About the Dr. GKC hunger strike in #Nepal March 28th, 2015


I occasionally blog on DailyKos in USA, a web page for political issues. I haven’t been active there lately, but today I wrote about the hunger strike here. I wanted to get some international solidarity with the NMC, NMSS, Dr GKC – and – everybody.

I know I am an expat, but I think some international pressure would help.

Click here to read the DailyKos blog.

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donating ACLS books to LNC Library in #Nepal, March 2015


CCNEPal always follows a certain rule: If you bring something to Nepal to share, leave it in Nepal when you return to USA.

Here are the books that LNC now owns. Most are from the American Heart Association.  I will also give them the complete set of materials form the pen drive I usually share at sessions of the CCNEPal class

Here are the books that LNC now owns. Most are from the American Heart Association. I will also give them the complete set of materials form the pen drive I usually share at sessions of the CCNEPal class

I brought with me a set of the most recent up-to-date books from the American Heart Association. I have donated them to the library of Lalitpur Nursing Campus.  Here is more info about donating.

Here is a video tour of LNC library I recorded a few years back.

LNC allows nursing students from other schools, as well as nurses from the community, to use this resource.

The LNC Librarian was happy to get these books.

The LNC Librarian was happy to get these books.

Here is the list of books. Click on each one and you can read about  contents and reviews of these books from Amazon if you like.

Textbook of Advanced Cardiac Life Support – ACLS

Textbook of Pediatric Advanced Life Support (PALS)

STEMI

Airway Management

Facilitator’s Manual for AHA Airway management course

Basic Life Support

EKG/Pharmacology 

Rapid Interpretation of EKGs ( Dale Dubin)

If you are doing a school report, or if you are a critical care nurse, or if you want to be a critical care nurse, you need to take a look at these.

I am also leaving the LNC library a complete set of all the teaching tools I use in my classes, the ones on Pen Drive. They will be available for download on the computers in the library.

What if every videshi nurse or doctor did this?

Here is something we can all do to help keep Nepal nursing education up-to-date. If you know of anybody in USA who will be coming here, ask them to bring just one textbook in their luggage.  Where to get the textbook? they don’t need to buy it – they can go to the nearest nursing school and ask for the faculty to donate a “desk copy” on a current topic. ( a desk copy is one the faculty gets free, to decide whether they will adopt for a course). It doesn’t even need to be the most recent edition!)

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part 3 about “thrashing” of healthcare workers in Nepal – building design


Part three of a series

Be sure to read parts 1 and part 2. The threat of violence against health care workers in Nepal is real.  CCNEPal has always addressed this issue in our training. In fact, people say that the part where we cover this has been just as useful as going over the actual protocols. I’ve been sharing all the info about ways to keep safe.

This section of the series may be boring to some, but it is a way to minimize the problem.

Part of the answer is – build the building in such a way as to discourage the things you don’t want. Many hospitals are already doing this. If you know what to look for, you can see for yourself. This should be part of every employee’s orientation.

I did a websearch on security. The most comprehensive review is a pdf from SecuredByDesign.com which gives excellent instructions on how a building can be secured.

at the end of that booklet, there is a checklist of items to assess. Here it is:

48 Secured By Design Checklist – Hospitals

Please tick appropriate boxes

Campus Layout

 A secure boundary equivalent to 2m high paladin, weldmesh or similar. Note – Unless particularly dense and well-developed soft landscaping (i.e. hedging) is not acceptable. (Defensive planting in addition to secure fencing is encouraged)

 Entrances to be strictly limited.

 Entrances controlled by gates of similar construction or security rating to boundary treatment. There shall be no unobserved access or escape routes to or from the hospital.

 All access points clearly signed including clear directional information to key areas (i.e. reception)

 Reception area and main entrance shall be in close proximity with the route between clearly signed and controlled.

 Direct access to children by visitors to be monitored. Babies and children should be tagged.

 The site arranged to maximise natural surveillance of all external spaces including entrances, car parks, cycle storage and main circulation routes.

 Buildings arranged on the site to avoid creation of unobserved areas.

 Recesses and complicated plan shapes that can conceal criminal activity from surveillance shall be avoided.

 External lighting and landscaping proposals considered together to maximise natural surveillance and avoiding hidden, shaded areas.

 Landscaping materials and external furniture i.e. litter bins and seating, to be robust so as not contribute to the crime risk.

 Avoid climbing features that provide unauthorised access to roofs or vulnerable windows

 Secure bin store area away from buildings.

Lighting

 Lighting provided to all entrances, recesses, movement routes and car parks.

 External lighting levels to be to BS 5489 Part 9.

 Light fittings shall be vandal resistant and easily maintained

 Lighting mounted at a height that allows best spread of light, without shadows and reduces vulnerability to vandalism.

 Lighting to be compatible with landscaping

CCTV System

 Designed fit for purpose – facial identification, general surveillance or management, quality of pictures checked to ensure suitability.

 Monitored on site or by remote station.

 Cameras, wiring and recording or monitoring equipment secured.

 Robust with easy to maintain components.

 Designed in coordination with external lighting and landscaping.

Building Design Generally

 Low or flat roofs to be avoided, use simple roof shapes that do not provide hiding places as seen from the ground and are not accessible to unauthorised persons.

 Roof materials and construction to provide a robust and secure construction with roof glazing, service openings and plant rooms protected.

Secured by Design Hospitals 2005 Page 18

 No climbing aids. (Check rainwater down pipe design, low canopies over entrances and roof eaves details).

 Simple plan shape is without recesses.

 Entrances kept to minimum number (preferably one).

 Fire escapes secured and controlled – see fire doors below.

 Avoid surfaces vulnerable to graffiti that are difficult to maintain and keep clean.

Entrance Doors

 All door sets to BSI. PAS 24. Specialist entrances using composite sets to achieve equivalent standard.

 Glazed panels in and adjacent to doors to be minimum 6.4mm laminated glass.

 Solid doors giving access to the public shall have a door viewer fitted at 1500mm above floor level.

 Fire doors without external door furniture. Each fire exit must be protected by an intruder alarm.

Letter Boxes

 Letterboxes shall be installed ‘through the wall’ to discharge into a secure and fireproof chamber. Installation shall comply with Post Office recommendations.

Windows

 Windows shall comply with BS 7950. 6.4mm laminated glass shall be used in all ground floor windows and vulnerable, easily accessible windows at other levels.

 Locking devices and opening restrictors shall be fitted to all ground floor and other vulnerable windows.

Roof Lights

 Roof lights shall be robust and use polycarbonate materials and where necessary with internally fitted steel mesh or grill.

Intruder Alarms

 An intruder alarm system shall be installed in compliance with ACPO Security policy.

Management practice

 A security file shall be created and maintained. Policy Statement in respect of hospital security should be put in place and displayed in a prominent position.

 Visitor Control procedures to be established.

 Contractors working procedures established and activities logged.

 Surveillance including CCTV and patrolling procedures established and recorded.

 Property marking record maintained.

 Crime Log and Police Contact Records maintained.

 Cleaning and repairs recorded.

NB Developers/architects should liaise at the earliest opportunity with the ALO / CPDA, who can provide useful advice from the outset in respect of Secured By Design – Hospitals, the potential crime risks and recommendations to constitute an approved design.

Every nurse and doctor needs to take an interest in the above.  Don’t assume that the hospital administrator has magically taken care of it.

One further step – Important

Having a secure building helps, but it doesn’t cover everything.

Here is a video from USA that describes how security guards work in that country.

and another one that tells what it is like to be a guard in USA.

In the above, “visitor control procedures established”  is on the list. We’ll go over that in the next blog.

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part 2 De-escalation techniques in #Nepal – eliminating the threat of “thrashing”


This is part two.

Here is the problem for MBBS docs who are doing a year-long internship:

In MBBS program, the curriculum has been science-based. They are rewarded for doing research on physiological problems related to medical diagnosis. They are always “junior” and not allowed to speak at rounds; they have not really counseled any patient during a crisis, instead deferring to the “senior.”

As a new intern, the situation continues. Unless somebody goes out of their way to challenge their interpersonal skill, the MBBS doc can stay in the comfort zone of the previous focus, not developing. this skill. “playing it safe” might be okay if you go into dermatology, but not for acute care.

After a year as an intern, the young doc ( who may still be 22 or 23) is posed to a rural area. All of a sudden, the responsibility in increased. It’s like jumping into the water – “sink or swim”

It doesn’t have to be that way. Every young doc needs to practice role play of the skills below.  The whole team – docs, nurses, security guards – needs this.

Here is another excellent resource  from USA. It’s directed toward police, but it applies to all of us.

http://www.crisisprevention.com/Resources/Knowledge-Base/De-escalation-Tips

The following article was written specifically for law enforcement professionals, but professionals in any field can better prevent crises and benefit from verbal de-escalation training in their workplace by using the five keys to empathic listening, as well as the five ways to remain in control of any situation.

Communication is the Key to Crisis De-Escalation

by Jerilyn Dufresne ( her twitter name is @Jerilyn65)

A difficult and potentially dangerous situation for officers involves being called to a scene and engaging with a person who may be mentally ill. Most individuals with mental illness are not dangerous, but a special set of skills is required to bring a mutually successful end to the encounter.

Although an officer’s inclination may be to intervene immediately, that may not always be the best response. As long as the individual isn’t an immediate danger to self or others, there’s time to make a quick assessment. CPI, an international training company specializing in violence prevention and crisis intervention, recommends evaluating the person’s behavior before acting, if at all possible.

How does an officer make the decision about how to treat that individual? Of course the answer is communication: talking to the person and evaluating the responses. But what if the person is unable or unwilling to speak? Again, as long as the person is not a danger to self or others, there is time. Use it to listen to what the person is saying—not only with words, but also with body language and tone of voice.

CPI stresses the importance of listening with empathy, trying to understand where the person is coming from. Like other skills, empathic listening can be learned. The five keys are: give the person undivided attention; be nonjudgmental; focus on the person’s feelings, not just the facts; allow silence; and use restatement to clarify messages.

Undivided Attention
When people are paid attention to they feel validated; they feel important. The converse is also true: people feel less important and sometimes feel they need to up the ante if they feel like they need attention. Paying attention doesn’t just mean saying, “I’m listening.” It means looking at the person, making eye contact if it’s culturally appropriate, and virtually listening with the entire body. By really listening, and conveying that through body language as well as words, an officer can take away the person’s reason for escalating the situation.

Be Nonjudgmental
If someone says, “The sewers are talking to me,” an officer’s immediate reaction might be to think that the person is crazy. That reaction, especially if verbalized, will probably upset the individual even more. Even if not said aloud, that attitude may be conveyed through the officer’s body language. If someone is psychotic, she may tune into the nonverbal communication much more than words. So besides paying attention to what is said, ensure that body language and tone are nonjudgmental as well. This will go a lot further in calming the individual.

Focus on Feelings
Going back to the previous example, if an individual says, “The sewers are talking to me,” a feeling response might be, “That must be pretty scary,” or even, “Tell me what that feels like.” This isn’t getting into a therapist’s bailiwick, but it is using a handy therapeutic tool. Most likely it will elicit a response that is positive, since the individual will know that the officer understands what’s happening.

Allow Silence
As people devoted to protecting and serving, officers are quite comfortable using silence during interrogations, but may not be quite so comfortable using it on the street. Officers want to make sure the incident is handled quickly and peacefully. However, sometimes allowing that moment of silence can be the best choice.

If the individual doesn’t immediately answer a question, it doesn’t mean he didn’t hear you. It may mean he’s thinking about his answer, or even that he wants to make sure he’s saying the right thing.

Allow a moment of silence. If the person’s face registers confusion, then repeat the question and let the silence happen again. Just as officers are taught in basic training, another good reason for silence is that no one likes it—and people tend to start talking when silence lengthens.

Clarify Messages
When a subject makes a statement, an officer may think he knows what the person means. The only way to be sure is to ask. Sometimes a question may be perceived as challenging and can make the subject defensive. So restatement is used instead.

For example, someone living on the street might say, “I don’t want to sleep here anymore.” The officer might think he knows what the person is saying, but instead of just making an assumption the officer could restate, “Oh, you’re ready to go to the shelter?”

The homeless person could say, “Yes.” Or perhaps, “No, I don’t want to sleep here anymore. I’m going to move over to Main Street where it’s safer.” In either case, the officer has shown an interest in the individual and has kept the lines of communication open.

One of the most important actions in any crisis is for the officer to remain in control of himself. This factor, which CPI calls rational detachment, will be the key to whether the officer helps de-escalate or escalate the situation. To rationally detach: develop a plan; use a team approach whenever possible; use positive self-talk; recognize personal limits; and debrief.

Develop a Plan
Devise a plan before one is needed. Decisions made before a crisis occurs are more likely to be more rational than those made when on the receiving end of emotional outbursts. Think about those things that are upsetting and practice dealing with those issues ahead of time. This is called strategic visualization and is effective in helping officers get through some stressful and even dangerous moments. Just as with other professional training officers receive, this training will kick in when needed.

Use a Team Approach
It’s easier to maintain professionalism when assistance is nearby. Support and back up are both crucial pieces when trying to rationally detach.

Use Positive Self-Talk
Positive self-talk has been the butt of many jokes. Picture Al Franken on Saturday Night Live saying, “I’m good enough, I’m smart enough, and doggone it, people like me.” Sure, that’s funny, but positive self-talk really can work wonders. Just as saying, “I can’t deal with this” might cause an officer to behave in one fashion, saying to oneself, “I’m trained, I know what to do” will cause another response.

Recognize Personal Limits
Being a professional doesn’t mean that a police officer must be able to excel at everything. That’s an unrealistic expectation. Know what your limits are. Know that sometimes it’s not easy to leave problems alone. Sometimes the most professional decision is to let someone else take over, if that’s an option.

Debrief
Be sure to debrief with coworkers, team members, or a supervisor after a major incident. Talking about it can relieve some of the stress and is also a good time to start planning for next time: what was done correctly, what could have been handled better, how could the response be improved the next time a similar situation occurs. This serves to assist in being able to rationally detach in the future.

Assisting someone with a possible mental illness is only one example of when an officer’s evaluation, assessment and negotiation skills come into play. There are many other examples: domestic disturbances, dealing with children, assisting victims, helping traumatized witnesses, and even calming down an out-of-control colleague. No matter what the situation, keeping the lines of communication open can help to de-escalate a potentially dangerous crisis.

Reprinted with permission from Law and Order Magazine, August 2003, www.lawandordermag.com.

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part 1) What #Nepal doctors and Nurses need to know about “getting thrashed”


Young doctors worry about this in Nepal. A lot.

Sooner or later, every nurse and doctor in Nepal has confronted a situation in which a family member threatens violence. It’s a fact of life, here. It happens to the junior doctors on night or evening duty when there are fewer backup  persons.  It’s the junior doctors who need the skills to deal with this,  the most.

This series of blog posts will explore ways to mitigate the problem. There are things that can be done.

(please share widely, and subscribe to this blog so you don’t miss future entries)

IF YOU ARE A CONSULTANT OR SENIOR DOCTOR READING THIS

my advice is to be sure to address how to act,  not just to how to diagnose and treat, when you meet with your entourage. Lead your team in role play.

IF YOU ARE A FOREIGNER READING THIS

A guy who comes frequently to Nepal to go trekking heard about this and he said “That’s preposterous, it’s just not the Nepal I know.” for non-medical foreigners it’s hard to believe that such a wonderful country has this problem. It’s because they shield you from it when you are here.

For medical foreigners volunteering in Nepal – as soon as anything like this happens, the Nepali professionals will generally shunt you away from it. It’s dirty laundry. Paradoxically, the only way to improve the climate is to bring it out into the open.

Future blogs will deal with building security and the like. Here is something I found on the web.

NOTE: this is adapted nearly verbatim from the source cited, in Massachusetts USA. The only part that is mine is the indents – the indents are my comments!

from http://www.naswma.org/

For Defusing or Talking Down an Explosive Situation

When a potentially violent situation threatens to erupt on the spot and no weapon is present, verbal de-escalation is appropriate.

In other words, if somebody has a weapon, get out and away. this is Number One Priority!

There are two important concepts to keep in mind:

  1. Reasoning with an enraged person is not possible. The first and only objective in de-escalation is to reduce the level of arousal so that discussion becomes possible.
  2. De-escalation techniques are abnormal. We are driven to fight, flight or freeze when scared. However, in de-escalation, we can do none of these. We must appear centered and calm even when we are frightened. Therefore these techniques must be practiced before they are needed so that they can become “second nature.”

Note: MBBS students advance on the basis of their science knowledge. To execute the above requires a skill set that also must be studied and practiced.

THERE ARE 3 PARTS TO BE MASTERED IN VERBAL DE-ESCALATION

  1. The Worker in Control of Him/Her Self
  2. Appear calm, centered and self-assured even though you don’t feel it. Relax facial muscles and look confident. Your anxiety can make the client feel anxious and unsafe and that can escalate aggression.
  3. Use a modulated, low monotonous tone of voice (our normal tendency is to have a high pitched, tight voice when scared).
  4. If you have time, remove necktie, scarf, hanging jewelry, religious or political symbols before you see the client (not in front of him/her).
  5. Do not be defensive-even if the comments or insults are directed at you, they are not about you. Do not defend yourself or anyone else from insults, curses or misconceptions about their roles.
  6. Be aware of any resources available for back Know that you have the choice to leave, tell the client to leave or call the police should de-escalation not be effective.
  7. Be very respectful even when firmly setting limits or calling for help. The agitated individual is very sensitive to feeling shamed and disrespected. We want him/her to know that it is not necessary to show us that they must be respected. We automatically treat them with dignity and respect.

Note: when you read about this, it sounds like common sense – “I already do those things!” you say to your self. You need to videotape yourself and practice the way a professional actor would. And by the way, the reason for #4 is to avoid being strangled.

The Physical Stance

  1. Never turn your back for any reason.
  2. Always be at the same eye level. Encourage the client to be seated, but if he/she needs to stand, you stand up also.
  3. Allow extra physical space between you – about four times your usual distance. Anger and agitation fill the extra space between you and your client.
  4. Do not stand full front to client. Stand at an angle so you can sidestep away if needed.
  5. Do not maintain constant eye contact. Allow the client to break his/her gaze and look away.
  6. Do not point or shake your finger.
  7. DO NOT smile. This could look like mockery or anxiety.
  8. Do not touch – even if some touching is generally culturally appropriate and usual in your setting. Cognitive dysfunction in agitated people allow for easy misinterpretation of physical contact as hostile or threatening.
  9. Keep hands out of your pockets, up and available to protect yourself. It also demonstrates non-verbal ally, that you do not have a concealed weapon.
  10. Do not argue or try to convince, give choices i.e. empower.
  11. Don’t be defensive or judgmental.
  12. Don’t be parental, join the resistance: You have a right to feel angry.

The De-Escalation Discussion

  1. Remember that there is no content except trying to calmly bring the level of arousal down to baseline.
  2. Do not get loud or try to yell over a screaming person. Wait until he/she takes a breath; then talk. Speak calmly at an average volume.
  3. Respond selectively; answer all informational questions no matter how rudely asked, (e.g. “Why do I have to fill out these g-d forms?” This is a real information-seeking question). DO NOT answer abusive questions (e.g. “Why are all social workers ___ ?) This question should get no response what so ever.
  4. Explain limits and rules in an authoritative, firm, but always respectful tone. Give choices where possible in which both alternatives are safe ones (e.g. Would you like to continue our meeting calmly or would you prefer to stop now and come back tomorrow when things can be more relaxed?)
  5. Empathize with feelings but not with the behavior (e.g. “I understand that you have every right to feel angry, but it is not okay for you to threaten me or my staff.)
  6. Do not solicit how a person is feeling or interpret feelings in an analytic way.
  7. Do not argue or try to convince.
  8. Wherever possible, tap into the client’s cognitive mode: DO NOT ask “Tell me how you feel. But: Help me to understand what your are saying to me” People are not attacking you while they are teaching you what they want you to know.
  9. Suggest alternative behaviors where appropriate e.g. “Would you like to take a break and have a cup of coffee (tepid and in a paper cup) or some water?
  10. Give the consequences of inappropriate behavior without threats or anger.
  11. Represent external controls as institutional rather than personal.
  12. Trust your instincts. If you assess or feel that de-escalation is not working, STOP! You will know within 2 or 3 minutes if it’s beginning to work. Tell the person to leave, escort him/her to the door, call for help or leave yourself and call the police.

There is nothing magic about talking someone down. You are transferring your sense of calms and genuine interest in what the client wants to tell you, and of respectful, clear limit setting in the hope that the client actually wishes to respond positively to your respectful attention. Do not be a hero and do not try de-escalation when a person has a gun. In that case, simply comply.

This document was developed by: Eva Skolnik-Acker, LICSW, evaskolnikacker@comcast.net

HOW to use this knowledge

Reading is not enough. you need to role play it and get personal feedback about how you perform.

Click here to go to Part Two!

Every family member needs to be assessed for stress level.

Note: if you got this far, please click here to take a look at the reviews of my book, available at Vajra Books in Thamel.

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donating books to Kathmandu – a nice way to help empower women


Empowering Women?

Empowering women is a buzzword in the international development community right now, partly because it is needed but also because USAID, a big player in funding of international development, is looking for ways to advance it in the real world.

Nurses always benefit from “Empowerment”

Nurses are maybe the original “empowered woman.” – to be a nurse means that you have been taught science, you hold down a job and you learn to speak up to authority (doctors). For some reason, nobody thinks of them that way. Both in USA and in Nepal, they are just “there” in the background. But for those of us in the know, it takes a lot to be effective as a nurse and the training is designed to create those desirable attributes. For a nursing faculty, it’s rewarding to know that the former students are using these skills.

Straight to the point

Foreign visitors to Nepal often search for a way to bring something meaningful here to contribute to women’s empowerment or to satisfy the “urge to help.” In some cases this means they arrive with a box of toothbrushes ( which can also be purchased here and don’t need to be shipped) or bandages (we are right next to India, largest cotton-growing country in the world) or soap ( available here, and most people use it every day. trust me).

What I bring is – textbooks. Nursing textbooks for the libraries of the nursing schools here.

when you bring a textbook:

- it will be used by hundreds of nursing students

-it will be taken care of, and students will rely on it for the next twenty years;

– it will impact not just that student, but every patient they take care in their career.

– you can bring just one, if you so choose, or boxes and boxes (which I have sometimes done).

_ you can deliver it in person to a school or hospital,  meet the people who will benefit from it, and enjoy.

– you will share tea, get a tour, and talk with a professional colleague about their day-to-day life in the trenches, making a meaningful connection that goes beyond seeing the architecture and eating the food.

doing it on the cheap

it does not have to be expensive. I get free or lowcost books in two different ways. First, I sometimes collect “faculty desk copies” from other teachers. these are free and the only cost  the baggage fare. If  you pack light, you can avoid the extra baggage fee.

The other way is not exactly free. Here is an example. One school I work with needed more copies of “Health Promotion Through the Life Span” by Murray and Zentner.  The 8th edition costs 98.50 mUSD on Amazon.  They needed ten copies.  They did not 985.00 USD.

Turns out the seventh edition of Murray and Zentner’s book, is also available on Amazon, for as low as .01 USD ( i.e., one penny. You would need to pay 5.00 per copy to get it shipped to your location)

My sister was planning to visit me here, and asked what she could bring. That’s how we decided to get ten copies of the seventh edition. Total cost was about 50 USD. And, she also can legitimately call herself an “international philanthropist.”

When Betsy Getman brought the donated textbooks to Lalitpur Nursing Campuse she posed for this photo with some of the students who will directly benefit from this.

When my sister brought the donated textbooks to Lalitpur Nursing Campuse she posed for this photo with some of the students who will directly benefit from this.

I have previously written about this, and in fact, I posted a couple of YouTube videos about this, click here and here

Mrs. Getman brought ten, but for the photo opp, one was enough. She is with Mrs. Radha Bangdel, Campus Chief, and two members of the mental health faculty.

My sister brought ten, but for the photo opp, one was enough. She is with Mrs. Radha Bangdel, Campus Chief, and two members of the mental health faculty.

After carrying them 12,000 miles, we stopped just outside the school at the last minute to write a dedication.  Mrs. Getman got a little teary-eyed when I reminded her that these books will influence the lives of every patient who ever is helped by one of these nurses, and she is contributing to the health of Nepal for years to come.

After carrying them 12,000 miles, we stopped just outside the school at the last minute to write a dedication. My sister got a little teary-eyed when I reminded her that these books will influence the lives of every patient who ever is helped by one of these nurses, and she is contributing to the health of Nepal for years to come.

.

So if you are coming to Nepal, please consider this.

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Update on seats available for CCNEPal sessions 3 (March 29, 30 and 31st) and 4 (April 5,6, 7)as of March 10th


As of March 13th, there are seats available in the last session of CCNEPal’s 3-day course.

Session three is March 29th, 30, and 31st. officially there are no seats remaining.

Session four is April 5th, 6th and 7th. Officially, there are four seats remaining.

After these two sessions, CCNEPal will go on a lo-o–o-ong “Road Trip” outside Kathmandu Valley, likely to continue until just a day or two before the Principal Faculty leaves Nepal May 30th. This means that these two sessions will be the last ones taught by Joe in KTM Valley, for awhile.

Stand by me?

for this reason, we will expand the number of available seats, to accommodate up to fifty in each batch. You will still need to register in advance, so we know how many handouts to bring. Also – in order to make this a success, I invite previous assistants to return and help us – please oh please!

to register, go to LNC in Sanepa and go to library. the fee is 600 nrs.

They do not accept phone registrations, but you can call them first to make sure it’s a day when they are open. the number is 9851 168105 ( Mr Pravash Pokharel) or 5521634 ( LNC main number).

as before, this fee covers chiya and administrative costs, but lunch is not included, due to the LP gas shortage. BRING LUNCH MONEY and we will organize momo takeout.

Who: CCNEPal, led by Joe Niemczura, RN, MS from USA

What: the 3-day course that covers basic life support, elementary ecg, airway, drugs, protocols, teamwork and communication. We teach standards that are based on research done by the American Heart Association( AHA); but it needs to be carefully and clearly noted that this is not the “Official” American Heart Association class. It is significantly adapted for the needs of Nepali nurses. At the end of the three days, participants get a certificate from CCNEPal. Mr. Niemczura has taught this course about fifty times throughout Nepal.

(note: sign up for just one of the two)

Where: The class will be held in the legendary “Green Ballroom” – complete with crystal chandelier, at Lalitpur Nursing Campus in Sanepa.

Why: to advance the skills of the participants.

IMPORTANT: about the course fee. 600 rupees. there will be chiya at morning and afternoon but it does not include lunch. Bring lunch money. we will organize momo takeout.

OTHER COURSE POLICIES:

Each session is limited to thirty participants only. At the time of registration, it is “first-come, first-served.”

Bring the course fee and a pen drive. we do not accept telephone registrations, and the fee is nonrefundable. If after you register you are unable to attend, you can send a substitute, but you can not get your money back.

for further information: read back entries of this blog – the course objectives and outline are amply described. Browse the FaceBook page for photos of past sessions. Talk with one of the 1,400 previous participants in this training. send all questions to the CCNEPal FaceBook page. Please do not phone or email me directly.

All course announcements will be on the CCNEPal FaceBook page. Be sure to “like” the page.

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