The Covid-19 outbreak is currently a major problem globally. In Indonesia, based on data from the Ministry of Health (Kemenkes), there were 4,100,138 positive cases of Covid 19, 3,776,891 of them recovered and 133,676 people died. In the problems that occur, it is very necessary to have a hospital that can accommodate and overcome the problems of this epidemic. Central General Hospital Dr. M. Djamil Padang is a government hospital located in the city of Padang, West Sumatra province, which is a referral hospital for the Central Sumatra region.Hospitals have various ways to achieve their goals and the most important thing is their human resources, which are the driving factor for the hospital wheel. In this era of globalization, hospitals need quality human resources so that they can adapt to prepare for future hospital challenges. The use of an effective, healthy and directed workforce is the key to improving employee performance, so we need a policy that can trigger a movement so that employees can work more productively in accordance with the plans set by the hospital. The performance of employees in a hospital is very influential with the operation of the hospital. In an organization individual performance (individual performance) greatly affects organizational performance organizational performance), both government and private organizations in achieving the goals that have been set must go through activities that are driven by people or groups of people who work together who actively act as actors in producing good organizational performance. In other words, the achievement of organizational goals is due to the efforts made by people in the organization.

Based on table 1 data on the performance of Covid 19 nurses at Dr. M. Djamil Padang can be seen that the positive patient who was treated at Dr. M. Djamil Padang is still high compared to the number of recovered patients. The high number of COVID-19 cases in the city of Padang, the average number of positive patients is 146 people and the number of patients who have recovered is 110 people. Based on the percentage of patients who recovered as much as 75%, while according to the provisions of the government performance rating scale at RSUP M. Jamil, very good performance was on a scale of 90-100%, good criteria were worth 80-89%, criteria were quite good worth 70-79%, criteria for good were worth 70-79% less good is worth 60-69% and very poor is worth 0-59%. Meanwhile, the performance achievement data for nurses is only 75%, meaning that this performance is included in the rating range of a fairly good scale, namely 70-79%.

In this study, it was focused on health care nurses, because nurses worked more hours related to contact in patient handling actions compared to other health workers. So that there is an opportunity for nurses to be exposed to this virus, the work safety and health of these nurses is threatened. In addition to occupational safety and health, other factors that affect the performance of nurses at Dr. RSUP. M. Djamil Padang, namely work life balance, this work life balance often occurs in female nurses, especially those who are married because women have a dual role that is not owned by men, namely in taking care of the household and children and the high demands of work in handling this case resulted in sacrifices to domestic life so that the balance between personal and work life was disturbed.

Table 1: Data on Covid Inpatients at RSUP Dr. M. Djamil Padang

Source: M. Jamil Hospital, Padang

Figure 1: Research Conceptual Framework

In addition, there are facts that happened at Dr. RSUP. M. Djamil Padang, where the guarantee of occupational safety and health for nurses working to deal with Covid has not yet been realized. This is due to the lack of obedience of nurses in using work tools and there are still many nurses who violate health protocols during the current pandemic where there are still many nurses who do not use masks in the hospital area and there are still many nurses who are not disciplined without following social distancing. So that the job satisfaction and performance of nurses in an effort to improve their work results are still less effective.

From the phenomena described above, the authors are interested in conducting research on "The Effect of Occupational Safety and Health, Work Life Balance on Performance with Job Satisfaction as a Mediation Variable: A Study on Covid-19 Nurses, Dr. M. Djamil Padang".

Based on theories about the variables of occupational health safety, work life balance, job satisfaction and performance, there is a direct and indirect positive influence. Thus the formulation of the problem can be made a plot that describes the research framework as Figure 1.

Based on the conceptual framework drawing, it can be concluded that this study was conducted to analyze the direct influence between occupational safety and health, work life balance as an independent variable with performance as the dependent variable and the indirect effect between occupational safety and health and work life balance as an independent variable with performance as dependent variable and job satisfaction as a mediating variable.

In this study the population consists of all covid nurses at Dr. M. Djamil Padang, totaling 299 people. The sample consists of a number of members selected from the population or subgroups of the population Now. More according to Sugiyono, [1]. The sample is part of the number and characteristics possessed by the population. The sample was carried out because the researcher had limitations in conducting research both in terms of time, energy, funds and a very large population, so the researcher had to take a truly representative sample (can represent). It can be concluded that the sample is part of the population that is expected to be able to represent the population in the study. The sample in this study were 155 COVID-19 nurses at M. Jamil Hospital, Padang. This study uses a non-probability sampling technique with a purposive sampling method which Sampling is based on pre-determined intent. This sample selection method is by deliberately selecting certain samples and ignoring other samples, because this particular sample has special characteristics that other samples do not have. The selection of samples based on the specific characteristics that have been described can be seen in the Table 2.

Table 2: Sampling Criteria

Source: M. Jamil Padang

Therefore, the samples in this study were all Covid 19 nurses at Dr. RSUP. M. Djamil is a woman who is married and has worked for 2 years in the number of 155 COVID-19 cases.

Measurement Model Test

Structural Model Evaluation: Structural model testing is carried out in stages until the appropriate results are obtained. Then the complete structural model is estimated by containing the indicators that have been tested in the analysismeasurement model. Indicators that have passed the test will be carried out to the structural model stage with the following techniques: bootstrapping. To test the hypothesis, where the t-value (t-value) generated by running the Bootstrapping algorithm on Smart PLS is used to determine whether the proposed hypothesis is accepted or not. The hypothesis uses a two-tailed test, the rule of thumb has a significance level of 10% (t statistics 1.65), a significance level of 5% (t statistics 1.96) and a significance level of 1% (t statistics 2.57). So the hypothesis is accepted when the significance level is less than 0.05 or the t-value exceeds the critical value of 1.96 (Figure 2).

Figure 2: Results Bootstrapping

Source: PLS Data Processing Results, 2018

Structural modeling is done to predict the relationship between latent variables in the research model or in short to find out whether the research hypothesis is accepted or rejected. The hypothesis is accepted or rejected can be seen in the value of the critical ratio (critical ratio) and the level of significance contained in the regression weights in the structural model. The hypothesis will only be accepted if the CR is 1.96 and the p value is 0.05 which is reported in the Table 3.

Table 3: Structural Model Assessment Results (Direct Influence)

Source: Smart-PLS Processing Results

The results of data processing can be substituted into the following structural equation:

Job satisfaction = 0.539 occupational safety and health +ς

1

From Table 3 it can be seen that sample original value of -0.197 and p values ​​of 0.000 <0.05. Thus the first hypothesis is accepted. It can be said that job satisfaction is positively influenced by occupational safety and health, meaning that the increasing occupational safety and health will increase job satisfaction.

Job satisfaction = 0.277 work life balance

2

From Table 3 it can be seen that sample original value of -0.197 and p values ​​of 0.003 <0.05. Thus the second hypothesis is accepted. Positively job satisfaction is influenced by work life balance. Thus, the better the work life balance, the higher job satisfaction.

Performance = 0.193 Occupational safety and health

3

From Table 3 it can be seen that sample original value of -0.197 and p values ​​of 0.042 <0.05. Thus the third hypothesis is accepted. Performance is positively influenced by occupational safety and health. Thus, increasing occupational safety and health will improve performance.

Performance = 0.262 work life balance

4

From Table 3. it can be seen that sample original value of -0.197 and p values ​​of 0.011 <0.05. Thus the fourth hypothesis is accepted Positively performance is influenced by work life balance. Thus, the better the work life balance, the better performance.

Performance = 0.465 job satisfaction

5

From Table 3 it can be seen that sample original value of -0.197 and p values ​​of 0.000 <0.05. Thus the fifth hypothesis is accepted. Positively performance is influenced by job satisfaction. Thus, increasing job satisfaction will increase performance.

Then hypothesis 6 and hypothesis 7 are indirect effects (influence through mediation). To find out whether there is mediation or not in this study, it can be seen in the Table 4.

Table 4: Structural Model Assessment Results (Indirect Influence)

Source: Smart-PLS Processing Results

The sixth hypothesis is that job satisfaction mediates the relationship between occupational safety and health on the performance of Covid 19 nurses at RSUP Dr. M. Djamil Padang. To see the mediation effect, we can use the formula variance accounted for(VAF). According to Mediation chart in PLS by the VAF method proposed by Hair et al. Mediation occurs if the direct effect is significant, namely job satisfaction is significant on performance, namely the p values 0.000 <0.05. Means there has been a mediating effect.

The seventh hypothesis is that job satisfaction mediates the relationship between work life balance and the performance of Covid 19 nurses at Dr. RSUP. M. Djamil Padang. To see the mediation effect, we can use the formula variance accounted for (VAF). According to Mediation chart in PLS with the VAF method proposed by Hair et al. Mediation occurs if the direct effect is significant, namely job satisfaction is significant on performance, namely the p values 0.005 <0.05. Means there has been a mediating effect. IThe information obtained from the table above is that job satisfaction is said to mediate performance and mediate the relationship between occupational health and safety on performance. Then job satisfaction mediates the relationship between work life balance and performance.

Model Quality Rating

To assess the quality of the model used the coefficient of determination (R²) and effect size (f²) [2]. The value of R square is the coefficient of determination on the endogenous construct. The coefficient of determination is meaningful as the contribution of the influence given by the exogenous construct to the endogenous construct or in other words, the value of R square is useful for predicting and seeing how much of the contribution of the influence given by the exogenous construct simultaneously (together) to the endogenous construct.

According to Chin, [3] R² value of 0.67 is categorized as strong, then if the value is 0.33 it is categorized as moderate and 0.19 is said to be weak. By using an endogenous construct consisting of performance, job satisfaction, occupational health and safety, work life balance in this study, the R square value obtained can be reported in the Table 5.

Based on the Table 5, information is obtained, the contribution of the influence given by occupational health safety and work life balance on performance is 0.713, it can be said that the contribution of the influence given by occupational health safety and work life balance on performance is strong, indicating a strong model prediction accuracy. Then the contribution of the influence given by occupational health safety and work life balance on job satisfaction is 0.608, then the contribution of the influence given simultaneously to occupational health safety and work life balance on job satisfaction is strong, thus indicating a strong model prediction accuracy.

Table 5: Coefficient of Determination Analysis (R²)

Source: Smart-PLS Processing Results

Changes in the value of R² can be used to see whether the effect of exogenous constructs on endogenous constructs has a substantive effect. This can be measured by using an assessment effect size (f²). For that, the effect size (f²) for each path model is calculated. If the value of f2 is 0.02 then it has a weak effect, while 0.15 has a moderate effect and a value of 0.35 has a strong influence.(Hair et al., 2013). The f2 values ​​for each path model in this study can be seen in the Table 6.

The table 6, shows a strong influence in the occupational health safety pathway on job satisfaction and has a weak influence in the occupational health and safety pathwaywork life balanceon job satisfaction. In the analysis in the performance path, occupational health safety and work life balance have a weak influence on performance. While in the path of job satisfaction has a strong influence on performance.

Table 6: Effect Size Analysis (f²)

Source: Smart-PLS Processing Results

In addition, the predictive relevance value (Q²) of Stone – Geisser was examined. Predictive relevance (Q²) Stone – Geisser aims to check whether the indicator data points in the reflective measurement model of endogenous constructs can be predicted accurately, in short to validate the model. Chin, [3] explains that a model shows a good predictive relevance when its Q² value is greater than zero which indicates a good exogenous latent variable (suitable) as an explanatory variable that is able to predict its endogenous latent variable. The value of Q2 in this study can be seen in the Table 7.

The information obtained from the table above is that the structural model obtained has a prediction of relevance. This means that occupational health safety, work life balance are appropriate as explanatory variables that can predict job satisfaction and performance variables.

Table 7: Predictive Relevance Value (Q²) Stone – Geisser

Source: Smart-PLS Processing Results

The results of hypothesis testing have provided various understandings of occupational safety and health, work life balance and job satisfaction on the performance of Covid 19 nurses at Dr. RSUP. M. Djamil Padang. To better understand it, it can be discussed on the results of the research that has been described below.

The Effect of Occupational Safety and Health on Job Satisfaction Covid 19 Nurse at Dr. M. Djamil Padang

Based on the hypothesis test in this study, it was found thatanalysis shows thatoccupational Health and Safetyhas a significant effect on performance. It means, performance improvement can be done by improving occupational safety and health through the implementation of risk management programs and biological risk mitigation.This finding is in accordance withTremblay [4], Neto et al., [5], Mohammad fam et al., [6], that occupational safety and healthhas a significant effect on performance.

Sahin, [7], believes that work safety is a safe condition, safe from suffering, damage or loss in the workplace that is felt by employees. While occupational health indicates a condition where employees are free from physical, mental, emotional or pain disorders caused by the work environment.

Effect of Work Life Balance on Job Satisfaction Covid 19 Nurse at Dr. M. Djamil Padang

Based on the hypothesis test in this study it was found thatwork life balance positive and significant effect onjob satisfactionto the Covid 19 nurse at Dr. M. Djamil Padang. This means that work-life balance determines how much time is available for a nurse to balance the demands of family and work. Therefore, Work-life balance is very important especially when the institution has to manage outstanding technical professionals because their high loyalty and commitment is required for the achievement of the institution, so that work-life balance affects job satisfaction as well as efficiency and effectiveness of nurses' performance.

This is in accordance with the opinion Soomro et al., [8], Work-life balance is the ratio of time divided by an employee between: work and family. The imbalance in both forms, when work spills over into the family realm or family problems extend into the work realm are potential causes of stress and non-constructive work attitudes, which are positively related to job satisfaction. According to MasMachuca et al., [9]. Employees who feel comfortable at work and have an effective work-life balance are proud to work for the company. These results suggest that this effect is a strong and long-lasting feeling that increases employee satisfaction. Thus, organizational pride is a full mediator between employees' work-life balance and job satisfaction.

Effect of Occupational Safety and Health on Performance Covid 19 Nurse at Dr. M. Djamil Padang

Based on the hypothesis test in this study it was found thatsafety and healthpositive and significant effect onperformanceto the Covid 19 nurse at Dr. M. Djamil Padang. This means that occupational safety and health if carried out will have an impact on the performance of nurses. When employees feel comfortable and their safety at work is fulfilled, the employee will feel satisfied with the work experienced so that it will have an impact on increasing the performance of the employee.

This is in accordance with the opinion Peron et al., [10], stated that occupational safety and health have a significant effect on performance, in his research he stated that performance will increase when K3 (i.e., stress management programs, active and healthy lifestyle promotion programs, job rotations, mixed age work groups, training for AW, career development training) , training provided by AW, physically and psychologically related workplace enhancements, assistive technology and part-time work practices) are well done. The same thing is also explained in the research Gopang et al., [11], Safety policies are a fundamental part of a company's safety practices because they provide a demonstration of the organization's basic beliefs and commitment to safety at work and that safety has a potential effect on organizational performance. In line with opinion Kim and Park, [12], In his research, occupational safety and health simultaneously protect the valuable lives of employees' performance and financial performance of the company.

Effect of Work Life Balance on PerformanceCovid 19 nurse at Dr. M. Djamil Padang

Based on the hypothesis test in this study, it was found thatwork life balance positive and significant effect onperformanceto the Covid 19 nurse at Dr. M. Djamil Padang. It meansThe results above show that nurses can manage their time in a balanced way, that is, they can share their personal time with work time without having to harm their work and have a positive impact on the quality of nurses' work, so that nurses can apply this work-life balance properly. take part in implementing fair rules and policies for each nurse but it also comes from the nurse's own awareness of how she is in aligning her personal life and professional life both in terms of time, communication and in terms of involvement.

This is in accordance with the opinion, Soomro et al., [8], which states that work-life balance has a significant effect on performance. Work-life imbalance is a potential cause of stress and most studies conclude that work-life imbalance has a negative effect on employees' attitudes towards work. Work-life imbalances have also been observed as a cause of reduced work effort on the part of employees, which in turn leads to low productivity and poor performance. The same thing was said by Bataineh, [13], an employee with a healthy work-life balance is in a better position to carry out the tasks assigned to him more effectively and efficiently.

The Effect of Job Satisfaction on Performance Covid 19 Nurse at Dr. M. Djamil Padang

Based on the hypothesis test in this study, it was found thatwork life balance positive and significant effect onperformanceto the Covid 19 nurse at Dr. M. Djamil Padang. This means that higher job satisfaction will lead to higher performance and ultimately higher organizational performance.Nurses are satisfied with the salary given from the agency because it is on time, in accordance with the workload, employees are also satisfied because the facilities provided by the company are very comfortable, employees are also satisfied with the establishment of good relationships and communication with colleagues.

This research is in accordance with previous researchIf employee job satisfaction is low, employee performance will decrease and vice versa if employee job satisfaction is high, employee performance will increase [14].Hendri, [15], argues that there are consequences of job satisfaction, one of which is employee performance, he believes that if job satisfaction is high, then employees will work as well as provide good performance. The results of the analysis show that the indicator that is considered important in the variables forming job satisfaction is the establishment of good relationships with coworkers, while this indicator is considered important in shaping employee performance is integrity and can form a cohesiveness among colleagues.

The same thing was also expressed by Karem et al., [16], Job satisfaction is proven to increase work performance and efficiency which has a beneficial impact on job satisfaction, because increased job satisfaction can increase employee productivity based on quality. Krishnan, [17], Job satisfaction is an effective indicator of happiness because it reflects a pleasant atmosphere, a state of mind and positive emotions resulting from well-being at work, which is largely determined by human resource management.

The Effect of Occupational Safety and Health on Performance Through Job SatisfactionCovid 19 nurse at Dr. M. Djamil Padang

Based on the hypothesis test in this study, it was found thatoccupational Health and Safetypositive and significant effect onperformanceto the Covid 19 nurse at Dr. M. Djamil Padang. This means that occupational safety and health really have a very big influence on improving the performance of Covid 19 nurses at Dr. RSUP. M. Djamil Padang. The better the implementation of occupational safety and health in an agency, the more impact it will have on improving its performance in the agency.This shows that the less than optimal work safety program provided by the agency will affect employee performance. The less than optimal work safety provided by the company will indeed have an unfavorable impact on the performance of the employees themselves, this has significant results on the performance of the Covid nurses at Dr. M. Djamil Padang. On the other hand, if the agency is able to maximize a good work safety system, this can positively assist them in producing good performance.

According to research conducted by Dufour, [18], Gibbs and Nonnenmann [19], Gharibi., [20] and Jahangiri et al., [21], which shows on occupational safety and health the importance of providing personal protective equipment, neutral detergents and hospital disinfectants training for their proper use, for the proper fight against the pandemic. In addition, these results corroborate the research Dennerlein et al., [22], who identified that risk management is an important tool for companies to determine which actions should be prioritized, such as administering soap and water or respirators. According to Demartini et al., Gharibi et al. [20] and Parker who highlighted the importance of implementing social distancing into occupational safety and health practices and guiding employees, customers and service providers. Besides that, Garzillo et al., [23], stated that government agencies had difficulty providing guidance on risk management programs, even if distance proved to be effective. Finally, this work also confirms the research by Neto et al., [5], which suggests that simple structural changes in the workplace can reduce risk.

The Effect of Work Life Balance on Performance Through Job SatisfactionCovid 19 nurse at Dr. M. Djamil Padang

Based on the hypothesis test in this study, it was found thatoccupational Health and Safetypositive and significant effect onperformanceto the Covid 19 nurse at Dr. M. Djamil Padang. This provesThis balance in work is an important factor that can support increasing work performance on a job. Work life balance is a concept of balance that involves ambition or career with happiness, leisure, family and spiritual development. The work life balance program implemented in an agency is expected to be able to increase the level of work performance of employees so that it can create morale for employees in carrying out their duties and obligations to the agency.

This is consistent with research Abdirahman et al., [14], Work-life balance is very important especially when the institution has to manage outstanding technical professionals because their high loyalty and commitment is required for the achievement of the institution, so work-life balance affects the efficiency and effectiveness of employees' performance. Bataineh, [13], in his research shows that work-life balance and happiness have a positive and significant effect on employee performance. Riani et al. the effect of work life balance, work stress and compensation on employee performance shows that work life balance has a significant positive effect on employee performance.

Based on the results of testing and discussing the hypotheses described in the previous chapter, it can be concluded that occupational health safety and work life balance have a positive and significant effect on the job satisfaction of the Covid 19 nurse at M Djamil Hospital Padang. Occupational health safety, work life balance, satisfaction have a positive and significant effect on the performance of the Covid 19 nurse at RSUP M Djamil Padang. Occupational safety and health and work life balance have a significant effect on performance through job satisfactionCovid 19 nurse at Dr. M. Djamil Padang.

The policy implications that can be suggested in this research for Dr. RSUP. M. Djamil Padang must maintain occupational health safety, maintain work life balance and increase job satisfaction for nurses, especially Covid 19 nurses, for example, continue to provide socialization regarding the prevention of accidents or disease transmission by providing adequate personal protective equipment so that the nurse performs her job properly and impact on the performance of nurses and the performance of the hospital itself.

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