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Tatau p Equality and Talanoa Tongan Oral Culture Tatau p Equality and Talanoa Tongan Oral Culture Dr Amelia AfuhaamngoTuipulotu Supervisors: A/Professor Maureen Boughton Professor Jill White The University of Sydney

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1.Background 2.Global and Tongan Contexts 3.The Research Approach 4.Research in Process 5.3 Foundational Elements for Nursing Practice: Challenges and Enablers 6.Tatau p Equality and Talanoa Tongan Oral Culture 7.The Future of Nursing and Midwifery Practice- Where to from here? Kanoi Lea Content Overview

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1.Personal Philosophical Stance Socrates Philosophy I only know that I know Nothing I know Nothing Holomui ki mua Background 2. a. Contrasting Nursing Experiences b. Externally driven Projects

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Holomui ki mua Background Purpose 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

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Holomui ki mua Background Significance 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

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Competency Standards in the Global Context Western World a.Challenges b.Why competency standards (CS) emerged? c.Other Conceptualisations surrounding CS d.Analysis of Professional CS e.Critiques of CS f.Gaps in the Literature

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The Tongan Context The Four Strands for Development: The Kafa Pekepeka a.Cultural Influences b.Economic situation c.Political Influence d.Geographical Influence

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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

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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) 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 groups 6 focus groups with 5 co- researchers in each Nursing leaders Community nurses School of Nursing Clinical nurses Retired nurses Nurses in the outer islands List of Broad Themes Emerged Endorsement Cycles

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3 Foundational Elements: Challenges and Enablers 3 Ike wooden mallet 1.Patient Care Management 2.Professional Comportment and Development 3.Resource Management

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a. Communication: Patients, Leaders, Doctors b. Quality and Safety: Practice, Workforce adequacy, Supervision, Competence Assessment 1. Tokangaekina a e Moui a e Kakai Patient Care Management 1.Nurses Level of Knowledge 2.Attitudes of all 3.Work overload 4.Supervision of Practice

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1UlungaangaAttitudes2 Ngaahi Vaa Relationships3 Tupulekina 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, structure 4.Attitudes of all

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3. Tokangaekina o e Ngaahi Naunau Fakangaue Resource Management 1. Understanding Scarcity of basic Resources a Reality 2. Fakapotopoto mo Fakamaopoopo Tongan economic strategy economic strategy 3. Fetokoniaki mo Fevahevaheaki Tongan Communal sharing 1.Lack of understanding 2.Nurses level of knowledge 3.Lack of maintenance 4.Attitudes of all

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Ngaahi Poupou Enablers for Nursing Practice 1. Encouraging Talanoa Tongan oral culture 2. Ongoing development 3. Embracing good attitudes 4. Building Va Relationships 5. Empowering one another 6. Structures in Place 7. Safe Nurse-Patient Workload 8. Ensuring Basic Resources are Place 9. Kau Katoa Everyone Caring for Resources

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

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Patients Nurses Leaders Respect Inclusiveness Recognition Empowerment Equal treatment Tatau p 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

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Talanoa Tongan Oral Culture AB Increasing Talanoa Patients Leaders Nurses Patients Nurses Leaders Increasing Talanoa from A to B will lead to stakeholders coming closer together

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Koe Luva atu Our Meaofa Gift

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Siueli o Tonga Motua 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

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The Future of Nursing and Midwifery- where are we heading? 1.Leadership 2.Regulation (and Accreditation) 3.Workforce Development 4.Innovation/ Relevance in Education and Practice 5.Working Together: The Responsibility of All-Local, Regional and Global Contexts

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Sosaieti mauiui matala alaha i Onopooni A fertile society blossoming into the Modern World

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First International Conference for Tongan Nurses, 2010

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Leveleva e Malanga Tua Ofa atu