Nursing Education system in Nepal as of April 2013


Updated Aug 29, 2015 by adding photos.  Also, be sure to click on the hypertext. Sept 8th update:  In May I wrote a companion piece, be sure to read that one too! Click here

What are the titles given to “nurses” in Nepal?

A.N.M. – Associate Nurse Midwife. analogous to a Licensed Practical Nurse (LPN) in USA. this was a one-year program for nurses, (help me: is it one or is it two?) and there are fewer of these programs than there used to be, which is why most A.N.M.s seem to be “older.”

PCL students from TNS, 2007. Every nursing school has their characteristic colors.

PCL students from TNS, 2007. Every nursing school has their characteristic colors.

PCLProficiency Certificate Level – the basic preparation. This is a 3-year program, usually sponsored by a hospital. The curriculum for PCL level nursing is thoroughly regulated and centralized by C.T.E.V.T. – the government agency that controls vocational education.  Historically, CTEVT serves a useful function in standardizing nursing education. Also, CTEVT schools adopted a policy to support enrollment of minority students into PCL level, essentially a quota system. At the CTEVT site is a database of all CTEVT schools including address and contact information.

The language of instruction in many schools is English. the texts are generally from India or U.K.

There is a different agency that coordinates college-based education.

To get admitted to PCL nursing, a young woman needs the School Leaving Certificate – also known as “SLC” – given around age 16. the SLC exams are a big source of anxiety, because the results dictate your future. There is also such a thing as “SLC +2” – which is essentially the equivalent of a high school diploma. the +2 component adds some science and math classes.

A student  can get admitted to PCL nursing at age 16, and graduate at age 19. Every nurse with PCL is also automatically a qualified midwife and usually has delivered 10 or so babies. The curriculum includes community health classes.

Most often, PCL students live in a hostel provided by the school. On the CTEVT site, one school listed the typical tuition as about 224,000 Nepal Rupees (nrs). at the current exchange rate of 87.2 rupees to the US Dollar, that is  $2,563.03 which may not seem like much to an American, but which is substantial for a Nepali.

faculty checking the roster for clinical duty. some things are the same whether you are in USA or Nepal.

faculty checking the roster for clinical duty. some things are the same whether you are in USA or Nepal.

The PCL student gets a lot of clinical practice, and in fact, is used as a cheap source of labor by the hospitals. Hospitals in Nepal tend to follow a “functional nursing” pattern, and this is what is taught at PCL level. The functional system is the most successful when the charge nurse  – the “didi” – is effective. The didi is the one person on the nursing staff who knows the whole picture of the patient; other staff mainly function in the role of task workers.

faculty at PCL level are often around 20 years of age – it is not unusual for a faculty to be a recent graduate of the same school where she now teaches. Such a person often relies on perpetuating the same system that was learned and has no further training in teaching pedagogy. The assessment skills are not necessarily any more sophisticated than those of the students. Usually the “Principal Ma’am” is older and more experienced in administration.

B.N. – after two years of clinical practice, the PCL nurse is eligible to enroll in a B.N. class, and this also involves clinical practice along with coursework in research and community health and teaching projects. The B.N. curriculum is two years in length. So in other words, a BN nurse has three years of education, two years of practice, and two years of additional school (seven years!)

For those thinking of going to USA? might as well answer this one right here. If you are thinking of coming to USA to work as a nurse, you will need to complete many many  steps. If you only have SLC and PCL, it is very unlikely that you will get a USA license. The minimum is SLC+2 and PCL; but it is much better to get BN or B SC.  I have done other blogs on this topic . I get asked about this over and over.

CMS Nursing College in Bharatpur enrolled their thirdyears in the CCNEPal 3-day class. They were really good.

CMS Nursing College in Bharatpur enrolled their thirdyears in the CCNEPal 3-day class. They were really good.

B. Sc. – This is new in Nepal. In the past five years there are more programs in which a woman who has SLC+2 can go to a college course for nursing. This trend mirrors the trend in international nursing education. At present, there is considerable controversy within Nepal about the B. Sc. nurses. the problem seems to be that they are viewed as not having enough clinical experience; some people think that the real problem is that the B Sc nurse is more likely to question the doctors and be assertive, which presents a challenge to the patriarchical system of medicine in Nepal. In general, the schools do not have well -equipped libraries or learning labs with manikins and simulated learning the way USA schools do. Click here for the graduation video of one of the B Sc schools.

BS degree – this is new. The problem with the BN degree as designed, is that it promotes “Churn” – the person taking it has to leave their job, just as they are getting good. The BS degree will remedy this.

Trends: One interesting trend which is still developing is that of young Nepalese citizens who go abroad for further study and get a basic nursing education with a BSN in UK, USA, Aus or India then return to Nepal. To re-adjust to the Nepali system of clinical practice after only working in a USA hospital is not an easy feat.  Likewise, with the growing number of Nepalese nurses practicing abroad due to poor economic outlook of Nepal, there is a question of how these nurses would change Nepal if they ever returned in large numbers when the economy improves.

Future of PCL education is something that is under discussion. There are rumors that all nursing education will be re-designed into some other system but I do not have firm information about this.

M.N., M. Sc, and PhD in Nepal – I will save discussion of this because I do not know enough about trends in this level. I don’t pretend that I am expert on basic nursing for that matter – if you think I have missed something, then help me!

In any case, there are a number of nurses in Nepal who have obtained graduate degrees outside the country, usually in other Asian countries such as Japan, Thailand or the Philippines. Some go to Europe or Australia.

Nurse manpower – It is a paradox in Nepal that many of the nurses use their education to leave the country and seek employment in Australia, India or the U.K. or use it to bolster their chances of getting a more desirable husband via the system of arranged marriage in Nepal. The health sector in the country is heavily dependent on foreign charitable support.

Nursing Associations

– there is a government body known as the Nepali Nursing Council – NNC – which serves as the governing body. This group oversees the system of licensure. At this time, they are implementing a mandatory license exam for new graduate nurses. This is given twice a year. The NNC site provides data as to the number of nurses in Nepal:

  • Current Registration Status Up to  31 January, 2013

  • NURSES  : 19098
  •  ANM : 19851

  •  FOREIGN NURSES : 739

  • TOTAL : 39688

(please note that the total of “foreign nurses” includes those from India, usually working in Terai. It is very rare indeed to see a “foreign nurse” from a western country who has a Nepali license.)

Nursing Association of Nepal

the Nursing Association of Nepal (NAN) is a separate membership group composed of nurses, which is the country’s official member of the International Council of Nurses.

New Nursing Schools and New Hospitals

There has been a recent surge in applications to create new nursing schools, just as there has been a surge in new hospital construction.  In the opinion of this writer, this presents a challenge to the health establishment of Nepal – balancing the need for the student to expect a quality education with the need of the hospitals to exploit inexpensive labor sources.

Issues, Opportunities and Challenges

This is the subject for ten future blogs. Nepal is a country of 26 million people and the government is evolving after years of instability.

About Joe Niemczura, RN, MS

Experienced nursing educator and problem-solver. I have fifteen years of USA nursing faculty background. Add it with 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. I travel outside of Kathmandu Valley as well. When the recent violence happened, I knew the cities - I had trained people in those locations. 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. Global Health Nursing is not all sweetness and light; not solely milk & honey and happy moms and babies.
This entry was posted in nursing education, The Hospital at the End of the World and tagged , , , , , , , . Bookmark the permalink.

46 Responses to Nursing Education system in Nepal as of April 2013

  1. Shirley says:

    Joe this is Shirley. I have just glanced at this and a LOT of misconceptions starting at the top. It is late so I will start delving into this tomorrow okay? Are we on for the end of May? What is the cost and where so I can get the nurses ready for you. See you soon.

  2. Mudbhari N. says:

    Hello there, I am a nurse myself registered within the nursing council of Nepal. I just went through your writing and noticed that some issues presented here are more generalized than it really should be. In fact I am quite unsatisfied with the way your theme relating to nursing trends in Nepal are presented here. Therefore I kindly request you to get some more reviews over this before presenting it finally. Thank you.

  3. Thank you for this. At the top of the document I clearly stated that I knew there would be a need to clarify and expand, and I invited feedback that would help it to improve it. Please be very specific as to what exactly you think should be improved, and I will happily incorporate those changes. To simply say that it is unsatisfactory is not enough to proceed on. I politely request that you would be a fine person to help it reflect the state of affairs. please do send more specific feedback line by line if necessary.

    I think many people in Nepal know how the system works, but it is not well known outside of the country, and I am trying to present a description to foreigners. There are many misconceptions among foreigners that have come to my attention.

    • Mudbhari N. says:

      I would be glad to help. Right now I really do not know where to begin from. There are a lot of issues that needs to be updated. I will work on it first and attach the document via email if you could provide me your email id or you can suggest me with some convenient alternative. I will be doing this within few days if it is fine for you. Thank you.

  4. Thank you so much!

    I appreciate this. Now, there are several ways to proceed. first, you could make your edits or suggestions into a Word document and attach it to me in an email – send to joeniemczura@gmail.com – and I will edit the original post that way.

    next, if you wish to simply choose a segment that needs expanding, and write a standalone piece that clarifies and amplifies, and send that, I would also consider publishing such an essay as a “guest post” to this blog.

    I guess I should say why I was prompted to write this. a graduate student in USA was assigned to write a piece comparing the health system of USA against that of a different country, and the person teaching that class told me about the piece. Her main reference was a newspaper article in the newspaper published by the American Communist Party which extolled the improvements in Nepal’s health sector that were brought about by the Maoists. As you can imagine, it was outright propaganda, highly distorted, and not reflecting the real world. So, I think there is a definite need for something to describe the system of nursing to westerners. The American Communist Party is not a valid source of news about Nepal if you ask me.

    looking forward to your email – by the way, please tell me who you are and where you work etc – would be happy to meet you when I am there!

    • Geeta Kamal Shrestha says:

      I appreciate your initiation, but the posts you have written were level of education. There are wider and raising trends regarding nursing in Nepal, which need to be explore.

  5. parbati says:

    i am registered nurse and passed mn adult nursing from TU Nursing campus,nepal i appreciate your initiation.there are wider and raising trends in nursing in nepal.PHD in nursing also started 2 students has been enrolling from 2 years in TU in nepal.its great for nurses of nepal.

  6. bhagwati says:

    if i become staff nurse after my slc then cant i go to abroad like us,uk

  7. I have recently completed my pcl nursing course and i am quite interested to apply for abroad bt m nt getting much / more informatn on nursing career in abroad esp australia and wt criterias should be met for applying for registered nurse???

  8. Ganga Dangi says:

    Nameste i ve passed PCL nursing n want to go USA.

  9. karissa says:

    I just found your blog and already ordered your book from Amazon. I’m an RN in USA and have been with a Nepali man for 5 years now. So of course your blog interested me right away. I tend to read through comments and hope you don’t become discouraged from some of the more critical comments I’ve read. You are one person and can only cover so much but I’m already learning from what I’ve read so far. I’m always interested in how health systems work in other countries. I am a psychiatric nurse and it would be great if you would consider covering how psychiatric disorders are handled in Nepal. I understand your area of expertise is critical care, but if you came across psych at all in Nepal I would love to hear more about it. Please do keep writing and sharing your experiences. Looking forward to reading your book when it arrives.

    • Thanks. I have a YouTube channel, and on it there is an interview With Ramesh Subba, a psyche nurse from Bharatpur. It is in Nepali language. But – it *is* about psyche.

      When will you be in Nepal next?

      Joe

  10. karissa says:

    I still haven’t been to Nepal (I’m american but have been with a Nepali guy for years) but hope to visit one day. I read as much as I can about it, but of course that is no substitute for actually visiting. So until then, I’ll continue to learn and travel vicariously through books and blogs:) Thanks for the heads up on the youtube video. When I am with D next I’ll watch it and ask him to translate.

  11. SHARMA M. says:

    Hello I’m a registered Nepali Nurse. I’ve just gone through your blog n you are doing good job, the trend of Nursing in Nepal is being changed, of course PhD in Nursing is started since 2012 & now 2 nd Batch is running, fortunately I’m one of them. Keep going. ANM is 18 months course in Nepal

  12. RAJEE says:

    I M A STUDENT OF BSC NURSING STUDING IN INDIA SHARDA UNIVERSITY BUT I M A NEPALI CITIZAN.I RESENTLY CAME TO KNOW THAT NEPAL DOES NOT REGISTE STUDENT LIKE ME.SO THATS MY QUESTION TO U MR.JOE CAN U PLEASE TELL ME IS IT SO OR ITS JUST A RUMER????????

    • Dear Rajee: This is a new idea to me. I don’t know for sure. the best way to lay this rumor to rest is to email or phone the nursing council. I do know other BSc graduates who are now working in Kathmandu, and none of them have told me this is a problem – so I tend to think it is only a rumor. But the best thing is to ask somebody who is in authority – not me!

      joe

  13. Preety says:

    Great info!
    Joe I hve been following you virtually for sometimes. Your first book was entertaining and I will look forward for the second one too!

  14. Jita says:

    I really appreciate your initiation, but the posts you have written were almost focused on education. Do you know that till june 2014 50470 nurses are registered in Nepal nursing council and here are wider and raising issues regarding nursing services and education as well in Nepal, which need to be explore for sensitizing to all concerned stakeholders and need to make a strong advocacy program throughout the country. What’s your suggestion regarding Nurse’s issues of costly education, unemployment , No or less remuneration for nurses at private sector against the labour act, not much professional advocacy and strengthening program for nurses, decreasing quality nursing care etc.
    I am a nursing educator since a decades and near about a decade clinical experiences in various hospital through out the country.
    .

    • Thank you. You raise excellent points.

      I do not have the answers for the big problems and paradoxes you give in your list. I do what I can, which is to raise the visibility of need for better education of nurses and the value to the people of Nepal.

  15. Raj Kumar Shah says:

    Sir,My doughter is PCL Nursing Study Just Start From 2014 AD .i Do’t Know The Future of Staff Nurse Can You Clear Me About Staff Nurse Futer..?

    • I am not able to give you specific advice without knowing your daughter’s situation, her goals and plans. I have written many opinions here but they are offered as general advice, not specifics. I apologize that I am unable to tell you about the future with certainty.

    • sona lama says:

      Namasre ,if your daughter wants to study in usa first she has to completed her higher graduate diploma(+12). plus tofel score is around 6-7 or above is better.and she has join from the nursing school.but some nursing school didn’t accept international higher diploma(+12) certificate, or if she is in usa she can join English language first,i am Talented teacher in nepal at the age of 16.nowi am at the age of 24 last week .i am going to join nursing school this semester in California

    • sona lama says:

      I dont know about nepal but , in usa bsn nursing earn a lot here in usa. Our neighbour jas earn 80,000-90,000 $ per year that is 80-90 lakh in nepal,, she is very friendly because she is american.

  16. kali says:

    THose who were staff nurses in Nepal and came to US have to take all the classes in US to be a registered nurse. I wonder if they do credit tranfer for those staff nurses.

  17. anita says:

    Hi,
    i am a PCL gradute from Nepal and have been working with a hospital in Nepal over a year now. And i am looking forward to apply for US student visa for my bachelors degree, do you know if PCL is equivalent to SLC+2 ??? will i be eligible to apply for Bachelors degree in USA?

    • PCL is PCL. SLC +2 is SLC +2.

      They are not equivalent to each other.

      You can apply to school in USA, but they may not accept your previous work – you might do everything all over form beginning.

      You need to see a counselor, in person, I can’t really advise you on what is best….

  18. aki says:

    hi there joe…this is akreety n i just found out about your blog n it is really helpful for us but i want some suggestions from u. I am a pcl student(about to finish my course) and i m already planning for my future which include going abroad (US) n since u said we pcl student are very unlikely to get a job I was thinking to study there but don’t know which course is for us like is it B.S.N or is there any other? n I was planning to study and do a part time together. is it ok for us? please give us suggestions what should we do? n thank u in advance🙂

    • this is very difficult question. if you are in KTM, I advise to the NCLEX class in Chaubahil and asking their advice. I am not a consultancy.

    • sona lama says:

      Namaste,
      You have to study nursing class from grade 1 i mean started from nursing school. Must have higher school complete. (+(12). Mostly nursing school didn’t accept international higher diploma. But some accept with tofel. 6-7 score . It depends which faculty subjects did you graduated. My sis is planing to join pcl nursing in Nepal can u give me any idea. If you need info about usa bsn i can asked to the nursing school around my area.i am also going to join nursing school this semester in California. American are the best people in this world .

  19. Timila says:

    Hi Joe,
    It’s great to see that finally i found someone who initiated to write about nursing in Nepal. I am very thankful to you. I am also planning to start of my own blog and was thinking about focusing in nursing profession (as i am a Nurse too). Don’t know where to start as it is hard to get any information online..
    Just wanted to add sth about PCL programme – This prog. is not only run via CTEVT, TU also offer PCL programme (government education).
    TU – affiliated with TU university, government education, no monthly fees, less admission fee compared to CTEVT, much cheaper to study, limited seats so competition will be high, there are about 7 nursing colleges ( used to be 7, now i think its 6 as Bir Nursing campus is under NAMS now).
    CTEVT – affiliated with private univerisites like Ktm Uni, PU, private education, expensive as you have mentioned the costs already, has many colleges in ktm and outside the valley.
    Also, PCL student doesnot considered as midwife “automatically”, 2nd year of education is totally about midwifery, and we have to do at least 25 deliveries in our placement (not 10), also antenatal, postnatal and community placement are mandatory.

    Regards,
    Timila

  20. neha says:

    hie joe, i just have a curiosity to know that if a student who have completed there +2 can apply for plc nursing or bsc in US or not

  21. anu adhikari says:

    i hav been studying health assistance…i really waana do B.N now…can health assistance get oppurtinities for B.N….

  22. puspa khatri says:

    Im a slc+2 student and Im planning to study Bsc nursing in Nepal. My question is that is it equally appreciable study in Nepal in campare to foreign education. Or foreign education is considered good than that of bsc nursing in Nepal? Is it okay if I study in Nepal?

    • My view is that Nepal needs good nurses, and especially needs well-educated articulate women to actively participate in the new democracy. I think the B Sc programs are fine programs. B Sc is the way to go.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s