Tatau pē Equality and Talanoa Tongan Oral Culture

Dr Amelia Afuha’amngoTuipulotuSupervisors:A/Professor Maureen BoughtonProfessor Jill WhiteThe University of Sydney

1. Background2. Global and Tongan Contexts3. The Research Approach4. Research in Process5. 3 Foundational Elements for Nursing Practice:

Challenges and Enablers6. Tatau pē Equality and Talanoa Tongan Oral Culture7. The Future of Nursing and Midwifery Practice- Where to

from here?

Kano’i LeaContent Overview

1. Personal

Philosophical Stance

Socrates Philosophy“I only know that I know Nothing”

Holomui ki mu’a Background

2. a. Contrasting

Nursing Experiences

b. Externally driven

Projects

Holomui ki mu’a BackgroundPurpose of the Study

To explore and identify collaboratively with Tongan nurses the foundational elements that will underpin the implementation of standards for nursing practice in Tonga

Holomui ki mu’a BackgroundSignificance of the Study

1. Gaining insights and understanding: enablers and challenges

2. Identification of Context-specific foundational elements for standards: to inform future development of standards

3. “Bottom up” Approach

Competency Standards in the Global Context

Western Worlda. Challengesb. Why competency standards (CS) emerged?c. Other Conceptualisations surrounding CSd. Analysis of Professional CSe. Critiques of CSf. Gaps in the Literature

The Tongan Context

The Four Strands for Development: The Kafa Pekepeka

a. Cultural Influencesb. Economic situationc. Political Influenced. Geographical Influence

The Research Approach

a. Constructivism Paradigm: multiples, constructed, context-specific

b. Influences from Action Research Perspective: participation, collaboration, reflection, investigation, reflective cycles

c. Data Analysis Frameworks: Thorne (1997), Sandelowski (2000)-Braun & Clarke (2006): 6 Phases-1.familiarizing, 2.coding, 3.searching for themes, 4.reviewing themes, 5.defining themes, 6.reporting

Research Process

Community Clinical

Group meeting 1

Group meeting 2

Group meeting 3

Group meeting 4

Community Clinical

Community Clinical

Focus Group(10 co-researchers)

Final meeting with group of co-researchers

Nursing Profession

4 focus groups with all 10 co-researchers

10 co-researchers divided into two groups6 focus groups with 5 co-researchers in each

Nursing leadersCommunity nursesSchool of NursingClinical nursesRetired nursesNurses in the outer islands

List of Broad Themes Emerged

Endorsement Cycles

3 Foundational Elements: Challenges and Enablers

3 Ike wooden mallet1. Patient Care Management2. Professional Comportment and

Development3. Resource Management

a. Communication: Patients, Leaders, Doctors

b. Quality and Safety: Practice, Workforce adequacy, Supervision, Competence Assessment

1. Tokangaekina ‘a e Mo’ui ‘a e Kakai

Patient Care Management

1. Nurses’ Level of Knowledge 2. Attitudes of all3. Work overload

4. Supervision of Practice

1‘Ulungaanga

Attitudes

2Ngaahi Vaa

Relationships

3Tupulekina Professional Development

2. ‘Ulungaanga moe Tupulekina Fakapolofesinale

Professional Comportment and Development

1. Nurses’ Level of Knowledge 2. Nurses’ willingness to listen and show restrain

3. Lack of ongoing development, supervision, structure4. Attitudes of all

3. Tokangaekina ‘o e Ngaahi Naunau Fakangaue Resource Management1. Understanding Scarcity of basic Resources – a Reality2. Fakapotopoto mo Fakama’opo’opo –Tongan economic strategy3. Fetokoni’aki mo Fevahevahe’aki –Tongan Communal sharing

1. Lack of understanding2. Nurses’ level of knowledge

3. Lack of maintenance4. Attitudes of all

Ngaahi PoupouEnablers for Nursing Practice

1. Encouraging Talanoa Tongan oral culture2. Ongoing development3. Embracing good attitudes4. Building Va Relationships5. Empowering one another6. Structures in Place7. Safe Nurse-Patient Workload8. Ensuring Basic Resources are Place9. Kau Katoa Everyone Caring for Resources

Tatau pe Equality &Talanoa Tongan Oral Culture:The two Strands

Patients Nurses Leaders

Respect

Inclusiveness

Recognition

Empowerment

Equal treatment

Tatau pē Equality

All stakeholders; patients, nurses and leaders are equal in relation to respect, inclusiveness, recognition, empowerment and treatment despite their individual status

within the Tongan hierarchical society.

Tongan Hierarchical Society

Talanoa Tongan Oral Culture

A B

Increasing Talanoa

Patients

Leaders

Nurses

Patients

Nurses

Leaders

Increasing Talanoa from A to B will lead to stakeholders coming closer together

Koe Luva atu Our Me’a’ofa Gift

Siueli ‘o Tonga Motu’a Tongan Concepts

1. Pukepuke ‘a Fufula Nurturing the Priceless

2. Hoko e Fau moe Fau Excellence woven into Excellence

3. Alai-sia-alai-Kolonga Ambidextrousness of Talent and Performance

The Future of Nursing and Midwifery-where are we heading?

1. Leadership2. Regulation (and Accreditation)3. Workforce Development4. Innovation/ Relevance in Education and

Practice5. Working Together: The Responsibility of

All-Local, Regional and Global Contexts

Sosaieti ma’ui’ui matala ‘alaha ‘i Onopooni

A fertile society blossoming into the Modern World

First International Conference for Tongan Nurses, 2010

Leveleva e Malanga

Tu’a ‘Ofa atu