Implications of Nursing Clinical Practice to The Student ’ s Spiritual Health

This study aimed to clarify the implications of Nursing Clinical Practice (PLKK) to the spiritual health of STIKES Bali students. This study employed purposive sampling method to determine the number of respondents. To conduct this study, the fourth grade of nursing students were recruited as the sample with total number 136 respondents. A questionnaire about spirituality from World Health Organization (WHO) was used in this study as the instrument. In addition, the data were analysed by using quantitative descriptive technique. The result showed that 50.0% of students had a very good spiritual health, 42.6% had good spiritual health, 6.6% had moderate spiritual health, and 0.7 % had poor spiritual health. It can be interpreted that spiritual health of nursing students of STIKES Bali is good after conducting Nursing Clinical Practice. Thus, this study can be concluded that Nursing Clinical Practice has implication to the ability of students to love themselves and others meaningfully as the evidence of students’ spiritual health.


INTRODUCTION
Spiritual health in health education is an integrated part to form professional health workers in accordance with international standards.Nurses have an important role in improving the quality of public health.Nurses are required to appear professionally while providing nursing care and able to establish cooperation with various parties to provide services provided comprehensive and can meet basic needs, including the needs of bio, psycho, socio, and spiritual clients [14].
Nursing services provided to the public must meet international quality standards, which can be ensure the safety and the comfort of clients and their families.Nurses are required to perform professionally when providing nursing care and able to establish cooperation with various parties to provide services comprehensively and able meet basic needs, including the needs of bio, psycho, socio and spiritual clients [15].
The health is justly as a pyramid which could divide into three parts: physical, mental and spiritual.A complete health comprised the satisfactory state of physiological, psychological and spiritual needs.The current students enjoy the high quality of material life with the noble clothes and the delicacy, but their spiritual life are vanity [3].
As an effort to achieve academic ability, in accordance with the expected competence, the students of STIKES Bali are given the opportunity to Nursing Clinical Practice (PLKK).PLKK is a process by which students practice to improve nursing skills.Through the implementation of the nursing process, students are expected to be able to conduct assessment, planning, implementation and evaluate and do documentation in meeting with bio-psycho-social-spiritual health problems.
Empirically the students make contact with the patient so that in both personality and skills able to develop.As the real cases in practice areas that concern with various aspects of nursing will have implications for students, one of them is in the aspect of spiritual health, whereas students as a prospective nurse as a professional health worker has greater opportunity to provide comprehensive nursing care by helping clients meet their basic holistic needs.Students also have the ability to view clients as bio-psycho-sociocultural and spiritual beings, so indirectly the interaction also affects the personality and skills of students, one of them is in the aspect of spiritual health.
From the philosophical, theoretical, and empirical backgrounds of this study, this research becomes very important.This is because PLKK is one of the processes in nursing education so that students are able to apply knowledge and skills in the form of nursing care as well as one of the factors that can build the spiritual health of the students.

METHODS
This study employed descriptive quantitative design.The sample were determined through purposive sampling technique.The sample in this study were the fourth grade of nursing students of bachelor program at Institute of Health Sciences Bali who have done PLKK IV with 136 respondents.The data were collected by using the instruments of spiritual health questionnaires from WHO.Data were then analysed by using quantitative descriptive technique.The category of spiritual health of students after PLKK IV was grouped into four categories, those categories were very good, good, enough and less

RESULTS AND DISCUSSION
Nursing Clinical Service and its implication for student's spiritual health was carried out in STIKES Bali and conducted on the students of bachelor of nursing program academic year of 2016/ 2017 who had implemented PLKK IV.From the total population of 206 students, the sample of the study was taken using the sampling formula to obtain a sample of 136 students.Implications of nursing clinical service on the spiritual health of STIKES Bali students were presented with 32 statements.Based on the results of the research above, it could be shown that 50.0% of nursing students of grade IV had excellent spiritual health and 42,6% had good spiritual health after PLKK IV.Kozier et al [3] states that because spirituality was a reflection of internal experience (inner experience) that was expressed individually, then spirituality presents from many aspects in human beings such as religion, belief, hope, transcendence and forgiveness.Spirituality is one that influenced by culture, development, life experiences of trust and value of life.Spirituality could bring love, trust, and hope, see the meaning of life and nurture relationships [12].The ability to love others and self was meaningfully the evidence of spiritual health.Establishing a relationship with the great, life, or value was one way of developing spirituality.Health of healthy spirituality was something that gave peace and acceptance about self and it was often based on a lasting relationship with the Supreme God.Spiritual health was achieved when one found a balance between the value of life, the purpose of life, the belief system, and one's relationship with oneself or others.

CONCLUSION
Based on the discussion above, it could be concluded that there are 50.0% of students have excellent spiritual health, 42.6% have good spiritual health, 6.6% have adequate spiritual health, and 0.7% have inadequate spiritual health after the implementation of PLKK IV.This research is expected to be the basis for Bali STIKES to evaluate the implementation and improve the implementation process of Nursing Clinical Practice.PLKK could be received well and receive good perception among students therefore it could be improved in accordance with the development of the world of health and education.In addition, research on Nursing Clinical Practice in next research should be developed with input and review from other variables so that the improvements in the implementation of PLKK could be improved.

Table 1 .
Implications of nursing clinical practice on spiritual health Student Grade IV in Bachelor of Nursing ProgramThe category of spiritual health of the students after the PLKK is categorized into four, that is very good, good, enough and less.The categories are shown in Table2.

Table 2 .
Category of spiritual health of fourth grade students of bachelor of nursing after PLKK IV