ENGLISH COMPETENCE NEEDED BY NURSING STUDENTS AT BAITURRAHIM VOCATIONAL HIGH SCHOOL JAMBI

The research aimed at finding out the English competence needed by nursing department students during the course of their studies as well as in preparing themselves for their future work as nurses at the international level. The competence needed by the students and nurses-to-be was then used as the basis for designing the English material to be proposed to and adopted by the curriculum at Baiturrahim Vocational high School Jambi. This research took place at the Baiturrahim Vocational high School Jambi. The research was descriptive qualitative in nature. This study used interviews and observations to collect the data to answer the research questions. The source of data was sixteen nursing students, one teacher and the headmaster. The results of the data analysis indicated that there were ten main competencies to acquire by nursing students to function properly in the nursing profession. The competencies included giving explanation of the escort of basic treatment, giving the health counseling, giving the explanation of the escort of pathology and its treatment, translating the data collection, medical record and report data, executing the basic treatment, using communication skills in a healthcare, approaching to the patient, listening, questioning and diagnosing, giving explanation and advice, and communicating in term of involving patient in management. The ten basic competencies were then used as the bases in designing the syllabus for the Nursing Department students. The type of syllabus chosen was competence-based one. The syllabus stated the competency standards, basic competencies along with their indicators, list of teaching materials

theoretical review discusses three major points.They are communicative competence, English for Specific Purposes (ESP), and syllabus design.The first discussion starts with communicative competence needed by nursing department students based on the needs.The discussion on communicative competence comprises their development and elements as well as their roles in learning.The second discussion is on the program for learners having specific purposes in learning English.The program to be discussed in the English for Specific Purposes (ESP).
ESP also serves as the background of this study since the English for nursing department students is part of it.The discussion on ESP talks about the origin, definition, criteria, categorization, and components.The last part discusses syllabus design within which the English competence-based syllabus design, need analysis as the bases for finding the English competence needed and designing a syllabus and the steps in syllabus development are reviewed.Finally, all the discussion reviewed will be compiled within a framework provided in the second subchapter.In this research aims at describing the English competence needed related with communication activities performed by nursing department students in English learning activities and the graduate students in their future work.The required competences are needed in order to perform those international communication activities successfully.
Thus its basic purpose is that of enabling the students to function adequately through the medium of English both in the classroom and in the work setting.Austin (1976) stated that nurse is a health care professional who is engaged in the practice of nursing.Nurses are men and women who are responsible (along with other health care professionals) for the treatment, safety and recovery of acutely or chronically ill or injured people, health maintenance of the healthy, and treatment of life-threatening emergencies in a wide range of health care settings.To support their responsibilities for doing treatment, a nurse need a communication activities and competences in order to maintain a good relationship to other people.
Learning English in the nursing department is not an easy task since the students were not accustomed using English in their previous formal school.Teachers are easy to be trapped as the only learning 'models'.In this condition, a learning process will be boring if students are only as 'good spectators' and 'listeners' without an interactive communication.This class will produce passive students, and this is contradictory to the language learning principle; be active, more practices.Passive students are also the effect of the class-learning situation when the teacher takes much more place in class.Krashen (1985) acknowledges that two-way interaction is a particular good way of providing comprehensible input because it enables the learners to obtain additional contextual information and optimally adjusted input when meaning has to be negotiated because of some communications problem.The learners who are accustomed to being taught English exclusively in their mother tongue may at first be uncomfortable if the teacher speaks to them in English expecting them not only to understand but also to respond.Making an effort to get the gist and using strategies to interpret, express, and negotiate meaning are important to develop their communicative competence.
Baiturrahim is the name of The Health Science Vocational High School in Jambi, this school has established the Enrichment of English subject for nursing students in every grade of clases, so that the students get the English subject for 3 years taught into 6 (six) semesters.In English syllabus, the core courses consist of listening, reading, writing and speaking, which are divided into 8 sub materials.The four main courses can be synergized, therefore, it is hoped that the courses can bring real benefits to English competency for students.According to that purpose, the main priority and priority scale to the materials which are given according the real needs of the students.
In order to perform the communication activities in English, the nursing department focuses on cognitive language proficiency and discipline specific language competency for nursing, where communicative and socio-linguistic competences in the area of specialization are paramount.The belief is that linguistic competence alone (i.e.knowledge of grammar and doing grammar exercises without reference to use and function) is not enough to guarantee or automatically lead to the ability to communicate.The Baiturrahim Vocational High School also tries hard to wean the students from the "giving or receiving the lesson" condition by preparing them to educate themselves, monitor their own work and invent their individual strategies for learning.It engages them in procedures of converting items of knowledge into actualized communicative behavior from knowing to functioning, emphasizing that what students learn in English is transferable to all areas of the curriculum.
The efforts of institution to build and increase the English Competence for the students ideally get the positive respond from the students in order to get the purposes which are hoped by the institution.But the students can have the different perspectives.Therefore, the need of English competence from the students' perspective is interesting to be studied.And to specify the scope of the study, applying English for specific purposes is suitable for this case.Hopefully, the research result can provide valuable information and give stimulus for further research.

B. METHOD
The research was descriptive-qualitative method.The qualitative method is a research procedure that results a descriptive data in the form of written words or statements from people and behavior observed.Qualitative method obtains the descriptive data in the form of written words or statements from people and behavior observed (Bogdan dan Taylor, 2000:3).

Data collection
It is carried out by searching for the required data on various types of data and forms of data in the field, then carrying out data recording in the field.

Data Reduction
After the data has been collected, the next step is to reduce the data.According to Sugiyono (2011) this means summarizing, choosing the main things, focusing on the important things, looking for themes and patterns and discarding unnecessary ones.Thus the data that has been reduced will provide a clearer picture, and make it easier for research to conduct further data collection and look for it if needed.meaning and the possibility to draw conclusions.4. Withdrawal of Conclusions (Verification).After presenting the data, the next step is drawing conclusions or verification based on data reduction which is the answer to the problems raised in the study.In this study using source and technique triangulation, source triangulation is conducting interviews with several informants with the same questions.
Qualitative methods interpreted a better understanding of the complex reality of a given situation and the implications of quantitative data.Although the findings from qualitative data can often be extended to people with characteristics, similar to those findings in the study of population, gaining a rich and complex understanding of a specific social context or phenomenon typically takes precedence over eliciting data that can be generalized to other geographical areas or populations.In this sense, qualitative research differs slightly from scientific research in general.In this study, the phenomena observed, was the approach used by teacher, in teaching English as communicative competence at nursing students at Baiturrahim Vocational High School.This research was concerned with English competence for nursing students in their communication activities both in their study and in the work setting for their international relationship.The discussion of a syllabus design which need analysis as the bases for finding the English competence needed.The nature of the research data of this research was qualitative data.The data were descriptive because the obtained data described the nursing competencies related with the successfully perform nursing competencies in term of communicative competence.The students need to improve their communicative in English by joining the language course; therefore, the nursing students are able to successfully perform their competencies activity in order to maintain their international relationship and communication.The data were investigated and generated from the participants' answer on the interview and the result of observation activity.Source of data used in this research was the nursing department students', which were argumentative ones, and the documentation.
The types of needs were used to answer the first research question.The nursing department students' needs on which teacher had given English materials.Those needs, then, were analyzed to know the types of needs for the nursing department students' needs.Documentation was done by analyzing the documents, files, and other types of documents whish relevant to the research topic, and it is a technique of data collection that is done by searching documents, files, and references that relevant with the theme of research.
Document was a research method applied to writers in visual materials for the purpose of identifying specific characteristics of materials.The analyzed materials can be textbooks, newspaper, speech, TV program, advertisements, musical composition, or any other types of documents" (Ary et al 2002: 420).
Based on the result study, the researcher got some relevant documents such as the profile of the Vocational School of Baiturrahim and English syllabus.Those documents were necessary analyzed for some purposes as follows; a.
to give the general description about the profile of its school b.
to know the direct materials in English subjects given to the students Data verification needed to check the data compatibility from the informants with relevant documents.The result of needs analysis serves as the basis of the syllabus design for answering the second research question.The process of syllabus development in language teaching involve assessing needs of learners in a languages program, developing goals and objectives, planning a syllabus, selecting teaching approaches and materials, and deciding on assessment procedures and criteria (Richards & Renandya, 2002).

Interview
The first instrument employed in the current study was the interview.An Interview was an interview applied deeply and intensively toward the informants in order to dig the data deeply and widely.Interview was not applied strictly and stiffly, but by giving questions which progressively focus on the problems; therefore, the information could be gathered deeply.
According to Miles and Huberman (1992: 24), interview was an interview applied deeply and intensively for getting the data deeply and widely from participants.In this research context, interview guideline was as the main instrument used, and has functioned for digging the primary data from the informant based on the social situation of research data and from their point of view.
According to Kvale (1996: 11), as cited in Cohen et.al (2000: 267), interview was an interchange of views between two or more people on a mutual interest and emphasized on the social situation of research data.It also enabled participants to discuss their interpretation of the surroundings and express how they saw situations from their point of view.
The interview applied in this current research was personal interview.One of the most important aspects of this interview was its flexibility.The interviewer had the opportunity to observe the participants and the situations in which they were responding.Questions could be repeated or the meaning could be explained in case the participants did not understand them.
Furthermore, the interviewer could also press for additional info when a response seemed incomplete in which the interview was held in face-to-face setting (Ary et.al, 2002: 382).
The strategy used in conducting the interview was interview guide approach to the students of Nursing Students at Baiturrahim Vocational High School, the teacher, and the headmaster, in which the topics and issues discussed were specifically outlined.The interview guide contained a number of questions and the questions were used to dig the data needed based on the research problems.Every question can develop in such a manner, based on the deepness and broadness data wanted.The interviewer decided the sequence and the wording of the questions.By using this strategy, the comprehensiveness of the data would be improved and the data could be collected systematically.In addition, gaps of the data gathered could be anticipated.
In its application, the researcher made preparation for interview, asked for permission, made time schedule for conducting the interview, and finally conducted the interview with the students of Nursing students at Baiturrahim Vocational High School, the teacher, and the headmaster.In the interview process, the researcher asked some questions for digging the data related with the English existence, based on the research problems.

Observation
Observation was a technique of collecting data done by observing the phenomena happened in research setting, related with the research problems.By applying the observation technique, it was expected that the complete description and the whole object observed could be gathered.
In this current research, firstly, the researcher made the preparation before doing the observation, then asked for permission to the institution, then made time schedule for conducting the observation, and finally observed some aspects related with the research problems, such as observed the classroom, learning process, library, and language laboratory.
In order to find the complete and well organized data, the researcher did series of activities as an effort to obtain the intended answers.The researcher did observation at Nursing Students at Baiturrahim Vocational High School to find the answer the first research problem, by describing the programs that engaged the activities, which provide a good atmosphere in learning process for the students.Some of the things observed were about the teaching technique, learning activity, and learning media that were used and applied.The other aspects were observed such as the supporting facilities in learning English materials, like classroom, and the language laboratory.The researcher also conducted the observation of the resources or references in the form of literary books in library, and the internet education web sites.
Those activities were needed for some reasons as follows; a.
To know the effort of improving the communicative competence of Nursing Students at Baiturrahim Vocational High School b.
To know the compatibility between the objectives of improving communicative competence of students with the policies taken for supporting that achievement c.
To know the students' enthusiasms in improving the communicative competence.

C. FINDINGS AND DISCUSSION
In order to answer these problems, this chapter is divided into two main sections.They are English competence for nursing students' in term of communicative competences activities and syllabus development.English competence for nursing department students' in term of communicative competences activities.The result of English competency for nursing students in term of communicative competence activities.The data were obtained by means of interview investigation and observation.
process in a hospital, patient can feel comfortable and safe in a ward, and create the customer's satisfaction.When they give the explanation of the escort of basic treatment, they performed some language functions.

Giving the health counseling
The competence standard in giving the health counseling able to communicate, spoken, and written, by the use of proper and acceptable field, tenor, and mode of the language which concern with giving the health counseling.In giving the health counseling in nursing activities performed correlated with the communication service in a process of interaction with patient, family, and other officers in giving explanation in order to give a communication guidance standard in a treatment unit of hospital and give the explanation of the escort of basic treatment such as the ethics treatment to accomplish clear information about giving treatment, handling miscommunication of information or service to the patient, family, and other officers, the concept of human being and create the customer's satisfaction.When they give the health counseling in nursing activities, they performed some language functions.

Giving the explanation of the escort of pathology and its treatment (CPD3-
`The competence standard in giving the explanation of the escort of pathology and its treatment was able to communicate, spoken, and written, by the use of proper and acceptable field, tenor, and mode of the language which concern with giving the explanation of the escort of pathology and its treatment.In giving the explanation of the escort of pathology and its treatment performed as a process of interaction with patient, family, and other officers in doing medical/nursing treatment such as explaining the types of disease for mother/family planning (KB) and its treatment, types of internal disease and its treatment, types of surgical disease and its treatment, types of psychiatry and its treatment, and the treatment of health soul.The purposes are to accomplish clear information about giving treatment, handling miscommunication of information or service to the patient, family, and other officers, giving instructions on discharge, giving advice on lifestyle, health promotion or risk factors, and create the customer's satisfaction.When they give the explanation of the escort of pathology and its treatment activities, they performed some language functions.

Translating the data collection, medical record and report data
Translating the data collection, medical record, and report data activities is the process of with patient, family, and other officers in assisting the doctor's visit, and filling data to medical record.The competence standard in translating the collect data, medical record and report data was able to communicate, spoken, and written, by the use of proper and acceptable field, tenor, and mode of the language which concern with translating the collect data, medical record and report data.Those activities are performed to give the service in a ward, deliver information to the patient as long as the process of treatment, give the service so that the patient can feel comfortable and safe in a ward, and create the customer's satisfaction.When they translate the collect data, medical record and report data, they performed some language functions.

Executing the basic treatment
Executing the basic treatment is a process of interaction with patient, family, and other officers in order to use communication skills in executing the basic treatment, such as explaining the basic concept of treatment action, conservancy of individual hygiene and environmental, accomplishment of oxygen requirement, accomplishment of nutrition requirement, dilution and electrolyte, inclusive of sonde requirement (installation of infuse and transfusion), accomplishment of elimination requirement, accomplishment feel safe and convenient requirement, accomplishment of requirement activity, medicines requirement, emergency action, treatment of client of terminal and corpse treatment, and summarize and clarify understanding, and create the customer's satisfaction.The competence standard in executing the basic treatment was able to communicate, spoken, and written, by the use of proper and acceptable field, tenor, and mode of the language which concern with executing the basic treatment.When they execute the basic treatment, they performed some language functions.

Listening, questioning and diagnosing
The communicative competence in listening, questioning and diagnosing is a process of interaction with patient, family, and other officers in order to ensure the nurse has understood the patient's symptoms/problem and concerns and summarize and clarify understanding.The competence standard in facilitating electrolyte and liquid needs listening, questioning and diagnosing was able to communicate, spoken, and written, by the use of proper and acceptable field, tenor, and mode of the language which concern with listening, questioning and diagnosing.When they do the listening, questioning and diagnosing activities, they performed some language functions.

Giving explanation and advice
Giving explanation and advice is a process of interaction with patient, family, and other officers.It has the purpose to enable the patient to understand the problem/situation, reassure appropriately, summarize and clarify understanding, and create the customer's satisfaction.
The competence standard in giving explanation and advice was able to communicate, spoken, and written, by the use of proper and acceptable field, tenor, and mode of the language which concern with giving explanation and advice.When they Give explanation and advice, they performed some language functions.

Communicating in term of involving patient in management
Communicating in term of involving patient in management is a process of interaction with patient, family, and other officers.It has the purpose to involve patient in management, execute the basic concept of treatment in medical action, conservancy of individual hygiene and environmental, accomplish feel safe and convenient requirement, and create the customer's satisfaction.The competence standard in communicating in term of involving patient in management was able to communicate, spoken, and written, by the use of proper and acceptable field, tenor, and mode of the language which concern with communicating in term of involving patient in management.When they communicate in term of involving patient in management, they performed some language functions.
In term of English competence for nursing was addressed in observation activity, individual or group lecturing sessions are developed around the course material in the Medical and Health Assessment courses.Each session is one a half hour long and focuses on a particular system of the body and medical treatment of patients.Prior to the session, the students listen to a taped report of one patient who exhibits a problem in the area to be discussed.For example, if the temperature, pulse and respiration (TPR) system are to be discussed, the condition.The taped report is similar to a verbal report a nurse might hear in a hospital.Since the student has already studied this material in the courses, s/he is expected to review the material and to compose an appropriate nursing note.
It is essential that the practicing nurses have the ability to take and record these signs accurately.This allows the student to review material prior to the next session.The student is also given a medical-terminology tape that consists of a speaker pronouncing a list of medical terms relating to the area that will be discussed during the next session, or the student is asked to complete the missing word(s) or blank spaces into appropriate word(s).The student also receives a written list of the same words so that he can read the words while listening to the tape.
Every lecturing session is divided into four exercises to cover the four areas of language.In the first exercise, the session deals with the listening skills of the student.In a hospital setting, an oral report is usually given about each patient.Frequently, this is a taped report that does not allow the listener any time to ask for clarification.To help develop this skill, a taped report of two or more patients is played.The first report presents a patient with a diagnosis that was discussed during the study session.The second patient introduces the system of the body that will be covered the following week.Several people tape these reports, allowing a student to practice listening to different voices, expressions, and speech patterns.The student is asked to take the report on a standardized form.This form has been created to use in an actual clinical setting.It allows the student the opportunity to listen to reports on several patients and to organize the data into a working format.After the tape is finished, the teacher looks at how much information the student is able to transcribe following the initial playing of the tape.It is then replayed as many times as necessary, until the student is able to comprehend the complete tape.The teacher also works with the student on differentiating "important" versus "unimportant" information.
The second exercise helps the student with his reading and verbal skills.The student is asked to read from the list of words that he has listened to on the tape.This exercise assists him with pronunciation and allows time for him to ask questions about the course material.This activity enhances both the comprehension and pronunciation of the words.
In the third exercise, the student's written skills are evaluated.The teacher helps the student correct the written nursing note.This helps him to learn the correct phraseology, grammar, and spelling for the nursing notes.The teacher enhances this part of the session by discussing other possible examples or descriptive terminology.For example, the teacher reviews all of the appropriate terminology for describing different types of drainage on a dressing.
The fourth exercise, the student's verbal skills are assessed.The student is asked to read aloud the nursing note s/he has written.This enables the teacher to listen for the correct pronunciation of each word.It also allows the student to ask for clarifications of pronunciation.Frequently, the student must repeat a word several times in order to be able to pronounce it correctly.After the student can pronounce all the words correctly, s/he rereads the complete nursing note.
At the end of each session, the project work for the next study group is assigned.The disease or body system that will "be covered is discussed.In the previous exercise, the student has listened to a taped report on one patient that represents the new material to be covered.

D. CONCLUSION
The student is expected to write a nursing note on this patient for the next session.The student is also given the medical terminology tape and list of words covering the new material.The student is expected to listen to and practice the pronunciation of those words that will be covered in the next session.This study was aimed to find the English competency needed by nursing department students related with the communication activities.There is one main research question to answer in this study.That is What are the communication activities performed in English by nursing students related with the communicative competences at Baiturrahim Vocational High School Jambi.The competencies in nursing in term of English communication were addressed explicitly in the interview and implicitly in the observation.The results of the data analysis indicated that there were ten main competencies to acquired by nursing students to function properly in the nursing profession.They included Giving the explanation of the escort of basic treatment, Giving the health counseling, Giving the explanation of the escort of pathology and its treatment, Translating the collect data, medical record and report data, Executing the basic treatment, Using communication skills in a healthcare, Approaching to the patient, Listening, questioning and diagnosing, Giving explanation and advice, and Communicating in term of involving patient in management.The ten basic competencies were then used as the bases in designing the syllabus for the Nursing Department students.The type of syllabus chosen was competence-based one.The syllabus stated the competency standards, basic competencies along with their indicators, list of teaching materials, suggested learning experience, time allotment, list of resources and media, and assessment