The COVID-19 pandemic requires changing the learning system in health education institutions. Delayed laboratory practice makes students less skilled in providing nursing actions. This situation was exacerbated when students were required to conduct clinical learning in practical areas during COVID-19. Lack of knowledge and skills, anxiety about the health of themselves and their families, and the absence of an image of caring for patients directly become challenges. The methods case study focuses on articles conducted during clinical learning at the Regional General Hospital (RSUD) X in Jakarta. There were challenges and obstacles when students did clinical learning. Challenges a present internally and externally. Cooperation is needed from both the institution and the field of practice to assist and guide students. However, students must take the initiative and be critical to creating a gradual increase in skills followed by new things learned while in practice.

This study aims to describe nursing care for a hemorrhoid patient at the X Regional General Hospital (RSUD X) located in DKI Jakarta by describing the patient's management. The method used is a case study with a nursing process approach through interviews (anamnesis), observation, reviewing documents and analysis of problems. The results showed that the suitability of symptom signs between theory and the clinic, dominated by pain, was influenced by work history. Furthermore, two primary diagnoses are enforced according to the signs and symptoms that arise. The focus of the action was to minimize pain, but it was found that at the end of the evaluation, the pain had not been resolved because the prognosis for hemorrhoids had entered an advanced stage, requiring surgery. In conclusion, implementing nursing care has yet to be effectively carried out due to unequal work time and responsibilities. The primary key to treating hemorrhoids is to examine when things are different or uncomfortable in the anal area.  Keywords: Nursing Care, Hemorrhoids, Pre-Operation

Every citizen has the right to get comprehensive health services, but the current condition is that there are many complaints and dissatisfaction with health workers and health facilities. The purpose of writing this article is to provide an overview of the importance of creating quality health services through increasing accreditation culture. The method used through literature review. It was found from the results of the study of this article that the implementation of accreditation has not been cultured optimally, this is because some views of the accreditation process are momentum and technical in nature. Therefore this view must be changed, through improvements from various aspects. Things that can be done such as change together, commitment, creating a service focus on patient health and safety, and creating healthy hospital management.

Elderly people (elderly) experience a decrease in physical condition which affects the decline in activity, health and independency. Objective of this study to see an overview of the level of independency of the elderly in fulfilling the ability of daily activities (ADL). The research was conducted on the elderly at Tzu Chi Cengkareng Flat, West Jakarta during January-March 2022 with a survey method research design with a cross-sectional approach to 103 elderly people. Collecting data by direct interviews. Descriptive analysis to explain the characteristics of the independency of the elderly. The elderly in the Cengkareng Tzu Chi Love Flat are aged between 60-74 years, 97 people (94.2%), more than 75 years, 6 people (5.8%), female, 57 (55.3%) more than men. 46 (44.7%), more did not work 70 (68.0%) than those who worked 33 (32.0%) and had comorbidities, 62 people (60.2%) were elderly who had comorbidities. Of the 103 elderly, 101 (98.1%) had high independency and 2 (1.9%) had low independency. Conclusion  the elderly in the Tzu Chi Love Flat, are able to meet their daily needs without the help of other family members, more than 50% of the elderly are categorized as having high independency.