Of Documents, paperwork and certificates with a capital “C”

Catch-Up Catches Up

please do check out my book on Amazon

Thursday was catching up on administrative things, stultifying but necessary. Hardly the stuff of which riveting blog-o-pulchritude is woven. In today’s installment of the serial we do boring things….

Higher Ground, the coffee shop five blocks away,  has a nice atmosphere and free WiFi so I set up shop there early. Answered email, 166 messages to sort. I can do a lot on the BB but for some things I need the laptop. Started  a course roster and I made a FB page for the course, I will use it to support the class.

It’s titled “LNC Critical Care Nursing 2011” and anyone can peek at it but please don’t “like” the page – I want to limit it to class members.  Right now not much is uploaded there. Internet here is limited but I will use the site to share links with the students.

Campus Chief’s assistant called to set up a meeting for 2 PM so I walked to LNC. Stopped at the apartment to load one book – the 2008 Luckman and Sorenson. This weighs about 3.5 kilos – the biggest single med-surg book I brought. I arrived  early so I brought it to the library and gave it to Pravash, the librarian. He said med-surg books are the single biggest category of demand and this was very timely and needed.

At the meeting, Campus Chief told me she awoke at 0330 saying to herself we have got to get this organized. She had a list of decisions to take, so, she and I went methodically down her list. This was a working session and Campus Chief was down to brass tacks. In a word – competent. She called in various assistants to  ask questions then gave instructions. Done. Things like assigning the crew to clean the classroom Monday. How the chairs will be set up.

The phone has been ringing off the hook, we are worried that 300 people will show up Wednesday clamoring for admission to the class. On the scale of things this is a good problem to have! No any  phone registrations accepted.  We set the class size limit at 80.  We decided the final fee: 2,000 rupees.  Mainly for fooding it also includes the price of gas to get terkari every Wednesday etc. How many times in USA have I had these meetings? Happy to have one here. I have support!

The cost of this has been a question from the beginning. What is “value?”  Some students may decide it’s too much, but they have no choice. There will be no shortage of students willing to pay whatever fee we set, the class will be full. Likewise, part of the goal in meeting students during the registration was to get comfortable with the idea  that lectures will be in English….. Some of the students were worried – I told them I’d talk slow and I would assign a more fluently bilingual person to sit near them – we’ll see. But I digress.

Certificate with a capital C

The meeting continued. And then –  next item – the certificate. In this land of personal documents – the certificate.  Or should I call it the Certificate with a capital C? I realize now that the question of having a Certificate had come up all along from the students, and I’d just said, Oh Sure. Yup, I will give a piece of paper that says you did this….photocopy.  No problem.

Personal disclosure: I was a Boy Scout, an Eagle Scout, and my merit badge sash is still somewhere at the home of my former wife.  (I probably could recite the list of badges on it from memory, and yes I earned a merit badge in bugle-ing).  I once had the BLS, ACLS, ACLS-I, Regional Faculty cards, all four, from the Heart Association. As State C.E. Chair for ANCC-COA in Maine I led the compliance with the rules regarding these. I worked with ER nurses who maintained BLS/ACLS/ATLS/PALS/PHTLS.


That was then, this is now.  Hijo-aja, I personally never do anything for the purpose of getting one more validation, getting “qualified”. I often go to a professional C.E. meeting and spend the whole time in personal sideline conversation with the people there entirely outside the formal program, ignoring the steps to get the CE certificate. I learn more networking that way. When I work at a place that has employee-of-the-month, it doesn’t make me deliver better customer service, personally.  If somebody nominated me for employee-of-the-month I would gag.   I’m already trying as hard as I can to be nice. I could be better at it but I don’t want a two-hour class on how to have manners.

I’ve had all the Myers-Briggs indexing back along, which indicated I was a “high-stress intuiter” and I concluded then that many ICU nurses are “high-stress intuiters”, which means they react unpredictably to external attempts to motivate.  To manage such a group is a challenge. At RFGH I supervised a crew full of people like me. We could move heaven and earth, and we often did,  but nobody could tell us to.

Back to reality to deliver a cultural insight. *What I think about certificates doesn’t matter.*  Cheap certificate paper would be an insult.  It can’t be just computer-generated. It has to look, feel and be official. What was I thinking?

 Examples of Bureaucracy in Nepal?

After all, I am the guy who just watched the paperwork process associated with important 115 kg of cargo.  The red carbon paper has a different function than the blue carbon paper. I was cool with that.

I have also  been through the visa process. You go to one desk to pay fee, then take receipt to other desk for visa. Placed in passport by one guy, signed by second guy. I’m down wid it.

I spent three hours getting a Nepali cellphone which included photocopying of passport and supplying my Father’s and Grandfather’s full name and places of residence, as well as two thumb prints side-by-side in which the Right was on the left and vice-versa.  Hey – it’s a great SIM card!

You can’t pay for  coffee here until you spend five minutes watching the clerk hand write the receipt. In duplicate.

Prior to coming I accumulated the documents required to obtain Nepali nurses license. Including sealed transcripts and three photos. This will take three months but I’m going to do it this time.

Don’t even get me started on the subject of rituals in this land.  People come here from all over the world to watch and learn complicated ritual practice of Hinduism and Buddhism. Me too. A favorite cross-cultural pastime.

Ah yes, the Certificate. So the mechanical details were explained to me. Turns out the school uses a supplier in New Road, and the school  will show me what past Certificates look like.   Though I can design the Certificate, I should not personally go to New Road – the price there doubles when a videshi walks through the door. (It’s not actually very expensive, all things considered). The business director of LNC will go on our behalf.

To complete the formality, along  with the certificate we will have  a welcome ceremony on day one, and a presentation ceremony on the last day. In USA we would always invite the leader of a host agency to welcome people, so I was expecting this – The photo op is not solely an American convention, and Campus Chief will be gracious.  Likewise the need for validation is not unique to Nepal. I think LNC is a fine school or I wouldn’t have worked to send them books  for three years, and for the Campus Chief to share this platform with me is a mitzvah.

Happy to speak with the liaison to the Nepal Society for Critical Care Medicine (NSCCM) today. Good news: They are scrounging to get me the props I need for mega-code; they will also arrange some physician lectures, and also send a representative to the opening day. I sent the doctor  the course outline and he will help find speakers. Takes some pressure off.

Because the NSCCM endorsed this program, an idea came to me: I asked him if they wanted NSCCM to be on the Certificate.  I am a fast learner.  Ho! And so they will. We will all jointly look good, here.

Anyway, the summary of the day is that both the Campus Chief and the doc from NSCCM offered significant material aid, and did some heavy lifting for me, for which I am grateful. ThankyouGod. The administrative details, the logistics of presenting an event for 80 people, are pulling together. I knew I was going to need to do this kind of diligent work, to organize the course. It’s great to have these folks on my team. All that remains is for me to produce my part. Stand and deliver! Will I be able to command their attention in a classroom?

Creating Nepal, in your own mind

At Higher Ground, four Americans were fumbling their way through Nepali language class. Fulbright Scholars. Pale. Horn-rimmed glasses and tweedy-looking in a Harry Potter-ish way. Boston maybe? New Haven?   I need some lessons myself. Despite all the time here, it’s only this week I grasped the proper musical  inflection of the verb root “ho” as a suffix. I am hearing it better and I have been trying to use it in small verbal transactions.

The end of the day consisted of revising one of my handouts, and time to enjoy my first succulent South Asian Mango of the trip while watching Chelsea vs Man U on the tube. My flat mate picked up the suit he bought, and asked me to take his photo. He looked like a gangsta. He is ending his time at Patan Hospital this week and departs soon for London.


PS Friday morning and I came to LNC for a bit anyway. The bandh is on, and in Putalisadak the mob burned a TV truck and one other vehicle. A haze is over the Valley. Here it’s serene, sitting under the covered patio listening to the twittering birds. At 0400 every morning, I am treated to the performance of a nightingale; then at 0500 a cuckoo-bird. Sounds just like the clock my grandmother owned.


About Joe Niemczura, RN, MS

These blogs, and my books, and videos are written on the principle that any person embarking on something similar to what I do will gain more preparation than I first had, by reading them. I have fifteen years of USA nursing faculty background. Add to it fifteen more devoted to adult critical care. In Nepal, I started teaching critical care skills in 2011. I figure out what they need to know in a Nepali practice setting. Then I teach it in a culturally appropriate way so that the boots-on-the-ground people will use it. One theme of my work has been collective culture and how it manifests itself in anger. Because this was a problem I incorporated elements of "situational awareness" training from the beginning, in 2011.
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One Response to Of Documents, paperwork and certificates with a capital “C”

  1. Pingback: CCNEPal2013 twitter feed invitation – follow us there | CCNEPal 2013

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