doctor who has authority to conduct anesthesia is named specialist of anesthesiology. To deliver the anesthesia services into patient, medical specialist of anesthesiology is accompanied by anesthesia nurse and refers to Minister of Health regulation Number 31 Year 2013; if medical specialist of anesthesiology is absent, his authority can be delegated to anesthesia nurse. Nevertheless, in verdict number 109/Pid.Sus/2015/PN.Trt, anesthesia nurse who delivers the services to patient without permission or command of medical specialist of anesthesiology, anesthesia nurse doesn`t have authority to deliver services. Hereby juridical-normative method, this research aims to know about the authority and accountability of anesthesia nurse and medical specialist of anesthesiology in surgical procedure, moreover descriptive-analysis is regarding the delegation of medical specialist of anesthesiology`s authority into anesthesia nurse and his accountability which stipulated in verdict number 109/Pid.Sus/2015/PN.Trt. The research outcomes are medical specialist of anesthesiology has the power to monitor and overcome anesthesia procedure and anesthesia nurse has authority to deliver anesthesia procedure by collaborating with medical specialist of anesthesiology. To delegate the authority, a nurse has to responsible directly into medical specialist of anesthesiology as executor, then he has to responsible individually outside authority which delegated by.

Abstrak :
Latar Belakang: Penelitian ini bertujuan menentukan efek dari pemberian Oksigen Hiperbarik (OHB) sesi tunggal, terhadap kadar plasma Malondialdehyde (MDA) pada perawat yang mengalami kelelahan di RS. X. Metode: Penelitian ini adalah randomized double-blinded controlled trial pada 30 orang perawat RS X yang terdefinisi mengalami kelelahan berdasarkan kuesioner JIFRC (Japan Industrial Fatigue Research Committee). Subyek dirandomisasi, dibagi menjadi 15 orang di kelompok kontrol (menghirup udara biasa pada tekanan 1 ATA) dan 15 orang di kelompok intervensi (menghirup oksigen hiperbarik, pada tekanan 2,4 ATA, menghirup O2 100% selama 3 x 30 menit, dengan interval udara biasa selama 5 menit). Sampel darah untuk menentukan kadar plasma MDA, diambil sebelum dan 1 jam setelah perlakuan, dengan metode TBARS (Thiobarbituric Acid Reactive Substances). Hasil: Nilai rerata kadar MDA sebelum perlakuan dan sesudah perlakuan, 3,42 ± 1,05 nmol/mL dan 3,63 ± 1,34 nmol/mL (p=0,623), sedangkan pada kelompok intervensi, berturut-turut, 3,50 ± 1,12 nmol/mL dan 3,50 ± 1,24 nmol/mL (p=0,990). Nilai rerata Δ MDA (selisih individual nilai MDA sebelum dan sesudah perlakuan), antara kelompok kontrol dan intervensi, berturut-turut, 0,08 ± 1,05 nmol/mL dan - 0,13 ± 1,77 nmol/mL (p=0,692). Kesimpulan: Walaupun tidak terdapat hasil bermakna pada penelitian ini, namun dapat kami temui adanya kecenderungan penurunan kadar MDA pada kelompok intervensi yang dibandingkan dengan kecenderungan kenaikan kadar MDA pada kelompok kontrol. ......Background: This study aimed to determine the effect of HBO single session on Malondialdehyde (MDA) plasma level for nurses with fatigue at Hospital X. Methods: This study is a randomized double-blinded controlled trial, on 30 fatigue nurses from Hospital X in Jakarta, defined by JIFRC (Japan Industrial Fatigue Research Committee) Questionnaire. Subjects randomized into 15 nurses in each group (control vs intervention). Control group was given atmospheric air (21% O2) under 1 ATA pressure, while intervention group was given 100% oxygen, for 3 x 30 minutes, under 2.4 ATA pressure, with 5 minutes interval-break inhaling compressed air (21% O2) in between. Blood sample for determining MDA plasma level, were sampled before- and 1 hour aftertreatment, using TBARS (Thiobarbituric Acid Reactive Substances) method. Results: MDA plasma levels before- and after-treatment in control’s group, were consecutively, 3.42 ± 1.05 nmol/mL and 3.63 ± 1.34 nmol/mL (p=0,623), while in the intervention’s group, respectively, were 3.50 ± 1.12 nmol/mL and 3.50 ± 1.24 nmol/mL (p=0,990). Δ MDA (individual MDA value differences between after and before treatment) means, in control’s and intervention’s group was compared, subsequently they were 0,08 ± 1,05 nmol/mL and - 0,13 ± 1,77 nmol/mL (p=0,692). Conclusions: Even though, there is no significant differences, between the two groups in MDA plasma level, there is propensity of MDA plasma level decrease in intervention group, compared with raising MDA plasma level in the control group.