Tatau p ē Equality and Talanoa Tongan Oral Culture

1. Tatau pēEquality and TalanoaTongan Oral Culture Dr Amelia Afuha’amngoTuipulotu Supervisors: A/Professor Maureen Boughton Professor Jill White The University of Sydney

2. Kano’i LeaContentOverview • Background • Global and Tongan Contexts • The Research Approach • Research in Process • 3 Foundational Elements for Nursing Practice: Challenges and Enablers • TataupēEquality and TalanoaTongan Oral Culture • The Future of Nursing and Midwifery Practice- Where to from here?

3. Holomuikimu’aBackground 2. a. Contrasting Nursing Experiences b. Externally driven Projects 1. Personal Philosophical Stance Socrates Philosophy “I only know that I know Nothing”

4. Holomuikimu’aBackground 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

5. Holomuikimu’aBackground Significance of the Study Gaining insights and understanding: enablers and challenges Identification of Context-specific foundational elements for standards: to inform future development of standards “Bottom up” Approach

6. Competency Standards in the Global Context Western World Challenges Why competency standards (CS) emerged? Other Conceptualisations surrounding CS Analysis of Professional CS Critiques of CS Gaps in the Literature

7. The Tongan Context The Four Strands for Development: The KafaPekepeka Cultural Influences Economic situation Political Influence Geographical Influence

9. The Research Approach Constructivism Paradigm: multiples, constructed, context-specific Influences from Action Research Perspective: participation, collaboration, reflection, investigation, reflective cycles 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

10. Group meeting 1 4 focus groups with all 10 co-researchers Group meeting 2 Group meeting 3 Group meeting 4 Community Clinical 10 co-researchers divided into two groups 6 focus groups with 5 co-researchers in each Community Clinical Community Clinical List of Broad Themes Emerged Endorsement Cycles Focus Group (10 co-researchers) Nursing leaders Community nurses School of Nursing Clinical nurses Retired nurses Nurses in the outer islands Nursing Profession Final meeting with group of co-researchers Research Process

11. 3 Foundational Elements: Challenges and Enablers 3 Ike wooden mallet Patient Care Management Professional Comportment and Development Resource Management

12. 1. Tokangaekina ‘a e Mo’ui ‘a e Kakai Patient Care Management a. Communication: Patients, Leaders, Doctors b. Quality and Safety: Practice, Workforce adequacy, Supervision, Competence Assessment Nurses’ Level of Knowledge Attitudes of all Work overload Supervision of Practice

13. 2. ‘UlungaangamoeTupulekinaFakapolofesinaleProfessional Comportment and Development 1 ‘Ulungaanga Attitudes 2 NgaahiVaa Relationships 3 TupulekinaProfessional Development Nurses’ Level of Knowledge Nurses’ willingness to listen and show restrain Lack of ongoing development, supervision, structure Attitudes of all

14. 3. Tokangaekina ‘o e Ngaahi Naunau Fakangaue Resource Management 1. Understanding Scarcity of basic Resources – a Reality 2. Fakapotopoto mo Fakama’opo’opo –Tongan economic strategy 3. Fetokoni’aki mo Fevahevahe’aki –Tongan Communal sharing Lack of understanding Nurses’ level of knowledge Lack of maintenance Attitudes of all

15. NgaahiPoupou Enablers for Nursing Practice 1. Encouraging TalanoaTongan 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. KauKatoaEveryone Caring for Resources

16. TataupeEquality & TalanoaTongan Oral Culture: The two Strands

17. Tongan Hierarchical Society 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. TataupēEquality

18. TalanoaTongan Oral Culture Nurses Patients Nurses Patients Increasing Talanoa Leaders Leaders A B Increasing Talanoa from A to B will lead to stakeholders coming closer together

19. Koe Luva atu Our Me’a’ofa Gift

20. Siueli ‘o Tonga Motu’a Tongan Concepts • Pukepuke ‘a FufulaNurturing the Priceless • Hoko e FaumoeFauExcellence woven into Excellence • Alai-sia-alai-KolongaAmbidextrousness of Talent and Performance

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

22. Sosaietima’ui’uimatala ‘alaha ‘iOnopooniA fertile society blossoming into the Modern World

24. First International Conference for Tongan Nurses, 2010

25. Leveleva e Malanga Tu’a ‘Ofaatu