Legal Protection and Accountability of Nurses Performing Delegated Medical Actions in Remote Government Health Services

Authors

  • Deni Atmaja Universitas Islam Nusantara, Indonesia
  • Asep Sapsudin Universitas Islam Nusantara, Indonesia

DOI:

https://doi.org/10.54518/rh.6.1.2026.899

Keywords:

Delegation of Authority, Legal Protection, Legal Responsibility, Medical Actions, Nurses, Task Shifting

Abstract

In remote Indonesian islands with scarce doctors, nurses often perform physician-level medical procedures to maintain urgent patient care. These necessary actions expose them to legal risks if viewed as exceeding their authority. This study examines legal protection and accountability for nurses undertaking such tasks under government duties at a regional general hospital in a remote island setting. The research maps existing legal safeguards for nurses and the forms of responsibility they hold under Indonesian law. A qualitative study combined normative legal analysis with empirical field data from all thirty-six nurses, using questionnaires, interviews, observations, and document review. Descriptive analysis contrasted legal standards with actual practice. Nurses show reasonable awareness of basic legal foundations and hospital tools like standard operating procedures and delegated authority. However, delegation is frequently undocumented, competency checks are irregular, and understanding of dispute safeguards is limited. Accountability is well-defined across administrative, civil, and criminal levels, yet practical administrative support remains inconsistent. Stronger regional policies, regular legal training, mandatory written delegations, and accessible legal assistance are urgently needed to reduce vulnerability, build confidence, and ensure safer, more equitable healthcare in isolated areas.

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References

Anwar. (2021). Legal accountability of nurses in fulfilling their obligations based on the nursing code of ethics. Jurnal De Facto, 8(1), 1–16.

Asqar, M., Puteh, M. A., & Ngatwadi. (2024). The influence of credentials on the performance of nurses at the Dr. Zubir Mahmud Idi Regional General Hospital in East Aceh Regency. Public Health Journal, 1(3), 173–186.

Bakhtiar, M. Z., Rahman, S., & Busthami, D. S. (2022). Legal protection for patients against medical actions performed by nursing staff outside their authority. Journal of Lex Generalis (JLS), 3(4), 788–798.

Berlianti, A., & Purwanto, D. (2023). Legal responsibility of nurses who perform medical actions outside their authority based on Law No. 38 of 2014 concerning nursing. Doktrina: Journal of Law, 6(2), 151–163.

Chandra, T. (2022). Legal certainty of sale and purchase binding agreements as the basis for the transfer of certified land rights. Research Horizon, 2(6), 615–625.

Fibrini, D. (2024). Legal protection for health workers in performing medical procedures. Journal of Legal Studies, 5(1), 147–156.

Haryadi, T., Sumarno, & Risdawati, I. (2025). The importance of legal protection for medical and health workers in health service practice. Journal of Science and Social Research, 3(8), 4239–4245.

Hasibuan, A. A., & Sidi, R. (2023). Legal protection for nurses in carrying out nursing services in hospitals. Journal of Nursing, 7(1), 378–383.

Hasmita, D., Kuntardjo, C., Putra, M. D., Hari, I. P., & Tirta, J. (2025). Legal and ethical review of the delegation of authority between health professions in health care facilities. Tambusai Education Journal, 9(2), 13848–13853.

Hastuti, A., Syahrul, Arafat, R., & Yusuf, S. (2023). Factors affecting the implementation of clinical competence in nursing services: A scoping review. Journal of Nursing, 15(49), 587–600.

Herniati, & Ingratubun. (2021). The responsibility of nurses who perform medical procedures in the context of carrying out doctors’ duties at Jayapura Regional General Hospital. Ius Publicum Law Journal, 1(2), 126–146.

Huda, K., & Huda, M. K. (2021). Legal protection for nurses regarding the delegation of authority from doctors in performing medical wound suturing in hospital emergency rooms. Journal of Health Law and Ethics, 1(1), 98–121.

Irfan, M., & Andriyani, S. (2025). Legal protection regulations for independent nursing healthcare workers in health service facilities. Journal of Compilation of Law, 10(1), 266–270.

Mahaputri, A. A. I., Budiartha, I. N. P., & Dewi, A. A. S. L. (2019). Legal protection for the nursing profession in the practice of nursing. Journal of Legal Analogy, 1(3), 277–281.

Ministry of Health of the Republic of Indonesia. (2019). Ministry of Health Regulation No. 26 of 2019 concerning the implementation of Law No. 38 of 2014 concerning nursing.

Ministry of Health of the Republic of Indonesia. (2011). Minister of Health Regulation No. 2052 of 2011 concerning medical practice.

Ministry of Health of the Republic of Indonesia. (2013). Minister of Health Regulation No. 49 of 2013 concerning hospital nursing committees.

Mustafa, A. D. S., Maria, C., Yunus, S. M., Dharmasanti, R. P., Sukardi, A., Budi, R., & Subroto, A. (2024). Law as a control of social attitudes and behavior. Caraka Justitia Law Journal, 4(2), 138–153.

Nugroho, K. S., Mustofa, Z., & Aran, F. D. (2025). Legal responsibility of nurses for nursing malpractice: A case study focus on Wates Husada Hospital. Label: Law, Accounting, Business, Economics, and Language, 2(1), 136–143.

Pertiwi, B., Hariyati, T. S., & Anisah, S. (2020). Evaluation of the implementation of clinical authority of clinical nurses at the Jakarta Military Hospital. Journal of Hospital Accreditation, 2(1), 15–20.

Pramudito, D., & Widjaja, G. (2022). Legal responsibility in the delegation of authority between different health professions. Jurnal Cross-Border, 5(1), 365–384.

Purwanto, R., & Wijayanti, E. (2024). Nurses’ accountability to patients in hospitals from a civil law perspective. Cahaya Mandalika Journal, 5(2), 930–941.

Putri, R. A., & Mannas, Y. A. (2025). Legal protection for nurses in the delegation of health services authority based on Law Number 17 of 2023 on health (A study at Dr. Reksodiwiryo Padang Type III Hospital). Unes Law Review, 7(3), 1108–1121.

Republic of Indonesia. (2023). Law No. 17 of 2023 on health.

Republic of Indonesia. (2014). Law No. 36 of 2014 on health workers.

Republic of Indonesia. (2014). Law No. 38 of 2014 on nursing.

Republic of Indonesia. (2009). Law No. 44 of 2009 concerning hospitals.

Riasari, R. H. (2021). Legal protection against nurses on hospital based Law Number 38 of 2014 about nursing. Lex Generalis Law Journal, 2(10), 946–960.

Richard, T., Samosir, A., & Gultom, E. (2025). Constitutional analysis of the state’s responsibility in providing health services for citizens. Indonesian Education Journal, 6(5), 2297–2310.

Safitri, D. N., Prayogo, P., & Tuwaidan, H. (2025). Implementation of legal protection for patients in health services by medical personnel based on Law No. 36 of 2014 at Tondano1 Hospital. Lex Privatum Journal of the Faculty of Law, Unsrat, 15(2), 1–10.

Salsabilla, R. N., Asmaningrum, N., & Afandi, A. T. (2024). An overview of the role of nurse advocacy in patient care in the inpatient ward of Baladhika Husada Hospital, Jember Regency. Tambusai Health Journal, 5(1), 924–935.

Santoso, P. A., Irawan, A., Sumirat, A. G., Karno, A. L. S., & Putri. (2022). Legal accountability of nurses in nursing actions reviewed from the concept of sociological jurisprudence. Journal of Social Sciences and Education (Jisip), 6(4), 2571–2587.

Sudiyanto, H. (2019). Legal ethics and nursing. Mojokerto: Stikes Majapahit Mojokerto.

Tallupadang, E. D., Indrayati, Y., & Widyarto, D. (2016). Legal protection for nurses performing medical procedures in the course of government duties, particularly in relation to Minister of Health Regulations. Soepra Jurnal Hukum Kesehatan, 2(1), 17–29.

Triana, Y., Winarsi, S., Khairul, F., & Ningsih, N. (2023). Legal protection for nurses in hospitals based on Law Number 38 of 2014 concerning nursing. Journal of Education and Counseling, 5(2), 1938–1947.

Tutik, T. T., Hudi, N., Komaratih, E., Fatmariyanti, S., & Fricella, A. (2025). Legal protection for medical and health workers. PT Rineka Cipta.

Usman, S., Fitriani, A. D., & Simanjorang, A. (2020). Analysis of nurses’ compliance with the use of standard operating procedures (SOP) in nursing at the Subulussalam City Hospital Emergency Room. Indonesian Health Promotion Publication Media, 3(1), 137–142.

Wijaya, G. P., Rizki, M. C., & Sudja. (2025). Legal accountability for nurses who perform medical actions beyond their authority. Journal of Law, Humanities, 3(1), 272–288.

Yani, S., Alwy, S., & Nyorong, M. (2020). Legal protection for nurses in the delegation of authority in medical actions. Manarang Health Journal, 6(1), 8–15.

Yanto, S., Suhendro, & Yetti. (2023). Legal analysis of the legal responsibility of nurses practicing without a license based on Law Number 38 of 2014. Journal of Social Science Research, 3(2), 1–10.

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Published

2026-02-28

How to Cite

Atmaja, D., & Sapsudin, A. (2026). Legal Protection and Accountability of Nurses Performing Delegated Medical Actions in Remote Government Health Services. Research Horizon, 6(1), 351–362. https://doi.org/10.54518/rh.6.1.2026.899

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