ORGANIZATIONAL CULTURE AND MOTIVATION INFLUENCE ON NURSE PERFORMANCE WITH ORGANIZATIONAL COMMITMENT AS A INTERVENING VARIABLE AT SATYA HOSPITAL

Organizations have specific goals, structures and interrelated goals and rely on human communication to coordinate organizational activities. Therefore, the organization expects employees to excel and create conducive situations and conditions so that employees do not experience boredom, boredom and laziness at work, leading to decreased performance. Human resources are essential for hospitals. Therefore, human resources must perform competently to achieve the hospital's vision and mission. The purpose of this study was to analyze the influence of organizational culture and motivation on the performance of nurses with organizational commitment as an intervening variable at Satya Negara Hospital, Sunter, North Jakarta. The sample used was 115 nurses. This research uses explanatory causality quantitative analysis with AMOS SEM quantitative method. The results showed that there was a significant influence of organizational culture and motivation on the performance of nurses through organizational commitment as an Intervening variable; There is no significant effect between organizational culture on organizational commitment; There is a positive and significant influence between motivation and organizational commitment; There is a positive and significant influence between organizational culture on nurse performance; There is a positive and significant effect between motivation on nurse performance; There is a significant influence between organizational commitment to the performance of nurses at the Satya

obtained, the conditions at this time indicate that nurses providing nursing care services tend to be dissatisfied.
Based on data, there was a decrease in BOR in 2020 from 32.57% to 22.10%. This low BOR percentage indicates a slow level of efficiency in-room use. This efficiency level can also be influenced by the services provided to patients, such as fast, responsive, and friendly hospital staff.
Regarding work motivation, when ten nurses were interviewed in depth (in-depth interview) randomly, 6 or 60% of them had decreased work motivation. The most dominant decreased work motivation include nurses who are still undisciplined, communication between nurses in patient care, there is no good cooperation between nurses if anyone wants to change services, lack of response time for nurses to patients, not enthusiastic about work, feeling more bored, and do not want or are lazy to attend training/training from the hospital, and nurses are worried about the new human resources, the problem is worried about career advancement opportunities.
Regarding organizational commitment, where as many as five nurses or 50%, indicated a lack of loyalty to the hospital, they felt that other hospitals were better and more attractive because they felt more concerned about the welfare of their employees. Sometimes there is a desire to resign. In addition, a preliminary survey with in-depth interviews with the Head of Nurses at the Satya Negara Hospital concerning organizational commitment. According to information from the Head of Nurses, nurses every month are absent from work every day due to illness or information. This is detrimental for hospitals, with many nurses who do not come to work, an obstacle for hospitals to provide excellent service to patients and increased costs due to overtime. Actions taken against nurses who are not disciplined are carried out by coachingNursing Committee (ethics), reprimand (from HRD) and warning letters.
Judging by the data where employees consist of medical personnel, medical support and general staff, the most significant outgoing employees occurred in the 2020 period, 76 people compared to 2020 employees, who were 53. Based on the results of direct interviews with several nurses who are still working, there are several reasons why many nurses leave or change jobs from this hospital, one of which is the problem of salary differences between old nurses and new nurses. Meanwhile, nurses have a more extended working period and have more experience. Another reason was getting a job offer at another hospital with a more attractive salary compensation or a better career path.
Regarding the organizational culture at the Satya Negara Hospital, the Head Nurse sees that there are still nurses who work in their work environment who feel less comfortable and calm in doing their jobs.
The primary approach used as the basis of this research uses the concept of human resource management. The main target of human resource management is to create a personnel empowerment system that can display the performance of nurses. The performance of nurses shows the level of ability of nurses to achieve results (outputs), especially in terms of quantity. Therefore, the performance of each nurse can be different. It can be high or low, depending on the persistence in carrying out their duties. In line  (2011) suggests that performance means changing and being profitable. In this context, performance is synonymous with improving quality, productivity, cooperation, initiative and responsibility.

A. Research design
This research will use a descriptive analysis research design using the explanatory causality quantitative analysis method.

B. Sampling and Sampling Techniques
The sample is part of the number and characteristics possessed by the population. The non-probability sampling technique used by the researcher is a purposive sampling technique. The definition of purposive sampling is a sampling technique with specific considerations on nurses at the Satya Negara Hospital, Sunter, North Jakarta. So the sample to be used is 127 nurses. The nurses studied were nurses who worked in outpatient and inpatient settings, not including nurses who worked in management C. Data collection technique The quantitative data collection method used in this study is the survey method, namely data collection techniques carried out by using questionnaires or questionnaires to reveal information or data from respondents. In this study, the measurement scale used is the Likert scale, as follows: SS: I Agree S: Agreed KS: Disagree TS: Disagree STS: Strongly Disagree D. Research Instruments 1. Independent Variable The independent variable or independent variable is a variable that affects or is the cause of the change or the emergence of the dependent (bound) variable. This study's independent variables were organizational culture (X1) and motivation (X2).

Intervening Variables
Intervening or intermediate variables theoretically affect the relationship between independent and dependent variables into an indirect relationship and cannot be observed and measured. In this study, the dependent variable is Nurse Commitment(Z).

Dependent Variable
The dependent variable is influenced by the data because there are independent variables. The dependent variable or the dependent variable is the variable that is influenced or becomes the result because of the independent variable. In this study, the dependent variable is nurse performance (Y).   Likert scale score 1-5 (favourable and non-favourable)

E. Validity and Reliability Test Results
Based on the table of the validity test results above, it consists of 51 statements, with a sample size of 30 so that the value of df = n-2 = 30-2 = 28. According to the calculation of the validity test results, most of the questions are declared valid because they have a value of r count > r table (0.306). Only a few questions were declared invalid because they had r count < r table.

F. Data analysis technique
The data obtained were then processed using SEM AMOS software.

Results and Discussion A. Demographic Data
BeBased on the distribution of the respondent's characteristic data, it was found that the number of male respondents was 14 nurses (12.2%) and female respondents 101 nurses (87.8%). In other words, female nurses provide the most services at the Satya Negara Sunter Hospital, North Jakarta.
BeBased on the distribution of data on the characteristics of respondents, totalling 115 respondents, the total distribution of characteristic data on respondents aged 21-30 years is 83 respondents (72.2%), those aged 31-40 years are 22 respondents (19.1%), and those aged 31-40 years are 22 respondents (19.1%). Aged 40-50 years amounted to 10 respondents (8.7%). In other words, nurses who provide services at the Satya Negara Sunter Hospital, North Jakarta, are mostly nurses aged 21-30 years.
BeBased on the distribution of data on the characteristics of respondents, totalling 115 respondents, it is obtained an overview of the last education level of the most dominant respondents to provide services at the Satya Negara Sunter Hospital, North Jakarta, then continued with the last education level of S1 respondents, as many as 26 nurses (22.6%).

B. Test Requirements Analysis
The next test is the Goodness of Fit test to see whether or not the research model is good. The test results the state that the model meets the assumption of Goodness of fit. Overall this model shows a good model. Referring to the opinion expressed by (Hair, Black, Babin, Anderson, & Tatham, 2010), the path model proposed in this study already meets the assumption of Goodness of Fit (good fit model).  The existence of the first indirect effect shows that organizational culture affects nurse performance, and organizational commitment as an intervening variable proved insignificant. This is indicated by the estimated value of -0.023 with a CR of -1.13 and a p-value of 0.258 (p-value >0.05).

C. Hypothesis test
The results of the second indirect effect test show that motivation affects the performance of nurses, with organizational commitment as an intervening variable proven to be significant. This is indicated by the estimated value of 0.044 with a CR of -2.21 and a p-value of 0.027 (p-value <0.05).
In the measurement model test, the Chi-square results are 0.001 (the value is small, so the simultaneous test is accepted), the degree of freedom is 1, and the probability level is 0.978> 0.05. Thus the first hypothesis, "H1 There is a positive and significant influence between organizational culture and motivation on nurse performance with organizational commitment as an intervening variable", is supported This shows that organizational commitment cannot mediate significant organizational culture on nurse performance. Thus, the stronger the organizational culture, the nurse's performance could be better through organizational commitment. Variable organizational commitment acts as a partial mediation between motivation and perceptions of nurse performance, meaning that motivation can affect nurse performance directly or indirectly through organizational commitment. Motivation and organizational commitment are essential factors in improving performance. High performance, influenced by motivation, causes employees to have a high organizational commitment. High motivation will encourage the growth of organizational commitment and result in more employees with optimal performance in the organization or company.
These results indicate that the organizational commitment variable acts as a mediation between organizational culture and motivation on nurse performance, meaning that organizational culture and motivation can affect nurse performance directly or indirectly through organizational commitment. Organizational culture, motivation and commitment are essential factors in improving nurse performance. High performance, influenced by organizational culture and motivation, causes employees to have a high organizational commitment at work. Organizational culture and high motivation will result in the growth of organizational commitment and result in more employees having optimal performance in the organization or company.
This is under research conducted by (Ariyani, Haerani, Maupa, & Taba, 2016) which found that organizational culture has a positive and significant effect on nurse performance. Organizational culture, work motivation, and environment also positively and significantly affect nurse performance through Job Satisfaction, Organizational Commitment and Organizational Citizenship Behavior (OCB). In addition, it was found that organizational culture, motivation and work climate have a positive and significant effect on Organizational Citizenship Behavior (OCB) through job satisfaction and organizational commitment. Similarly, job satisfaction has a positive and significant effect on the performance of nurses through Organizational Commitment and Organizational Citizenship Behavior (OCB). Besides that, (Saryadi, 2018) the results 1) Organizational culture and motivation have a significant positive effect on organizational commitment; and 2) organizational culture, motivation and organizational commitment have a significant positive effect on nurse performance. Based on the path analysis, it is known that the direct influence of culture on nurse performance is greater than the indirect effect through organizational commitment, so the direct path is chosen, and the direct influence of motivation on nurse performance is greater than the indirect effect of motivation on nurse performance than the indirect effect through organizational commitment.
Hariyanto, Indrawati & Muninghar (2021) found that organizational culture, commitment and work motivation had an influence on employee job satisfaction. Organizational culture, commitment, work motivation and job satisfaction influence employee performance. Organizational culture commitment and motivation indirectly significantly influence employee performance through job satisfaction at Asyiyah Hospital Bojonegoro. (Setiawan & Lestari, 2016) With research results, organizational culture has no positive or significant effect on performance. Organizational culture has a positive and significant effect on organizational commitment. Organizational communication is insignificant in performance. Organizational communication is insignificant in organizational commitment. Motivation has a positive but not significant effect on performance. Motivation has a positive and significant effect on organizational commitment, the work environment does not have a positive and significant effect on employee performance, and the work environment does not have a positive and significant effect on organizational commitment.

Influence organizational culture on organizational commitment.
The estimated value of organizational culture on organizational commitment is 0.011, the CR value is 1.295, and the p-value is 0.195 > 0.05, then H0 is accepted, and H2 is rejected, meaning that there is no significant positive and significant effect between organizational culture on organizational commitment. Based on the estimated value of 11% on organizational commitment, it can be concluded that organizational culture has no significant effect on organizational commitment. Some organizational cultures can be said to be strong while others can be said to be weak. All organizations have a culture, but not all organizations are equally strong in influencing the behaviour and actions of employees (P. Stephen . (Ndraha, 2005) reveals that a strong culture is an ideal organizational culture, widely adopted and conveyed, and the strength of culture affects the intensity of behaviour. This is in line with the opinion of (P. Stephen   (and Ndraha, 2005), which says that a strong culture is an organizational culture that is held more intensively (its values are embedded the more fundamental and solid), the more widely it is embraced (the more members of the organization who adhere to it), and the clearer it is. Disseminated and inherited. The stronger the culture, the stronger the effect or influence on the environment and human behaviour. This is not supported by previous (Ariyani et al., 2016) found that organizational culture has a positive and significant effect on Organizational Commitment. (Saha & Kumar, 2018) The results show that a supportive and innovative culture moderates the impact of affective commitment on employee job satisfaction. (Heriyanto, 2021) The results show that organizational culture has a direct effect on organizational commitment. (Saryadi, 2018) with the results 1) Organizational culture and motivation have a significant positive effect on organizational commitment This is in contrast to (P. Stephen , who says that a robust organizational culture gives specific results: reduced employee turnover rate. With the culture, employees and the organization will establish harmony to realize an organizational commitment to employees. This theory is reinforced by (Cho, Kim, Chae, & Song, 2017). It states that if clear organizational goals and job autonomy measure organizational culture, there is a positive and significant influence on organizational commitment in private or government companies. An organization with employees who can uphold values and be able to comply with applicable norms will clarify the goals of the organization and strengthen the organizational culture in it. If the organizational culture is good, employees will show good attitudes and behaviour.

Influence motivation on organizational commitment.
The estimated value is that the influence of motivation on organizational commitment is 0.667, the CR value is 7.843, and the p-value is 0.000 <0.05, then H0 is rejected, and H3 is accepted, meaning that there is a positive and significant influence between motivation on organizational commitment. Based on the estimated value of organizational culture, it has an effect of 66.7% on organizational commitment, and other variables influence the rest. It can be concluded that organizational culture positively and significantly affects organizational commitment. Motivation is an essential factor in encouraging individual morale to work optimally in order to achieve specific goals. Motivation arises from within humans because of the drive of need. That is, motivation will arise in employees when they feel a need. If members have high motivation, then usually these members also have a good performance which leads to the achievement of total work commitment. This is in accordance with the opinion of (P. Stephen  which states that motivation is an attitude and values that can influence individuals to achieve specific things that are under their goals. Luthans (2006) states that organizational commitment is a form of determination of the desire to achieve specific organizational goals in the form of loyalty shown within the organization. This organizational commitment is indicated by an attitude that reflects nurses' feelings of likes or dislikes towards the organization.
This is under previous research, which said that there was an influence carried out by (Ariyani et al., 2016) finding that motivation had a positive and significant effect on Organizational Commitment. (Saryadi, 2018) with the results that organizational culture and motivation have a significant positive effect on organizational commitment (Gheitani, Imani, Seyyedamiri, & Foroudi, 2019) with the results that intrinsic motivation plays a partial and complete mediator role in the relationship between IWE and job satisfaction and between IWE and organizational commitment 4. Influence organizational culture on nurse performance The estimated value of the influence of organizational culture on performance is 0.249, the CR value is 2.580, and the p-value is 0.010 <0.05. This value shows the results that meet the requirements, namely <0.05 for P, so it can be concluded that H0 is rejected and H4 is accepted. From the estimated value of the influence of organizational culture on performance of 24.9%, the rest is influenced by other variables. Based on these results, organizational culture positively and significantly affects performance.
(Stephen P. Robbins & Judge, 2008) is of the view that organizational culture influences the content of an organization's competitive advantage. When all employees perceive objective factors equally, it will form the organizational culture. The culture that will be produced later can be a strong culture or a weak culture. The corporate culture socialized with good communication can determine the company's overall strength, performance and competitiveness in the long term. Stephen P. Robbins describes the relationship between communication and corporate culture that impacts employee performance.
Research conducted (by Ariyani et al., 2016) found that organizational culture has a positive and significant effect on performance. (Anggapradja & Wijaya, 2017) This study concludes that organizational commitment, culture, and motivation variables have a positive and significant effect on the performance of PT. CORE (Shahzad, 2014) Overall results support that organizational culture significantly positively impacts employee performance in selected software houses in Pakistan. Employee participation is the most vital factor in achieving organizational goals.
Organizational culture, compensation, and career development positively and significantly affect job satisfaction and nurse performance at RSU X Denpasar. In addition, the results of this study also show that job satisfaction can mediate the influence of organizational culture, compensation, and career development on the performance of nurses at RSU X Denpasar. (Koesmono, n.d.) The study's results explain that personality, leadership, and organizational culture have a positive and significant effect on work motivation and job satisfaction and affect the performance of the Nursing Staff of the Islamic RSU Surabaya. (Prastyo, Nuryakin, & Aini, 2021) This study obtained a work motivation hypothesis test with a significance level of 0.000, indicating an effect of work motivation on performance. The organizational culture hypothesis test with a significance level of 0.083 shows no influence between organizational culture and performance. The calculated F value is 20,719, and the significance is 0.000, indicating a simultaneous influence between work motivation and organizational culture on employee performance. (Saryadi, 2018) with the results that organizational culture, motivation and commitment significantly positively affect nurse performance.

Influence of Motivation on Nurse Performance
The estimated influence of motivation on performance is 0.631, the CR value is 5.304, and the p-value is 0.000 <0.05. This value indicates that the results meet the requirements of less than <0.05 for P, so it can be concluded that H0 is rejected and H5 is accepted. From the estimated value of the influence of organizational culture on performance of 63.1%, the rest is influenced by other variables. Based on these results, motivation has a positive and significant effect on performance.
Motivation is vital for employees. Because with motivation, employees are encouraged to work better to achieve the company's goals. Motivation is an incentive for employees to act to meet their needs and achieve goals (Purwanto, Sumiati, & Djumahir, 2018).
Work motivation is one of the critical things in implementing employee performance at work. For employees, work motivation is critical in achieving good performance, or work motivation is related to employee performance. As stated by (Stephen P. Robbins & Judge, 2008), this is the importance of motivation because motivation is the thing that causes, distributes and supports human behaviour so that they are willing to work hard and enthusiastically achieve optimal results. Motivation is increasingly essential because managers share their work with their subordinates to be done well and integrated into the desired goals. Work motivation itself is not only in the form of material but can also be in the form of affection, such as feeling happy with your work, enthusiasm for work for the sake of your family, and so on. When an employee does his job with passion, the results of his performance will be good.
These results are the following research (Sriekaningsih & Setyadi, 2015) (Ariyani et al., 2016 Found that motivation has a positive and significant effect on performance. (Anggapradja & Wijaya, 2017) This study concludes that organizational commitment, culture, and motivation variables have a positive and significant effect on the performance of PT. CORE (Nikmah, 2019) The study results the show that job insecurity, work motivation, organizational commitment and job satisfaction significantly affect employee performance.
Dwewi, Mahanggoro & Urmila (2018). The work motivation factor significantly affects the performance of nurses at hospital X. The results show that the motivational factor significantly influences performance as (0.049), which means that h0 is rejected and h1 is accepted. (Koesmono, n.d.) The study's results explain that personality, leadership, and organizational culture have a positive and significant effect on work motivation and job satisfaction and affect the performance of the Nursing Staff of the Islamic RSU Surabaya. (Prastyo et al., 2021) This study obtained a work motivation hypothesis test with a significance level of 0.000, indicating an effect of work motivation on performance. The organizational culture hypothesis test with a significance level of 0.083 shows no influence between organizational culture and performance. The calculated F value is 20,719, and the significance is 0.000, indicating a simultaneous influence between work motivation and organizational culture on employee performance.
Yulianti (2021) states that the suitability of employee training, employee engagement, and work motivation has a significant effect on the performance of nurses. However, employee training and work motivation have no significant effect on nurse performance through employee engagement during the COVID-19 pandemic. (Saryadi, 2018) Competence and motivation positively and significantly affect nursing performance directly and indirectly through satisfaction. This study shows that the competence variable has a dominant effect on nursing performance (Saryadi, 2018) with the results that organizational culture, motivation and commitment significantly positively affect nurse performance. 6. Influence Organizational commitment to nurse performance against.
The estimated value is that the effect of organizational commitment on performance is -0.241, CR value is -2.287, and the p-value is 0.022 <0.05, then H0 is rejected, and H6 is accepted, meaning that there is a significant influence between organizational commitment to performance. Based on the estimated value of organizational commitment to performance, it gives an effect of 24.1%, and other variables influence the rest.
Organizational commitment is the attitude of a person who has a strong desire to maintain being a member of the organization in a company and has an attitude of loyalty to the organization. Organizational commitment is an attitude that reflects the extent to which an individual or employee knows and is bound to his organization (Purwanto et al., 2018).
Luthans (2016) defines organizational commitment as an attitude that shows employee loyalty and is a person's ongoing process of expressing his concern for organizational success. Low commitment causes problems for the organization because commitment is an expensive "commodity" that determines the organization's success. Low commitment reflects a person's lack of responsibility in their duties.
Based on previous research conducted by (Ariyani et al., 2016) found that, commitment has a positive and significant effect on performance. (Anggapradja & Wijaya, 2017) This study concludes that organizational commitment, culture, and motivation variables have a positive and significant effect on the performance of PT. CORE (Nikmah, 2019) The study results a show that job insecurity, work motivation, organizational commitment and job satisfaction significantly affect employee performance. (Sharma & Dhar, 2016) Research findings reveal that fatigue levels are significantly higher among the nursing staff and have an inverse relationship with affective commitment. Furthermore, perceived organizational support and procedural fairness showed a positive relationship with affective commitment in contrast to burnout. In addition, affective commitment substantially impacts the performance of nursing staff, indicated by a direct relationship with a value of 0.70. Saryadi (2018) results that orgaorganizationalture, motivation and orgaorganizationalmitment significantly positively affect nurse performance.

Conclusion
The orgaorganizationalmitment variable can mediate the influence between orgaorganizationalture and motivation on the performance of nurses at the Satya Negara Sunter Hospital, North Jakarta. This means that the existence of an orgaorganizationalture, in this case, a high attitude of nurses accompanied by clear motivation, can improve the performance of nurses at the Satya Negara Sunter Hospital, North Jakarta. A high orgaorganizationalmitment of nurses also supports this. There is no significant influence between orgaorganizationalture on orgaorganizationalmitment, which means that no matter how high the orgaorganizationalture of the nurse is, it does not affect orgaorganizationalmitment. There is a positive and significant influence between motivation and orgaorganizationalmitment, which means that clear motivation in the hospital can increase orgaorganizationalmitment. There is a positive and significant influence between orgaorganizationalture on nurse performance. The meaning is that a high nurse orgaorganizationalture affects nurse performance, namely with good nurse work attitudes. There is a positive and significant influence between motivation on nurse performance, and the meaning is clear that motivation can provide higher nurse performance. There is a significant influence between orgaorganizationalmitment to nurse performance, which means that the more effective the orgaorganizationalmitment, the higher the nurse's performance.