Nepali Nurses working as “caregiver” in Canada Nov 26, 2014


If you are thinking of going to Canada to be a “caregiver” – read this first.

There was a FaceBook posting from a consultancy that described the need for “care givers” in Canada, and I was a bit surprised by the number of nurses who seemed to be interested in this. The flyer reads “opportunities for Caregiver – confirmed job in Canada for nurses” – you know the one. You probably saw it. In a past blog, I wrote that it is very difficult for a young single nurse to go to Canada unless they have a confirmed job. And so – if you are excited by the headline on the FaceBook posting, you might jump at this.

But you need to read it more closely. The “confirmed job” is not a nursing job – it’s a caregiver job.

What is a caregiver?

A caregiver is a person who stays at the home of an elderly person who has frail health, and helps with Activities of Daily Living, such as feeding, bathing, dressing, incontinence care, and toileting. A caregiver works for a Home Health Agency.

In Canada, the government pays for health care, and caregivers are paid via the “Compassionate Care Benefit”  – the government tries to help families with an elderly relative who voluntarily care for the aged person – but if there is no such person, a paid caregiver is hired. The Home Health Agency is funded by the government. Read about it at the Canadian Caregiver Association.  They focus on family caregivers. You would be doing things the family would normally do.

A caregiver is not the same as a Registered Nurse – you don’t need a complete nursing education to do this job. They would love to have a person with a nursing education from foreign country go to Canada and do this, because they can get a person with good language skill and good education who will be excellent “servant.”

Here are the problems:

You would not be using your education to the fullest scope.

No opportunity for advancement. You can’t go there as a caregiver and then switch to RN position.

You stay in one house all the time, and you are subject to the whim of the family members who may or may not like you as a person. You do many non-nursing tasks to please the family.

You are visited periodically by an RN who checks on you, but you don’t use your own license.

The pay is at caregiver scale – about $10 per hour. Not at RN scale which would be $30 per hour.

You would not be at a hospital, there are no team of friends to share work with and knowledge.

The job involves lifting of disabled patients, and there is a high rate of back injury.

For all these reasons, there is a shortage of Canadians who want to work in this job – that’s why they want foreign workers to come in at low wages.  If you just finished PCL nursing and you are nineteen years old like many new PCL nurses, you need to become aware of these issues.

Another part is – you pay a fee for the consultancy to complete your application, with no guarantee that you will be selected in the end.

Ask yourself –

Do you have pride in your nursing education?

Do you have loans to pay already?

Is is worth paying more for a consultancy?

Can’t you be of the most help to nursing right here in Nepal, instead?

What to read:

Read the fine print.

Ask if it is a caregiver job or a nursing job.

Ask about every single thing I listed above.

Please share this with every nurse and with every young woman who is considering doing this job.

One Last thing

Finally, if you got this far, please take a look at the reviews for my second book about Nepal Health care, a novel titled The Sacrament of the Goddess. It will be published in Nepal in January 2015.

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Nov 2014 for Nepali Nurses who want to work in USA


Going to USA?

Before we get further, why not read some reviews of The Sacrament of the Goddess? It’s my second book, it’s about Nepal health care during the period of the Civil War. It will be published in Kathmandu in January 2015.

I just spent three weeks in USA visiting family members and meeting with people. On my last day there, I went to Jackson Heights, Queens. This is the neighborhood of New York where the Nepalis live.

You can get panipuri in Jackson Heights.

Also, it’s where many members of NAN‎A live. NANA is the Nepali Association of Nurses in America. Check out their website. They have some links there about CGFNS, etc

I met with the President of NANA, and some members. We had time to chat.

A correction!

In a number of previous blogs I have said “You can’t get a USA RN license with just a PCL and SLC. You need SLC plus two.”

When somebody says “No, that’s not true” I always say: “show me an actual person for whom that is the case”

Well, I finally met somebody for whom that is the history. She’s working in New York, but got her PCL in 2002. Since coming to USA she got her BSN, as well as a M Sc and she is working as a Nurse Practitioner. I don’t want to give her name just yet, because she will probably get three hundred emails and FaceBook friend requests. She has a job and two preschoolers, and a husband who also works in health care.

So – there is at least one such person. She is out there…….. I apologize for being a skeptic and deflating everyone’s dream….

Nepali nurse chances of getting to USA?

She and I discussed how everybody wants to go to USA (or so it seems). She said:

“For awhile there, a nurse could get a visa to work as a nurse, but this has ended and nobody is getting any such visa these days”

Also she said:

“There are only three ways that the Nepali nurses are able to get here. The first is to win the DV lottery. The second is to have arranged marriage to a guy with a green card. The third is to come as a M Sc student.”

I thought this was worth passing on.

I will point out there is a fourth way, which is to go there as a B Sc student. If you do that, you can work for one year afterwards. Then you must return to Nepal. I think I will do a future blog on the subject of the difficulties faced by nurses who do this route.

I’m still travelling. I’ll try to blog some more. I’m interested in everyone’s reaction…….

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Our Friends may change or die


Book review Oct 24, 2014
Books are the most faithful of friends. Our friends may change or die but our books are patiently waiting to talk to us. But to read nothing but books of fiction is like eating nothing but cake and sweets. As we need plain and wholesome food for our body, we must have serious reading for the mind. This book ‘The Sacrament of The Goddess’ is simply right one that we ought to read. This provides us not only solid pleasure but education as well.
The book ‘The Sacrament of The Goddess’ revolves around the story of a young resident going abroad to practice medicine in a third world country. The medical scenes described in the book are accurate and detailed. The main characters of the story Matt, Ranjit, Sushila has their important role throughout the story. In addition to it, Bimala, Manju and Ram played small yet a significant role.
I have really enjoyed the book because it was entertaining despite main characters unfortunate circumstances. The story is full of lessons about ethical issues in the art of survival. The story has more than enough actions to keep my attention page after page.
The story primarily focuses on the importance of education in bringing awareness. But it also has shown that everyone is not literate enough to understand the cause, consequences and prevention of any problem. One might not be able to cope out superstition however this can certainly help prevent from those kind of suffering.
It also have shown-love can make every one perfectly happy be enjoying everything you are but everything it have every day. Marriage is a part of our life which cannot be taken as sole aim and should not be taken as compulsion to live with. Instead our education should determine whether it’s time to give time to marriage or not. Even when marriage fails and when things around you is not at all favourable, death should not be taken as last frontier and one should strive to be heroes.
After reading the whole book, it reminded me of song by John Lennon ’Imagine’, I felt myself as dreamer. I dreamt of a world where element of respect, tolerance and sensitivity is no longer missing and there be a sincere thought of respect and tolerance around us.
The book has been successful in creating emotion in us. I could not control my tears any more, when the characters faced difficult situation.

Throughout the book, I had been eagerly waiting for the moments when the lead characters be reunited and when they live happily thereafter.
Looks all kills and we cannot judge book by cover. But this book ‘The Sacrament of The Goddess’ has been packaged well and that is certainly a bonus.
To put everything in a nutshell, if you like a book with page turner and like real stories of rural areas, then I highly recommend you to read this book. You will definitely find it hard to put down the book once you have started and probably would like to discuss the symbolic twist that presents at the climax. I hope you enjoy the reading this book as much as I did. I definitely would like to rate it 9 out of 10.

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review of The Sacrament of the Goddess by a Nepali person Oct 2014


warning: spoiler alert.

If you don’t want to read one of the twists and turns of the book, don’t continue!

 THE SACRAMENT OF GODDESS

”Today, I felt my heart inundated with an elegant blend of emotion, feelings of love overshadowing the sadness, rays of respect enlightening the hatred. You know! I am not the one that I was yesterday. I have a vigor mounted to that summit from where I can fathom the depth of life, explore me and my ethnicity, the Humanity. Yes! today I have ‘The sacrament of goddess’ between my thumb and the index finger with my eyes acquainted with its every pages and my heart drenched in its every scenarios.”, I thought quietly, and made a mental note to gratify the king of that creativity, Joe Niemczura.

Suddenly, I looked next to me in my room and quickly turned around the window as soon as I noticed that I was not there alone. A feeling of shame and fear mingled through my veins, I wished my sister didnot see me as the drops of tear rolled down my cheeks and two of them ended up making the 1/100th of the page of book wet. Helplessly, I was witnessing the inhumane scenario of (spoiler of dramatic plot twist edited out from this spot…)  I felt it, I saw it, not through my eyes but through the writer’s. Can you imagine it??

This is why, I call writing is a magic!

Yes! I have their photographs in the gallery of my mind. I know the way they look, the way they talk and behave. Though they donot know me, I can say how Matt looks like, I can exactly picture the smile of Sushila, I have a clear idea about the behave of Dr. Ranjit in operation theatre..I have obvious pictures of Sara, Arjun, Captain Gurung, Sushila’s mother and Matt’s parents. I have kept the record of every details of them being completely invisible to them. Can you believe it???

Oh! Thats why, I call writing is a magic!!

I have no idea, How can I pay my debts to this guy who arranged my travel upto Beni, Uk and USA, who arranged the visits with so many wonderful people, who displayed the numerous stories of life.. just within a single day. Have you heard anyone completing all of these stuffs in such a short period? You may be thinking.. no… never…

But see, I am here who did it some days back. I know you would surely love to.

The respect of the Nepali culture, religion and appreciation of the different dimension of life in the countries like Nepal are there in the novel that mount your feeling of patrotism, love and the unbound grace of humanity.

To realise a true sense of the dynamic relation between the writer, the characters and the reader, with the ascended sensation of love for the people, country and life in the universe you must go through ”THE SACRAMENT OF GODDESS” once.

Regards,

Asmita Panthi

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looking for nurses and docs in Nepal to become Official Instructors of BLS or ACLS


Updated due to fee clarification, 5 PM Oct 13 -see below.

Health-Care Technology Upgrade in Nepal

Throughout the country of Nepal, the hospitals are upgrading the investment in critical care services, and the health care professionals are catching up to the skills needed. Also, more and more nurses and doctors are trying for abroad career, where specialized credentials are required before a person can be considered for advancement. Both home and abroad, there is tremendous desire for skills upgrade.

CCNEPal has been working to raise awareness of the skills needed, and we have trained 1,100 nurses and doctors since 2011. The policy makers and professional bodies are now turning attention to this area of need in a way that did not seem likely four years ago.

Disclosure: I am not employed by the Center for Medical Simulation. I have consulted with them on a voluntary basis since their goals are close to those of CCNEPal. The opinions expressed here are my own, and I am not authorized by CMS to make any offer of employment or offer any service on their behalf. Any statements made here are subject to revision or revocation by C.M.S.

We are pleased to report that Prudent Meditech, pvt., ltd a major medical supply company in Nepal, has made significant investment in training equipment and classroom space to move this forward with this vision. They have formed a subsidiary named The Center for Medical Simulation which will be Nepal’s first International Training Center certified by the American Heart Association. (The application has been submitted to AHA International as of Oct 2014).

The Heart Association produces the curriculum and standards for their official courses on Basic Life Support, using an AED, and Advanced Cardiac Life Support.

The goal of The Center for Medical Simulation is to offer a full menu of courses, including the ones above, as well an non-AHA courses to address specific topics such as ecg, STEMI M.I., airway management, infection control, and the like.

And Now the Announcement

This is a big and bold goal. In order to meet this, CMS  needs to expand the number of Official Instructors for all of these programs, and this email is to encourage qualified persons persons to apply.  CMS wants a mix of nurses and doctors to become instructors. Please apply before Nov 10th, 2014.

For MBBS doctors, you do not need to be a cardiologist! The best instructors are ones working as Internists or Medical Officers in a “front line” role, able to apply these skills and share real-world day-to-day experiences.

For nurses, CMS prefers that you have prior teaching experience or critical care nursing experience, but CMS will consider a person with less experience who is enthusiastic and dedicated.

Training

CMS will train the successful applicants. The training will involve:

- studying the Official manual for a month beforehand, and taking some prep sessions to be sure of the skills, during the period between Nov 15th and Dec 20th. These can be tailored to the background of the individual.

-taking a five-day sequence of course work supervised by an official Heart Association Regional Faculty from Hyderabad, India, in late December 2014.

- becoming familiar with the policies and procedures of an Official International Training Center.

5 PM clarification of course fee for instructor training: The Official Certification as an ACLS-Instructor at the end, is recognized worldwide as part of the worldwide network. Successful trainees will be expected to teach several courses per year for CMS, for which a per diem pay rate will be given (specific amount is not yet established).

IMPORTANT NOTE regarding training deposit

NOTE: at the time of registration for the training, participants will pay a deposit, and when the requirement for teaching is fulfilled, they will be eligible for reimbursement of the training deposit. This policy is necessary to prevent “no-shows’ and to ensure that Instructors fulfill their teaching obligation.

How to Apply

To apply you must send an email to Srijana Kansakar, RN, BSN, who is the Training Center Coordinator. Her email is srijana.cms@gmail.com

All the application materials are available in a Word document, and they are attached to the end of this blog. If you want the attachment, send email to joeniemczura@gmail.com Prospective Instructors must sign the detailed agreement to follow the specific policies, procedures and standards of the Training Center. (see below).

The forms

From here below, are the forms you will need to complete in order to be considered for this opportunity. Applying is not a guarantee of acceptance. See below.

One last note, Oct 14th. This job involves teaching and due to the stringent requirements of the American Heart Association for documentation, also involves meticulous recordkeeping, as you can see from below. One person already said “The application is too hard. Can’t I just give you my name?” I can sympathize, but my reply was “Perhaps if you can’t do the application, you won’t be able to fill out the course documentation. are you sure this right for you?”

*****

Last name: ________________________

The Center for Medical Simulation

Kathmandu Nepal

ACLS and/or BLS Instructor profile

policy number: __________________date of policy______________ approved by __________________

Policy: The AHA requires each International Training Center (ITC) to keep a file on every Instructor aligned with the ITC. Please complete the following information:

Name_______________________________________________ title: _________________________

Address: ____________________________________________

Phone number: ______________________________________

Mobile: _____________________________________________

Email: ______________________________________________

Courses to be taught: ______________________________

Attach   ⃝ BLS   ⃝ACLS card

***************************************************************

For administrative use only:

⃝ CV attached _____

⃝ cards attached _____

⃝ course record attached.____

⃝ user agreement parts for ITC alignment attached, part one_____ part two _______

⃝ conflict of interest statement agreed to and signed____

⃝ code of ethics agreed to and signed _____

Last name: ________________________

The Center for Medical Simulation

Kathmandu Nepal

policy number: __________________date of policy______________ approved by __________________

date of this agreement _____________________________

User Request for ITC alignment, part one

I, _________________________ request to align with an International Training Center (ITC) known as the Center for Medical Simulation as an Instructor of  ⃝ ACLS  ⃝ BLS (check all which apply).

The ITC may require a meeting or monitoring before acceptance, and the Center makes the sole decision. The decision is final and there is no appeal.

I understand that my performance will be monitored and that the ITC may revoke alignment based on performance issues, as described in part two of this agreement. I agree to act in accordance with AHA course policies, Instructor policies, the Code of Ethics, the Conflict of Interest, and any other policies of the ITC. I recognize that the ITC has the sole right to determine which instructors to keep on the roster.

This agreement does not preclude serving with another International Training Center.

I understand that I must remain aligned with an ITC in order to retain Instructor status, and that the ITC will comply with AHA rules on revocation as outlined in the ITC Manual page 30. I will surrender my Instructor card if requested to do so.

I understand that the following activities will lead to revocation of Instructor status, and that this list is not all-inclusive of reasons that can result in revocation:

  • Falsification of class records
  • Non-adherence to AHA guidelines and curricula
  • Producing or issuing non-AHA course completion cards
  • Continued instruction that is inconsistent with AHA standards for the course/program after    remediation by the TCC, TCF, ECC staff, or RF
  • Using non-AHA examinations or breaching security of AHA exams
  • Inappropriate activities, language, harassment, or conduct during courses or directed toward other instructors, students, ECC staff, or volunteers

signed: ___________________________________ date: ____________________________-__

ITC administrator signature: ___________________ date: ______________________________

Last name: ________________________

The Center for Medical Simulation

Kathmandu Nepal

policy number: __________________date of policy______________ approved by __________________

date of this agreement _____________________________

Instructor Agreement for ITC alignment, part two

To be signed by Instructor when Alignment is authorized by the Training Center.

The Center for Medical Simulation’s name is on all of the cards that you will issue and we require all instructors to adhere to the following policies.

 

As an Aligned Instructor with the Center for Medical Simulation, Pvt., Ltd., I agree to:

 

  1. Use AHA materials and content as core curriculum when teaching AHA ECC courses.
  2. ONLY use the current versions of all forms found on the NEMSA Training Center website. Use of older versions of all

forms may require resubmission.

  1. Purchase Provider and Instructor manuals for each AHA discipline I teach within 30 days of new updates being

released.

  1. Evaluate all students based on the established AHA guidelines.
  2. Arrange for or coordinate AHA ECC courses as requested to further the AHA’s ECC mission and chain of survival

initiatives.

  1. Disseminate appropriate information concerning new materials, changes in policies, procedures and techniques to

ensure quality control.

  1. Sign up for the AHA Instructor Network and align with The Center for Medical Simulation, to ensure I receive all updates as soon as they are released.
  2. Attend Instructor Update meetings as requested.
  3. Teach 4 courses every 2 years and arrange to be monitored by a TCF or RF every 2 years, as required by AHA

guidelines.

  1. Maintain current Provider status.
  2. (BLS and Heartsaver Instructors) Provide documentation of a successful completion of the BLS Instructor Exam (score

84% or higher).

  1. Refrain from engaging in activities that are in conflict with the goals of the AHA and represent the AHA in a professional

manner at all times.

  1. Notify the Center for Medical Simulation of any changes in my address, telephone number, email address or employment immediately.
  2. Submit a copy of all required paperwork for each course taught, including course rosters, monitoring forms, individual

course evaluations (or a summary) and grievance procedures within 2 weeks of the course date.

I understand The Center for Medical Simulation has the right to revoke my Instructor alignment if AHA guidelines are not followed or for any Instructor who fails to honor any part of the Agreement. I understand The Center for Medical Simulation, Pvt., Ltd reserves the right to monitor my teaching at any time as a quality assurance protocol.

 

I agree to the above terms required to align with The Center for Medical Simulation International Training Center as an AHA Instructor.

_____________________________________________________ _________________________

Signature Date

_____________________________________________________

Print name

Address

City, State, ZIP

Telephone

Email address


 

Last name: ________________________

The Center for Medical Simulation

Kathmandu Nepal

conflict of interest statement

policy number: __________________date of policy______________ approved by __________________

from AHA ITC Manual page 54

The AHA, its affiliates and components, and all officers, directors, delegates, council and committee members scrupulously shall avoid any conflict between their own respective personal, professional, or business interests and the interests of the Association in any and all actions taken by them on behalf of the Association in their respective capacities. In the event that any officer, director, delegate, council, or committee member of the Association shall have any direct or indirect interest in, or

relationship with, any individual or organization which proposes to enter into any transaction with the Association, including but not limited to transactions involving:

  1. The sale, purchase, lease, or rental of any property or other asset
  2. Employment, or rendition of services, personal or otherwise
  3. The award of any grant, contract, or subcontract
  4. The investment or deposit of any funds of the Association

Such person shall give notice of such interest or relationship and shall thereafter refrain from discussing or voting on the particular transaction in which he or she has an interest, or otherwise attempting to exert any influence on the Association or its components to affect a decision to participate or not participate in such a transaction.

I have read the above statement and will comply with it.

Signed,

______________________________________ date ____________________________

Last name: ________________________

The Center for Medical Simulation

Kathmandu Nepal

policy number: __________________date of policy______________ approved by __________________

Code on Conduct

All persons in AHA ECC leadership are expected to conduct themselves with honesty, integrity, and a commitment to the goals of the AHA and the ECC Programs. This code is intended to provide standards of professional conduct.

The scope of the standards implied in this code includes activities directly related to the discharge of ECC leadership functions, such as committee activities and assignments, as well as actions performed with other AHA programs or activities, such as ECC classes and activities related to AHA affiliate programs.

Competence

ECC leaders must demonstrate a competent knowledge relative to their assigned specific area of responsibility. Leaders must maintain all prerequisites for the position and participate in required educational or informational sessions.

Respect for others

ECC leaders must respect and treat others fairly, regardless of race, ancestry, place of origin, color, ethnic origin, citizenship, religion, gender, sexual orientation, socioeconomic status, age, disability, or any other basis protected by law. Additionally, there is no tolerance for sexual harassment, including sexual solicitation, physical advances, or verbal or nonverbal conduct that is sexual in nature and that is unwelcome, offensive, or creates a hostile work or classroom environment.

Integrity

ECC leaders must conduct themselves with honesty, fairness, and trustworthiness and must not make statements that are false, misleading, or deceptive. ECC leaders must adhere to all applicable AHA rules and regulations governing the ECC Programs, course, and ITC operations as well as all federal, state, and local laws and regulations in the discharge of their AHA duties.

Neutrality

AHA volunteers should maintain neutrality in terms of specific proprietary products or brand names (eg, drugs, devices, and publications) and in terms of descriptions of other professional individuals and organizations. Specifically, whenever possible, generic names for drugs and devices should be used. While in their volunteer roles, instructors and Faculty will not be advocates for specific brand names or proprietary products outside of AHA recommendations. Furthermore, instructors and Faculty, while in their volunteer roles, will use caution when referring to others, particularly when referring to differences or negative descriptions of other professional individuals or organizations.

I have read the above and will comply, Signed ________________________________ date: ______________

Last name: ________________________

The Center for Medical Simulation

Kathmandu Nepal

policy number: __________________date of policy______________ approved by __________________

courses taught by ________________________________________

Title of course date role Course evaluations
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for Nepali Nurses thinking of Canada PR status


note: if you found the link on Facebook – please do not send me a FB friend request. I don’t accept requests for people I do not know.

also, why not buy my book? The Sacrament of the Goddess will be released in Nepal soon.

Permanent Residency

A friend of mine asked me to help her figure out how to apply for P.R. status in – Canada.

I know how to ice skate on a frozen pond. I am a Boston Bruins  hockey fan. I have been to Canada. My daughters read the Anne of Green Gables books when they were little. But – until now I never gave much thought to Canadian Immigration. Why should I?

The first thing was, she told me that she checked out a consultancy on Putali Sadak, and it was going to cost “three lahks and fifty thousand rupees” which she did not have. Could I possibly help her? And how can I resist the entreaties of a damsel in distress! A Lahk is a hundred thousand. so – using a currency converter, I figured that this was $3510 in American money. I had no idea as to what they charge. On the scale of things, $3510 is not too too much for an American, but when the nurse is being paid $240 per month in Nepal, it is a lot of money.

Online Assessment

She said everyone told her that there was an online assessment she could take, but she and her friends were not able to find it. She sent me the link to the one she was going to complete. It was obvious right away that this was a commercial site, and mostly interested to collect her personal information so that they could give her a sales pitch.

Hmmmmm, I said, with furrowed brow. She showed me the links on her laptop, and there was a problem. there is one named canadianimmigration dot org and another named www.canadianimmigration dot com and another named canadianpr dot net .  It was easy to see that not one of these was an official government website. To make matters worse, there was a spot on the official site for advertising, and the ad showed a Canadian flag with a link to a self-assessment quiz that looked official, but was not.

Lesson #1

So, the first lesson of Canadian immigration is, be sure the site you are visiting is the one run by the government, especially if you are trying to go to the source and not a consultancy.

Here is the link to the site run by the Canadian Government.

Here is the link to check your eligibility> this is the actual link.

http://www.cic.gc.ca/ctc-vac/getting-started.asp

(link updated since the first one was wrong…..)

Lesson #2

There seem to be multiple pathways to get to Canada. This advice is independent of applying to go to graduate school there. And also, this applies only to the Canadian Federal Government, not to the Provinces.

Lesson #3

The system is evidently changing in January 2015, but the length of the process will stay the same: It takes six months to get approved. Also, if you have a job offer in hand, the process is faster. So – somehow you need to get the job offer. I presume that is where the consultancy adds value to this particular process. Without the consultancy, an individual nurse has a limited chance of getting such an offer. The nurse would need to compose a resume, fill out the job applications, and send it online, then do a Skype interview with the potential employer. Somewhere on the site it said if you go there with no job you need to prove that you have enough money to support yourself, which for an unmarried nurse is $11,600 dollars in cash.

Lesson #4

Oh, and did I say that you need to take the license exam? and also have a good IELTS score? They speak English, sort of. But you get extra points if you speak French, because that is the major language of Quebec.

Lesson #5

I have this idea that if the government matches you with a nursing job, it has a higher-than-average chance of being in a geographical area that is less-desired by the Canadian nurses. If they have a shortage in a particular spot, there may be a reason why…..

It’s a whole nother maze of governmental rules to learn…..

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What is A.C.L.S. and why should every MBBS doc enroll in A.C.L.S. course?


“Critical Care is not a geographic location like the ICU of a hospital. Critical care is a set of knowledge and skills that a doctor carries with them. And nurses too!”

_Joe Niemczura, CCNEPal

A.C.L.S. (or just plain ACLS) is Advanced Cardiac Life Support.  The abbreviation denotes a two-day course in critical care skills in USA, leading to a certificate. ACLS is only just now becoming more widely known in Nepal.  Note: be sure to click on the hyperlinks, in blue.

A Mandatory requirement in USA

ACLS  was developed decades ago by the American Heart Association (AHA) and in USA it is a required course for any doctor or nurse who works in O.T., Casualty, post-op, or critical care. In a USA hospital, no doctor or nurse is allowed to administer midazolam unless they have had this course, because this drug produces “conscious sedation.” In USA, most medical students take an ACLS course during their senior year, and it is required before starting any residency program.

ACLS is a two-day course, but most people who take it for the first time will prepare by taking an ecg course, an airway course, a Basic Life Support (BLS) course, and a pharmacology course. ACLS is not simply a sit-down-and-take-notes class; it involves simulated patient situations that teach you how to react and save a life. ACLS  gives assessment skills and teamwork skills that apply to a wide variety of situations.

High Standards

Because of the reliance on high standards of instruction, the AHA has a stringent set of requirements for anybody who proposes to teach the course leading to the “official” certification. These are laid out in a 60-page Program Administration Manual. Until very recently, the only way a person from Nepal could take this course was a) travel to Delhi and enroll there; b) enroll in a course brought into Nepal by various groups of videshi doctors who bring the equipment with them; or c) take an unofficial version of the course.

The difficulty and expense of enrolling in a course has led to a sort of secrecy about the training, in which it becomes mysterious and limited to a few persons. The problem is, the need for the skills is universal here, just as it is in USA. In Nepal, ACLS training is needed by everyone who works in an Emergency Room or any kind of critical situation. Not just doctors either, but nurses too. Right now, a coordinated effort needs to be made to share this set of skills as widely as possible in Nepal.

USMLE?

If you are thinking of someday taking USMLE you will find that ACLS is indispensable. The items tested in ACLS are considered to be among the core knowledge for any doctor in USA. There are rumors that Nepal MBBS graduates are not ranked as highly as they could be, because they don’t have this training when they apply for residencies in India or abroad countries. They are unfairly penalized.

There are two resources of which you should be aware.

First, CCNEPal is a group that teaches a version of the ACLS class which does not lead to the official certificate. CCNEPal has trained 1,100 nurses and doctors since 2011. CCNEPal will be scheduling more courses in the near future. CCNEPal is also looking for docs who wish to help lead the training.  You do not need to be a cardiologist!

Next, The Center for Medical Simulation (CMS) will soon be opening in Kathmandu. CMS will have a state-of-the-art Simulation learning center, including a “3G Sim Man” used for this type of training. Most importantly, CMS has applied to be designated an International Training Center via the American Heart Association, and will soon be offering high-quality training in ACLS that follows every standard of the Heart Association just as if you were taking an ACLS class in New York City. CMS will offer the full series of pre-course prep classes as well.

To find CMS, go to their FaceBook fan page. https://www.facebook.com/PrudentMeditechSimulationCenter

ACLS, and the skills it encompasses, needs to be taught in every medical school and nursing school in Nepal. ACLS is not simply a sit-down-and-take-notes class; it involves simulated patient situations that teach you how to react and save a life. ACLS  gives assessment skills and teamwork skills that apply to a wide variety of situations.

for more information, or to volunteer in the effort to make ACLS more widely available to MBBS docs in Nepal, send an email to joeniemczura@gmail.com

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