Analysis of Work Stress, Burnouts, Emotional Intelligence of Organizational Commitments and Nurse Performance of Hermina Hospital Tangkubanprahu Malang

In hospital services, nurses are most vulnerable to stress because they are related to mental safety. Nurse performance is the main factor in determining the success of hospital services. This research design uses explanatory, namely explaining the direct and indirect effects between variables. Research population 135 nurses with precision = 5%, sample (n) of 101. Sampling technique using Probability Sampling, independent variables: Job Stress, Burnout and Emoisonal Intelligence. dependent variable: Organizational Commitment and Nurse Performance. The result of testing the total effect is greater than the direct effect, so the accepted hypothesis shows that the variable organizational commitment can mediate the work stress variable on nurses' performance with a total of = -0.386, the organizational commitment variable can mediate the work fatigue variable on the nurse's performance dg total = -0.280, the commitment variable organizational intelligence can mediate the emotional intelligence variable on the performance of the woman with a total = 0.395. The career success paradigm from Intelligence Quotient (IQ) to Emotional Quotient (EQ) proves that emotional intelligence makes a greater contribution to success and achievement in the workplace compared to intellectual intelligence.


INTRODUCTION
The hospital is one of the health service delivery units with an open system and always interacts with its environment to achieve a dynamic balance with the main function of serving the community for 24 hours and prioritizing excellent health services. The most important role of health services is the assurance of the quality of health services, which means that it is in accordance with the expectations and needs of patients so that it is expected to provide quality health services and pay more attention to the interests of patients. A nurse is inseparable from setting working hours which is better known as shift work.
Shift work can play an important role in human problems that can extend to sleep disturbances, physical and psychological health problems as well as social and family life disorders. Nurses are the workforce that is most susceptible to stress because in addition to having to interact directly with patients and their families in a long time, nurses also have characteristics of a task or work environment that is complex, and sometimes is related to the safety of a person's soul. The high work demands on nurses will be vulnerable to stress. Stress that arises and lasts continuously has the potential to cause anxiety in employees. On the other hand, nurses generally do not have adequate knowledge about the importance of managing and controlling stress that occurs to them. So far, nurses consider the problems that occur to be resolved by themselves and try to avoid the causes of stress they are experiencing. Boredom, absenteeism, irritability, insomnia, increased mistakes and so on are symptoms of work stress as stated by Robbins (2015: 309).
Symptoms of work stress include behavioral, physical, and psychological symptoms, this can affect the nurse's commitment in carrying out their duties and the nurse's performance. Stress can cause a person to feel unhappy, aloof, irritable, and as if he no longer has self-control. This will lead us to a static state that has a negative impact on decreasing various levels of productivity so that aspects of life become chaotic. Work stress can be something positive or negative for a job, it depends on the level of work stress itself. If there is no work stress, there will be no job challenges and low performance. There is an increase in work stress, performance tends to increase, because work stress can help individuals explore their potential to overcome job challenges. This is a healthy stimulus because it encourages nurses to respond to existing challenges. On the other hand, the level of work stress that continues to increase along with the maximum ability in daily work, the work stress that occurs tends not to have an impact on progress. In fact, if the work stress continues to get higher, there will be a decrease in performance. Murali et.al (2017) in their research found evidence that work stress as measured by time pressure, role ambiguity, high workload and lack of motivation jointly affect employee performance. The results of the study partially show that time pressure and role ambiguity have a significant and negative effect on employee performance, and two other factors, namely high workload and lack of motivation, do not have a significant effect on employee performance. Furthermore . sNurses are often faced with conditions of trying to save patients, doing routine tasks, crowded work spaces, large numbers of patients, and must act quickly in dealing with patient needs. The large number of patients being treated and the increasing variety of diseases are work stressors for nurses, work stressors that cannot be adapted and last for a long time with high enough intensity are called burnout (Novita, Budi and Nurcholis. 2011). Schaufeli & Greenglass (2001) stated that Burnout is a collection of symptoms that arise due to the use of energy that exceeds one's resources, resulting in physical, emotional and mental fatigue. Suharto (2007) emphasized that burnout is closely related to stress. Burnout is a reaction to a very stressful situation (stress). This term is closely related to terms such as alienation, indifference, apathy, cynicism, pessimism, physical and mental exhaustion, or tension. (Schaufeli & Greenglass, 2001) Maslach et al., (2001 said that burnout is a multi-dimensional definition. He said, burnout is a psychological syndrome consisting of three dimensions, namely: (1) emotional exhaustion, (2) depersonalization, and (3) low personal accomplishment. He explained that work that is oriented to serving others can form an "asymmetric" relationship between the provider and the recipient of services. Someone who works in the service sector will provide attention, service, assistance and support to clients or patients. Rehman and Janjua (2015) in their research found evidence that burnout has a negative impact on sales staff performance. Sales staff performance is affected by the level of fatigue they face. Furthermore, Gorji (2012) in his research also found evidence that high work fatigue experienced by employees such as emotional exhaustion and depersonalization had several negative effects on employee performance. This means that employee performance decreases due to increased emotional exhaustion, depersonalization. According to Mangkunegara (2013: 28) that the causes of work stress and burnout include work demands that are felt to be too heavy, urgent work time, low quality of work supervision, an unhealthy work climate, inadequate work authority related to responsibilities, and work conflict.
Surya (2013: 76) states that emotional intelligence has a big role in achieving more meaningful work results. A person who has high emotional intelligence is able to control his intellectual potential so that it can manifest in meaningful success. Emotional intelligence is the ability to feel, understand and effectively apply emotional power and sensitivity as a human source of energy, information, connections and influence. (Goleman, 2002) With this ability, a person is able to know who he is, control himself, motivate himself, empathize with the surrounding environment and have social skills that can increase the quality of a person's understanding of performance, because the implementation of his duties is based on his own awareness.
Performance achievement is determined only about 20% of IQ, while 80% is determined by emotional intelligence (EQ). Therefore, if the leader hopes to achieve maximum performance, he must be able to seek human resource development by increasing emotional intelligence. With emotional intelligence, a person is able to understand himself and others correctly, has an identity, is not jealous, is not hurt, does not hate, does not resent, does not have excessive guilt, is not anxious, is not easily angry, and is frustrated. A person is expected to be able to manage their emotions by understanding and relating them to the situation at hand so that they can have a positive impact (Mangkunegara, 2013: 93) Khanzada et.al (2018) in their research found evidence of employee emotional intelligence as a determinant factor in determining employee performance. Correlation results and linear regression analysis show that there is a significant positive relationship between emotional intelligence and employee performance. Furthermore, Gunu and Oladepo (2014) also found evidence of a significant relationship between employee emotional intelligence and organizational commitment and performance. Gorgi et al (2015) in their researchers found different evidence where there is no significant relationship between Emotional Intelligence and the performance of hospital managers. Nurses are part of the hospital organizational system which has a strategic role in achieving hospital goals, therefore the nurse's commitment to the organization is an important variable that needs attention to be studied. Commitment to the organization can be seen from the ability of nurses to adapt to their environment, the existence of a high sense of trust in the place of duty, participation in decision making, and high loyalty and discipline. Organizational commitment is the attitude of a person's nurse at the hospital which relates one's identity with the organization. Commitment is the strength of the individual in identifying himself with the organization and his involvement in organizational tasks. Kaplan & Kaplan (2018) examined the Relationship between Organizational Commitment and Performance in Manufacturing Companies in Turkey. The results of this research have a positive and significant effect on performance. On the other hand, normative commitment has no significant effect on performance. In addition, this study also shows that continuation commitment has no significant effect on performance. Nurses who have prolonged work stress and burnout will have an impact on low organizational commitment, so that the higher the work stress and burnout experienced by employees, the lower the organizational commitment. This means that work stress and burnout experienced by nurses can affect the nurse's perception of the harmony between the goals and values of the individual and the organization. However, the existence of emotional intelligence possessed by individuals will be able to manage prolonged stress and burnout.
Based on the results of previous research related to variables that affect performance, it can be identified the variables that are determinants of performance, namely, job stress, emotional intelligence burnout and organizational commitment. This study tries to re-examine the influence of variables, job stress, burnout, emotional intelligence and organizational commitment. on employee performance, because it is based on the fact that empirical evidence about the influence of these variables on employee performance shows inconsistencies or contradictions in empirical findings. This inconsistency shows evidence of what is described by experts as incompleteness theory, mainly relating to factors affecting performance. The inconsistent results of previous research also motivated the authors to re-examine work stress, burnout, emotional intelligence and organizational commitment to performance in one research model. The aim is to contribute to the treasury of empirical findings in an effort to test explanatory models of theory and test the consistency of previous findings.

MATERIALS AND METHODS
The research method used is an explanatory or explanatory research type that aims to explain the effect of Job Stress, Burnout and Emotional Intelligence on Nurse Performance through Organizational Commitment. Hypothesis testing with Path analysis to determine the direct and indirect influence between the variables of Job Stress, Burnout and Emotional Intelligence on Nurse Performance through Organizational Commitment.
The population in this study were all nurses at the Hermina Tangkubanprahu Hospital. which numbered 135 people. To determine the number of samples, the researcher used the formula from Slovin, the level of precision was set at = 5%, the number of samples (n) for nurses was obtained at 101.The sampling technique used is Probability Sampling (sampling based on the probability of each element). Probability Sampling is a sampling method by providing the same probability or opportunity for each element of the population selected as the sample by randomly selecting the sample.
The sampling technique used is probability, in this study, using the validity test with the product moment method. If the correlation coefficient is known, then then compare the results of the calculation correlation coefficient with the correlation coefficient contained in the table. If the value of the calculated correlation coefficient is greater than the correlation coefficient in the table at a certain alpha, it is said to be significant so that it can be concluded that the question is valid, whereas if the calculated correlation coefficient is smaller in the table then the instrument is declared invalid. The criteria applied are the calculated correlation coefficient greater than the table at the significant level ∞ = 0.05, if the correlation coefficient is greater than the critical value, the tool is said to be valid. Rebility test: if the reliability of the calculated instrument is greater than the reliability of the table instrument, then the data used is realistic, on the other hand, if the reliability of the calculated instrument is smaller than the reliability of the instrument table, the data used is not realistic. A research instrument is said to be realistic if the alpha value is> or = 0.6 Ethical Approval: 1924/KEP/IV/2020

RESULTS
The results of the pathway test of the effect of work stress on the performance of nurses show that the estimated path coefficient is -0.311 and t count -10.539 at the significance level = 0.000. The results of empirical testing are sufficient evidence to accept the hypothesis that job stress has a significant effect on nurses' performance, the path coefficient is significant negative, indicating that an increase in job stress will reduce the performance of nurses. These results indicate that job stress is a determining factor for nurse performance.
The result of the path test of the effect of burnout on the nurse's performance shows that the estimated path coefficient is -0,260 and t count is -13,417 at the significance level = 0,000. The results of empirical testing are sufficiently evident to accept the hypothesis that work fatigue has a significant effect on nurse performance, the path coefficient which is significantly negative indicates that an increase in work fatigue will decrease the performance of nurses. These results indicate that job loss is a determining factor in the performance of nurses The results of the path test of the influence of emotional intelligence on the performance of nurses show that the estimated path coefficient is 0.357 and t count is 11.370 at the significance level = 0.000. The results of empirical testing are sufficient evidence to accept the hypothesis that emotional intelligence has a significant effect on nurses' performance, the path coefficient is positive and significant, indicating that increased emotional intelligence will improve nurse performance. These results indicate that emotional intelligence is a determining factor for nurse performance.
The results of the path test of the effect of work stress on the organizational commitment of nurses show that the estimated path coefficient is -0.296 and t count is -9.114 at the significance level = 0.000. The empirical test results are sufficient evidence to accept the hypothesis that job stress has a significant effect on nurses 'organizational commitment. The path coefficient is negative and significant, indicating that an increase in work stress will reduce nurses' organizational commitment. These results indicate that job stress is a determining factor for the organizational commitment of nurses. The results of the path test of the effect of work fatigue on nurses' organizational commitment show that the estimated path coefficient is -0.080 and t count -2.871 at the significance level = 0.004. The results of empirical testing are sufficient evidence to accept the hypothesis that job fatigue has a significant effect on nurses' organizational commitment. The path coefficient which is significantly negative indicates that the increase in work fatigue will decrease the organizational commitment of nurses. These results indicate that job loss is a determinant of the nurse's organizational commitment. The results of the path test of the influence of emotional intelligence on nurses' organizational commitment show that the estimated path coefficient is 0.151 and t count is 3.422 at the significance level = 0.000. The results of empirical testing are sufficient evidence to accept the hypothesis that emotional intelligence has a significant effect on nurses 'organizational commitment.
The path coefficient is positive and significant, indicating that increased emotional intelligence will increase nurses' organizational commitment. These results indicate that emotional intelligence is a determining factor for nurses' organizational commitment. The results of the path test results of the influence of Organizational Commitment on the performance of nurses showed that the estimated path coefficient was 0.254 and t count was 3.778 at the significance level = 0.000. The results of empirical testing are sufficient evidence to accept the hypothesis that organizational commitment has a significant effect on nurse performance. The path coefficient is positive and significant, indicating that an increase in organizational commitment will improve nurse performance. These results indicate that Organizational Commitment is a determining factor for nurse performance The relationship between the exogenous variables of emotional intelligence has a direct effect on the endogenous variable of nurse performance by 0.357. While the indirect effect through Organizational Commitment has influence value of = 0151 x 0.254 = 0.038. The effect of total work fatigue on nurse performance through organizational commitment = 0.357 + (0.038) = 0.395. Thus the total effect is greater than the direct effect, the hypothesis is tested or accepted. This suggests that organizational commitment variable capable of mediating variables of emotional intelligence on the performance of nurses. The results of path analysis of direct and indirect effects of work stress variables,

DISCUSSION
This study combines the results of several studies which varies by examining the effect of 3 independent variables at once, Khanzada et.al (2018) in their research found evidence of employee emotional intelligence as a determinant factor in determining employee performance. Correlation results and linear regression analysis show that there is a significant positive relationship between employee emotional intelligence and employee performance. Surya (2013: 76) states that emotional intelligence has a big role in achieving more meaningful work results. This implies that intellectual intelligence alone does not provide full guarantee for success, but it needs to be supported by emotional intelligence optimally. Gorgi et, al (2015) in their researchers found different evidence where there is no significant relationship between emotional intelligence and manager performance.
In this study, it was found that organizational commitment as an intermediate variable is the variable that connects the 3 independent variables, namely work stress, burnout and emotional intelligence with performance. These results indicate that the relationship between the exogenous variables of emotional intelligence has a direct influence on the endogenous variables of performance, but the effect is smaller than the indirect effect (total effect) by using the connecting variable, namely organizational commitment. Thus the total effect is greater than the direct effect, the hypothesis is tested or accepted. This shows that the variable organizational commitment is able to mediate the variables of job stress, burnout and emotional intelligence on nurse performance, which is different from previous studies.

CONCLUSION
In general, it can be ignored from the results of research which show that job stress, work level and intelligence affect organizational commitment and performance. The specific conclusion is that nurses do not experience significant stress in carrying out nursing tasks or outside nursing duties, this shows that nurses do not feel work risk when carrying out existing tasks and nurses are able to handle workloads well and have good time management. Nurses have good emotional intelligence, nurses are able to manage their emotions both in themselves and in maintaining their relationships with patients, colleagues, and with the patient's family.
Nurses have a high commitment to the institution in the sense that they are related to the institution so that they are willing to accept everything and are willing to continue to serve in the institution. Nurses have carried out nursing duties well, nurses have high discipline at work, nurses have good attitudes and behaviors in carrying out their duties, always carry out tasks in accordance with hospital procedures and carry out nursing activities/care according to procedures set by the hospital. Based on research and empirical conditions, it can be stated that job stress, work emotions and intelligence affect the performance of nurses. The meaning of this finding indicates that empirically job stress, work level and emotional intelligence are the determining factors in organizational commitment and nurse performance at Hermina Tangkubanprahu Hospital, Malang.
The results showed the effect of Organizational Commitment on the performance of nurses, this shows that the performance of nurses in carrying out nursing tasks is determined by the emotional attachment of nurses to members of the institution or work, nurses are emotionally attached to institutions who are willing to accept everything and are willing to serve and work at home. ill both the shade and the institution on it. Organizational commitment that is able to mediate the influence of Job Stress, work violence and emotional intelligence on the performance of nurses. The meaning of these findings shows empirically that the stressful conditions of nurses, increased work and intelligence in managing their emotions both on themselves and in maintaining relationships with other people and patients do not necessarily improve nurses' performance in carrying out nursing tasks, but through increasing the nurse's emotional attachment to members of an organization or job or institution as well as an attachment to the institution and a willingness to accept all risks first