Tatau pē Equality and Talanoa Tongan Oral Culture Dr Amelia Afuha’amngoTuipulotu Supervisors: A/Professor Maureen Boughton Professor Jill White The University of Sydney Kano’i Lea Content Overview 1. 2. 3. 4. 5. 6. 7. Background Global and Tongan Contexts The Research Approach Research in Process 3 Foundational Elements for Nursing Practice: Challenges and Enablers Tatau pē Equality and Talanoa Tongan Oral Culture The Future of Nursing and Midwifery Practice- Where to from here? Holomui ki mu’a Background 1. 2. Personal Philosophical a. Contrasting Nursing Experiences Stance Socrates Philosophy “I only know that I know Nothing” b. Externally driven Projects Holomui ki mu’a 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 Holomui ki mu’a 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 Competency Standards in the Global Context Western World a. b. c. d. e. f. Challenges Why competency standards (CS) emerged? Other Conceptualisations surrounding CS Analysis of Professional CS Critiques of CS Gaps in the Literature The Tongan Context The Four Strands for Development: The Kafa Pekepeka a. b. c. d. Cultural Influences Economic situation Political Influence 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 Group meeting 1 4 focus groups with all 10 coresearchers Group meeting 2 Group meeting 3 Group meeting 4 Community Clinical Community Clinical Community Clinical 10 co-researchers divided into two groups 6 focus groups with 5 coresearchers in each List of Broad Themes Emerged Endorsement Cycles Focus Group (10 co-researchers) Nursing Profession Final meeting with group of coresearchers Nursing leaders Community nurses School of Nursing Clinical nurses Retired nurses Nurses in the outer islands 3 Foundational Elements: Challenges and Enablers 3 Ike wooden mallet 1. Patient Care Management 2. Professional Comportment and Development 3. Resource Management 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 1. Nurses’ Level of Knowledge 2. Attitudes of all 3. Work overload 4. Supervision of Practice 2. ‘Ulungaanga moe Tupulekina Fakapolofesinale Professional Comportment and Development 1 ‘Ulungaanga Attitudes 2 Ngaahi Vaa Relationships 3 Tupulekina Professional 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 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 1. Lack of understanding 2. Nurses’ level of knowledge 3. Lack of maintenance 4. Attitudes of all 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 Tatau pe Equality & Talanoa Tongan Oral Culture: The two Strands Respect Inclusiveness Recognition Empowerment Equal treatment 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. Leaders Nurses Patients Tatau pē Equality Talanoa Tongan 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 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 Midwiferywhere are we heading? 1. 2. 3. 4. Leadership Regulation (and Accreditation) Workforce Development Innovation/ Relevance in Education and Practice 5. 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