Thinking of the future
Please help me. How can we make it so that every nurse in Nepal is comfortable with skills of emergency response? I want to know!
In two weeks I will get on the plane to USA. I expect to exceed my 2013 goal of training 500 nurses in skills of critical care nursing. Throughout my courses, I have heard the same comments:
“We never learned this in nursing school”
“Now I have more confidence about emergency skills”
“Nobody actually showed us how to do the hands-on things, I always wondered what to do.”
And of course:
“Your style is very active. The class was never boring” – thanks, I am flattered. more than I ought to admit. I didn’t invent this, it’s mostly from usa advanced cardiac life support courses.
In a future blog I will write about the responses I have gotten from doctors, regarding teaching these skills to nurses. Some are enthusiastic supporters and others are skeptical. One videshi doctor in particular said (at the beginning of the summer):
“In a year or so your training will not be necessary” –
which made me laugh out loud. It’s naïve. I don’t expect doctors to know anything about nursing education, and this one proved that point. He never taught at PCL level, as I have. He had no idea about typical curriculum of BN or B Sc. He only worked in one hospital, in Kathmandu, and never traveled to any other. never went outside the valley.
But he did have a point. It’s the way it ought to be. There are definitely some new things that I do – teaching ecg, using role play, emphasis on how the skill is applied, anatomy lab, that sort of thing. But now that so many nurses have taken the class, how can we get it so that these are adopted widely? I am a videshi but I use techniques to give help in Nepali bhasha when needed in class – why can’t this course be taught completely in Nepali, by the many Nepali nursing experts we now have?
The Tipping Point
There is a USA book by Malcolm Gladwell titled The Tipping Point, in which the author discusses this very idea. When something new comes along, how does everybody decide to adopt it from now on? Or discard it like a fad? That was in my mind when I designed CCNEPal. I could have chosen a bureaucratic approach to things, writing a proposal to some Person In Authority (Ministry of Health, some NGO, USAID, etc etc) and waiting for a positive response. But I didn’t, because it would have taken five years, and the answer would have been – no. Somebody would have said, “No, spend time on clean water or maternal-child health, or something else” and that would have been the end. I don’t like writing reports or grant proposals. I have a Nepali RN license which makes me legally able to conduct these courses (according to Nepali Nursing Council) and I like the teaching, not the paperwork.
What I did do was to train 190 people in 2011 and 500 more this summer. There are now a large number of nurses who have seen this training and who will say “oh yes, we need this.” It’s a question of creating a network of people who agree that it is important. Not just to get the certificate and go to UK, but to use the skills right here in Nepal.
Questions for discussion
Should we form a group of some kind – and call it “ACLS nurses of Nepal” – or is Facebook enough?
Should we create an NGO and bring future videshis to help advance knowledge?
What is the role of school curriculum to promote this content? Many B Sc schools have ICU content but are weak in teaching ecg and other theory content because the faculty themselves never were formally taught?
Many skillful nurse are chained to their job and are never released to teach this material – how can we create a system that offers critical care expertise to all nurses, even those not currently employed?
How do we get the CTEVT, or the B Sc schools, or the Ministry of Health, to get on board?
Let’s have some dialogue…… There are many issues affecting Nepali nursing, but this is the one I am offering…..